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HomeMy WebLinkAbout022-240-131`_ i► �,, • S.K. BROWN, Estate KOFFORD Ave., e/s nust to ditch, Gridley r� contr: Watson Hardware, Gridley Permit# 859-75E(service change, etc. & I ami sc .) az /V", 0crrxPiti� 22-24-33 i Paul Jackson .,�1via' A 41 V07 i T/S Kofford Ave., 1000 S. of Justeson Ave., Gridley Permit #1294-76B,P,E,M(new single family), 01 022-240-160 06-1837 JACKSON, FAMILY TRUST 1716 KOFFORD RD, GRIDLEY r Cont: BICB ROOFING RE ROOF I ' S , J - ' ` BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP061837 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS 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 Issued Date: 07/31/2006 APN: 022-240-160-000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: �(^ Site Address: 1716 KOFFORD RD GRI Date: Z3AContractor: 4 Map Index: Description: REROOF W/COMP (39) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: JACKSON FAMILY TRUST to its issuance, also requires the applicant for such permit to file a 1714 KOFFORD RD signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section GRIDLEY, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95948 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).): ❑ 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 Contractors' State License Law does not apply to an Applicant: BILL'S ROOFING owner of property who builds or improves thereon, and who does GRAHAM, BILL such work himself or herself or through his or her own employees, 1770 KOFFORD ROAD provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one GRIDLEY, CA 95948 year of completion, the owner -builder will have the burden of 530-846-3981 proving 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 Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: BILL'S ROOFING and who contracts for such projects with,a contractor(s) licensed GRAHAM, BILL pursuant to the Contractors' State License Law.). 1770 KOFFORD ROAD ❑ 1 am Exempt under Article 3 of the Business and Professions Code GRIDLEY, CA 95948 530-846-3981 Date: Owner: License #: 801512 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 Architect: is issued. ❑ I have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: otal Square Ft: 0 S. F. Policy #: Valuation: $0.00 kJ -1 certify that in the performance of the work for which this permit is Census Code: issued, I shall not employ any person in any manner so as to become subject to the 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 thoseprovisions. Date: Z Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. `hoer CONSTRUCTION LENDING AGENCY This permiti toy issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the of the work for which this is issued (Sec 3097 Civ.) Resoluti n work i_udi ated above for which fees have been paid. Q� performance permit BY:Date-.: Name: /). �) PERMIT EXPIR N: / G / Address: Date ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter pon the above mentioned property for inspection purposes. 1 i Print Name: / a.�L-d. Signature: Date: T �— ( �) •� ❑ Owner 0-117-5-n1ractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICA TION Website: www.buttecounty.net/dds PERMIT NO. \w.' BIN # bm CA "PLEASE PRINT CLEARLY* * �'�� , d LA 0 - 1 �.# Q OWNER INFORMATION Last Name C 4 5 D �l irst Name r t j Address City , 1 State A Zip Phone /2 Fax E-mail CONTRACTOR Name Address .7 �� Ord Q City �✓, . / S State Zip.95 Phone q�l rr ! Fax E-mail Lic. # ;561SI2 Clas!C;g PPLICANT SIGNATURE X For office use only: ARCHITECT/ENGINEER Name Flood Zone Address v o� City I No State Zip Phone p J Fax E-mail Planner State License Number PPLICANT SIGNATURE X For office use only: APPLICANT INFORMATION Name Flood Zone Address v o� City ' f I No State0 Zip _Z 6 Phone p J Fax E-mail Planner PPLICANT SIGNATURE X For office use only: Zoning Flood Zone Property Address SRA I Yes I No Occ. I Type Const. Subdivision Name Map Book Page Lot #> Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc i Page 1 of 2 Descri Po r Scope f Work: r' o� 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 #: Sheriff Lf -cilo45) SMIP Date: r Other , I Total REV 8-12-05 PROJECT LOCATION Property Address �/w City Cross Street WORKER'S COMPENSATION Policy Number Carrier 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 Address Page 1 of 2 Descri Po r Scope f Work: r' o� 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 #: Sheriff Lf -cilo45) SMIP Date: r Other , I Total REV 8-12-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. \ ❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line. info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Building Permit Application Without Required Clearances Form ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 I COUNTY OF BUTTE- — DEPARTMENT OF PUBLIC WORKS 7 County Centet Drive '— Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT autnunce representatives or the county or butte to enter upon the above-mentioned property for inspection purposes. X Signature of Permitee or Agent Date 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. DIRECTOR OF PUBLIC WORKS By Receipt No. — White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Building permit expires Date Date BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee&/or Penalty Telephone No. Permit Fee $ $ Building Address PLUMBING No. @ FEE PERMIT 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. Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fees W. C. Sanitation Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans I Parcel Parcel Ma Declaration P 60' R/W Improvements P Lawn sprinkler system 2.00 Bldg. Plans Recd I Parcel Approval Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Single Family ❑, Duplex ❑ Mobil Home ❑ Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures 51 10 Receps., switches & fix outlets 2T,'-23 10 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 $ autnunce representatives or the county or butte to enter upon the above-mentioned property for inspection purposes. X Signature of Permitee or Agent Date 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. DIRECTOR OF PUBLIC WORKS By Receipt No. — White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Building permit expires Date Date -Fjeose COUNTY OF BUTTE — DEP5MNT OF PUBLIC WORKS 7 County Center Drive — Oroville' California 95965 cf?rtif A&,1A 7 Telephone: 534-4541 APPLICATION AND PERMIT /f/L5y- M. authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. t X Date Signat of Permitee or Agent Receipt No. / -V�O 6 2.� 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. �9;1=REOF PUBLIC WORKS By Date -'Buifdi permit expires Date/ ............ 7w BUILDING �l 1111 Owner S K, 13 row �fi C/ 1Y%�l�/'Ecj�Cccc�t.u�i`�h. ' -SQ. FT. OCC. BUILDING VALUATION Mai I i n g Address J ' f r+s yy f Ca f f Calif Telephone No. Fireplace Contractor -0. Total Valuation Mailing Address60 -2-ef- Permit Fee Plan Checking Fee &/or Penalty Dele�p �d b permit Fee $ $ Building Address PLUMBING No.1 @ FEE PERMIT FILING FEE $2.00 s d , nL.3 / 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 -.� 3 3 Zoning a Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F ke sl W. . SSiiatis ire Dep"! Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration parcel Ma P 60' R/W Improvements P Lawn sprinkler system 2.00 Bldg. Plans Rec'd Parcel Approval Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ® ELECTRICAL No.1 @ I FEE PERMIT FILING FEE $3.00 300 Main service incl. 1 meter ,312�7 %O Additional meters, each 1.00 Sub -panel (12 or less) (marathon 12) Single Family �, Duplex ❑ Mobil Home ❑ Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 j Light fixtures 2u (a Receps., switches & fix outlets 2 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: _ iG►, %�Gv:�G%erllw d. Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. lisp. or D.W. 1.00 Air conditioner or heat pump Water pump I Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No._ J` � �% 7 Classification_ C f D Misc. wiring .6V J ❑ 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.1 @ FEEPERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 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 $ S authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. t X Date Signat of Permitee or Agent Receipt No. / -V�O 6 2.� 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. �9;1=REOF PUBLIC WORKS By Date -'Buifdi permit expires Date/ ............ 7w F PERMIT NO. 1294-7&B,,P-,Fr,M t t PERMIT EXPIRES iNER Paul Jackson CONTR. owner LOCATION (A.P. 22-24-33 E/fi Kofford Ave.,1000' S. of Justeson Ave., Gridle, 31 Temp. Power Po I e Called PG&E 4 Temp. Elec. Serv. AW -41 Called PG& -.e Temp. Gas ,4Serv. Called PG&E • B FINALED (Date) (Signature) _,-THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH THE CURRENT REGULA- TIONS, CALIFORNIA ADMINISTRATIVE CODE, TITLE 26, -STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT: v6,4 -'j` StLdt Number Tract No. EXTERIOR ALLS'� ( <_ Manufacturer d Thickness/Type —_� L R Value J CEILINGS ` `' r ' Batts: Manufacturer -v� Thickness R Value Blown: �Maiufacturer Thickness No. Bags Wt./Bag Sq. Ft. Covered R Value FLOORS Manufacturer Thickness/Type R Value SLAB ON GRADE Manufacturer Thickness/Type R Value Width of Insulation inches FOUNDATION WALLS Manufacturer Thickness/Type R Value GENERAL CONTRACTOR LICENSE No. BY. TITLE — DATE INSULATION CONTRACTOR' HAWKINS INSULATION CO. LICENSE No. 215-925 BY TITLE Gv o DATE , Z �z/%7 Cf %�O`00� ' �� Je\,\G GO .. 0'<9 Q�Q�• ,�p�'� 1 Q� 1oz /C12, f t• COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD DATE REMARKS OR CORRECTIONS Vie% 7,����7-�, c, .C.–.-e.(�IOTE: An entry must be made on this form each time you visit the job site.) BUILDING BUI DING (Co!%Q PLUMBING Setback 2�iZ / Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Fini h 2nd Floor Footings Windows 3rd Floor Stemwall ro Siding 36 To out Slab Roof Sheath in Water Piping Piers Roofing Sewer Garage Fdn. Vent Fixtures Footings 4Garage Vents -t, % Water Htr. I Stemwall Slab ' Prov. for physically handicapped ��` Heaters Appliances Carport Footings Conformance of ex. structure Gas Pi ing & Test Temp. Gas Slab Final Sanitation ? 2 Patio FI PLAC Final Footings Footing I ELECTR A Masonry Walls Throat Rou h �D Reinf. Steel Final Fixturesoz Bond Beam FIRE SPRINKLERS Motors Framing Test _ Water Htr. �— Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Pro Scratch Heating Service Brown Cooling Temp. Pole Finish =m Ducts Underground Interior Lath Ventilation ' - Permanent Door Closer Ja J Final %% Final DATE REMARKS OR CORRECTIONS Vie% 7,����7-�, c, .C.–.-e.(�IOTE: An entry must be made on this form each time you visit the job site.) 751 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive' - Uruv1IIe, California 95965 Tp,lephonei 534-4541 76 APPLICATION AND PERMIT ��.-----�' .-,1. ---1...-......, .,. w v..a..ay v. uuaw w o 1a 1 UP -1 u1c above-UMntioned property for inspection purposes. --� X of Pergftee or Agent FXeceipt No. i`'1-0 i L 1 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. DIRECTOR OF PALIC WORKS Rv Date/6 —//— 7 1O ilding permit expires Date BUILDING OwnerV V�, A O� SQ. FT. OCC. BU4J_Dl G VALUATION Mailing Address 7,0 2 lele 6p_i ou- CA • C( hone No. 1-7f? -712- Fireplace Contractor Q\N IN Ems. Total Valuation Mailing Address Permit Fee I ( I ,gip Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ i21 ' O� a Building Address 61,5 KR FFOQU AYE. PLUMBING No. @ FEE PERMIT FILING FEE J$3.00 pp 00d (i F JUS-rLsO+ vF Each Trap 1.50 3 0 GP_ Repair drainage or vent piping 1.50 Water piping ✓ 1.50 ISO Each gas water heater or vent 2 1.50 3, 0O A. P. No. �2 _ Z4 ^ -33 Zoning &Planning Gas piping system 1 - 5 outlets 3 1.50 f 570 Each additional outlet .30 F,<s` I `W -C- I Sa I ire Dept. LFireZone I Use Permit Building sewer 1 5.00 D0 EQA I PPlans Declaratio r I Ma 60' R/W Improveme is Lawn sprinkler system 2.00 Bldg. Plan ec'd Parcel Approval Plans A royal Permit Fee $ Z •50 $ 27 C NEW Ja ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 3 Main service 600V OR LESS 5.00' 100 AMP OR LESS Main service EA. ADD'L 100 AMP 2.50 Single Family ® Duplex ❑ Mobil Home ❑ Others ❑ Main service OVER 600V too AMP OR LESS 25.00 Main service EA. ADD'Lpt.ogo�AMP 1.00 NEW CONST. DWELINGOR ADONS. ( ACCLBLDGS.L a Z&) r 20sgft _ NEW CONSTR. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS) 2.50ea NEW CONSTPOWER APPARATUS 8C)i NON.R. RESID. (SINGLE OUTLET CIR. 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: Ex. OccuP(OUTLETS OR FIXTURES) @�C 100 Ex. Occu FIXED APP LNS. OR p•(OUT LETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ 4%.45' $ LI -17 WS 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. L �I certify that in the performance of the work for which this ermit 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 2 (rj�p BTOd Cooling D Ventilation Hood 1 2.00 12.00 Permit Fee $ 1-7-50 $ ` 55 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 .-,1. ---1...-......, .,. w v..a..ay v. uuaw w o 1a 1 UP -1 u1c above-UMntioned property for inspection purposes. --� X of Pergftee or Agent FXeceipt No. i`'1-0 i L 1 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. DIRECTOR OF PALIC WORKS Rv Date/6 —//— 7 1O ilding permit expires Date