HomeMy WebLinkAbout021-110-0343
r-CALKINS Mel 159-6713
36,4,- '6r7p
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CONTR: Joe P 11 Rt 2, Box 69, Gridley
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COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING D#ISION
7 County Center Drive - Oroville, California 95965 9 Telephone (530) 538-71,341 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
ZONING
BUILDSIGPERMIT
TELEPHONE
MUM OLSON 846-3W6
OWNEWS MAJUNG ADDRESS
14()6 s, ymmba ST., GRIDI.EY, CA 959"
SO. Fr. OCC. BUILDING VALUATION
720.00
CONTRACTOR'S NAME
TELEPHONE
JWTORS MAJU2MSRS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAJUNG ADDRESS
Total Valuation $ 0.00
ARCHITECT OR ENGINEER
NO.
Filing Fee $ 20.00
Permit Fee $ 21.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDINGADDRESS
11-406 S_-VERNXn_' STS CRTINRY CA 9094A
Energy Plan Checking Fee $
$
PERMIT FEE $ 41.00
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT Filing Fee 20.00
USEOFSTRUCTURE
SF 0 Duplex 0 Mobilehome 0 Other
SPECIFY
Each Trap 7.00
Solar or heat pump water heater 23.66'
Water piping 15.00
Each gas water heater or vent 15.00
TYPE OF WORK
New 0 Addition 0 Remodel 13 Ublities; 0 Installation 0 Other 0
Describe Work: RFR0QF ---------
Gas piping system I - 5 outlets 15.00
Building sewer 15.00
Home ISI G1 W1
—Mobile
PERMIT FEE
ELECTRICAL PERMIT Filing Fee 20-00
Main Service ( '."..v o.' :.' ) 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 and Professions Code,
and my license is in full force and effect.
License Class Lic. No.
Ar OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
NA1, 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.
0 1, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
0 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:
0 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.
0 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
Main Service 200A TO tOOOA 46.00
NEW CONST. DWELLING OCCUP. 3.50 so.
OR ADONS. & ACC. BMS . FT.
NEW CONST. OUTLET
NON-RESID. tU.LT,' CIRCUITS @7.50
&PSO.W.E.RAP.PARATUS
0 C'R.
20 @ 1.00
Ex. Occu OUTLET OR FDmJAES BAL @ .50
FIXED APPUNS. OR
Ex. Occup. OUTLETS (RESID.) EA 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE $
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEIE $
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.)
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 workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with thpse provisions.
X Date j1
=4t 6
Signatuie �of Appli�ant -A Owner 0 Contractor 0 Agent
An OSHA,permit is required for excavations over 60" deep and demolition or construction
of stru�ctures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
OCC
CO�NST. TYPE
TOTALFEE$ ZA I r"
HAZ.
I D. FEES IMP
I FLOOD
I CDF
PARCEL
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.
4,1, �_ �064A, 3-1 -oo
Date -3
PERMIT EXPIRES ON 13-0(
(Date)
ReceiptNo. c2k]�pj F;7—
WHITE-D.D.S.-B. . D.— CANARY -ASSESSOR PINK -INSPECTOR GOLDEN ROD -APPLICANT
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
411 Main Street * Chico, CA * (530) 891-2751
7 County Center Drive - Oroville, CA - (530) 538-7541
CORRECTION NOTICE
ER
L--"-V-0C./0PP-
PERMIT NO.
A routine inspection indicates that the following violations of butte county Ordinances exist at the
above address and should be corrected. Please notice this office when correction of work is
completed. If you have any questions pertaining to this matter, or need additional explanation,
PIT on act this office immediately.
ceca) LA I rmb.
[-/699-�54� �-> Co In- 7��-r Q a g. -
REV 10/92