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021-260-044
2Fv f.. .S . •. +, 7 � j CL" CHISUM7- --_-- -- - �"w/s Los Ave., a mi . �N. R Liberty -Rd, ey - �✓ ffST - Permit# 4332-74B, ,M r odel i / '. G ex. res.) 1y LOT BLOCK suB�Iv. Permit# 444-75B(fireplace TYPE OF PERMIT NO. PLAN NO. DATE ISS 021 260-044_.x..: �- ,`,PERMIT#,94=2435 REMARKS PERMIT c ' CHISUM, ! BEN � 1247 ,LOSSERAVE.',GRIDLEY'_`F - ..,PARTIAL REROOF/SF PERMIT DESIGNATION: B—BUILDING DEPARTMENT OF P—PLUMBING T—TRAILER BUILDING AND SAFETY E—ELECTRICAL U—USE PERMIT HM—HOUSE MOVING TV — RADIO -TV ANTENNA V — VARIANCE EP — ENCROACHMENT S/W—SIDEWALK NOTICE S= SIGN PERMIT D—DEMOLITION 600.1 f PERMIT DESIGNATION: B—BUILDING DEPARTMENT OF P—PLUMBING T—TRAILER BUILDING AND SAFETY E—ELECTRICAL U—USE PERMIT HM—HOUSE MOVING TV — RADIO -TV ANTENNA V — VARIANCE EP — ENCROACHMENT S/W—SIDEWALK NOTICE S= SIGN PERMIT D—DEMOLITION 600.1 f INSPECTION RECORD BUILDING APPROVALS ~ W LL f LL Z Z OUIO a m D Up LL J O LL Z_ UJ O W LL. Z y W K Z Q K LL O W F Z J O W FQ Hx J W O W W N �.g Z a 0w W I.,� y'� a W tj5c U O zJ O m U J WJ3 .G W m t, W W LL J Z LL SIG. DATE SIG. DATE SIG. DATE SIG. DATE SIG. DATE SIG. DATE SIG. DATE SIG. DATE SIG. DATE SIG. DATE SIG. DATE SIG. DATE PLUMBING APPROVALS PERMIT NUMBERS SIG. DATE SIG. DATE SIG. DATE SIG. DATE SIG. DATE ROUGH -IN GAS PRESSURE TEST WATER PIPING SEWER LINE APPLIANCES Q VENTS FINAL ELECTRICAL APPROVALS PERMIT NUMBERt SIG. DATE SIG. DATE SIG. DATE SIG. DATE SIG. DATE ROUGH -IN FIXTURES & APPLIANCES METERS FINAL MISCELLANEOUS APPROVALS PERMIT NUMBER: DESIGNATION SIG. DATE •021=260=04'4 0, PEFMIT#94-72435. CHISUM, BEN -11247 LOSS�R:AVE.., GRIDLEY t.TARTIAL REROOF/SF-', P•; ,•-7i R"^ r--q�. .�� ...._'�'�T'----)•q•�AM-,---,-...f'--..i► F,R".9..7R,.A."�Is•-�-. .-.,.,-�..w COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION i -7-**-.* j7 County Center Drive - Oroville, Oalifornid 95965 - Telephone (916) 538 _.PERMIT NO. -7541 ` APPLICATION AND PERMIT 9q— .4v3s;_ ASSESSOR PARCEL NUMBER 021-260-044 ZONING BUILDING PERMIT OWNER ben chisum TELEPHONE SO OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1245 loaBer ave. ridle 4 @ 60 240 CONTRACTOR'S NAME owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $ 15.W ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 1247 LOSSER AVE., BRIDLEY PERMIT FEE $ 35.00 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Water piping 15,00 Each gas water heater or vent 15.00 USE OF STRUCTURE S010 Duplex ElMobilehome O Other SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W Mobile 20'00 TYPE OF WORK New ❑ Addition EIRemodel O Utilities O Installation ❑ Other E] Describe Work: PARTIAL RFROOF W.If' W_ PERMrr FEE 1 $ Contractor ELECTRICAL PERMIT Filing Fee- 20.00 Main Service ( BOOV OR LESS ) 23.00 2OOA OR LESS Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. so. OR ADONS. ( a ACC. BLDS. ) 3.5C IT CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) ❑ I am a licensed under provisions of Chapter 9, Division 3 of the Business and P P Professions Code and my license is in full force and effect. License No. Classification Qi I, as the owner, 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) O I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) ❑ I am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET -NON-RESIO. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) a SINGLE OUTLETCIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 @ 1.00 BAL. 50 Ex. Occup.FIXED APPLNS. OR ( OUTLETS IRESID.1 EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): O This permit is for $100.00 (valuation) or less. O 1 have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. 0.1 shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE S Contractor I certify that I have read.this application and state that the above information is correct. 1 agree to comply to all Butte County Ordinances and California State Laws relating to building construction, and hereby authorize representatives of the County of 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 f the granting of this permit. AY �/r / �' Date �_ �9 - `� `� Signature of Applicant - O Owner O Contractor O Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ DOC CONST. TYPE TOTAL FEES 35.00 HAZ. D. FEES IMP FLOOD CDF PARCEL PD HD I U 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. By �� 1 Date // ^ PERMIT EXPIRES ON 17/7 ? W /Dare! Receipt 1675G3 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 (916) 538-7541ERMIT NO. APPLICATION AND PEAMIT 9q- S_ ASSESSOR PARCEL NUMBER 2— ZONING BUILDING PERMIT OWNER ben chisum TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1245 losser ave. ridle 4 @ 60 240 CONTRACTOR'S NAME owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $ 15.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 1247 LOSSETZ AVEE. GRIDLEY PERMIT FEE $ 35.00 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Water piping 15.00 Each gas water heater or vent 15.00 USE OF STRUCTURE SF)Cq Duplex O Mobilehome O Other SPECIFY Gas piping system 1 5 outlets 15.00 Building sewer 15.00 Mobile Home S G I W I]!ffoo TYPE OF WORK New O Addition O Remodel O Utilities ❑ Installation ❑ Other IT Describe Work: "D}T IAS R7:�_00R W11=2 PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service I 6001 OR LESS ) 200A OR LESS 23.00 Main Service I 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP.so' OR ADDNS. ( & ACC. BLDS. ) 3.SG FT. CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) O I am a licensed under provisions of Chapter 9, Division 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 compensation, will do the work, and the structure is not intended or offered for sale. (Sec 7044) O I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) O I am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET NON.RESID. ( BRANCH CIRCUITS ) @7.50 POWER APPARATUS ) & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) BA20 @ 1.000 Ex. Occu FIXED APPWS. OR (RESID.) EA p' I OUTLETS . ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): 9 -This permit is for $100.00 (valuation) or less. O I have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. RS. I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all Butte County Ordinances and California State Laws relating to building construction, and hereby authorize representatives of the County of 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 f the granting of this permit. / �% L` X ,/jT Date r/ Signature of Ap li" nt - O Owner O Contractor El Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ DCC CONST. TYPE TOTAL FEE $ 35.00 HAZ- I D. FEES I IMP I FLOOD I COF PARCEL PD I HD I I U This permit is hereby P y issued under of the Butte County Code and/or indicated above for which fees have / 1 By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. ll �1'4N I Dae A 4� (Date Receipt No. 167543 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT ,��� .. `��l,�,y,u'ki�tti�li�'I . y .I. �f`��'MF'.7�1."FtK`rf,_,Yny` /i'jw... l,y....•.{1M�1r-wr,.�+n."h r•l'+-• .: r t COUNTkYOF BUTTE - DEPARTMENTOF DEVELO,PMENTSERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, C&LIFQfttMA 95965 -TELEPHONE (916) 538-7541 ` PERMIT APPLICATION DATA SHEET OWNER ZJr, a I A. P. No. (0c) "-c � ' 0� Proposed Building Use Building 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 BY 1. All items have been submitted . ........................................ 2. Plot plans, 3/4 sets, signed by preparer of plans . .......................... 3. Complete plans, 3/4 sets, signed by preparer of plans . ...................... 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form . ....................... : . 6. Energy Design Compliance and supporting documentation.}'. -7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). .... 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $ .......................................... 11. Impact fees as shown on attached schedule. ............................. . 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer ................... 14. Sanitation and plot plan approval Health Department . ............ 15. City of Chico plumbing permit . ......................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: 18. Contact Land Development.about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). ...Pre�a�ape�6o� riqjest 20. Pre -inspection for required. . to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . ... .. ....... 22. Certificate of Workmans Compensation Insurance. ............. 23. Owner -Builder Verification (Given to owner , Mail to owner ..... `� 24. Recorded copy of Agricultural Acknowledgement Statement . ..................� 25. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on building use . .......................................... 28. Mobilehome utility clearance . .......................................... 29. Documentation of legal access . ..................... :.................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ............................. ......... . 32. Plan check list . ....................................................... -- 33. 34. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for p'ck p at office. Deliver with inspector. Other Parcel Creation Acreage Applicant Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent 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 Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail - Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works i � � - .1 � � � � f ' � 1 � { "{ � r 1 r � � � � �1 f � i ' ' � I � i ! � i � i �' i i' 1 � i 1 1 � , 1 1 { ; � t , 1 1 � � i � � i �� � . i 1 - ,, � ,� � � + . 1 � � / � � ' ! t t < 1 � I 1 �' + 1 � i r � � J ' t i � � � 1 I r � . � 7 � r i , 4 � 1 \, 1 � 1 t � � � 1 t ' 1 � t 1 1 e 1 i � { ' F i � t' 1 1 � ' a � t • �i i� I I ' .� �1� COUNTY OF BUTTE Department of Development Services Building Divi, iota ' Oroville: 7 County Center Dr., Oroville CA 95965 Ph: 916-538-7541 Chico: 1469 Humboldt Rd., Chico CA 95928 Ph: 916-891-2751 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. COUNTY OF BUTT BUILDING DEPT SEP061994 Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) 777777 iJ_ - - 2. I (have/have not) signed an application fora building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name �( Address City Phone Contractor's License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address X City Phone Contractor's License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed: Property Owner Social Security Number !' _ / - Date 67—,- NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. ��35- t err i`. � � / % w •.', .1•�.���,#^, • - � ' A' - •z PERMIT NO. 4.332-74B, P,E ,M °. •,. P qt MH UTIL. y ' PERMIT NO. f / PERMIT EXPIRES ( OWNER Clemie Chisum ' �• CONTR. A LOCATION (A.P, 21-26-14 ) w/s Losser Ave., a mi. N. of W.Liberty r' �1 Rd, Gridley i Temp. Power Pole 1 Called PG&E r Temp. Elec. Serv. - Called PG&E t SeCalled PG&E /Tep:Gas I� 9 �! FINALE J (Date) 41•� ,` s (Signature) t, DATE REMARKS OR CORRECTIONS L a COUNTY OF BUTTE'-- DEPARTMENT OF' PUBLIC WORKS ` BUILDING INSPECTION RECORD BUILDIN9 BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping " Forms Parapets. 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Piping Piers Roofing % d Sewer Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. StemwaII Slab Prov. for physically handicapped Heaters Appliances Carport Footings Conformance of ex. structur Gas Piping & Te S "Z - Temp. Gas Slab Final Sanitation Patio FIREPLACE Final2--- Footings Footin s Footing ELECTRICAL Masonry Walls Throat Rou h K Reinf. Steel Final Fixtures Bond Bea92 FIRE SPRINKLERS Motors F r a m i n Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch 5P Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Penn ent Door Closer Final �'�'�'-L� Final _ DATE REMARKS OR CORRECTIONS L a County of Butte DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - OYoville Phone: 533-1230; Ext. 259 CORRECTION NOTICE Building or Property Address 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. i r -- o `( 511 Vv� r 4 t-21 �Avi i� r �. "� i`y. �,(�'1' � � /s7'' ©1" `'•�F t f/J r�� . 1 0 , Inspector - Date .................................. _' , .s rza lzl *Nrl, ZY COUNTY OF BUTTE DEF?ARTMENT OF PUBLI W RKS 7 County Center Drive — Oroville California 9596 Tel ellhdne v 534-4541 APPLICATION AND PERMIT BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address • 77 A 13 LJ r� ep on'.� K3 Fireplace Contractor Total Valuation Mailing Address Permit Fee ere, Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ Building Address �� �'. PLUMBING No. @ FEE PERMIT FILING FEE $2.00 ;ZL►�► (� `o / t p Each Trap 1.50 S Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No.% & Planning Gas piping system 1 - 5 outlets 1.50 .5-0Zoning Each additional outlet .30 F e6ffW S�ji io Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Park i Plans cel eclaration Parcel M P 60' R/W Improvements P Lawn sprinkler system 2.00 Bid ans Recd Parcel A royal Plans Approval Permit Fee $ $ NEW [:]ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 :3Cr - Main service incl. 1 meter a Additional meters, each 1.00 Sub -panel (12 or less) (mor�2) �r Single Family Duplex ❑ Mobil Home ❑ Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures bal a10K R s., s rhes & fi `cdtlets b, 0An ECONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Hood, Ex. Fan or F. A. Furn. Motor 1.00 7 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump t H IDr. O Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ ' C WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 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 the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 <303 Heating S r�� V Q Cooling Ventilation Hood 2.00 Permit Fee $ $ `� } 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 TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1' �p X 1(�ir�, ,c�1i L�_ate�L' —�(�L/" Signature of Permitee or Agent Receipt No. /,Q C 22 ss -6 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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. DI CTOR IC WORKS By Date Building permit expire ate ..................!..� ...75.. c COUNTY OF BUTTE 'DEPARTMENT OF PUBLIC WORKS 7 County Center Drive Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT ... � cF..c.ac��aa-aa� v c a vl aUc t✓V UU ay VI �Ullc lV CIIICI UPUII 1110 above-mentioned property for inspection purposes. Xat Signature of Permtee or Agent Receipt No._&-®/ mJ.2t3 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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. DIRE TOM;'OF PUBLIC WORKS B§;F� Date Building permit expires Date ............................................. BUILDING Own h Is SO. FT. OCC. BUILDING VALUATION Mailing Addr s e ne Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/orPenalty Telephone No. Permit Fee $ Building Address5 S e % r PLUMBING No. @ FEE ERMIT FILING FEE $2.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. —'26 ` Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 es I W-6] Fire Dept. Fire Zone Use Permit Building sewer 5.00 EOA Parking Plans Parcel Declaration Parcel Ma P 60' R/W Improvements provements Lawn sprinkler system 2.00 -bldg. ans Recd Parcel Approval Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service incl. 1 meter Additional meters, each 1.00 Single Family Duplex [J Mobil Home ❑ Ot rs ❑ Sub -panel (12 or lees) (more than 12) Range, Cook -top or Oven 1.00 .33 Water Heater or Space Heater 1.00 Light fixtures bal(10 Receps., switches & f i x outlets20 bla CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 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 the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating• Cooling Ventilation Hood 2.00 Permit Fee $ $ 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 TOTAL PERMIT FEE $ ... � cF..c.ac��aa-aa� v c a vl aUc t✓V UU ay VI �Ullc lV CIIICI UPUII 1110 above-mentioned property for inspection purposes. Xat Signature of Permtee or Agent Receipt No._&-®/ mJ.2t3 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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. DIRE TOM;'OF PUBLIC WORKS B§;F� Date Building permit expires Date .............................................