HomeMy WebLinkAbout007-200-043STEVENS,-Jean .0
RGERY L. AME 3606B
L k. - 1 37 9E
5 Mayfair Dr., Chico 3083P
Contr:.Butte Creek Landscaping,
#5 Mayfair Dr., Chico
Permit #3187-78P _nsst awn
sprinklers k —1e r s CONTR: Jim Lauderdale, 259 ,Rio Linda Rd. )C
p -r (pew, Sin g1p.
Contr: Four Counties Roofing,.
Permit#1022-83B(reroof/SF) A�A
007-200-043 799
HENDERSON, MICHAEL
5 MAYFAIR DR, CHICO INALED
Cont: ALLADIN ROOFING
REROOF/SF
�_ � _
Y-- .. __ ---�
y � � � �
iy
i
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION M (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAX#: (530)538-2140
WEBSITE: www.buttecounty.net\dds
`I
PERMIT NO.
VBP041799
LICENSED CONTRACTORS 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
Issued Date: 06/21/2004 APN: 007-200-043-000
the Business and Professions Code, and my license is in full force and
effect. ���t,
License Class: =�f — License Number:. L �3' y
Site Address: 5 MAYFAIR DR CHI
Date: Contractor:T e,..fv,44/7e,Z
Map Index:
Description: TEAR OFF RE -ROOF W/COMP (30 SQ)
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
Owner: HENDERSON MICHAEL DAVID
to its issuance, also requires the applicant for such permit to file a
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commencing with Section
5 MAYFAIR DR
7000) of Division 3 of the Business and Professions Code) or that he or
CHICO, CA
she is exempt therefrom and the basis for the alleged exemption. Any
95973-0706
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ 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 (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
owner of property who builds or improves thereon, and who does
Applicant: ALLADIN ROOFING
such work himself or herself or through his or her own employees,
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
P O BOX 4262
year of completion, the owner -builder will have the burden of
OROVILLE, CA 95965
proving that he or she did not build or improve for the purpose of
(530) 533-2934
sale.).
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
Contractor: ALLADIN ROOFING
pursuant to the Contractors' State License Law.).
O I am Exempt under Article 3 of the Business and Professions Code
P 0 BOX 4262
OROVILLE, CA 95965
Date: Owner:
(530) 533-2934
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
License #: 532834
❑ 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
Architect:
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
Engineer:
Ik
insurance carrier and policy number are:
Carrier: lG l �L1 vr>�
Nkrg j ► `
Total Square Ft: 0 S. F.
Valuation: $0.00
•
Policy #: % l 3 7 2 -d r
❑ I certify that in the performance of the work for which this permit is
-person
Census Code: �l 1
issued, I shall not employ any in any manner so as to
become subject to the 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
l
forthwith comply with those provisions.
y.AppDate: ' 2 6v -
licant: �D�
Applicant:
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
4.04,4-711f Z* I dos / O 4 -
code, interest, and attorney's fees.
f'3
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the applicable provisions of the Butte County Code ?nrver
I hereby affirm that there is a construction lending agency for the
Resolutions f do work indicated above for which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
L Ca,� Date: 6 • a (, b 4
Name:
By: rpt✓
PERMI PIRES ON: �P' 1 ' O 5
Address:
Date
❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes.
/nom r
Print Name: Signature:
Date:
❑ Owner 1,14,ontractor ❑ Agent for Owner 0 Agent for Contractor
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAM (530)538-2140
WEBSITE: www.buttecounty.net\dds
PERMIT NO.
BP041799
LICENSED CONTRACTORS 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
Issued Date: 06/21/2004 APN: 007-200-043-000
the Business and Professions Code, and my license is in full force and
effect. ,
License Class: License Number:S3.Z �y
Site Address: 5 MAYFAIR DR CHI
Date: 52�� Contractor: Xe -,U i'!/il%%,�
Map Index:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Description: TEAR OFF RE -ROOF W/C.OMP (30 SQ)
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
Owner: HENDERSON MICHAEL DAVID
to its issuance, also requires the applicant for such permit to file a
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commencing with Section
5 MAYFAIR DR
7000) of Division 3 of the Business and Professions Code) or that he or
CHICO, CA
she is exempt therefrom and the basis for the alleged exemption. Any
95973-0706
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ 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 (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
owner of property who builds or improves thereon, and who does
Applicant: ALLADIN ROOFING
such work himself or herself or through his or her own employees,
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
P O BOX 4262
year of completion, the owner -builder will have the burden of
OROVILLE, CA 95965
proving that he or she did not build or improve for the purpose of
sale.).
(530) 533-2934
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
Contractor: ALLADIN ROOFING
pursuant to the Contractors' State License Law.).
❑ I am Exempt under Article 3 of the Business and Professions Code
P O BOX 4262
OROVILLE, CA 95965
Date: owner:
(530) 533-2934
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
License #: 532834
❑ 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. I have and will maintain workers' compensation insurance, as
Architect:
required by Section 3700 the Labor Code, for the performance of
Engineer'
the work for which this permit is issued. My workers' compensation
insurancecarder and policy number are:
Carrier:_ I4 /�P (�Lt�vrri
Total Square Ft: 0. S. F.
Policy #: %3 _ / 9 7 Z —C9 r
Valuation: $0.00
❑ 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
Census Code:
become subject to the workers' compensation laws of California,
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith//comply with those provisions.
Date: (n -2-1-6V
Applicant:GD�
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
4,06v 4-7 ( to E; l0 3 I O 4-
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the applicable provisions of the Butte County Code 2nrver
I hereby affirm that there is a construction lending agency for the
Resolutions t do work indicated above for which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
y' (o • (. O 4
�' L� Date: a
Name:
BY�
PERMI PIRES ON: �' 1 ' '05
Address:
Date
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby
authorize representatives of Butte Countytoenter upon the above mentioned property for inspection pu oses.
Print Name: moi} P - /'� �4 l<Qi� Signature:
Date: 6-.1
❑ Owner Contractor ❑ Agent for Owner ❑ Agent for Contractor
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 - CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
OWNER
Name
Address ... ,
City ,
State
Zip
Phone S _
Fax
E-mail
APPLICANT NAME
CONTRACTOR
Name
Name
a D
Zip
Address /
State
City 6o <
Phone
Ste
Fax
._
PhoneFax
� _33
3
State License Number
E-mail
Lic. #
3,p3
q•
CI ss
_
APPLICANT NAME
ARCHITECT/ENGINEER
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Map Book
Fax
E-mail
Planner
State License Number
APPLICANT NAME
Name
Address
City
State
Zip
Phone
Fax
E-mail
APPLICANT SIGNATURE
X
For offic4 use onI
Zoning
Flood Zone
SRA
I Yes
No
Occ.
Type Const
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
PERMIT
NO.
BP x41799
BIN #
LOCATION
AP#
Property Address
t
Street
WORKER'S COMPENSATION
Policy Number
3- -p/
Carrier �., . .��
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit Issuance.
LENDING AGENCY
Name
Address
Description or Scope of Work:
Sq. Footage a 17
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Received by: �'� Amount: Bldg
SRA
Receipt #: Atc)4. -71 Sheriff
SMIP
11
Other
Date: (031/04
Oth
Total
KAFORMS\BUILDING F0RMS\B1doAoo1SubRamts.doc Paae 1 of 2 REV 4-30-04
SUBMITTAL REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply
fora permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE
LEGIBLE AND INIIVK.
Residential, New, Remodels, Additions, and Accessory Structures:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER!
❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPHPAPERI
❑ 3. 3 Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed
calculations.
❑ 4. 2 Engineered truss details and layouts (if required) (NO FAXES!).
o 5. Letter from Engineer or Architect for truss design review.
❑ 6. 2 Energy compliance design and supporting documentation: (Note: Not required for additions to
mobile or modular homes.)
❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑ 8. Detached Accessory Building Form, filled out by the property owner (if required).
❑ 9. Sanitation and site plan approval from the Environmental Health Department.
❑ 10. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in
triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer.
Mobile, Manufactured, or Modular Homes:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPERI
❑ 2. 2 Data sheets and installation instruction manual.
❑ 3. 2 Marriage line information.
❑ 4. 2 Floor plans. _
❑ 5. 2 Engineered Tie Downs or Foundation plans.
0 6. Sanitation and site plan approval from the Environmental Health Department.
❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
Commercial, New, Additions and Remodels:
❑
1.
4 Site Plans, signed by the preparer. NO GRAPHPAPERl
❑
2.
4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations;
with code analysis.
❑
3.
2 Engineered truss details and layouts (if required) (NO FAXES!).
❑
4.
Letter from Engineer or Architect for truss design review.
❑
5.
2 Energy compliance design and supporting documentation (if required).
❑
6.
2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑
7.
Statement of Intent for Non -heated and A/C (if required).
❑
8.
Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in
triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer.
❑
9.
Letter of intent.
❑
10.
Hazardous Material Form.
❑
11.
Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, contact a Permit
Application Assistant at (530) 538-7541.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMSWILDING F0RMS\BIdgApp1SubRgmts.doc Page 2 of 2
REV 430-04
TCoo
yE7
Grave
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
a 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICAfiIDI�AND PERMIT
ASSESSOR PARCEL NUMBER -
44-38-43
ZONING
BUILISINd PERMIT
OWNER
Margery L. Ames
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
#5 Mayfair_ Chico, CA 95926
25 squ re Shake
Re -Roof
CONTRACTOR'S NAME
Four Counties Roofing
TELEPHONE
343-1416
CONTRACTOR'S MAILING ADDRESS
1060 marauder St. Chico, CA 95926
Fireplace
CWWUCTION LENDER UNKNOWN
Total Valuation $
-- �
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$ 30.00
BUILDING ADDRESS
#5 Mayfair' Chico, CA 95926
PLUMBING PERMIT
Filin Fee 10.00
9
Each Trap
2.00
Solar Water Heater
111e.00
Water piping
5.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Each qas water heater or v
5.00
Gas piping system 1 - utlets
5.00
USE OF STRUCTURE
SF.8* Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer
5.00
Mobile Home S I G I W I
10.00e
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ®
Describe work: re—roof _
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V OR LESS
100 AMP OR LESS
1 0
Main service EA. ADD'L 100 AMP
2.50
NEW CONSDWELING
OR ADDNST ACCLBLDGS.CCUP
Hf!�21/20sqft
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 m license is in full force and effect.
Y
License No. 275945 Classification C-'39
❑ I, as the owner, or my employees with wages as their sole compen'TemDoraK
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 CONSTR. ULTI-OUT 2.50 ea
NON-RESID BRANCH C ITS
NEW CONSTR. POW ARATUS &\
NON.RESID. SING UTLET CIR. /
Ex. Occu BAL030
P" X TS OR FIXTURES eAL930Q
ED APPLNS, OR
Ex. Occup. UTLETS (REBID,) Eli,,) 2.00
service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee
$
Contractor
MECHANICAL PERMIT
ilingFee 10.00
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.
Heating
Cooling
Hood
3.00
VentiIati
permit Fee
$
Contractor
1 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 said County i consequence of the granting of this permit.
X�. �( tti{tiro- Date 4/12/83
Signature of Applicant — Owner ❑ Contractor ❑ Agent Pq
An OSHA permit is required for excavations over 5'0" deep and demolition or construct -j
ion of structures over 3 stories in height.
Mobile Home Installation Fee
$
TOTAL PERMIT FEE $ 40.00
OCCUP, GROUP
I TYPE OF CONST.
PARCEL
PD
HD
I ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
.DIRECTOR OF PUBLIC
!
By LA �-'
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS)
Date L• .� i
l i
�'"
Receipt No. "; r r
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
1 � �
' COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATI ON=ANif PERMIT
PERMIT O.
0
ASSESSOR PARCEL NUMBER
44-38-43
ZONING
BUILDING PERMIT
OWNER
Marciery L. Ames
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
#5 Mayfair Chico, CA 95926
25 squire Shake
Re -Roof
CONTRACTOR'S NAME
Four Counties Roofing343-1416
TELEPHONE
/%
4
CONTRACTOR'S MAILING ADDRESS
060 Marauder St. Chico 95926
Fireplace
CONSTRUCTION LENDER UNKNOWN
N/A
Total Valuation $
, dV
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$ 30.00
BUILDING ADDRESS
#5 Mayfair Chico, CA 95926
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Solar Water Heater
.00
Water piping
5.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Each qas water heater or YP<
5.00
Gas piping system 1 - outlets
5.00
USE OF STRUCTURE
SFkk Duplex ❑ Mobi lehome ❑ Other
SPECIFY
Building sewer
5.00
Mobile Hom S G W
10.00 e
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Installation❑ Other ®
Describe work: re -roof _
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V OR LESS
100 AMP OR LESS
00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. DWELLING OCCUP
OR ADDNS. ACC, BLDGS.
2I/20sq it
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. 275945 Classification C-39
❑ 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 CONSTR ULTI-OUT T 2.50 ea
NON.RESID, BRANCH CU ITS
NEW CONSTR. I POWERRPPARATUS &
NON-RESID. %SING OUTLET CIR.
_ETs OR FIXTURES ¢
Ex. Occu z09ALaoC@30
P
1 XED APP LNS. OR
Ex. Occup. OUTLETS (RESID.) EA.) 2.00
Tempowry service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
® I have plac 'j 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.
Heating
Cooling
Hood
3.00
Ventilati
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
al -I liabilities, judgments, costs, and expenses which may in any way accrue
against s id County in consequence of the granting of this permit.
X-' Date 4/12/83
Signature of Applicant — Owner F1 Contractor ElAgent
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over�33 stories in height.
Mobile Home Installation Fee
$
TOTAL PERMIT FEE $ 40.00
OCCUP. GROUP
I TYPE OF CONST.
PARCEL
PD
HD
ssuE
This ermit is hereby issued under
sio s fthe Butte County Code and/or
w k I dic d ove for which
c+ OR OF PUBLIC
By
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORK
P/� r-&
DaV—
LCL ��
Receipt No. 0 2�
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
, 'i . ("
1ptv00��e
No
(l✓�a�le � ��r� l
COUNTY OF aUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — iOrovi Ile, California 95965
Telephone: 534-4541
APPLICAT � ' ASD PERMIT
au LIIUIILC reNresentativCs oI the Luunty of tsutte to enter upon the
above-mentioned property for inspection purposes.
X
i -
I
Date f '
Signature of Permitee or Agent
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
r
BY �'• �Y Date
Building permit expires Date
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mai I i ng Address
Telephone No.
Contractor , r :�
/
Mailing Address -;
Fireplace
Total Valuation
Telephone No.
Permit Fee
Building Address
Plan Checking Fee &/or Penalty
-
Permit Fee
%• r / �/ ��;
PLUMBING No. @ FEE
ff
PERMIT FILING FEE $3.00 S, o U
Each Trap 1.50
Repair drainage or vent piping 1.50
A. P. No. �� �� ^' Cf ;'
Zonin & Planning
Water piping 1.50
Each gas water heater or vent 1.50
Fees
W. C.
Sanitation
- FireDept.
FireZone
Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking
Plans
Parcel
I Declaration
I Parcel Map
1 60' R/W
Improvements
Each additional outlet .30
Building sewer 5.00
Bldg. Plans•Rec'd
Parcel Approval
Plans Approval
Lawn sprinkler system 2.00 /,e) p
NEW ADDITION UTILITIES ❑ OTHER Q
Permit Fee $ .5�+ fi fl
-
$ ..
_
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service 600V OR LESS
100 AMP OR LESS 5.00
Single Family :' Duplex ❑ Mobil Home ❑ Others ❑
Main service EA. ADD'L 100 AMP 2.50
Main service OVER 6 00V25.00
100 AMP OR LESS
Main service EA. ADD'L 100 AMP 1.00
NEW CONST DWELIN.
OR ADDNS. ACCLBLDGS.CCUP. S) 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
style
le of:
NEW CONSTR MULTI.OUTL T
NON-RESID BRANCH CIRCUITS) 12.50ea
NEW CONSTR. (POWER APPARATUS 8
NON-RESID. SINGLE OUTLET CIR.
Ex. Occuo{OUTLETS OR FIXT(IRES 5 L 250
,
Ex. Occup -(OUTLETS FIXED APPLNS. OR
p•(OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
--y . ��• ,_� �� ��f�,, �7� ,
Mobile Home Facilities 15.00
License No. ' ' 9 %
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.
EJI 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.
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
$
au LIIUIILC reNresentativCs oI the Luunty of tsutte to enter upon the
above-mentioned property for inspection purposes.
X
i -
I
Date f '
Signature of Permitee or Agent
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
r
BY �'• �Y Date
Building permit expires Date
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS Z(1,7 County Center Drive — Oroville, California 95965/ O��
Telephone: 534=4541 O
APPLICATIN AND PERMIT
�2Z.
BUILDING
OwnerA��
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Contractor
Mailing Address 2_o3
Fireplace
Total Valuation
YelepJW
a No.
41
Permit Fee
Building Address
Plan Checking Fee&/or Penalty
Permit Fee
n
PLUMBING No.1 @ I FEE
GL
PERMIT FILING FEE $3.00 pej
Each Trap 1.50
Repair drainage or vent piping 1.50
7
A. P. o. �` J
Zoning 8 Planning
Water piping 1.50
Each gas water heater or vent 1.50
es
-Vtf-C'
.SaR�
Fire Dept.
FireZone
Use Permit
Gas piping system 1.- 5 outlets 1.50
EQA
Parking
Plans
I Parcel
Declaration
Parcel Map
60' R/W
Improvements
Each additional outlet .30
Building sewer 5.00
BldgPlanv-Rred
Parcel A royal
Plans Approval
Lawn sprinkler system 2.00 -L—)p
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
Permit Fee $ ,
$ S t
ELECTRICAL No.1 @ FEE
PERMIT FILING FEE $3.00
Single Family Duplex ❑ Mobil Home ❑ Others ❑
Main service e00V OR LESS
100 AMP OR LESS 5.00
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
OR ADONST t DWEACCLBLDGS.LING Ccup- 4� 20sgft
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
NEW CONSTR (MUL TI.OUTL T
NID BRANCH CIRCUITS 2.50ea
NEW EW CONSTR. (POWER APPARATUS 6
NON-RESID. SINGLE OUTLET CIR.
250
EX. OCcUD(OUTLETS OR FIXTIIRES BAL101
Ex. OCCU FIXED APPLNS. OR
Occup.((RESID.) EA) 2.00
Temporary service 10.00
,Qc-�E C /' 4 4/4
Brag<e p!5aPE
Mobile Home Facilities 15.00
License No. X7.5-2 3JV Classification C— Z
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.
I certify that in the performance of the work for which this
permit is issued 1 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.
X � '+�"'� Date g O
It—
Signature of Peermmiit'ee or Agent
Receipt No/ z/ e
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.
RECTOR OF PUBLIC WORKS p�
By Date �w
permit expir e�