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BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES INSPECTION CARD 24 Hour Inspection Line: (530) 538-7636 (Oroville) (530) 891-2834 (Chico) Office: (530) 538-7541 Fax: (530) 538-2140 Website: www.buttecounty.net/dds Permit No: B06-2791 Issued: 12/06/2006 Address: 652 LITTLE AVE GRIDLEY APN: 021-070-117 Permit Subtype: Electric Panel Owner: COMCAST Applicant: CLEAR CONNECTION CORPORATION Description: Comcast Meter Box MUST BE ON JOB SITE JOB SHALL BE READY PRIOR TO CALLING FOR INSPECTION. THE INSPECTION CARD AND APPROVED PLANS MUST BE AVAILABLE FOR EACH INSPECTION OR THE INSPECTION WILL NOT BE MADE AND A RE -INSPECTION FEE MAY BE , ASSESSED. ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING Inspection Type IVR INSP DATE Setbacks 132 Foundations / Footings 111 Pier/Column Footings 122 Grade Beams 114 Eufer Ground 216 Forms/Steel/Holdowns 122 Do Not Pour Concrete Until Above are Signed Pre -Slat; _ t -,...._ Gas Test _ OFFICE COPY 'M Masonri..._ - Address Masons .....� ..1- M Underfll •,i• ._ Y ° �w- Underfll^, G 45+ 7_50 Shear T-1, Meteratee`"'" Under r FS 's.,fx..ELEC�TRIC +� rMeter"'� Gas Pipj;,►, _ t- Do Not`lnstal Floor Sheat6mg or Slab Untie Above Signed Rough Framing 128 Rough Plumbing 406 Rough Mechanical 316 Rough Electrical 208 Gas Piping 403 Roof Nail 129 Shower Pan/Tub Test 408 Fire Sprinkler 702 Do Not Insulate Until Above Signed Wall Insulation 117 Ceiling Insulation 118 Do Not Cover Until Above Signed T -Bar Ceiling / RC 145 Gas Test 404 Stucco Lath 142 Stucco Scratch 143 Stucco Brown 144 Building Final 802 Electrical Final 803 Mechanical Final 809 Plumbing Final 813 Project Final 801 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE. IF WORK HAS COMMENCED, YOU MAY PAY FOR A 1 YEAR RENEWAL 30 DAYS PRIOR TO EXPIRATION Inspect+ r Copy �*V T rF BUTTE COUNTY F 16 0. DEPARTMENT OF DEVELOPMENT SERVICES , • BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) c�UN'�y OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 _ WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 652 LITTLE AVE Owner: Permit NO: B06-2791 APN: 021-070-117 COMCAST Permit type: MISCELLANEOUS 4450 EAST COMMERCE WAY Issued Date: 12/06/2006By AAM Subtype: Electric Panel SACRAMENTO, CA 95834 Expiration Date: 12/06/2007 Description: Comcast Meter Box (916) 515-2851 . Occupancy: Zoning: CABLECOM OF CALIFORNIA CLEAR CONNECTION CORP Building Garage Remdl/Addn 4585 PELL DRIVE 814-B STRIKER AVE SACRAMENTO, CA 95838 SACRAMENTO, CA 9834 Other Porch/Patio'. Total ' (916)567-9956 (916)567-0144 FEE INFORMATION Single Phase Service Res $55.00 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires CABLECOM OF CALIFORNIA 826295 / C7 A / 10/31/2007 1 HEREBY AFFIR RIDER PE ALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing wi e ' 70 of Division 3 of the Business and Professions Code, and my license is in full for a e e I. X 12/06/2006 Contractor's ignature Date WORKERS' COMPENSATION DECLARATION 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; Balance Due: $0.00 Receipt No: - ' B1101 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]; y Please check one of the following: —]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 (Sec. 7044, Business and Professions Code: The Contractor's 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 not intended 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 Contractor's 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 Liberty Mutual WC76310042700 Contractor's License Law.). Cartier: tPolicy Number: �xp. Date:07/31/2007 - (This section neeee not be completed if the permit is oror ons Ilars ($100) or less. � - I AM EKE/T and Section B. & P.C. for this reason: ❑I CERTIFY THAT THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall Ot employ any person in any manner so as to become subject to the Workers' Compensation s of Ca' omia, and agree that if I should become subject to the workers' X 12/06/2006 compensation rov'sions f Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Owne gnature Date acaner Contractor OR. Agent for Owner pffA�gent for Contractor Lender's Address City, StateZip FILE COPY XAW/ 12/06/2006 I here y certify that I have read this application and state that the above information is correct. I agree Signature Date to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless WARNING FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, Butte County, its officers, agents and employees from any and all claims and liability for personal ArL AND SH L SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE injury, including ath, and property damage caused by, arising out of, or in any way connected with HUNDRcD THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, the issuance of is permit. I hereby acknowledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupa y f a sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to an t e v mentioned property for inspection purposes. I hereby certify that I am the CONSTRUCTION LENDING AGENCY property o a orized to act on the property owners behalf. 12/06/2006 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Na f Permittee (SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) acaner Contractor OR. Agent for Owner pffA�gent for Contractor Lender's Address City, StateZip FILE COPY BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.nettdds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name ust Name Mailing Address City State Zip Phone Fax E-mail CONTRACTOR Name CAR9COM - MNE SA/b Address 4S95 FELL DIE City SACRA MaffO State CA Zip 95838 Phone r�lG ' 7' �s� laxg/,_ 79.58 E-mail Lic. #82(o29s Class + APPLICANT INFORMATION ARCHITECT/ENGINEER Name city SACPA9�15Vr,D Address Phoney/!o' 5 2 7 City E-mail State Zip Phone Lot # Fax E-mail Date Approved: State License Number APPLICANT INFORMATION Name COMCAST- CW Address SO EAST COMME&5 WAY city SACPA9�15Vr,D State Zip Phoney/!o' 5 2 7 Fax �/o'S/S' 2;9 E-mail APP 1CANT SIGNATURE X / k:�4 For office use only: Bldg Zoning Flood Zone SRA I res I No Occ. WORKER'S COMPENSATION WORKER'S I Type Const. Subdivision Name If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit Issuance. Map Book I Page Lot # Planner Date Approved: PERMIT NO. BIN # PROJECT LOCATION Bldg 7C. ProPe qd� 6s`(%�i+c f � Cross � o "I WORKER'S COMPENSATION WORKER'S Policy Number WC -103/ -01042100- 030 Carrier L ackry t 4d-rimL 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 /7 Address Description or Scope of Work: ISUILD CATV aW9X WPPLY DN EX/S?/.Vl UT/L/T1 POLE Sq FT- Living Garage Open Cov ❑ 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 required. 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 M Sheriff SMIP Other Date: 7