HomeMy WebLinkAbout024-110-05924-11-59
ARTHUR SCHELL
Nb Nielson Rd, 6ridley
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024-11-0-059
SCHELL, ARTHURCONTR:
91-3433
OWNER366
NIELSON AVE.,
GRIDLEYNEW
GAS PIPING/SFWATER
`
H`EATER/SF
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COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville. California 95965 - Telephone: 916/538-7541
APPLICATION MW PERMIT
ASSESSOR PARCEL NUMBER
24410-459
ZONING'
A 5
BUILDING PERMIT
OWNER _ AUTfiOR 9GHELI.
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
/
OWNER'S MAILING ADDRESS
366 NIELSON AVE GRIDLEY
CONTRACTOR'S NAME
DD -4--U
TELEPHONE
529-3837
CONTRACTOR'S MAILING ADDRESS
P.O. BOX 1010 RED BLUFF 96080
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation is
LENDER'S MAILING ADDRESS
Filing Fee $ 15.00
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
366 NIELWN AVE GRIDLEY 95948
Permit fee $
PLUMBING PERMIT Filing Fee 15.00
Each Trap 5.00
Solar or heat pump water heater 20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping 7.00
Each qas water heater or vent 7.00
USE OF STRUCTURE
SF J;� Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets 5.00
Building sewer 15.00
Mobile Home S I G I W @ 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ®
Describe work: NEW WATER HEATER
Permit Fee $ 22.00
Contractor
ELECTRICAL PERMIT Filing Fee 15.00
Main service 200AA 00OR LESS 18.50
2OR LESS
Main service 200ATO1000AI 37.50
CONTRACTORS LICENSE LAW
I declare nder penalty of perjury (check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full, fgrce and effect.
.Y
License ,Jo.��' 7,;V,,( Classification _�-�' i - �r1
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. / DWELLING OCCUP.&\ 3.64 sq.ft.
OR ADDNS. 1 ACC. BLDGS. //
NEW CONSTR ULTI.OUTLET @ 5 00
NON•RESID BRANCH CIRC ITS
POWER APPARATUS e
SINGLE OUTLET R.
Ex. OccU OUTLETS OR FIXTURES 20 76
p5AL. 46
Ex. Occup. OUTLETS II REST D.)R'A.� I 3.00
Temporary service 15.00
Mobile Home Facilities 15.00Misc.
Wiring
g 15.00
Permit Fee $
-
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
a�-I-have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
1 to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT Filing Fee 15.00
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 County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
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, anct expenses which may in any way accrue
against said County in consequent lelof the granting of this permit.
`-
X._�o _ �t ?mate �L' ��- /�
g pp ❑ Contractor ❑ Agent �'^�
Si nature of Applicant - OWngr
An 'OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.QIRE
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $ 22.00
HAz
I DFEES I
IMP
I FLOOD
I CDF
PARCEL
I PD
HD
ISSUE
This permit is hereby Issued under the applicable rovi-
P Y � PP � P
sions of the Butte County Code and/or resolutions to do
work indicated above for which fees have been paid.
O,RR ()FPP.U, LIC WORKS
By i'e
PER IVES / Date /L' DaG�Z
Receipt No. 101414
WHITE-D.P.W., YELLOW -ASSESSOR, PINK- NsPECTOR. GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Orovlller California 95965 - Telephone: 916/538.7541
APPLICA.TIGN AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
24-110-059
Z5)N I -NG
A 5
BUILDING PERMIT
OWNER AUTHOR SCHELL
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
366 NIELSON AVE GRIDLEY
CONTRACTORS NAME
DO -4–U
TELEPHONE
529-3837
CONTRACTOR'S MAILING ADDRESS
P.O. BOX 1010 RED BLUFF 96080
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
LENDER'S MAILING ADDRESS
Filing Fee $ 15.00
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
366 NIELSON AVE GRIDLEY 95948
Permit fee $
PLUMBING PERMIT Filing Fee 15.00
Each Trap 5.00
Solar or heat pump water heater 20.00
LOT NO.
SUBDIVISION NAMEPARCEL
MAP
Water piping 7.00
Each qas water heater or vent 7.00 7.00
USE OF STRUCTURE
SFP Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets 5.00
Building sewer 15.00
Mobile Home S I G IW @ 15.00
TYPE OF WORK
New [_1 Addition❑ Remodel❑ Utilities❑ Installation❑ Other]
Describe work:__ NEW WATER HEATER _
Permit Fee $
Contractor
ELECTRICAL PERMIT Filing Fee 15.00
Main service R LESS
200AORLESS 18.50
Main service 200ATO1000A) 37.50
CONTRACTORS LICENSE LAW
I declare der penalty of perjury (Check One):
I am licensed under provisions of Chapt. 9, Div. 3 of the Busines$POWER
and Professi ns Code and my license is in f rce and effect.
License No Classification '
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST.OR ADDNS. ( ACC. BLDGS. DWELLING OCCUP.6I
� 3.6Q sq.ft.
NEW CONST" ULTI.OUTLET
NON.RESID BRANCH CIRC ITS @ 5.00
APPARATUS
(SINGLE OUTLET CIR.f1
Ex. Occup(OUTLETS OR FIXTURES 20 76
Ex. Occup. OUTLETS FIXED P(RESID.)REA.1 3.00
Temporary service 15.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $
—
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
The permit is for $100.00 (valuation) or less.
2if' Tiave placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
11 to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT Filing Fee 15.00
Heating
Cooling
9
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 County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
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
ia15 judgments, costs, an xpenses which may in any way accrue
against said C my in consequenc of he granting of this permit.
ate ! %Uf—
Si atur Applicant — Owner
pp ❑ Contractor ❑ Agent �'
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee S
Energy Inspection Fee $
OCC
CONST TYPE
TOTAL FEE $
HAz
DFEES
IMP
FLOOD
CDF
PARCEL PD HD
ISSUE
This permit is hereby issued under the applicable provi-
sions of the Butte County Code and/or resolutions to do
work indicated abAve for which fees have been paid.
OR F LIC WORKS
By Date /C,)
PE IRE Date
Receipt No. 101414
WNITE•D.P.W., YELLOW -ASSES NSL
3C – Z -9 /--6l16lZq — //0
COUNTY OF BUTTE - DEPARTM NT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroviller California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER ✓
2Z/- MQ` (9 5-9
2PNING�
BUILDING PERMIT
OWNER
r-�hvf e`
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS /
,3(,(- Nr' 1 6 A V P -Id
_TR
_FO
NAC TO SNAME
0— - v
TELEPHONE
5'21-383
CONTRACTOR'S MAILING ADDRESS
G Efs /D /6 e 6 r✓F�' 960�o
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
LENDER'S MAILING ADDRESS
Filing Fee
$ 15.00
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE No.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
3 AJI Me ErJle
Permit fee
$
PLUMBING PERMIT
Filing Fee 15.00
e
Each Trap
1 5.00
Solar or heat pump water heater
20.00
LOT NO. SUBDIVISION NAMEPARCEL MAP
Water piping
7.00
Each qas water heater or vent
7.00 ,
USE OF STRUCTURE
SFM Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home S I G I W@
15.00
TYPE OF WORK
New ❑ Addition ElRemodel ❑ Utilities ❑ Installation❑ Other
Describe work: MQJ (A/dre-� t,/riz
Permit Fee
$ 22
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 200A OR LESS
18.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 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 compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract -
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
Main service 200A TO IOOOAI
37.50
NEW CONST.( DWELLING OCCUPM
OR ADDNS. ACC. BLDGS. //
3.60 sq.tt.
NEw CONSTR ULT' -OUTLET
NO N.RESID BRANCH CIRC 'ITS
/�
` 5.00
POWER APPARATUS &)
(SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES
20@76d
A
EX. Occup. OUTLETS FIXED PIRESID IREA.1
1 3.00
Temporary service
15.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00
Permit Fee
$
—
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 15.00
Heating
Cooling
g
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 County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
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 of the granting of this permit.
X Date
Signature of Applicant — Owner❑ Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
Ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ ICONST
TYPE
TOTAL FEE $ 2o2' d
HAz
1 0FEES I
IMP
f FLODD
I CDF
PARCEL
I PD HD
ISSUE
This permit is hereby issued under the
sions of the Butte County Code and/or
work indicated above for which fees
DIRECTOR OF PUBLIC
By
EXPIRES Date
applicable provi-
resolutions to do
have been paid.
WORKS
DatePERMIT
Receipt No. /
WHITE-O.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROO-APPLICANT
1tiIb ..
ILr*
1
OFFICE COPY
Address
GAS`
Meter By Dat
ELECTRIC \
Meter By
to
T1
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y
i
OFFICE COPY
Address
GAS`
Meter By Dat
ELECTRIC \
Meter By
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T1
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y
i ti
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Orovllle, California 95965 - Telephone: 916,'538-7541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
A
Z ONIN
BUILDING PERMIT
ARTHUR
R�� SCHELL
T' L PHONE
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
366 Nielson Ave, Gridley 95948
CONTRACTOR'S NAME
V-
TELEPHONE
CONT OR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee
$ 15.00
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS t
365 Nielson Ave, Gridley
Permit fee
$
PLUMBING PERMIT
Filing Fee 15.00
Each Trap
1 5.00
Solar or heat pump water heater
1 20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
7.00
Each qas water heater or vent
7.00
USE OF STRUCTURE
SF ❑nDuplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00 5.00
Building sewer15.00
Mobile Home S G W
@ 15.00
TYPE OF WORK
New ❑ Addition O Remodel ❑ Utilities ❑ InstallationC OtherW
Describe work: new gas piping
minimum
KOO
Permit Fee
$ 25.00
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00 ,
Main service 20LESS
0A OR LESS
18.50
Main service 200A TO 1000A1
37.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check One):
❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
Icense No. Classification60
I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure Is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUP.E
OR ADONS. ( ACC. BLDGS.
3.60 sq.ft.
NEW CONSTR ULTI.OUTLET
NON.RESIO. BRANCH CIRC ITS
@ 5.00
(POWER APPARATUS a)
SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES
20 760
A
FIXED APPLNS. OR
EX. Occup. OUTLETS (RESI D.1 EA.)
I 3.00
Temporary service
15.00
Mobile Home Facilities
15.00
Misc. Wiring
g
15.00
Permit Fee
$
—
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
I I have placed on file with the County of Butte Building Department
u Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subjectpermit
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 15.00
Heating
Cooling
g
Hood
6.50
Ventilation
Fee
$
Contractor
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 authorize representatives of the Countyot
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 of the granting of this permit.
,r -x—).
" Date'
�' x"✓E]❑
Signature of Applicant — OContractor Agent
An OSHA permit is required forr a excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee S
Energy Inspection Fee $
OCC
CON ST TYPE
TOTAL FEE $ 25.00
HAz
I DFEES I
IMP
I FLOOD
CDF
I PARCEL
PD
HD
ISSUE
This per it is ereby ssued under the applicable provi-
Bions t e utte C unJode and/or resolutions to do
wor in I ted ab fob which fees have been paid.
PUBLIC WORKS
By Date9/25/91
PER EXPIRES Date 9 5 92
n
Receipt No. a`d 14n
WHITE-O.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT
COUNTY OF BUTTE -DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Orovllle, California 95965 - Telephone: 916.'538-7541
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
_
ZONING
BUILDING PERMIT
DW ARTHUR SCHELL
L PHONE
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
366 Nielson Ave, Gridley 95948
CONTRACTOR'S NAME
TELEPHONE
CO OR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee
$ 15,00
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
366 Nielson Ave, Gridley
Permit fee
$
PLUMBING PERMIT
Filing Fee 15.00
Each Trap
1 5.00
Solar or heat pump water heater
1 20.00
LOT NO.SUBDIVISION
NAME
PARCEL MAP
Water piping
7.00
Each qas water heater or vent
1 7.00
USE OF STRUCTURE
SF ❑XXDuplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
1 5.00 5.00
Building sewer
15.00
Mobile Home I S I G JW 1
@ 15.00
TYPE OF WORK
Newl 1 Addition❑ Remodel❑ Utilities❑ Installation❑ Other By
Describe work: new gas piping _
mi
5,00
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 200A OR LESS
18.50
Main service 20CATO 1000AI
37.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check One):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
(cense .Jo. Classification
f I, as the owner, or my employees with wages as their Sole compen-
sation, will do the work,and the structure Is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. ( DWELLING OCCUP.B�
OR ADONS, l ACC. BLDGS.
3.6a sq.ft.
NEW CONSTR ULT' -OUTLET
NON -RES D• BRANCH CIRC ITS
` 5.00
POWER APPARATUS &
(SINGLE OUTLET CIR.
Ex. Occup( OR FIXTURES
20 761
A
FIXED APPLES. OR
EX. DCCUp. OUTLETS (RESI D.) EA,)
I 3.00
Temporary service
15.00
Mobile Home Facilities
15.00
Misc. Wiring
g
15.00
Permit Fee
$
—
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I Shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shal I be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 15.00
Heating
Cooling
g
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 County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
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 of the granting of this permit.
X Date
Signature of Applicant — Own e Contractor ❑ Agent ❑
An OSHA permit i5 required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee S
Energy Inspection Fee $
OCC
CONST TYPE
TOTAL FEE 25.00
HAz
1 DFEES I
IMP
I FLOOD
I CDF
PARCEL
PD
HD
ISSUE
This per it is ereby ssued under the
sions t e utte C ode and/or
Wor in c ted ab fo which fees
PUBLIC
By
PER EXPIRES Date
applicable provi
resolutions to do
have been paid.
WORKS
Date0125/91
Receipt No.
WHITE-D.P.W.. YELLOW -ASSESS - NSPECTOR. GOLDENROD -APPLICANT
COUNTY OF BUTTE. -Department of Public Works
7 County Center Drive, Oroville, CA 95965 Phone.: 916-538-7541
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An 'owner -builder" building permit has been applied -for in your name and bearing
your signature.
N
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.
I personally plan to provide the major labor and materials for construction of
the proposed property improvement (yes or no)
2. I (have/have not)�r% signed an application for a building permit
for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed
construction:
Name
Address City
Phone Contractors 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 City
Phone Contractors 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
Sign �� &-44U.
Property Qw�
ac' ecurity Number
Date 9-Z 5-- 9I
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 per-
mitted to issue the permit.
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville. California 95965 - Telephone: 916.'538-7541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER -
-0,5
ZONING
-5
BUILDING PERMIT
OWNER
u SCh'
I TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS 114-1
IvIlel.50111LAM 59111F
1
CONTRACTOR'S NAME
ti (11Vp
ELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee
$ 15,00
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE ND.
Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee
$
Penalty
$
BUILDING ADDRESS j G / ,p
N `� • l ^ C
Permit fee
$
PLUMBING PERMIT
Filing Fee 15.00
.57C/of
Each Trap
1 5.001
Solar or heat pump water heater
1 20.00
LOT NO.SUBDIVISION
NAME
PARCEL MAP
Water piping
7.00
Each qas water heater or vent
7.00
USE OF STRUCTURE
SFJ�/Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
1 5.00 Y,UV
Building sewer
1 15.00
Mobile Home S i G 1W
@ 15.00
TYPE OF WORK
New;—. Addition ` Remodel L_' Utilities ❑ Installation[ Other
Describe work: 14-V 61+5
rAJ
Permit Fee
$ �5
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service soov OR LESS
200A OR LESS
Main service 20CA TO 1000A1
—�-1 8.50
I 37.501
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
_ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License .Jo. Classification
I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
[I I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING oCCUP.&\
OR ACDNS, ACC. BLDGS. 77
3.5Csq.ft.
Ew CONSTK 'AULT1.OUTL"'
N ON.P ESI D�. eR aNCH CIRC 'ITs
1@ 5.00
POWER APPARATUS a
SINGLE OUTLET CIR. )
EX. OCCUp OUTLETS OR FIXTURES
RAO,a 76a
Ex. Occup. OUTLD TS (R,ESIO.IPEA.)
1 3.00
Temporary service
1 15.00
Mobile Home Facilities
15.00
Misc. Wiring
g
15.00
Permit Fee
$
—
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
;` 1 The permit is for 5100.00 (valuation) or less.
<1 I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
71 1 shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 15.00
Heating
Cooling
Hood
6.50
Ventilation
Fee ee _
$it
Contractor
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 authorize representatives of the Countyot
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 of the granting of this permit.
X Date
Signature of Applicant — OwnerContractor G Agent 17
An OSHA permit is required For excavations over 5'0" deep and demolition or construct -
ion of structures over 3 stories In height.
Mobile Home Installation Fee $
Energy Inspection Fee $
OCC CONST TYPE TOTAL FEE $ aS�
IriAZ 0FEES IMP FLOOD I COF
i
I PARCEL PO
11. ISSUE
This permit is hereby issued under the
sions of the Butte County Code and/or
work indicated above for which fees
DIRECTOR OF PUBLIC
By
PERMIT EXPIRES Date
applicable provi-
resolutions to do
have been paid.
WORKS
Date
Receipt No. e / ��
.`/NITC-O.P.W., •EL LO VI -♦S SC930 R, PINK -INSPECTOR, GOLD ENROO-APPLI CANr
� �9
9
o i ► ' ��
b� �� � �
)�
19� �
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
ZONING
BUILDING PERMIT
OWNER
/ i,,/ /
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
,�
OWNER'S MAILING ADDRESS
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS r
Fireplace
CONSTRUCTION LENDER �•
UNKNOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ !
ARCHITECT OR ENGINEER
LICENSE No.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$ ,
BUILDING ADDRESS
PLUMBING PERMITng
Fili Fee 10.00
Each Trap
2.00
Solar Water Heater
20.00
WaterP�P 9 I in
5.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
5.00
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer
5.00
Mobile Home I S I GJWJ
10.00e
TYPE OF WORK
New ❑ Addition Remodel❑ Utilities ❑ Installation❑ Other ❑
Describe work:
f
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 1Doo AMP ORV OR LESS10.00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. DWELLING OCCUP.&
OR ADDNS. ( ACC. BLOGS.
2t/20sq ft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the BUS Ines$
and Professions Code and my license is in full force and effect.
License No. 1 _ Classification
❑ 1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONSTR.ULTI.OUTLET 2,50 ea
NO N.RES ID BRANCH CIRCUITS)
NEw CONSTR. ( POWER APPARATUS &')
NON -R ESID. SINGLE OUTLET CIR. /
Ex. OCCUp(OUTLETS OR FIXTURES BA 030
FIXED APPLN5. OR
EX. OCCUp. OUTLETS (RESID.) EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $
Contractor
MECHANICAL PERMIT
FiIingFee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Heating
Cooling
Hood
3.00
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 County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
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 of the granting of this permit.
Signature of Applicant — Owner❑ Contractor [--Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.J
Mobile Home Installation Fee
$
TOTAL PERMIT FEE $ 1
^PD
OCCOP. GROUP
I TYPE OF CONST.
PARCEL
I No
ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF PUBLIC
By � ♦r '
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date . J '.
r� j
r�
Receipt No.
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
f
M E Y E R S 860 ONSTOTT ROAD
YUBA CITY, CALIFORNIA 95991
ROOFING SERVICE TELEPHONES:
YUBA CITY: (916) 673.1266
-/� COLUSA TOLL FREE
1917
GRASS VALLEY ASK OPERATOR
NEVADA CITY FOR ENTERPRISE
OROVILLE No. 14060
PARADISE
i SACRAMENTO
Date. May 26, 1987 ,
We request an inspection of the completed Arthur Schell
project which was completed on Maj 20 19 87 Permit No. 1344-87B
located at 366 Neilson Ave id X+ CA -
at your convenience.
Sincerely,
46.
Y -
t-
V f
Emtatn obim to chww, , okbetat notice. Quoudam Emimd to films dere • Na B" lar faibme to puEatm owd 'by or&*&. tire, or o Wdm" bay oed our cmaol.
s
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION ANQ PERMIT
PERMIT O.
ASSE S PA EL NU BER
ZONING
BUILDING PERMIT
OW
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
1
O �R' I N DD S Atd/
CO AC OR' A E HONE
r/
ON CTO MAILE
CI D R
Fireplace
CONS RUCT DER IJUNKNOWN
Total Valuation Is
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDING ADDRESS
PLUMBING PERMIT
FiIingFee 10.00
•
Each Trap
2.00
Solar Water Heater
20.00
Water piping
5.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
5.00
� / USE OF STRUCTURE
SF I`_T Duplex ❑ Mobi lehome ❑ Other
SPECIFY
Building sewer
5.00
Mobile Home S G W
10.00 e
TYPE OF WORK
New❑ Addition Remodel❑ Utilities[] Installation❑ Other❑
Describe work:
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 10ov OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. DWELLING OCCUP.&
OR ADDNS. ( ACC. BLDGS.
2/20Sq ft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
Dam licensed under provisions of Chapt. 9, Div. 3 of the Business
and Profession Code and my license is in full rce and effect.
License No. Classification
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NE_NON.RESID `L BRANCH CIRLF
CUITS 2.50 ea
NEw CONSTR POWER APPARATUS
NON.RESID. ( &SINGLE OUTLET CIR.
20®50a
Occup(o
Ex. uTLETs OR FIXTURES 6AL®ao
FIXED APPLNS. OR
EX. Occup. OUTLETS IRESID.) EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
Eq.�F have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ 1 shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
FiIingFee 10.00
Heating
Cooling
Hood
3.00
Ventilation
permit Fee
$
Contractor
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 authorize representatives of the Countyot
Butte to enter upon the above-mentioned'property for inspection purposes.
1 als agree to save, indemnify and keep harmless the County of Butte against
all bilities, judgments, osts, and expenses which may in any way accrue
aga' t said County in c quence of the granting of this per it.
Date 4?�
ig ature of Applicant — ner ❑ Contractor �/gent ❑
OSHA permit is requi a or excavations over 5'0" deep and demolition or construct-
on of structures over 3 st I.In'�height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE $
OCCOP. GROUP
TYPE OF CONST.
PARCEL
PD
NO
ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
IREC PUB
BY _
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
ORKS
Date
Receipt NO. 9c30(2 F_ 1
WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT
• r
{`.. ,y .�. Y .phi .v..'. -x. � :4._ ,,�. L `„ ,,�\�. .r .� �:� •.F �
• 1 `� fa\" ,�'� .;__��\.. ••tel..; i_>..`. �.i. • �...✓` `Y,t'•,. .\ t '�•4•ti '.-•, ,'` .r `! _ •i> `` ;
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California,95965 - Telephone 916/534-4541
APPLICATION- AND PERMIT
PERMIT NO.
/Y'!�-
ASSESSOR PARCEL NUMBERy \
1j`7
ZONING
A
BUILDING PERMIT
OWAR
jS� 14ri-
iP�uA
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
CONTRACTOR'S NAME
QCT, G
TELEPH ONE
SfiC� /Z4-
CONTRACTOR'S MAILING ADDRESS �)r,�
/U i C , TIE- v ��
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGIN ER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDING A.Q�DRE(// SS ��
r7 �,�
•/
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Repair drainage or vent piping
5.00
4 -PARCEL
Water piping
LOT NO.
SUBDIVISION NAME
MAP
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
-, /
SF L`� Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer
Lawn sprinkler system
em
5.00
TYPE OF WORK
New❑ Addition❑ Remodel[] Utilities,[] Installation[] Other
Describe work: C-
�dii/ rte.
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service V OR LE
100 AMP ORSLESS
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. ( DWELLING OCCUP.61\
OR ADDNS. ACC. BLDGS.
26 sq ft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code
�, /and my license is in full force and effect.
r. Classification � �/a
License No. �4ft0 T
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONSTR I_ u LET 2,50 ea
NON.RESID BRANCH CIRCUITS)
NEW CON'STR // POWER APPARATUS h
NON.RESID, %SIN'GLE OUTLET CIR.
5o'ae
Ex. Occup OUTLETS OR FIXTURES BAL@1
Ex. Occup.( OUTLETS P(RESID )LNS REA.) 2.00 U
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 7.50 U
Permit Fee $ 1. U
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
PM to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Heating
Cooling -%
4'60
Hood
3.00
Ventilation
permit Fee
S OO
Contractor , ;k
oA/p}.IV
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 authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
Ialso agree to save, indemnify and keep harmless the County of Butte against
atI liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
X . r�l1_ G'A Date �-�
Signature of Applicant - Owner ElContractor ElAgent Elwork
permit is required for excavations over 5'0" deep and demolition or construct-
An OSHA/
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE $ ,-';C
OCCUP. GROUP
I TYPE OF CONST,
I
PARCEL
PD
I HD
I ISSUE
This.permit is hereby issued under
sions of the Butte County Code and/or
i dicated. above for which
?DIRECTOR OF PUBLIC
By �✓
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
/ r
Date `- D
/
Receipt No. &9�8
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
JCOUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 'P7ERMIT NO.
7 County Center Drive - Orovill �, Calif(rrnia 95965 - Telephone 916/534-4 1 /',c �/—"
APPLICATION AND PERMIT A / Cy D
ASSESSOR PAR ELMB
--/�.�j •+ -BUILDING
ZONING
PERMIT
O WR
TELEPHONE
SQ. FT.
OCC. BUILDING VALUATION
MAILING ADDRESS
C NTRACTO R'S NAME 6
•(ELE-I..I/NF `
Z'/T/
C T O R•SILID�E2 �(/� �JCjjj[ggjj'7!
/�C/
Fireplace
CONSTRUCTION LEND
UNKNOWN
Total Valuation $
Filing Fee $ 10.00
LENDER'S MAILINVA13DRESS
Permit Fee $
ARCHITECT OR ENG ER
LICENSE NO.
Plan Checking Fee $
Penalty $
ARCHITECT OR EN EER'S MAILING ADDRESS
Permit fee $
BUILDING AD RESPl� o , /
C® /V
PLUMBING PERMIT Filing Fee 10.00
Each Trap 2.00
Repair drainage or vent piping 5.00
�D
Water piping
LOT NO.
SUBDIVISION NAMEPARCEL
MAP
Each qas water heater or vent 5.00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
SF Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer
Lawn sprinkler system 5.00
TYPE OF WORK
New Addition Remodel[:] Utilities Installation❑ Other
Describe work: ��T4 /,0!; 1—h&L—
Permit Fee $
Contractor
ELECTRICAL PERMIT Filing Fee 10.00
Main service 800v OR LESS co
100 AMP OR LESS r
Main Service EA. ADD'L 100 AMP 2.50
NEW CONST.
OR ADDNS. �ACCLBLDGS.LING CCUP.M1 22 sq It
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
Professions Code and my license is in full force and effect.
License No. �g✓.��j�l' �Classification __ G° t
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CO ID R BRANCH CIRCUITS) Ts 2.50 ea
NEw CONSTR. f POWER APPARATUS &�
NON RES,D. (SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES_ 2t
BAL
and
00
EOccup
Ex. OCCU FIXED PLNS (RESID )REA. 2.00
.(OUTLETS (OUTLETS p0
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 7.50 �v
Permit Fee $
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
ZZ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT FiIingFee 10.00
Heating
Cooling 7—
Hood 3.00
Ventilation
Permit Fee S
Contractor g5i5yrzg
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 authorize representatives of the Countyot
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 Ad Coun in consequence of the granting of this permit.
/
%� Date b /-197z-
Signature of Applicant - Owner
g pp ❑ Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE $ ,,50
OCCUP. GROUP
TYPE OF CONST.
PARCEL
PO
HD
ssuE
This rmit is hereby issued under the applicable provi-
sio of the Butte County Code and/or resolutions to do
wo i icated. above for which fees have been aid.
P
I CTOR OF PUBLIC WORKS
By Date /y
PERMIT EXPIRES Date
Receipt No. &D �O
WHITE-D.P.W., YELLOW -ASSESSOR, PINK-INSPE CTOR, GOLDENROD -APPLICANT