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COMCAST
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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