Loading...
HomeMy WebLinkAbout024-140-026B07-0176 024-140-026 MISCELLANEOUS HVAC Change Out REPLACE HVAC AND CUT IN 74 E EVANS REIMER RD LEWIS, ROCKY L & ELIZABETH 24-14-26 ROBEATakHOLLANDSWORTH 74 East E� ,s R imer Rd, Gridley Cgntr- G & Mz''&Uctric, Biggs P rmit#3144-8101'3' .,ser ch)S.E contr ::Da13=] ahmy"Const., Biggs oiit �k3243-'8lB,P(remodel/SF) 24-14-26 2274-91P,E LEWIS, Rocky 74 East Evans Re' er, Gridley (mh util) ELEC k GAS COMPACTION TEST REQ SUPPORT STRUCT-REQ B08-0086 024-140-026 MISCELLANEOUS Electric Panel REPLACE ELECTRICAL POLE AND P. 74 EVANS REIMER RD LEWIS ROCKY L & ELIZ, B08-0512 024-140-026 MISCELLANEOUS Re -Roof REROOF 74 EVANS REIMER RD LEWIS ROCKY L & ELIZ, 0,94 - �14o-.� 04-2& _717 -77 ai BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 74 E EVANS REIMER RD Owner: Permit No: B07-0176 APN: 024-140-026 LEWIS, ROCKY L & ELIZABET Permit type: MISCELLANEOUS 74 E EVANS REIMER RD Issued Date: 01/30/2007 By KEJ Subtype: HVAC Change Out GRIDLEY, CA 95948 Expiration Date: 01/30/2008 Description: REPLACE HVAC AND CUT IN (530)682-8 . 464 Occupancy: Zoning: A5 Contractor Applicant: Square Footage: SECO HEATING AND AIR SECO HEATING AND AIR Building Garage Remdl/Addn 4320 ANTHONY CT, SUITE 1 4320 ANTHONY CT, SUITE 1 ROCKLIN, CA 95677 ROCKLIN, CA 95677 Other Porch/Patio Total (916)652-6755 (916)652-6755 FEE INFORMATION DBM Heat Pump (Package Unit) , $55.00 • LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires SECO HEATING AND AIR 788807 / C20 C38 / 12/31/2008 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and act. X Q� ,1 A, 4 ZI ^ 01/30/2007 Signature Date I - WORKERS' COMPENSATION DECLARATION I I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 of 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: PREFERRED EMPL(policyNumb,r:WKN1275722 Exp, Date:05/01/2007 (This section need not be completed if the permit is or once hundred dollars ($100) or less.) ❑I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any manner so as to become subject to 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 those provisions. X •/r/ 01/30/2007 Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. - CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lenders Address City State Zip Total Charged: $55.00 Fees Paid: Balance Due: $0.00 Receipt No: OWNER / BUILDER DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code] or that he or 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]; Please check one of the following: ❑I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof 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 Provessions Code: The Contractors License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors License Law.). ❑ I AM EXEMPT under Section B. & P.C. for this LX 01/30/2007 Owners Signature Date I hereby certify that I have read this application and stale that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnity, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the propeyty owner or ar"9111horized to a9L,(r the property owners behalf. aM_ 101/30/2007 Owner Contractor OR. ElAgent for Owner E>,gent for Contractor y FILE COPY BUTTE.COUNTY 0�����0 DEPARTMENT OF DEVELOPMENT SERVICES 0 BUILDING PERMIT APPLICATION 0 o OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 o A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds , �VN't **PLEASE PRINT CLEARLY** OWNER INFORMATION Last Name • L First Name k (< Mailing Address c C= v rri-a s - e. M City C State ZiRW 17 "- Phone Fax E-mail CONTRACTOR Name 'e C C, (At�c F X Address 4 Z.co IA )-t k o ,,, It e I City ucl��.v State CA- Z. c D 677 Phone r G 61--a- Fax�/i b L S` Z- E-mail Phone Lic. # o .� Class L 2 J APPLICANT iNFORMATION ARCHITECT/ENGINEER Name CityState SA�s a p I-ro Address Zi City y b / / 3 State Zip Phone Fax E-mail State License Number APPLICANT iNFORMATION Name Address I Oct 'CA- a CityState SA�s a p I-ro 4__ /A. Zi PhoneG' d . P2 _� •7 o' O y b / / 3 E-mail wCi� � �O� -� M J✓�1 � t i �- APPLICANT SIGNATURE X �ef PERMIT NO. �,oil BIN # PROJECT LOCATION AP# Property Address L � VVi-n-► S c� t� .City L V WORKER'S COMPENSATION Policy Number <N ? Carrier n tt" r,_ -e ✓d -e �_ �cv� LO r.� N .3 If hiring anyone o her than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: IQ �L� v Sq FT- Living Garage Open Cov ❑ , Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning Flood Zone SRP, Yes No Occ. Type Const. COUNTY OF BUTTE - DEPARTMENT OF -PUBLIC WORKS 7 County Center Drive - Oroviller California 95965 - Telephone: 916/538-7541 APPLICATION AD PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 24-14-26 ZONING _ " BUILDING PERMIT OWNER ROCKY XtWf/ LEWIS (GRIDLEY) TELEPHONE 846-0476 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS RETMF.R CONTRACT R'S NA TELEPHONE CONTRACT ILING ADDRESS Fireplace T$ CONSTRUCTION LENDER UNKNOWN Total Valuation Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 4EVANS REIMER Permit tee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 (, Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PA CEL MAP Water piping " 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome® Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S 0.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Installation ❑ Other ❑ Describe work: MHU 60/640 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP OR101 OR LESS10.00 10.0 Main service EA. ADD'L 100 AMP 2.50 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 NEW CONST. DWELLING OCCUP.N OR ADDNS. ACC. BLDGS. , /zQsgft NEW NSTMULT'-OUTL CO NON•RESID R BRANCH CIRCUITS 2.50 ea POWER APPARATUS tr SINGLE OUTLET CIR. I Ex. Occup(OUTLETS OR FIXTURES 20 ® 50QSALO 30 FIXED APLNS Ex. OCCup. OUTLETS P(RESID.)REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 9 15.00 15.00 Permit Fee $35.00 Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): The permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate I 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. MECHANICAL PERMIT FiIingFee 10.00 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 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 agaiwo-"dVunty in onsequence of the granting of this permit. X 7 k� Date Signature of Ap licant — 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 CONST TYPE TOTAL F E - HAz. can PARK SCHL FL CDF — PAR 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 above for which fees have been paid. DIRECTOR OF PUBLIC WORKS , By Date ' PERMIT EXPIRES Date Receipt No. 94506 WHITE-D.P.W.. YELLOW-ASSE390R. PINK -INSPECTOR. GOLDENROD -APPLICANT r 4 - � - Copy of Hdz-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 submittedr to permit iss anc : (Circle new item not checked above). ri 1. Index permit for above items No. / Cf M L & 2, Additional items required: Contractor, designer, owner, was advised of above required data by_phone--jnail—counter by Contractor, designer, owner, was advised of above required data by—phone —ma II—counter by Plans checked by1 Date.L �, / Plans approved by Sets of plans on hold in File cabinet AP folder date date Date Copy—DPW %i ZIr f/ Lf_ �7. �i�sf 49, vy/ AW Cq 49T'z 7 -�/ a"m �.�Su✓s%'c—� H / 0Q.) COUNTY OF BUTTE - DEPARTMENTQF ;BLIC WORKS -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET OWNER Permit No. !/ V ��/�- � �`�'" A. P. o. - Proposed Building Use Building Inspector. Date r i At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED All items have been submitted . .................................... 2. Plot plans in duplicate/tri lic�at signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans ... 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... �. 13 Sch1,2i trict fees paid .............. 14. Sanitation approval from e-92 (� Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... FA 18. -Improvements may be required. Contact Land Development Section DPW 9. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required ... Pre-Inspec. request to Building Inspector /Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... Recorded cop of Agricultural Acknowledgment Statement ......... of sirization ��2/5 �C2.Lett 6 27. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other Applicant Date q/ Copy of Hdz-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 submittedr to permit iss anc : (Circle new item not checked above). ri 1. Index permit for above items No. / Cf M L & 2, Additional items required: Contractor, designer, owner, was advised of above required data by_phone--jnail—counter by Contractor, designer, owner, was advised of above required data by—phone —ma II—counter by Plans checked by1 Date.L �, / Plans approved by Sets of plans on hold in File cabinet AP folder date date Date Copy—DPW %i ZIr f/ Lf_ �7. �i�sf 49, vy/ AW Cq 49T'z 7 -�/ a"m �.�Su✓s%'c—� TO: Building Department FROM: Encroachment Permit Section RE: Driveway Clearance Re. AP # location owner / �d has been issued for the above property Driveway permit . date si ature 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. 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) 2. I (have/have-not) a 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 4. 3 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 Signed: Property Owner Social Security Number t* Date % l/ 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. NOTE:—All Materials &Workmanship Shall Be in. . Accordance with Recognized Good Practices and.. of a quality prescribed:for the Specified use in the - Uniform. Buildirto, Plumbing& Mechanical Codes and the National Electrical Code. s set pf plans and specifications MUST be kep on thlob ai'all times and it is unlawful to ma any hanges or alterations on same without, wri n peri issbn from tAe Department of Rublic Wor, s, County f Butte. ► I t r I j e i Asetback of 5 ft. from the )property lines rd a set -back Of 50 ft. from the road t { certerline shall be cle of ! t structures or equipment exoept for a 2 ti. save ov7han9. - r i [ 14QI El �4 0 _ BUTTE C& ' BUILDING DEPARTMENT 72- I� • 1 i3 r , c Wor, s, County f Butte. ► I t r I j e i Asetback of 5 ft. from the )property lines rd a set -back Of 50 ft. from the road t { certerline shall be cle of ! t structures or equipment exoept for a 2 ti. save ov7han9. - r i [ 14QI El �4 0 _ BUTTE C& ' BUILDING DEPARTMENT 72- I� • 1 Return to D.P.W. �. NOTICE OF COMPLIANCE WITH COUNTY CODE SECTION 24-202 (A-) (3) TO BE RECORDED BY OWNER (ADDITIONAL DWELLING IN SINGLE FAMILY RESIDENTIAL ZONES) Applicant Date . Zone AP # Building Permit # I, do declare, that the dwelling (Building Permit # ) at address (present) on AP # is intended for the sole occupancy of one adult or two adult persons who are 60 years of age or over, and the area of floor space of the dwelling unit does not exceed 640 square feet. Said ro ert more - P P y particularly des- cribed in Exhibit "A" attached hereto. I also understand that violations of these provisions are subject to the penalties provided -in Section 24 -63.1 -of the Butte County Code. Signed Dated - Attach Notarization Form COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County'Center Drive - Oroville. California 95965 - Telephone: 916/538-7541 APPLICATIOM..AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER TELEPHONE 846-0476 SQ. FT. OCC. BUILDING VALUATION OWNER'S MA / CONTRACT E TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE N.O. Plan Checking Fee $ 15.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDR S3 ` Permit fee $ 25.00 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping , 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome® Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home I S I G JW 1 10.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: MHI 60/640 1 BDRM MHU #2274-91 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6001 OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business nd 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 NEW CONST. ( DWELLING OCCUP.&) OR ACDNS. l ACC. BLDGS. , �Z �SQa NEW RES'DCONSTR. U BRANCH NON-RESID BRANCH CIRC ITS 2,50 ea POWER APPARATUS IN (SINGLE OUTLET CIR. Ex. Occu p(ouTLETs OR FIXTURES 20 0 506 aAL030 FIXED APPL.NS. Ex. Occup. OUTLETS (RESID )KEA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Iyirin 9 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. ❑ 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. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g 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 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 C unty in cc;sequenFa of the granting of this permit. X Date �^ '—� Signature of App Dont — 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 $ 45.00 Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 70.00 HAi. cuA PARK sc L FLD cDF PAR PD I HD. ISSUE This permit is hereby issued under the applicable provi- sions of the Butte County. Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date Receipt No. g4596 WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT f .._. - f 24-14-26 Permit#2275-91MHI ` (mh install - 60/640) (///� (� 1 1 4 \ 4 '�`r�r`w�^r7r,:�a��'t:.l:,.�1♦!�'� �•��+-J'+�' i�.."'�J�eC'..'7Vti�y�,v..:����i�s, ("''r ,. „�����5 �..-�.Y LQ.�:I�;,Yti�L �r�T�.�� �if..."7�-.r „,i�i`-�..-�"+�; , ^�,.' Y COUNTY OF BUTTE - DEPARTMENT, OF_: PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - ORC'V L-6E�:G%!ILIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET Permit No. OWNER A. P. o� Proposed Building Use �/% /T Building Inspector Date 7K,:: At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . ............................... * * 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8 Engineered truss details and layout in duplicate (required prior to plan check) —:::9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... . 1?. -Park fe�eas.pai�.�............................................... �� (J School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec. request to Building Inspector (pate) 21. Contractor's license information (No., Name Style, Classifications ... 1 2. Certificate of Workmans Compensation Insurance ........... �. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner::.. 24. Recorded copy of Agricultural Acknowledgment Statement 25. Lett ignature au�oriza_ion,. ............................. lJ �.•- 27. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other ( 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_phon taff—counter 64iitNte Contractor, designer, owner, was advised of above required data by—phone —ma ll—counter by date Plans checked Copy–DPW Date Plans approved by Sets of plans on hold in File cabinet AP folder Date El BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM (One Form per Building) A.P. Number ;�2 4/-/4/ - Building Department No. ' School District �5 z -'/S D City = County Jurisdiction Property Owner �� ,7 s� F. `Project Location/Address Subdivision Residential Development: � a # of Living MHI Units i ti Lot Number p�-C?Vg/ Sq . Footage Addition (Group R) Commercial/Industrial: Sq. Footage New Addition (Including Exterior Roofed Areas) Building Oepartment Representative D e ******************************************************************* (Floor Plans reviewed by School District Personnel) District Id No. 1p School District certifies that (Ap icant Name) (Phone Number) (Street Address) A (City (State) Zip Code) has complied with the requirements of Resolution No. by the p yment of $ O representing square feet. 7//f /I/ Schd 1 District Representative —� Date PAID BY CHECK" NO . REMARKS: BANK NO C�fi1Z c�� PAID BY CASH white -applicant, yellow -building department, pink -school district SCHOOL.FEE (8/88) P3243-81B,P�® PERMIT NO. s PERMIT EXPIRES /y��I • OWNER Bob Hollandworth CONTR. Dillahunty Const, Biggs } ASSESSOR PARCEL 24-14-26 +r LOCATION 74 East Evans.Reimer Rd., Gridley ;. 3-4-1 Temp. t s i i i� Y Temp. Power Pole Called PG&E i Temp. Elec. Service { Called PG&E_ i Temp. Gas Serce _ Called PG&E JOB Fl ABLE[ V Signature O = Not OK Y = Not Applicable MOBILEHOMES ' ~� MISCELLANEOUS * = Not Ready Date MOBILEHOME UTILITIES (Plans) OK except #'s Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 2. Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/O -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rfirs.-Con nec.-Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete _ 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6.Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors 7. Utility Clearance _ 7. Elec. Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except #'s Card -BI Date Date Card -BI Date _ POOLS (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 1. Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances 4, Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/0 to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date J = OK 0 = Not OK - = Not Applicable * = Not Ready RESIDENTIAL (,Single and Duplex) Date UNDERFLOOR Plans OK except #'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FINAL (Plans) OK except q's 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date Date Card -BI Date PLUMBING (Permit) OK except p's 14. Water Ht.; Vent -Access -Combustion Air 15. Water Pipe; Test & Anchors -Nail Protection 57. 58. Smoke Detector Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. 62. Elec. Trim & Subpanel; Breaker Sizes -Labels Stairs & Rails 19. Gas Pipe; Size & Anchors 63. Fireplace or Stove; Clearances -Hearth (Lard -BI Date Card -BI Date 64. 65. Elec. Outlets at Wood Panel; Int. & Ext. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. 67. Elec. Outlets & Receptacles at Kit. Counter Garage Fire Door; Swing -Landing -Closer Date ELECTRICAL Permit OK except q's 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 22. 23. Size Boxes & No. of Conductors -Stapled Romex Installed Close to Edge of Studs & C.J. 70. 71. Plb., Elec. & Mech. Equip. Listed for Location Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. Insulation -Foam -Looked in Attic ❑Yes 25. 2 Appliance Circuits in Kitchen & Conductor Size 73. Guard Rails & Deck Construction -Post Caps _ -- 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 74. Fdn. Vents Crawl Hole Door -Drainage &Wood -Earth Clearance Looked under Floor ❑Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral Yes 0 N 75. Following ❑ Yes No; Walks instld.: Drive Planters❑Yes El ❑ ❑Yes [I No; 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77. A.C. Unit; Disconnect-Cirnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. 80. Water Well; Disconnect, Electrical, Plumbing Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B-1 Date Card -BI Date 81. 82. Ventilation throughout House Glass Protection Card B -I Date Date Card -BI Date MECHANICAL (Perrr,it) OK except q's 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 31. A.C. Ducts; Insulation & Support 85. Water & Sewer Connected -C/O to Grade -HD Approval 32.__ Vent Fan; Exhaust above Insulation 86. Energy Compliance Certificate -Other Certificates _ _33. Condensate Drain & Overflow; Size & Grade 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic Card -BI Date Card -BI Date - --- Card -BI- Date _-- Card -BI Date Card -BI Date Card -BI Date Ca rd -BI Oate Card -BI Date Card -BI _ Date Card -BI Date Comments at Final: Date FRAMING(Plans) OK except q's 36. Sills; Proper Material & Anchors _ 37. 38. 39. _ _Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls over Girders & Floor Nailing Draft Stop in Walls (rat proof) _40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. 42. 43. 44. Header & Beam -Size & Bearing Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfnq. Fireplace Ties or Type A Flue -Fireplace Throat _ _ 45. 46. 47. Attic Access; Size & Rom_ex Protection -Draft Stop -Ins. Baffles Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions Garage Fire Protection Framing (NOTE: Anentrymust be made each time youvisit jobsite) 'i D] %. COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE 131-1I`1�DING`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. A.&Ow4to Tb L A-f3&L- *4Z(- a<91�' tc/TiY A2jr6W1k(Av &ZO aivto Pko-,4 s-- 77' FW c2zwl 2 11 1: �!77 i • �L U6.S J if _ oe--v' �s /Nth- ( MIZ114AICir, 2 c!?"- Inspecto Date /`�' �� �.�PX t Inspecto Date /`�' �� �.�PX o C/ g� je4 C444B, IA -f -let I'T .Aj Lk C7- Foe— MPEI&-od- ,,.jo L �� . .. zcyo� I CAi-L-F—O 's eln-o HIS wDaL 6 1-4-04S C)Oe4&- AR) PI -A -,--c COUNTY OF BUTTE -DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PAROL NUMBER 14 —2 � ZONING' � BUILDING PERMIT OWNER TELEPHONE S0. FT. OCC. BUILDING VALUATION OWNER'S MAILIN ADOR/(TS CONTRACTOR'S NAMx',vV//�n''//l , TELEPHONE Fireplace CONTRACTOR'N AILINGDDRES S c�?� _ CONSTRUCTION LENDER UN'NOY1N dPIC Total Valuation $ c Filing Fee � 10.0 ` C LENDER'S MAILING ADDRESS `—� Permit Fee $ ARCHITECT OR ENGINEER � /LICSE v r� �` ENNO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit tae $ BUILDING ADDRESS r�- PLUMBING PERMIT Filing Fee 10.00 .. Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO. SUBDIVISION NAME - PARCEL MAP Each qas water heater or vent 5.09 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF 54— Duplex❑ Mobilehome❑ Other _ SPECIFY Building sewer Lawn sprinkler system 5,00 TYPE OF WORK Remodel lilitie Ins _ Pc^Naw❑ Addition[Other 0 ] Despribe work: te0 Jv P__1 C -f /C✓c* �_�LA(T 6 �� ZL� �i.—` _ s Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS TCO AMP OR LESS 5.00 !F:00 Main -service EA. ADD'L 900 AMP NEW CONST. / DWELLING OCCUP.ti) OR AC: DNS. \ ACC. BLDGS. -W 2¢sgft ' CONTRACTORS LICENSE LAY! I declar penalty of perjury (check one): t. I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and m license is in full force r.nd effect. y License No. �7 ��i6 Classification G ./y ❑ 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) ❑ 1, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason t4: --- CN S T FL M U L 7I-0U'rLET 2.50 ea I•;ON.:�ESID. BRANCH CIRCUITS NEW COST n^ /POWER APPARATUS A ON!1T NON -R F_SI v. ISINGL= OUTLET CIR. '_r,. / 0 @ ac Occu OR FIXTURES SAL Ly 10: _P(OUTLETS EX. Oi:�:tlp`�OUTLETS(RESID IREA.� 2.00 _ — — Temporary service 10.00 Mobile Home Facilities 15.00 ., I Isc. 11lring 7.50 it o c Permit Fee Contractor MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑/ The permit is for $100.00 (valuation) or less. rA 1 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: IfJafier 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 p{t Fee em S _ 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 Lads 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 liabilit'.es, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. '--- x--19 ~ X Date Signature of Appli ont — Owner ED Contractors Agent 11 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 $ o� TOTAL PERMIT FEE $ �: � OCC11P, GROUP TYPE OF CONST, PARCEL PD HD I.SSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By PERMIT EXPfRES Date _ the applicable provi- resolutions to do fees have been paid. WORKS Date t—C-�.r O� Receipt No._.� WHITE-D.P.W.. YELLOW-ASSCSSOP, PINK -INSPECTOR, GOLDENROD-APALI CANT P�COUNTY OF BUZ:IEf.-DEPARTMENT OF PUBLIC WORKS PERMIT NO. County Center Drive - Oroville,�Cafifornia 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT /0) ASSESSOR PARCEL UMBER ZONI G% BUILDING PERMIT OWNS�.,6 TELEPHONE `opt scv�vl� 4-43.3 SQ. FT. OCC. BUILDING VALUATION -5 OW ER'S IIL.I�rN-G ADDRESS // t50 Z Z i�`L d[ C TRA TO •S NAME /p TELEPHO E (fQ � ���,��Q� CONTRACTOR'S MAILI AD RESS vLO Fireplace CONST'RUCTION LENDER / UIfKf4OWN Total Valuation is 17c.0 Filing g Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ .Ob ARCHITECT OR ENGINEER QK LICENSE NO. Plan Checking Fee $ Penalty $ 0 ARCHITECT OR ENGINEER'S MAILING ADDRESS on Permit fee $ —00 BUILDING ADDRESS _ '� c Z7 I PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Z',a0 Repair drainage or vent piping 5.00 e Water piping LOT NO. SUBDIVISION NAME PARCEL M AIP Each qas water heater or vent 5,00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF;3- Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 / TYPE OF WORK New ❑ Addition [:1 Remodel Utilities Installation❑ Other [:1 /V Describe work: 64d %;D6 Ce SA , �t//� e6m, ZIT �Simam Permit Fee contractor ELECTRICAL PERMIT Filing Fee 10.00 OR LES Main service 100 AMP ORS SLESS 5•00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. (DWELLING OCCUP.5j) OR ADDNS. ACC. BLOGS. / 22 sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check one): LP I am licensed under provisions of Chapt. 9, Div. 3 of the Business Professi s de and my license is in full ce and effect. License No. / Classification El 1, as the owner, or my employees with wages as their sole compen- IF 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 MULTI -CUTLET 2,50 ea NON-RESID BRANCH CIRCUITS) NEW CONSTR ( POWER APPARATUS 61 NON -RESID, SINGLE OUTLET CIR. I EX. OCCUp OUTLETS OR FIXTURES_ @1 BAL and IXED APPLNS. OR Ex. Occup.(o UTLETS (RESID.) EA 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 //15W FEW Permit Fee $ Contractor MECHANICAL PERMIT FiIirig 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. 1 shall not employ any person in any manner so as to become subject to the W. C. laws of California. Not ce 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 S 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 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 ia ilities, judgments, costs d expenses which may in any way accrue ounty in consequ n ofa Ing of this pThis taiDate of Applicant - Owner ❑ Contras Agent ❑ An OSHA permit is required for excavations over 5' deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE//,54"- $ OCCUP. GROUP I TYPE OF CONST. PARCEL PD ND S9u permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTO PUBLIC By PE EXPIRES Date the applicable provi- resolutions to doture fees have been paid. WORKS Date ����� Receipt No. S-6 ?1l5— WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7�County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT ASSESSOR PARC L NUMBER Z�-_ tt -2 ZONING BUILDING PERMIT OWNER ec- or TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNE 'S MAI LIN ADD 55 CONTRACTOR'S NAM ITELEPHON CON ACTOR' [LING ADDRESS 0, Ba< Z Z_ Fireplace CONSTRUCTION LENDER O UN OWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS �-� Permit Fee $ ARCHITECT OR ENGINEER /t4,` Y �' �- LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS �— Permit tee $ BUILDING ADDRESS % �ac Vapt! tit 60 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 +� Water piping LOT NO. SUBDIVISION NAMEPARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SFW Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ❑% Remodel ❑ U ' litie 0 Installation ❑ Other ❑ De cribe work: G'i%CO cc v e��-d 5'P&^I/l Z'`•* De ! V fff O in /_ co A zoo'16n Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service j00 AMP ORLESS5•00 t00 Main service EA. ADD'L 100 AMP 2.50 610 NEW CONST. ( DWELLING OCCUP.N OR ADDNS. ACC. BLDGS. 2� sq ft CONTRACTORS LICENSE LAW I declar under penalty of perjury (check One): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and m licese is in full force and effect. y n License No. 3%%3G� Classification G /V ❑ 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 C1 OUTLET 2,50 ea NON -REBID BRANCH CIRC ITS NEW CONSTR POWER APPARATUS &) NON.RESID. (SINGLE OUTLET CIR. ) sD L EX. OCCUp OUTLETS OR FIXTURES gAL01 :C7I! Ex. Occup.(ouTLETS FIXED P(RESID )REA.) 2.00 2049 Temporary service 10.00 Mobile Home Facilities 15.00 ppifiL 39; 00 -e K o 'j•Si`i 1 7 Ve Permit Fee $ >� Contractor 67C/iP 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 F� 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 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 of the granting of this permit. X Date Signature of Appll ant - Owner ❑ Contractors, Agent ❑ An OSHA permit is required for excavationsov 'r 5'0" deep and demolition or construct- ion of structures over 3 stories in Mobile Home Installation Fee $ TOTAL PERMIT FEE OCCUP. GROUP I TYPE OF CONST. -I PARCEL PD HD ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTO PUBLIC By PERM EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Z_ 2i —7, feiightt. L[[ /,17 Receipt No. 5` ®d 0 T 00 WHITE-D.P.W., YELLOW-ASSESSO PINK-INSP OR, GOLD ENRO APPLICANT ,