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Home My WebLink About018-440-067• .. 11 10=64 ,; �� 1.251 91P.,M BROUIL-L''ARD, .:Tohii 3 �., :'�• � " ' � �. - F� 374 Stilson, Cyn Rd, "Chico Cont: Action Heating •t. t .�~^ (gas piping & •hvac/sf) 011-1.00-064 �i 99-2428 _-7 - BOUH LARD;" JOHN ' :; p.; .,374 STILSON CANYON,THICO CONTR: RRR ROOFING ' REMOVE AND REPLACE ROOF 4W r-' r �v u I 1 d -7 -7 -7 -IN ,�^.r .. .gra.. �:k.��*a..:.�y,p.-.....�.t•.:•:..:. ,-y,T:-:�.-•v .:.�,+s..�z,�.� .�.,g.:-... .�y.:i 33 —�; ... .. r--•�.��...-„-n...., ., � .. .. ....-.. ... .<<L�.� ... y- '- .t. r - �. . �.a 4 .f is •i : i E •_ � � �' . � a �� -,S �. � jJ � i f { � ;y - - - _�� r X :! w COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 E MIT 0• (Rev. 12/96) APPLICATION AND PERMIT. w ASSESSOR PARCEL NUMB' I` /V\ Li ZONING BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION I OWNERS MAID ADD S CONTRACTORi�NR TELEPHONE CONTRACTORS MAIUNO DRESS, ' ("I/ , CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS - Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ • oo ARCHITECT OR ENGINEERS MAKING ADDRESS Plan Checking Fee $ BUILDINGADDRESS (�� ♦ .! v' \ Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE ADuplex ❑ Mobilehome ❑ Other s �. Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 1 5.00 { TYPE OF WORK New '❑ Addition ❑ Remodel ,,0 Utilities�y❑ /Ins�allattiionn ❑ Other ❑ Descriribbee Worlt: cif T �II + Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI GI W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service 2o0A OR LESS 23.00 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 an Professions Code, and my license is i II forc8 effect. - ^'j 1 License Class '" Lic. No. r t- O'VN -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 1, 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 Main Service TO lOCU00A 46.00 WEE200A NEW CONST. DWELLING OCCUP. SO OR ADDNS. ( a ACC. BMS. 3.5¢x_ NEW CONST. MULTI -OUTLET 7 =R IDT CU @7.50 POWER APPARATUS a SINGLE oUfLET cIR. Ex. Occu CUTLET OR FDCTURES Bn0 @ Iao UTED OR FDcrLNS R Ex. Occup. O.MED PPES,15J EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirin 23.00 PERMIT FEE $ 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` �ofrlBe11 'on in�anc carper and policy number are: Carrier ��.•WtAkK Policy Number + (The above sections need not be comp) te" 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' compensation provjsions of section 3700 of the Labor Code, I shall fort ith comply with tho 'e provison�. qof X _Date ant - f7 Owner ❑Contractor 11 Agent Signature -of Ap%equiredfor An OSHA permit excavations over 5'0" deep and demolition or construction!!of structures ovestor es in height. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ Oc cCO PE TOTAL FEE $ IS 9'61) HAz. D• ( IMP I -200 CDF FPARCELTPO I HD r ISSUE This permit is hereby issued under the applicable provisions the Butte County Code and/or Resolutions to do work indicat d above for which fees have been paid. By l.� Gk _l.l w Datte�, /"o PERMIT EXPIRES ON �d �y �7 U00 Date Receipt No. - 10!5q, 60 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT X COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center DriveA- Oroville, California 95965 - Telephone (530) 538-7541�� AE�MIr o. (Rev.12/96) PPLICATION AND PERMIT ASSESSOR PARCEL NUMB n O ZONING BUILDING PERMIT OWNER /t TELEPHONE 3D3 -.361a SQ. FT. OCC. BUILDING VALUATION OWNERS ADD S O CONTRACTOR�NA TELEPHONE �o CONTRACTORS MAI DRE ' CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 06 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS J Energy Pian Checking Fee $ $ PERMIT FEE $ L iid LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF, Duplex ❑ Mobilehome ❑ Other s Each Trap 1 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Worlf: Q��.(��'� b Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S G W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 Main Service 200A OR LESS 23.00 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 an Professions Code, and my license is i II foy effect. I `� License Class LIC. NO. �1 O N -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}qbe� Co e, for the performance of work for which this permit is issued. My workersa' i ranc ca ' r a licy n er are: Carrier "� \\ Policy Number a (The above sections nedd not be compete a 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 th I should become subject to the nsation pr "sio f section 700 of the Labor Code, I shall orLith fo pl with tho e p vi Ion X Date/0 Owner ❑ Contractor ❑ Agent Signatur of AppUequir An OSHA permit isor excavations over 5'0" deep and demolition or construction of structures over height. Main Service TO 46. 00 CCU000A NEW CONST. DWEWNG OCCUP. SO DWE200ALLING so OR ADDNS. ( 6 ACC. BUDS. 3.5¢FT, NEW CONSY. MULTI.OUTLET NON-RESID, @7.50 POWER APPARATUS a SINGLE OUTLET CIR. EX. Occup. OUTLET OR FIXTURES p BAL @ .50 Rl 5.00 Ex. Occup. ouTEit s ESIDOE Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ 2oc TOTAL FEE $ 19 j.6 HAZ. O 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 indica d above for which fees have been paid. By Date PERMIT EXPIRES ON �� ai) —L,200c) Dere Receipt No. C21 16 0691D _ .Crb WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT M aj'��Y"^t"'�w7[8'i'Gi .Rr '1�r,}�,,..nc..v: �, ...� ..-+,•.cs,'.+�., ar-.w•.-« .,» �: .,-.-+.r•.,+..a.., ...�.. ,,f t+'yt'j3'� ..j :4 �"'� %"`59."!.e'. jT..F f.'4'%'.t"• ,*'.. 'Gr..n7a.., L0. ra�yw rye. • 1251-91p,M 11-10-64,' BROUILLARD, John Chico 374 Stilson Cyn Rd, �.. Cont: Action Heating y` j;'t �• (gas .piping & hvac/sf) i COUNTY OF BUTTE -DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Orovill,ehCalifor+is 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 11-100--064 ZONING SR -1 BUILDING PERMIT John R343-5019 TELEPHONE SQ. FT. OCC.1 BUILDING VALUATION OWNER'S MAILING ADDRESS 374 nyon Chico 95928 R C O N T R ACTOR'S AME Actinn TELEPHONE 1343-4197 CONTRACTOR'S MAIL G ADDRESS 431 W. 9th Chico 95928 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 4 1.9tiEach 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 SF[J Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other] Describe work dcc !t AdsT _ �✓ Permit Fee $15.00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 300V OR LESS 10.00 100 AMP OR LESS 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 thei Business and Professions Code and my license is in full force and effect. License No. 21124,2 Q Classification ' e 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 DWELLING OCCUP.& / , NEW CONST. ( ACC. BLDGS. 2� ZQsgft OR AODNS. NEW CONSTR ULTI.OUTLET 2.SOea NO N.RESID BRANCH CIRC ITS POWER APPARATUS &) (SINGLE OUTLET CIR, ) Ex. Occup(OUTLETS OR FIXTURES eA 090 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 g Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. rl--j.-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 1 5.00 6.00 Split Cooling 3 Ton 11!1.00 11 00 9 � Hood 3.00 j Ventilation permit Fee X7.00 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 of the granting of this permit. X _X -��- e��---�.- y_ �6_ 9� Date Signature of Applicant — Owner ❑ Contractor g�r 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 $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $42 00 HAz I CUA PARK I SCHL I FLD PAR I PO HD ISsUlf This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DII�,EC OF PUBL'IC,'WORKS B 1010/Dat �A)q A/Receipt PE MIT EXPIRES Date • �� '--' No. WNITE-D.P.W., YELLOW PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE T NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. Date //—/� !� Ins.pectorv• _ 4 • COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, Califorgia 95965 - Telephone: 916/538-7541 Q� APPLICATION AND PERMIT M ll ASSESSOR PARCEL NUMBERZONING 11-100-0 BUILDING PERMIT OWNER John Brouillard TELEPHONE 1343-5019 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 374 Stil Ed-, Chico 95928 CONTRACTOR'SNAME Action TELEPHONE 343-4197 CONTRACTOR'S MAILI G ADDRESS 431 W. 9th St, Chico ()5928 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10_00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee ARCHITECT OR 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 SF ® Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 1 5.o0 Building sewer 5.00 Mobile Home S I G I W O.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other ® Describe work: f"�Vic_ A—A'GB.bLID/ 04_ Permit Fee $15.00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main Service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare u r 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. S License No. /24�Q Classification ❑ 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 CONST. DWELLING OCCUP.8d OR ADONS. ( ACC. BLDGS. , /20sgff NEW CONSTR. ULTI.OUTLET NON•RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. O(OUTLETS OR FIXTURES ccup 20®306 -8 L@300 FIXED APPLNS. EX. OCCUp. OUTLETS ((RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. �Virin 9 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. Fp�rhave 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. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating 1 6.00 6.00 S lit lin Cooling 31 Ton 111.00 L1.00 Hood 3.00 Ventilation - permit Fee $27.00 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 of the granting of this permit. S` n_- _ •� ° X Date V— A6 - 4/ Signature of Applicant — Owner ❑ Contractor Agent ❑ An OSHA permit is required For excavations over 5'0" deep and demolition or construct-DIR on of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ -i 42.00 HAZ CUA PARK SCHL FED PAR PD HD Issu This permit is hereby issued under sions or the Butte County. Code and/or work indicated above for which fee OF PUB I B PE MIT EXPIRES Date the applicable provi- resolutions to do have been paid. ORKS Dat Receipt No. 88717 WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT ,...-...,,,�r...r`,-,aux,.yctxr.inrsilaMrrtF.:•-rsI''.�ay'�.,�}'..±vtjY„^,.,� r * S..,j y {�� i� - �� e, `.x � �.th. �1�.�±p3r 1�'��t�.�`"%.''-I'.sin4l-t.�;�.gel-�,i«� ,� j'.!''r._. ,d . J.}1 COUNTY OF BUTTE - DEPARTMENT.OF.PUBLIC WORKS - BUILDING DIVISION .. _C•i.1D 7 COUNTY CENTER DRIVE - OROVIL�E., q CAI:IFORNI�A 95965 -TELEPHONE: 916/538-7541 All PERMIT APPLICATI N DATA SHEET Permit No. OWNER ��C/L �9I2 `r A P / -17 Proposed Building Use 13ui (ding Inspector- Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED " 1. All items have been submitted . .................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans .. 4. Complete, engineered plans and calcs, with wet signature on plans.. 5. Hazardos Material Form .......... 6. °s Energy Design Compliance and supporting documentation ......... �. 7. Statement of Intent for Non -Heated and AC Buildings .. ; 8. Enginee .6d truss deIIs and layout in duplicate (required prior to plan check) 9. Mobileh'ome instI tion data including manufacturer's installation � instructions .................... 10. Fees of $ 11. Chico Urban Area fees paid ....................................... 12. 13• Park fees paid ................................... I................ � School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of f (see City for other requirements) V l 17. Planning approval for (A) Use: (B) Parking: ...... ' 18. Improvements may be required. Contact Lana Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required ... Pre-Inspec. request to i .. Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 26. 27. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other Applicant l'r�a Date �f� 9,/ Copy of Hdz-Mat form sent Health Dept. '-Fire Dept. Air Pollution Date Copyofplanssent Health Dept. Fire'Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1, Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by -phone -mail -co nteN by -.date Contractor, designer, owner, was advised of above required data by_phone_mall_counter�y date Plans checked Sets of plans on hold in Copy -DPW Date Plans approved by File cabinet AP folder Date COUNTY OF BUT% - DEPARTMENT OF PUBLIC WORKS PERMIT N0. 7 County Center Drive - Orovllle, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER a - D 6 ZONIN SC2 % BUILDING PERMIT O WNE j�I I /�/', L� n to D VV !T tc— 3 SO. FT. OCC. BUILDING VALUATION 'TELEPHONE OWNER'S AILING .DDRESS S ILSOJJ - 04ff D CCANTR C 'S_ q.ME TELEPHON CONTRACTOR'S MAIL IAODR ESS . 3 N W � S:f-- H .Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee '$ ;0.00 Permit Fee $ ARCHITECT OR Lv ;IUEER LICE74SE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADORJtSS 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 55.00 Each pas water heater or vent 5.00 USE OF STRUCTURE SF Duplex[] Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home I S G W 0.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other Describe work: Permit Fee $ i Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service1000 AMP OV OR RLESS10.00 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): El 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. Classification. ❑ 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) ❑ 1, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ 1 am exempt under Sec. , Business and Professions Code for this reason Main service EA. AOO'L 100 AMP 2.50 NEW CONST. DWELLING Occu P.Ei OR ACDNS. (ACC. BLDGS. , hltsgft NEW CONSTR. U TI.OUTLET NON-RESID BRANCH CIRCUITS) 2.50 ea /POWER APPARATUS 61 SINGLE OUTLET CIR. I Ex. Occup(OUTLETS OR FIXTURES 200500 SALO 30t. FIXED APPLNS. EX. OCCUp. OUTLETS ((RESIO )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ 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. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Coolin g Hood 3.00 Ventilation permit Fee $ 6 - 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 said County in consequence of the granting of this permit. Signature of Applicant — Owner El 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 $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 1 00 HAZ. CUA PARK SCHL I FLD CDF Pq PD I HD. ISSUE This permit is hereby issued unser the applicable provi- sions 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 PERMIT EXPIRES Date Receipt No. WHITE-O.P.W.• YELLOW -ASSESSOR, INK•INSPECTOR, GOLDENROD -APPLICANT