HomeMy WebLinkAbout017-260-11903-3684
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COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT 19_1_3_3d29V
ASSESSOR PARCEL NUMBER
VARIOUS SEE ATTACHED
ZONING
BUILDING PERMIT
OWN COMCAST COMMUNICATIONS TELEPHONE
OWN S y SAeRi*ffMO 95838
WEST-COASTCOMMUNICATIONS
SO, FT, OCC. BUILDING VALUATION
CONTRACTOR'S NAME
53
I TELEPHONE
343-2473
CONTRACTORS MAILING ADDRESS
140 MEYERS ST CHICO 95973
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
—Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Flin Fee $
20.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
• Permit Fee $
Plan Checking Fee $
BUILDING ADDRESS
SEE ATTACHED
Energy Plan Checking Fee $
$
PERMIT FEE $
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
1 7.00
Solar or heat pump water heater
23.00
Water piping
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: PT.ACF. CATV EMER SUPPLY
Each as water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home Is I G W
@20.00
PERMIT FEE S
ELECTRICAL PERMIT
Fling Feel 20.00
Main Service 200A OR LESS 11
23.001 253.0
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license ISI ;ull f0 ce�gnd effect. •/`--/J, �''] y /,�
License Class ~ (/ Lic. No. Y65 / 6 Z
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 1 certify that in the performance of the work for which this permit is issued, I shall
not employ any person In any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' o pensatio visions of section 3700 of the Labor Code, I shall
forthw- o ply w' provisions.
�� O�
X Date
Signature of Applicant - ❑ Owner ^Contractor ❑ Agent
An OSHA permit is required for axcav tions over 5'0" deep and demolition or construction
of structures over 3 stories in heig
Main Service 200A TO IOOOA 46.00
NEW CONST. DWElLNGOCCUP. SO
OR ADDNS. ( a Acc. BLDs. 3.5QFT:
NEW CONS MULTI -CURET @7,50
NON-RESI0
PowER APPARATUS
a SINGLE ouTLET C'.
Ex. OCCU OUTLET OR FDnURES e20@' 0
FUCED APPLNS. Op
Ex. Occup. ounETs REBID. EA 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE = 273.00
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 273.00
HAz.
p, FEES IMP FLOOD CDF PARCEL Po HD ISsuE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
[ /1 07
By /� Date ( �(/1
PERMIT EXPIRES ON C)
De
Receipt No. v -AP_ 8. �
WHITE-D.D.S.-B.D. - CANARY -A ESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
LOCATION:
CH28—PO2
APN: ?
11 POLES N/E/O
450 HONEY RUN RD
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HpNEY RUN RD
CoPROPOSED CATV
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CH28=PO2
074
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