HomeMy WebLinkAbout017-170-044r
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DESIGNATION
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BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #:(530) 538-7541 FAX#: (530) 538-2140
WEBSITE: www.buttecounty.net\dds
--
PROJECT INFORMATION
DBF Room Addition - Multi Stor
Site Address:
2188 HONEY RUN RD
Owner:
DBFIRE Fire Inspection (SRA)
Permit No: B07-2548
APN:
017-170-044
FAITH KATHLEEN,
$441.64
DBMSC Room Addition-Multi-Stor
Permit type:
MISCELLANEOUS
2188 HONEY RUN ROAD
Issued Date: 02/07/2008 By TMP
Subtype:
Room Addn-Multi Stry
CHICO, CA 95928
Expiration Date: 02/06/2009
Description:
MULTI -STORY ADDITION- 950', D
1 (530) 343-8561
Occupancy: Zoning: FR5
FAITH KATHLEEN,
2188 HONEY RUN ROAD
CHICO, CA 95928
(530)343-8561
FEE INFORMATION
DBEH Building Review Fee
$75.70
DBF Room Addition - Multi Stor
$490.72
DBFIRE Fire Inspection (SRA)
$102.70
DBFIRE Fire Inspection (SRA)
$102.70
DBFIRE SRA Fire Plan Review (S
$102.70
DBINVES Investigation Fes @ 60
$441.64
DBMSC Room Addition-Multi-Stor
$736.07
DBOMSCF Fire Safe Standards Re
$115.98
LICENSED CONTRACTOR'S DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license
is in full force and effect.
X 02/07/2008
Contractors Signature Date
WORKERS' COMPENSATION DECLARATION I
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
❑I 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 WORKER'S COMPENSATION INSURANCE, as required by
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
My Workers' Compensation insurance carrier and policy number are;
Carrier. Policy Number. Exp. Date:
(This section need not be competed if the permit is or on' -7 a Fundred dollars ($100) or ess.
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 Workers'
Compensation laws of California, and agree that if I should become subject to the workers'
compensatig"rovisions of Section 3700 of the Labor Code, I shall forthwith comply with those
02/07/2008
Signatt" Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
the performance of the work for which this permit is issued. (3097 civ. code)
Lenders Address
City State Zip
DBSMIP Residential
Building
950
Other
quare Footage:
Garage
RemdUAddn
Porch/Patio
Total
622
1,572
$6.18
Balance Due: $0.00 Receipt No:
OWNER / BUILDER DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
requires a permit to construct, alter, improve, demolish, or repair any structure prior 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 License Law [Chapter 9 (commencing with Section 7000)
of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the
basis for the alleged exemption. Any 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];
Please eck one of the following:
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 License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
the work himself or herself or through his or her own employees, provided that such improvements
are notintended or offered for sale. If, however, the building or improvement is sold within one
year of completion, the owner -builder will have the burden of proof that he or she did not build or
improve for the purpose of sale.).
❑I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code:
The Contractors License Law dows not apply to an owner of the property who builds or improves
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractors License Law.).
❑ I AM EXEMPT under Section B. & P.C. for this reason:
IX K6;���—s`— 02/07/2008
Oyers Signature Date
I hereby certify that I have read this application and slate that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and Slate laws relating to building
construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
injury, including death, and property damage caused by, arising out of, or in any way connected with
the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the
use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
County to enter the above mentioned property for inspection purposes. I hereby certify that I am the
prop owner or am authorized to act on the property owners behalf.
�GC�-�-� 02/07/2008
Owner ❑ Contractor OR. Agent for Owner ElAgent for Contractor
FILE COPY
California Department of Forestry and Fire Protection
Butte County Fire Department
Fire Prevention Bureau
176 Nelson Avenue, Oroville CA 95965
(530) 538-7888 Office, (530) 538-2105 Fax
Reference Number:
B07-2548
Date:
12/17/2007
Location:
2188 HONEY RUN RD
By:
GLB
Parcel Number:
017-170-044
Sub Type:
Room Addn-Multi Sti
Owner Name:
FAITH KATHLEEN,
Phone:
(530) 343-8561
Description:
MULTI -STORY ADDITION- 950', DECKS 622'
To meet the requirements of Government Code section 51182 and Public Resource Code 4291, Butte County
requires a pre -construction inspection to pro -actively provide the below building and site requirements to the
property owner.
Your property is located within the State Responsibility Area (SRA) of Butte County. All development within the
SRA is required to meet the below requirements:
✓ Public Resources Code 4290
✓ Public Resources Code 4291
✓ California Building Code, Chapter 7A
✓ Butte County Improvement Standards
Requirements prior to scheduling the pre -inspection:
✓ Full plan submittal to Butte County Development Services -Building Division
✓ Driveway and building pad must be identified on site
✓ Structure location must be staked out on the building site
Requests for inspections shall be made a minimum of 72 hours in advance by calling the Fire Prevention
Bureau's 24 hour inspection line at (530) 538-6226, (When the recording comes on, enter the extension
number).
For the pre -inspections, the property owner or authorized agent is required to meet the inspector at the construction
site with two hard copies of the site plan.
I have read and understand the above pre -inspection requirements.
12/17/2007
Date Sig ature
All of the Fire Safe Requirements are posted on the Butte County Fire Department website at
http://buttefire.org/Fireprevention/protplan/protplan.html
ReJd 5/7/07
FILE
BUTTE COUNTY FEE SUMMARY
County Center Drive
Oroville, CA 95965
Department of Development Services
Phone (530) 538-7541 Fax (530) 538-2140
Permit Number: B07-2548
Job Address: 2188 HONEY RUN RD
Contractor:
Printed: 12/17/2007
10:20 am
Fee Description Account Number Fee Amount Paid Date Pmt Amt
DBINVES Investigation Fes @ 60
0010-440001-4210500-1010 $441.64 12/17/2007 $441.64
DBEH Building Review Fee
0021-540013-4614901-1010 $75.70 12/17/2007 $75.70
DBFIRE Fire Inspection (SRA)
0100450001-4617240-1010 $102.70
0100-450001-4617240-1010 $102.70 12/17/2007 $102.70
DBOMSCF Fire Safe Standards Re
Printed By: Gwyn Benedict
29174.39 $19458.81
Balance Due: $715.58
At the time of permit application, I was advised the above fees are required prior to issuance of the
permit. These a ay chane a plan checking process.
Signature: Date: 12/17/2007
Pursuant to Government code Section 66020, you are hereby notified those items listed above may have been imposed on your project. You have 90 days
from the date of approval of the project or from the impostion of the above referenced items during which you may request a protest. The requirments
for a protest are specified in Government Code Section 66020(a).
0010-440001-4210500-1010
$115.98
DBFIRE SRA Fire Plan Review (S
0100-450001-4617240-1010
$102.70 12/17/2007 $102.70
DBMSC Room Addition-Multi-Stor
0010-440001-4210500-1010
$736.07 12/17/2007 $736.07
DBF Room Addition - Multi Stor
0010-440001-4210500-1010
$490.72
DBSMIP Residential
1001-0-280-1011298
$6.18
Printed By: Gwyn Benedict
29174.39 $19458.81
Balance Due: $715.58
At the time of permit application, I was advised the above fees are required prior to issuance of the
permit. These a ay chane a plan checking process.
Signature: Date: 12/17/2007
Pursuant to Government code Section 66020, you are hereby notified those items listed above may have been imposed on your project. You have 90 days
from the date of approval of the project or from the impostion of the above referenced items during which you may request a protest. The requirments
for a protest are specified in Government Code Section 66020(a).
Butte County Department of Public Works
J. MICHAEL CRUMP, DIRECTOR
LAND DEVELOPMENT DIVISION
Storm Water Managment Program
7 County Center Drive
Oroville, CA 95965
(530) 538-7266 Telephone
(530) 538-7171 Fax
www.buttecounty.net/dds
C
AFtTMENT
National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm
Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgment
[LESS THAN 1 ACRE 1
Reference Number:
B07-2548
Date:
12/17/2007
Location:
2188 HONEY RUN RD
By:
GLB
Parcel Number:
017-170-044
Sub Type:
Room Addn-Multi Sti
Owner Name:
FAITH KATHLEEN,
Phone:
(530) 343-8561
Description:
MULTI -STORY ADDITION- 950', DECKS 622'
By signing below, I the project owner/owners' agent, certify that this project WILL NOT DISTURB 1 acre or more
of land and that I therefore, do not need to apply for a Construction Storm Water Permit from the State of California
Regional Water Quality Control Board. Phased projects that contain multiple site buildouts of less than one acre but
when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm
Water Permit from the state of California Regional Water Quality Board.
I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water
Permit from the State of California Regional Water Quality Control Board for this project that disturbes one acre or
more of land may result in revocation of grading and/or other permits or other santions provided by law.
Signed:
Title: ) n ��-
FILE
Date: 12/17/2007
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 95965
(530) 538-7601 Telephone
(530) 538-2140 Fax
www.buttecounty.net/dds
NOTICE TO BUILDERS
Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In
addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental
Health, and the California Department of Forestry for their clearances and approvals. There are some things you can do to
expedite your permit:
0 Make sure your application is complete.
0 Be responsive to requests from County departments for any additional materials or requirements.
The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes
without a complete application adds to processing time.
Every permit issued by the Building Official shall expire and become null and void if the work authorized by such permit is not
started or completed within one year from the date of issuance of such permit. A permit may be renewed (for a fee) prior to
expiration an indefinite number of times, provided construction progress has been documented by the Building Division during
each year during scheduled inspections. No changes may be made in the original plans and specifications for such work. In
order to reinstate action on a permit after expiration, the permittee shall pay a new full permit fee and additional plan checking
and documentation may be required. Upon completion of work covered by this permit, please contact this office for final
inspection. As a reminder to you, it is illegal to occupy this building or any portion of the building for which this permit is
issued without a final inspection.
EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY"
Application for which a permit has not been issued will expire one year after date of application.
Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications
(not yet issued) must be requested within two years from the date of fee payment. Fees paid at the time of application are
for Plan Check and administration. The Plan Check portion of fees is refundable only if the permit is cancelled or withdrawn
before any plan checking is done. Building Division costs will be deducted prior to authorizing a refund and a charge of
$54.99 to process the refund application will be assessed. Refunds on permits (issued) may be requested prior to the expiration
of the permit, provided no work has been done pursuant to the permit. An Inspection may be required (and deducted from any
refund amount) to determine no work was done.
Fee/refund information can be read on-line at http:Hmunicipalcodes.lexisnexis.com/codes/butteco/
"When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information
related to this application is subject to public inspection and will be posted on the County's website for electronic access.
Reference Number: B07-2548
Location: 2188 HONEY RUN RD
Parcel Number: 017-170-044
Date: 12/17/2007
Owner Name: FAITH KATHLEEN, Phone: (530) 343-8561
Description: MULTI -STORY ADDITION- 950', DECKS 622'
Signature of Applicant: l Date: 12/17/2007
FILE
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 95965
(530) 538-7601 Telephone
(530) 538-2140 Fax
www.buttecounty.net/dds
"PERMIT APPLICATION DATA SHEET"
Reference Number: B07-2548 Date: 12/17/2007
Location: 2188 HONEY RUN RD
Parcel Number: 017-170-044
Owner Name: FAITH KATHLEEN,
By: GLB
Sub Type: Room Addn-Multi Sti
Phone: (530)343-8561
Description: MULTI -STORY ADDITION- 950', DECKS 622'
The above permit application has the following Clearances required prior to permit issuance. Please contact each department
indicated below regarding specific requirements pertaining to your permit application.
Yes
No
DRAINAGE DISTRICTS
❑
❑
Thermalito Irrigation District, 410 Grand Avenue, Oroville CA 95965 - (530) 533-0740
❑
❑
LOAPUD, 1960 Elgin Street, Oroville CA 95966 - (530) 533-2000
❑
❑
City of Chico, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711
PARKS & RECREATION DISTRICTS
❑
❑
Chico Area Recreation District, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711
❑
❑
Durham Park & Recreation District, 9447 Midway, Durham CA 95938 - (530) 345-1921
❑
❑
Feather River Recreaction & Park District, 1200 Myers Street, Oroville CA 95966 - (530) 533-2011
®/
❑
Paradise Parks & Recreation, 6626 Skyway, Paradise CA 95969 - (530) 872-6393
SCHOOL DISTRICTS r
Biggs Unified School District, 300 B Street, Biggs CA 95917 - (530) 868-1281 y��G�
❑
Chico Unified School District, 1163 East 7th Street, Chico CA 95926 - (530) 891-3006
❑
❑
Durham Unified School District, 4920 Putney Drive, Durham CA 95938 - (530) 895-4675
E]
❑
Gridley School District, 429 Magnolia, Gridley CA 95948 - (530) 846-4723
❑
❑
Marysville School District, 1919 B Street, Marysville CA 95901 - (530) 741-6000
❑
❑
Oroville Elementary School District, 2795 Yard Street, Oroville CA 95966 - (530) 532-3000
❑
❑
Oroville Union High, 2211 Washington Ave, Oroville CA 95966 - (530) 538-2300 Ext: 105
❑
❑
Paradise Unified School District, 6696 Clark Road, Paradise CA 95969 - (530) 872-6400
OTHER
❑
❑
Recorded copy of Agricultural Acknowledgment Statement- See Attached Instructions
❑
❑
City of Biggs Planning Department, 3016 Sixth Street Biggs CA 95917 - (530) 868-5447
❑
❑
Other:
❑
❑
Other:
*"When filed, this application and all supporting material becomes subject to the California Public Records Act. All public
information related to this application is s bject to public inspection and will be posted on the County's website for electronic
access.
Signature
of Property Owne MDate: 12/17/2007
FILE
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 95965
(530) 538-7601 Telephone
(530) 538-2140 Fax
www.buttecounty.net/dds
OWNER -BUILDER INFORMATION
An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified.
For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed
by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from
possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by
law to put their license number on all permits for which they apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and
protection:
° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire
project and such persons are not licensed as contractors or subcontractors, then you may be an employer.
° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal
° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions.
There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance.
° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business
Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial
Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees,
without a license contractor or subcontractor, only under limited conditions.
A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is
providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321
-CLSB (2752) or by accessing thier website at www.CSLB.ca.gov.
PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE
AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED.
OWNER BUILDER VERIFICATION
PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING
PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED,
T 1. I PERSONALLY PILO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY
IMPROVEMENT. ENT. YES R NO)
' 2. I _`/ HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK.
3. 1 HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION:
ADDRESS CITY
PHONE CONTRACTORS LICENSE NO
4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE
THE MAJOR WORK:
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
Description: MULTI -STORY ADDITION- 950', DECKS 622'
Reference Number: B07-2548
Applicant Name: FAITH KATHLEEN,
Owner's Name: FAITH KATHLEEN AP 4
Signature of Property Owner: Date:
:017-170-044
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
OFFICE #: (530)5')8-7541 FAX #: (530) 538-2140
A FEE WILL BE REQUIRED AT TIME OF APPLICA TION
Website: www.buttecounty.net/dds
"PLEASE PRINT CLEARLY"
OWNER INFORMATION
Last Name `�—
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First
Mailing Address n
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City t C
State
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ARCHITECT/ENGINEER
CONTRACTOR
Name
Address,`—
Address
City 119
City
State
State
Zip
Phone
E-mail
Fax
E-mail
Lic. #
Class
ARCHITECT/ENGINEER
Name
•�
Address,`—
Address
City 119
City
State
Zip (tip p
Phone , I `!�r1 f?�
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Fax
E-mail
Fax
State License Number
PERMIT
NO. J
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BIN #
PROJECT LOCATION
APPLICANT INFORMATION
Name
Property Address ,w
Address
City Cw a
City
Occ.
State
Zip
Phone
Fax
E-mail
PERMIT
NO. J
D�
BIN #
PROJECT LOCATION
API (��
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Property Address ,w
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City Cw a
WORKER'S COMPENSATION
Policy Number
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:
Cil m
Sq FT- Living Garage Open Cov
(2 Structure Built without Permits t1 t i 11 I r
❑ Proposed Change of Occupancy
(Note previous use): , 1 ,Y/��(,,�
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For office u I .
Zoning
Flood Zone
SRA4
Yes
No
Occ.
Type Const.
J
APPLICANT SIGNATURE
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BUTTE
COUNTY
DEC 2007
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I
OROVILLE, CALIFORNIA
GENERAL CLAIM
CLAIMANT: Servamatic Solar Systems, Inc.
10 Williamsburg Lane
ADDRESS:
Chico, CA 95926
CITY 8 STATE: IMPORTANT:
November 23 1981 SEE INSTRUCTIONS_
DATE OF CLAIM: ' ON REVERSE SIDE ,
SUBMIT CLAIM TO DEPARTMENT RECEIVING cnnnc na crovfrcc
DATE
�. DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) i AMOUNT
Owner (Joe Silbernagel) has decided not to install solar system.
Contractor requesting a refund.
(Plumbing Permit #4193-81P -.Receipt #58179 - AP 55-34-44) .
i
!.
Plumbing permit fee paid ------------$30.00
Retain i ing ee-------------------
Amount of refund due ----------------$20.00
$20
00
TOTAL
$20.00
I, the undersigned, declare under penalty of perjury that the services or articles claimed have been p rfo d or Zdelivd, and thatthis
claim is true and correct as stated./b�Deted this �7 .....day. of N�'l.J�'��2it; 19 U�, at�1,� �..�.a. ..... ..... ...•....... ..................r............ .
....................
' - Signature of Claimant
I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above ha e'be n performed or de-
livered and that there is a Budget Appropriation E] or Specific Board Approval I[D (Chedkone) for the s me. '
Dated this .................... f J
. day of ../`'�".............19 at
... ...........
`.. �.................. Calif.
artment Head or Authorized puty-'
Dept. Exp, Code...., ........................................ Code PAYABLE FROM..
......................................................................... FUND
DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY
VENDOR
CODE
I DEPT.
&SUB.
PROD.
SUB.
OBJ.
CLAIM
NO.
(.INVOICE
NO%
INVOICE
DATE
DISC.
GROSS'
AMOUNT
ENCUMB.
SUB -DIST.
f
_ �
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATIOWAND PERMITt�'l
/PERMIT NO.
/M 8
ASSESSOR PPAARCE UMB
ZONING
BUILDING PERMIT
OWNER j0C
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
CONTRACTQ/ "I" -P�
PHOI�F
CONTRACTOR'S MAILING ADDRESS
&IC,11
L�f�Ms�L� c riC%(
Fireplace
COjJSJFLC T�N LENDER
NKNOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR I EER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUS Ng91DRES� /-jry �, / �
PLUMBING PERMIT
Filing Fee 10.00
�/lJ`
N 5 H�
Each Trap
2.00
Repair drainage or vent piping
5.00
Water piping
LOT NO.
SUBDIVISION NAME PARCEL MAP
Each pas water heater or vent
5.00
Gas piping system 1 - 5 outlets
--, � USE OF STRUCTURE
SF [Pe Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer
Lawn sprinkler system
5.00
SV LTL
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ yJti lities ❑ Insta lation ❑ Other
Describe work: �jOL/9� APDAJ �-Z �`! f�"
Permit Fee
$ - ,Qd
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 100 AMP OR00V OR LESS5.00
Main service EA. ADD•L 100 AMP
2.50
NEW CONST. ( DWELLING OCCUP.y)
OR ADDNS. ACC, BLDGS.
20 sq
CONTRACTORS LICENSE LAW
I declare er penalty of perjury (check One):
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code ,��( m license is in full force and effe t.
3� Y
License No. Class! fi catio
F1 1, 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 -OUTLET 2.50 ea
NON.RESID BRANCH CIRC ITS
NEW CONSTR. (POWER APPARATUS &I
NON-RESID. (SINGLE OUTLET CIR, /
50@230
Ex. Occup o DR FIXTURES BAL�1
FIXED APP LNS. OR
IXED A
EX. Occup.�OUTLETS (RESID.) EA. 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 7.50
Permit Fee $
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare nder penalty of perjury (check one):
cyThe 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
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 buildingons tion, and hereby authorize representatives of the Countyot
Butte to ent r union he ove-mentioned prop for inspection purposes.
p ha le s the County of Butte against
all (lab it! s, ju gxpe es which may in any way accrue
I also re to s vetnequeLnceof
gainst ai Coun he g an ng of this permit.
Date
Signature of A licant — Owner
g ❑ 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 $
TOTAL PERMIT FEE $
occuP. GROUP
TYPE OF CONST.
PARCEL
PD
MD
seuE
This imIt is hereby issued under
si s f the Butte County Code and/or
w rk i dicat d above for which
! T0')1 -0F PUBLIC
BY
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been aid.
p
WORKS
/ G
Date
Receipt No. 57c0'�/ 7
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
S E RVAMAT I C
SOLAR SYSTEMS, INC.
7
Please close your files on the following permits:
Building Permit #
Plumbing Permit #
Our customer has cancelled his request for a solar system at
this time. We respectfully request a refund of the. ab,otyent,3
permits, sent to Servamatic Solar Systems
10 Williamsburg Lane tint (4�
•
Chico, Ca 9592.6
Thanks for your time and consideration.
Mark Griner
Office Manager
encl:permit
10 WILLIAMSBURG LANE, SUITE B 9 CHICO, CA 95926 • (916) 893-8871
6�d�10181 a it, a in�5�6 9 A
186109 AON
SNNOM ,nwI1d 30 Jd003Q
Wns dp dlN/1
4
emud* ot
OROVILLE, CALIFORNIA
GENERAL CLAIM
CLAIMANT: Noel Williams
ADDRESS: c/o Rodney Kopsa
1765 Sparks Dr.
CITY & STATE: Paradise, CA. 95969 IMPORTANT:
DATE OF CLAIM: October 3,'1975 SEE INSTRUCTIONS
ON REVERSE SIDE
SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES
DATE
DESCRIPTION OF CLAIM (DESCRIBE FULLY .TO AVOID DELAY)
AMOUNT
Owner decided not to install mobilehome facilities.
_
(Permit - , - . . 55-34-44v
Plumbing permit fee ----- $10.00
Retain filing fee-------
Amount-of refund due ------------$ 8.00
Electrical permit fee --- $12.00
Retain tiling tee -------
Amount of refund --------------- 9.00
TOTAL REFUND DUE --------------- $17.00
$17
00
TOTAL
$17
00
. I, the undersigned, declare under penalty of perjury that the services or articles claimed have been p o ed or e ' ered, and that this,
claim is true and correct as stated. Chico
5 fflUeff
Dated this ................... 1St ............... day of Oct
Ct.................. • 19 �..... at.... �......• Calif.
............................
of Claimant
I, the undersigned, hereby certify that, to the best of my knowledge, the services or'articles s _ cified above have been performed or de-
livered and that there is a Budget Appropriation❑ or Specific Board Approval (Checkone) for the same.
3rd Oct. 75 Oroville
Dated this .................................... day of ............................. 19......, at .............................. . Calif.. ..... ..................................... .............................. ..........
Department Head or Authorized Deputy
Dept. Exp.
Code............................................ Code ................................................PAYABLE FROM............................................................................................FUND
DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY
VENDOR
CODE
DEPT.
& SUB.
PROD•
SUB.
OBJ.
CLAIM
NO.
INVOICE
NO.
INVOICE
DATE
DISC.
GROSS
AMOUNT
ENCUMB.
SUB -DIST.
t
I ; .f,
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC SID 1. /+
7 County Center Drive — OroviIIe, California 95965
Telephone: 534-441 �y
'APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned pro rt/ful " spection rposes.
AP x Date / r
Si nat r of jrmitee or Agent
Receipt N . / Z ��%�
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 P LIC WORKS
BY Date
8 ding permit expires Date.............................«-7��
BUILDING
OwnerAi� Z I= f
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee
$
$
Building AddressS
PLUMBING
No.
@ FEE
PERMIT FILING FEE $2.00
Each Trap 1.50
Repair drainage or vent piping
1.50
Water piping 1.50
C
Each gas water heater or vent 1.50
A. P. No. � --/—�
ZO
Gas piping system 1 - 5 outlets
1.50
Each additional outlet .30
F
Vl(,� S n Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
ParkingParcel
Declaration
T py
60' R/W
Improvements
Lawn sprinkler system 2.00
�Plaanns
Bldg. PIZ Recd
Parce Approval
44mdonooso Approval
Permit Fee
$
$
NEW ❑ ADDITION ❑ UTILITIES OTHER ❑
ELECTRICAL
No.
@ FEE
PERMIT FILING FEE $3.00
Main service incl. 1 meter
Additional meters, each
1.00
Sub -panel (12 or less) (more than 12)
Single Family ❑ Duplex ❑ Mobil Home Vr Others ❑
Range, Cook -top or Oven 1.00
Water Heater or Space Heater
1.00
Light fixtures1_ dlo
Receps., switches & fix outlets b 25
LM
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
Mobil Home Facilities 5.00
Temp. Power Pole 5.00
License No. Classification
Misc. wiring
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.
❑ 1 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.1
@ FEEPERMIT
^
FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
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
TOTAL PERMIT FEE
$
authorize representatives of the County of Butte to enter upon the
above-mentioned pro rt/ful " spection rposes.
AP x Date / r
Si nat r of jrmitee or Agent
Receipt N . / Z ��%�
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 P LIC WORKS
BY Date
8 ding permit expires Date.............................«-7��
fhis sei of plans e_
�a i .�. MUST be -
on the job at ali' limes and it is unlawful to
make any changes or alterations on same w4hout
written permisson from the Department of Public
0 Q�'� Works, County of Butte.
�0Urly �O�
m� lz�
Voter sot All utility connections shall be
Q mac, F, 2J located within 4 ft. outside the rear
third section. of the mobile home
0 on the left (road) side of the mobile
tqp v
BUTTE
�o
V
7r
_
- r
Cn
46vt
/ NL -14
114140.
The `. Setback shall be 5 ft. from
the side property line and 50 ft. from
the centerline of the road, permitting
maxim1.1m of a 2 ft. eave overhang.
1
U NTY
BUILDING DEPARTMENT
APPROVED
E
/T
S.377 _71 l Q
jw -- -- -
elm
FP
PERMIT NO. 5584-755
4
P.21?gl-2
E
M
`MH UTIL. ~�
s
PERMIT NO.
a
PERMIT EXPIRES �ZZ/3//
"OWNER Noel Williams
CONTR. Rod Kopsa, Paradise
r
LOCATION .(A:P. .:55-34-44
Ct'. ti
'�N/S Honey Run Rd., app. 13� mi. above
.covered bridge, Chico
Y
It
tQ
�77v
4
J
b Temp. Power Pole
u
Called PG&E
Temp. Elec. Serv.
Called PG&E
Temp. s Serv.
alled PG&E
FOINALED ! �' •o S
(Date)
(Signature)
I�
M
LE RS
FramingTest
COUNTY OF BUTTE — DEPANT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
Water Htr.
BUILD°IN,G — /)�G/C BUILDING (Cont'd)
PL"UMBI�9G
Setback
Firewall
Soil Piping
Forms
Parapets
1st Floor
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
Stemwall
SidingTo
out
Slab
Roof SheathingWater
Piping
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Garage Vents
Water Htr.
StemwaII
Slab
Prov. for physically
handicapped
Heaters
Appliances
Carport
Footings
Conformance of ex.
structure
Gas Piping & Test
Temp. Gas
Slab
Final `— —
Sanitation
Patio
FIREPLACE
Final
Footings
— Footing
ELECTRj AL
MasonryWalls
Throat
Rough
Reinf. Steel
Final
Fixtures
LE RS
FramingTest
Water Htr.
Stucco
Final
Subpanels
Mesh
MECHA ICAL
Grd. Fault Prot.
Scratch
HeatingService
Brown
Cooling
Temp. Pole
Finish
Ducts
Underground
Interior Lath
Ventilation
Permanent
Door Closer '
Final
Final
DATE ' REMARKS OR CORRECTIONS
.D e cle
A00� ��Q vi2c�e
PERMIT NO. 2941775111," F, -.M
P
t -E
p
M
YH UTIL. `
'PERMIT NO.
-76
PERMIT EXPIRES
PWNER Noel Williams
oNTR. Rodney Kopsa, Paradise
LOCATION (A.P. 55--34-44
)
1:.
n -s Honey Run Rd., ]1 mi. above
z
covered brid e
g
} Chico
' t O -W 0-' % �7
ifs
1,
1 .
l
l
" Temp. Power Pole
Called PG&E
Temp. Elea Serv.
1 Called PG&E Q
a Temp. Gas Serv.
CaLk4,1 & E
. JOB
FINALED / Z
0
� (Date)
(Signature)
}
i.
..-r
'COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION -RECORD
BUILDING BUILDING (Cont'd)' PLUMBING
Setback Firewall Soil Piping
Forms
Main Bldg.
Footings
Stemwal I
Slab
Piers
Garage
Footings
Stemwa I I
Slab
Carport
Footings
Slab
Patio
'Parapets
1st Floor
Masonry Walls Throat
Restroom Finish /' --28 -7
2nd Floor
Fixtures > ZO - 7
t7 -7 Windows
3rd Floor
.
Siding - __
To out'
-' % 3
Roof Sheathing . 7S" &4-v4—
Water Piping
oZ i� Roofing - i `T
Sewer
Temp. Pole
Fdn. Vents
Fixtures -=
Interior Lath Ventilation
Garage Vents -
Water Htr.
I'Final -7 .
Prov. for physically
handicapped
Heaters
Appliances
21
Conformance of ex.
structure
Gas Piping
Temp. Gas
8r Test
Final
Sanitation
(ZV E,P��
FIREPLACE
Final
- 2,0 -
Footin s it Footing
ELECTRICAL
Masonry Walls Throat
Rou h
Reinf. Steel Final ® /Q(s L Za-
Fixtures > ZO - 7
Bond Beam FI E SPRINKLERS
Motors
Framing Test `•
Water Htr.
Stucco Final
Subpanels `7
.- Mesh MECHANICAL
Grd. Fault Prot.
- Scratch Heating 1
/Service
Brown - Cooling
Temp. Pole
Finish Ducts "%
Under round
Interior Lath Ventilation
Permanent
Door Closer Final
I'Final -7 .
DATE % REMARKS OR CORRECTIONS
0 07P > p Le) ,1J
n./
(ZV E,P��
l 2 k E A
oF_ Ju 0-'. Fxte-n - .� , i2o�r - '®F Pwio 1. ek.�v-oe�v'
woo e U4V�. �i9c� c�til �rL �, �ucis ro crbE,C
7-0 W -479;r— /n/ kWC<
TUB
C_ C, U%l D r�% I' n Z b i7j''v " � iii P��,�t/ � /� o�P.Y
Pxoc
10 76,
-. r
TO: Building Department
FROM: Snvironmental Health
R E, Sewage and/or Waiter Clearance
x
Ot-11NER LOCATION A.P#
Has been approved for:
�WAG SAL
OS'�
R LY
Sabitaria.n
A DOI
Date
S95r775
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC0 S�9V j_
7 County Center Drive - Orovi Ile, California 95965 /
Telephone: 53474541
a '
APPLICATION AND PERMIT fj
X ate07
Signature of Per itee or A4ent
Receipt No.
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
f es have beenpaid. rlions to do work inoicateo
above for which
DIRECTOR OF UBLIC WORKS
:il�ding
permit expires Date 6 ' -
BUIL ING
Owner
SQ, FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Fireplace
Contractor S A
Total Valuation.--_
Mai I i ng Address
PermLLEee-
Plan Checking Fee &/or Penalty
P
Te ephone No.
-Permit Fee
a
Building Address
PLUMBING No.
@
FEE
PERMIT FILING FEE $3.00 3�0O
Each Trap 1,50
Repair drainage or vent piping
1.50
Water piping 1.50 �iSa
Each gas w -heater or vent f 1.50 6-4
A. P. No.
Zoning & Planning
Gas piping system 1 - 5 outlets
1.50
Each additional outlet .30
Fps
WC/
Wi!Don'
Fire Dept.
Fir Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
Declaration
Parc I a '
P
60' R/W
Improvements
provements
Lawn sprinkler system 2.00
Bldg. PI s Recd
Parcel Approval
Plans Approval
Permit Fee
$
NEW E]ADDITION ❑ UTILITIES ❑ OTHER
ELECTRICAL - No.
@
FEE
PERMIT FILING FEE $3.00 ��pd
Main service incl. 1 meter 3,Da
Additional meters, each
1.00
Single Family Er Duplex ❑ Mobil Home ❑ Others ❑
Sub -panel (12 ov41's—s) (more than 12) , "O
Range, Cook -top or Oven 1.00
Water Heater or Space Heater
1.00
Light fixtures _V1
, swi s & fix is O
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State California Business Professions Code under the name
st e :
,
zL
Hobr_Ex.Fan orF.A.Furn.motor
1.00
-J. 10
Evap. coo I er, gar.Ak<p. or D.W. 1.00 Ito C7
Air cocci • ner or heat pump ,,$"0
Water pump / # 1670
Mobil Home Facilities 5,00
Temp. Power Pole 5.00 aO
+�-
License No.�=Classification
Misc. wiring
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee
$
$ 6 c
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.
F -1I 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 X00
Heating O Dr1lJ . D v
Cooling �pQ
Ventilation
Hood f 2.00 DO
Permit Fee $
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 b ilding construction, and hereby
authoriz ep sentatives of the ounty of Butte to enter upon the
above -mention d Drooertv for insddddddertion nurnnses-
%
TOTAL PERMIT FEE
$ ,•,
This permit is hereby issued under the applicable provisions of
X ate07
Signature of Per itee or A4ent
Receipt No.
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
f es have beenpaid. rlions to do work inoicateo
above for which
DIRECTOR OF UBLIC WORKS
:il�ding
permit expires Date 6 ' -
..COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS ��
7 'County Center Drive — Oroville, California 95965
Telephone: 534-$541
' APPLICATION AND PERMIT
authoriz represe tatives of the Countypt Butte to enter upon -the
above- ntioned roperty,•for ins c, ion urposes.
Date
Signature of Perm' ee or Agent
Receipt No. /3708 r
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
abovafor which fees have been aid.
DIRECTOR 0 UBLIC WORKS
ev Date
(ding;permit expires Date
///, 7
BUILDING
°
Owner .�' p tL C�lilL i,. i /•t`6v°- '
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
-
Telephone No.
Fireplace
,.
Contractor J1
Total Valuation e.
Mailing Address z l- • G S° /".
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee
Building Address v Ru o . �2
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
0 f�
J_� % 2 ✓h °' dnot5 • VociCfe-
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. �'"
Z
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
F
W .
Sa i do
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
Declaration
Parcel Ma 0' R/W
P
Im r
p ovements
Lawn sprinkler system 2.00
/ t a
Bl d9.�,ans Recd'',^e4
• Parcel. Approval
Plans A proval
Permit Fee $
$
NEW ❑ ADDITION UTILITIES ❑ OTHER ❑
ELECTRICAL No• @ FEE
PERMIT FILING FEE J$3.00
'
Main service incl. 1 meter
Additional meters, each 1.00
Sub -panel (12 or less) (more than 12)
Single Family ® Duplex ❑' Mobil Home ❑ Others ❑
Range, Cook -top or Oven 1.00
rWater
e - • ( 7-
Heater or Space Heater 1.00
Light fixtures b e2
10
C/ T% ,5,`s�s � A,"'4449
Receps.,switches & fix outlets 025h.1 In
CONTRACTORS LIC NSE LAWHood,
I am licensed under the provisions of Chapter 9, Div. 3, of the
State o alifornia .Business & Pro ssions Code under the name
style of•
0,015� 1P
Ex. Fan or F.A. Furn. Motor 1.00
Evap.coo Ier,gar. disp. orD.W. 1.00
Air conditioner or heat pump
Water pump
Mobil Home Facilities 5.00
Temp. Power Pole 5.00
License No Classification
Misc. wiring
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
is
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability.
for Workmen's Compensation.
'}:' I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
❑I certify that in the performance of the work for which this
permit ,is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California. a
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/L"Iv1a relating to building\construction, and hereby
TOTAL PERMIT FEE
$ l3 '
authoriz represe tatives of the Countypt Butte to enter upon -the
above- ntioned roperty,•for ins c, ion urposes.
Date
Signature of Perm' ee or Agent
Receipt No. /3708 r
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
abovafor which fees have been aid.
DIRECTOR 0 UBLIC WORKS
ev Date
(ding;permit expires Date
///, 7