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Home My WebLink About021-134-002r. X021 '13 4=002 3;; 98-2673,-- .,'SANIPLE; IVIR & NMS.- }` 1312,BLOCK RD.; GRIDLEY r � GOLDE`�fi, herb 4031B-�jr CAL'" ROOFING%S�L 10n,8 " _�34==0ff 3200P - =•REROOFWITH'STEEL'. t' _ , approx. 1100' o e Ave.., E/S on--,. 1.. - Block Rd., Gridley - - - CONTR:, Joe C., Wright, Rt 2, Box •Grr (new, single-family) -� 6 - _- 77 If u ,� �' . f 4 ;,,,. �._ - .� - w � as •„•.�---•..-meo•�5.��.,,..�_,-�,��uar•.�s�•�.r�+i"a!e�[w:•Rw.xqSl6�Ir,�R`!f�TF:L_3�1!sY•'��3�5'' `?.��.�`'�`"n`" �"'." .� P ,021-13-4-002' _ •#98=2673 s') �• j� - - ' SAMPLE, MR & MRS. }.r. ' 1312 BLOCK RD. , GRIDLEY' `CAL PAC ROOFING ; -"REROOF WITH STEEL ' f d • M COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 , , _ i 71T NO. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 21-134-002 ZONING A'^ BUILDINGPERMIT OWNER SAU'M,v 1,111.& MRS. TELEPHONE SO. FT. OCC. BUILDING VALUATION 30 MI TILE 5250 OWNER'ij = J=K RD. GRIDLEY* CA 95948 CONTRf4s i'Hl. ROOFING I T&3'!5T;300 DO 1Ti dv / ILII+LJLIA ]IA RD. RANCHO CORDOVA CA 95870 CONSTRUCTION LENDER Fireplace LENDER'S !AILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Fee $ 20.00 —Filing Permit Fee $ 81.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINp1M PTSU1 �p RD, J Energy Plan Checking Fee $ $ GRIDLBY PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ,Q Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 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 ❑ Ulilities ❑ Installation ❑ Other ❑ Describe Work: REROOF WTH STEEL Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service 20 A OR IESS 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.POWEPPARATUS License Class �' J 'I Lic. No. �_ /� t��' 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. ❑ I 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 i ) `l i ._ :. �D Main Service EPDA TO 1000A 46.00 NEW CONST. pWELLNJG OCCUP. CCU OR ADONS. ( 8 ACC. S. SO 3.50FT. NON RES D. MULTI OUTLET @7.50 8 SINGLER AOUTLET CIR. EX. Occup. OUTLET OR FIXTURES .00 BAL Q I .50 FIXED APPLNs. OR Ex. Occup. cuTLErs REBID, En 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE S MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number /4 h 17 , i --,i (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' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. / X / Date Signature of Applicant - ❑ Owner Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ 101.00 HAZ. I D. FEES IMP I FLOOD I COF PARCEL 1 PD HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have BY � ,_.t� ' ~� •� PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date y JA —S 4- , , Dats Receipt No. 1 f Zy U WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT ;COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION ' 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-754 T NO. (Rev. 12/96) APPLICATION AND PERMIT ��ab ASSESSOR PARCEL NUMBER 21-134-002 ZONING A40 BUILDING PERMIT OWNER SAMPLE, MR. & MRS. TELEPHONE SO. FT. OCC. BUILDING VALUATION 30 MH TIE 5250 OWNER l Tff t0ft RD. GRIDLEY, CA 95948 0ON1•"` RV rXFC ROOFING I IT2-16300 COM 11n/ UfttVl°iH RD. RANCHO CORDOVA CA 95670 CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 81.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan CheckingFee $ BUILDIN1 js G J �Qq1 BLOCK RD . Energy Plan Checking Fee $ GRIDLEY S PERMIT FEE LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF P Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: REROOF WITH STEEL Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home IS I GI W1 1 1@20.00 PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.00 Main Service 200.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 and Professions Code, ( 9 ) and my license is in full for a and effect. License Class C -3 Lic. No. /6 8Z OWNER -BUILDER DECLARATION 1 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. ❑ I am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( a Acc, gLDS. s0 3.50FT; NEW CONST. MULTI.OUTLET NON•RESID. CU @7.50 POWER APPARATUS 8 SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FDCTURES BAL o .so Ex. Occup. DFIxLITLEEDrsA Aa DRQ 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE t WORKERS' COMPENSATION DECLARATION 1 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 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 insuranc carrier and policy number are: Carrier FM— /r 4 Policy Number /:i(/T 7 (The above sections need not be completed 0 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' compensation provisi s of section 3700 of the Labor Code, I shall forthwith omply w' those pr Visions. // // X Date 2s f�X'-- Signature plicant - ❑ Owner ntractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. 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 $ 101.00 HAz. D. FEES IMP I FLOOD CDF PARCEL I PD I HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRE ON the applicable provisions Resolutions to do work been paid. Date , z D 0 ReceiptNo.2 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT L 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 ASSESSOR PARCEL NUMeEA_ 4- 1 — c7 0 2ON1N V BUILDING PERMIT OWNER (//1_ TELEPHONE SO. FT. O C C. BUILDING VALUATION OWNER NLA 1 r % COM ORB 1— s ELEPHONE �— CONTRACTOR'S MAILING AO D CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS Total Valuation 3 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee 20.00 Permit Fee $ gl 60 ARCHRECT OR ENGINEER'S MAILING ADDRESS Plan Checking Fee b BUILDING0_RESS� 3 Energy Plan Checking Fee S S PERMIT FEE t O G IDT No. SUBDIVISIONSNAME ' PARCEL AARP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF,E�, Duplex ❑ Mobilehome ❑ Other SPECS Each Tra 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 ❑ Insta tion ❑ Other ❑ Describe Work: .- Gas piping system 1 - 5 outlets 15.00 Buildingsewer 15.00 Mobile Home S G W Q20.00 PERMIT FEE t ELECTRICAL PERMIT Fling Fee 20.00 Main Service x. oa L,ss 23.00 LICENSED CONTRACTOR'S DECLARATION 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. 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' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X Date Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 50' deep and demolition or construction of structures over 3 stories in height Service WELL TO I000A 46.00 NEW I NEW CONST. DWELIJNCAocc. 3.5Qso. AD NS. ( ORR,�,D A . BL SEr M NON•RESIO.' 97.50 PowEa mPARATus a swcuE oUTLEr Ga 20 EX. OCCu OUTLET OR FIXTURES BAL ®A.yE Ex. Occup. nTSADEs °ERLL 5.00 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 FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ COAST TYPE TOTAL FEE $ od, D FEES IMP I FLOOD I COF PARCEL PO HD ISSUE This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions indicated above for which fees have been By Date PERMIT EXPIRES ON I Palo) provisions to do work paid. ReceiptNo. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT