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HomeMy WebLinkAbout024-290-00424-29-4 r _ Bill Pearsall N/S Hollis Lane, 375'E.of.Hwy 99E, Gridley, Lot#4 Ufz-ily) mit #28 2-76B,P,E,M new single i /`. a. CHARLES FOLTZ 24-29-04 29 Hollis Lane, Gridley y-� Permit#2495-88B(reroof/SF)' B08-0518 024-290-004 MISCELLANEOUS Wall Furnace CHANGE OUT FURNACE ONLY 29 HOLLIS LN ROCHA, A B & JEAN 4 i i i f i i I f i i 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: 29 HOLLIS LN Owner: Permit NO: B08-051$ APN: 024-290-004 ROCHA, A B & JEAN, Issued Date: 03/25/2008 By KEJ Permit type: MISCELLANEOUS 29 HOLLIS LN Subtype: Wall Furnace GRIDLEY, CA 95948 Expiration Date: 03/25/2009 Description: CHANGE OUT FURNACE ONLY 530 Occupancy: Zoning: R1 Contractor Applicant: Square Footage: GALLAGHER'S HEATING & AIR ALL ABOUT PERMITS Building Garage Remdl/Addn PO BOX 35 JENNIFER D GRUBER LOS MOLINOS, CA 96055 CHICO, CA 95973 - Other Porch/Patio Total .(530) 384-2444 (530) 680-7619 FEE INFORMATION DBM Heater (Wall), $59.00 ' LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires GALLAGHER'S HEATING 8r AIF 777334 / C20 C38 / • 04/30/2008 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (co ncing with Secti 7000) of Division 3 of the Business and Professions Code, and my license is' full orceand Wectl I 7 , 03/25/2008 CoTltractors Vnature Date I' WORKERS' COMPENSATION DECLARATION 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. Y 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: State Fund Policy Number: 713-0013855 Exp. Date:05/01/2008 (This section nee not a completed if the permit is or ons e 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. A I , , 03/25/2008 Sigr»3ttlre dj Date WARNING: FAI E 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) Lender's Address. CityState Zip r Balance Due: $0.00 Receipt No: OWNER / BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY that 1 am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Cade: 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.). E1, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code: The Contractor's 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 Contractor's License Law.). ElI AM EXEMPT under Section B. & P.C. for this reason: Ix 03/25/2008 Owner's Signature Date I hereby certify that I have read this application and state that the above information is correct. I agree' to comply with all City and County ordinances, rules, regulations, and Slate laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmlessi 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 Wgpertn o4 teh%am authorized to action the Drooe V ownee4behalf. e - Owner 1:1 Contractor OR. Agent for OwnerAgent for Contractor FILE COPY BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION" OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds PLEASE PRINT CLEARLY PERMIT NO. K,6- t BIN # "When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. OWNER INFORMATION Last Name RU c --V l Name First Name LE Mailing Address J_J City(f „j` - �t Phone State � Zip i� / Phone Zip I Fax E-mail Fax APPLICANT INFORMATION CONTRACTOR Name I L\ l1 a Address ..V City Phone State O i S State (A Zip I Phone 5S Lf , f �-1 Fax E-mail Lic. # Class C oo G3� APPLICANT INFORMATION ARCHITECT/ENGINEER Name Address VA Address State City Phone State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name ' S Address VA City State Zip Phone Fax E-mail ARPLICANTAIGNATURE X � PROJECT LOCATION Property AddressD cityL� r i WORKER'S COMPENSATION Policy Number -7 1 -� Carrier 5f&+e. () If hiring anyone other than licensed 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: C Cv A_0—f 0-C 't ►'1 C� Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning FloodZone SRA Yes No Occ. Type Const. l ;i cPERMIT NO. 2852 76B P�,E,M- PERMIT EXPIRES 46 � OWNER Bill Pearsall Homes CONTR. owner LOCATION (A.P. 24-29-4 1 N/S Hollis Ln.,375'E.of Hwy 99E, lot #4,Gridley P n Temp. Power Pole Called PG&E Of Temp. Elea Serv. Called PG&E Te p. Gas Serv. Called PG&E a , JOB / FINALED (Da e) (Sign ture) COUNTY OF BUTTE —'DEPARTMENT OF PUBLIC WORKS BUILDING INS BUILDING BUILDING (Cont'd), PLUMBING SetbackFirewall AZ:K a 1rf` ;^! �� ��. s Soil Piping W4 Forms Parapets 1st Floor Q Main Bldg. Restroom Finish 2nd Floor Footings Windows /` ��"� �- .� 3rd Floor Stemwa1l Siding % To out Slab f% c Roof She'athl - ng 44 zWater Pi in J' Piers Roofing Sewer Garage Fdn. Vents — - Fixtures D Footings - Stemwall Garage Vents= f5 _ Insulation /.��"� - Water Htr. / -51 Heaters Slab y Carport Footings Prov. for physically i handica e. Conformance of ex. structure B' r����� Appliances Gas Piping & Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing ELECTBIC&L Masonry Walls Throat Rough /i r Reinf. Steel Final Fixtures © /� Bond Beam FIRE ORINKLERS Motors 14 Framing 8&5 Test Water Htr. Stucco Final Subpanels Mesh MECHANICA Grd. Fault Pot. 001// Scratch E2� Heating / Service 71111471,11,11W Brown Cooling Temp. Pole Finish '" Ducts Q Underground Interior Lath Ventilation e i/P'— Permanent Door Closer /�Q �✓~ ��/ Final /%,jam/�/ / Final DA TE REMARKS OR CORRECTIONS "� c (NOTE: An entry must be made on this form each time you visit the job site.) #��e 'k; THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH THE CURRENT REGULA- TIONS, CALIFORNIA ADMINISTRATIVE CODE, TITLE 25, STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT: Street Lot Number Tract No. EXTERIOR WALLS C„����� Manufacturer. Thickness/Type R Value - CEILINGS /f /�K 9 Batts: Manufacturer ( Thickness v R Value— Blown: Manufacturer Thickness No. Bags Wt./Bag FLOORS Sq. Ft. Covered R Value r 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 BY. TITLE — DATE INSULAT12P CONTRACTOR: AWKINS INSULATION CO. LICENSE a. 215-925 BY TITLE - DATE U l /7( -7 J - COUNTY OF BUTTE-- DEPARTMENT OF PUBLIC WORKS 7 County Center Drive- - Uroville, California 95965 //_ Telephone:•534-4541 ,K -70 APPLICATION AND PERMIT l� authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. Signature of Wrmitee or Agent Receipt No. A 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 BLIC WORKS BY Date b P Illd'ilding permit expires Date _27— BUIL CDW- 6 Owner � p`� i'`J �'�%S SQ. FT. OCC. BUILDING VALUATION c7//O- Mailing Mailing Address 4 Telephone No. Fireplace Contractor bih PEARSA0 HC44a's Total Valuation Mai Iin Address I g t %O 8� y w�� Permit Fee , ab P I an Ch eck i ng Fee &/or Pen aIty Y0614 - r I'F_ eleph ne No T�3 . �4_ Permit Fee $ Building Address A/A OF Z;L 1qF_PLUMBING No. @ FEE PERMIT FILING FEE $3.00 ` ,Ov 3 75- iFZ f gEegLS-77 6,, Each Trap 7 1.50 1,0 / Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. 1 4 ZoningGas & Planning piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fees W.C. Sa FireDept. FireZone Use Permit Building sewer 5.00 EQA Parking Plans Parcelparcel Declaration Ma P 60' R/W ImprovementsLawn sprinkler system 2.00 _ g. Plans Rec'd Parcel proval Plan ppr.,aI Permit Fee $ NEW E— ADDITION ❑ UTILITIES ❑ OTHER'[] ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 31fes Main service 1000 AMP ORV OR LESS5.00 Main service EA. ADD•L 100 AMP 2.50 Single Family Q ---Duplex ❑ Mobil Home ❑ Others ❑ Main service 1100EAMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW CONST, DWELLING OC U & OR ADDNS. ACC. BLOGS. ) 2¢syft NEW CONSTR. (MULTI -OUT -LFT NON.RESID. ( BRANCH CIRCUITS) '2.50ea NEW CONSTP- POWER APPARATUS & NON-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)50 @25` 104 FIXED APPLNS. OR Ex. Occu P'(OUTLETS (RESID.) EA) 2:00 Temporary service 10.00 Mobile Home Facilities 15.00 License No.Z2 4 k1 Classification_ Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee (� 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. -1 -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 fly Heating 10014 Cooling Ventilation Hood 2.00 i `�� Permit Fee $ (0 $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. Signature of Wrmitee or Agent Receipt No. A 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 BLIC WORKS BY Date b P Illd'ilding permit expires Date _27— NOTE:—All Materials & Workmanship Shall Be in Accordance with Recocinized Good Practices ,._and ; bf a quality prescribed Jor fhe Specified use in the Uniform Building, Plumbing & Machanical Codes and fh-o National Electrical Code. ---- _ P/L- go o„ 5. Sept?c system and location of but-ld. ..i.n_g_dra�ira—stub,ut`-•t'o -bo4S per Butte County Health Dept, Rem 5, quiz ments. CO FtD_ F )7- WC 4-TUTAL" .SRA.. , . -- ��• ,/fes ��r_-r_.�- Dom. lit! 1=1:a :!a./R/.STA U:AT OZ4 f Z. l5 1*./1:fj.Rlrtyl�r;'F_.l�"�V %MY/J`37 D wow s P�pP�•R�3' 4- .Z I;�� S, ;'Ta`Cfi. I�:, _'F"• ,='1 PML WDA;1 o WIDE_ _ 00 -- - SCALE A. SL-PTfC TANK That Bld ' Setb ' �' f ` q 9• k shall 6e 5 I from I. f , . . , '.. I-P3i �N °dee ,o�ah ash' - ,. ` la4 G d so` / lits �.� t`. 7iSan ph file 011k//9 o sui &= 7` v�.A BUTTE COUNTY '.p - n / d f i btu; ' BUILDING DEPARTM tIT •• ` h the'srdeprope line"and 50 ft. frmm the'cenferline o, the rgctd, pec illom ing a t�';taximum of ft, eave overhan T!DAL_��aT�l`�•.gN.�,1�1:L_MA�r•�' 50, 3V L. t • x-oVE � ,;G F:F. � 5.¢p ' � sa < <• o Cl"1�Z'7x! C` otlz P��4U S _..,.;... Ip/C. _`?0-0" R3A4-�7,.i C !t t TA StD&1JAt, A��,:r��FE��" • This set HO, &NOOE kept on the job at all times and• it is unlawful to .make any changes or alterations on same -without written permisson from the De(.partment of Public Works, County of Butte; P'T,140 4)5� . . k .._. ) i t L°t? A / lits �.� t`. 7iSan &= 7` v�.A BUTTE COUNTY '.p - n / d f i btu; ' BUILDING DEPARTM tIT •• ` APPROVED;: a1;u Ro8misb o, P'T,140 4)5� . . k i.- .,�, 75 � _ .,� r'� x,r yq'. .� �..e-.n: s`i;�/,fit-`�!`v'inti'�,.,r:ri"}.�'�'h.�,4.�t�t`'k/�'L.fere.';`�?ri.�';-.�"',.,r`!•'�r,-:y.-:.�v�. �,U.,".s: COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 i APPLICATION.AND PERMIT ,PERMIT NO. r i ASSESSOR PARCEL,NUMBE,R ;.) ;4 r; --() q ZONING BUILDING PERMIT OWNER - {(- TErL4/EPH/OONEE t SQ.FT. OCC. BUILDING VALUATION • J / OWNER'S MAILING' ADDRESS - CONTRACTOR'S NAME 1 / TELEPHONE CONTRACTOR'S MAILING ADDRESS 1 Fireplace CONSTRUCTION LENDER' UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS i Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee Energy Plan Checking Fee A=.' $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 //1 s 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 91 Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other Describe work: ,rt D .; !( �� Ji�fit •,k'(_.,.a S.�< - - rr.E Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 !/ Main service 100v 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): ❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Bushes$ and Professions Code and my license is in full force and effect. License No. 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 CONST. DWELLING OCCUPM yz¢sgft OR ADDNS. ACC, BLDGS. NEW CONSTF MULTI -OUTLET 2.50 ea NON.RESID .BRA CH CIRC ITS POWER APPARATUS 6 (SINGLE OUTLET CIR. / Ex. Occup OUTLETS OR FIXTURES .220 0 00 5030 AL@ FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.I 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. ❑ 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 FiIingFee 10.00 Heating Codling 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 County in consequence ofa,granting of this permit. %`�• �� �— g�, X Date Signature of Applicant — Owner El Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures overt 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ �C TOTAL PERMIT FEE $ OCCUP. CON3T.T7 SCHOOL I FLOOD PARCEL PD HD .29UE 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 � /% fl ,1� By ���•I–' f �+ r ��J Date 1% PERMIT EXPIRES Da a V /`� Receipt No. I v WHITE-D.P.W.. YELLOW-ASSE330 , OINK -INSPECTOR. COLD ENROD-APPLICANT V _ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS MI Np, ►—" �' 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541. _ APPLICATION AND PERMIT ASSESS R PARCE N BERD ZONING BUILDING PERMIT OWNER J TELEPHONE SQ. FT. OCC. BUILDING VALUATION O 'S MAI DRE5S 113 Lll:;, CONTRACTOR'S NAME 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 No. Pian Checking Fee } $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 fls(, Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME• PARCEL MAP Water piping- 5.00 Each gas 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 Mob le Home S I G W 0.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service eoov 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 ❑ 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 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 CONST. DWELLING OCCUP-ad)1/20sgft OR ADDNS. ACG, BLDGS. NEW CONSTR. U TLOUTLET 2,50 ea 'N ON.RESIO BRA CH CIRC ITS (POWER APPARATUS e� SINGLE OUTLET CIR. Ex. Occup OUTLETS OR FIXTURES 20@ 5 0 - FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) 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. ❑ 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 FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that 1 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 agai t id County in consequence o ranting of this permit. �_ S► g8 X Date Signature of Applicant - Owner E)ContractorElAgent ❑ 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 $ TOTAL PERMIT FEE $ occuP. coNsr.TYPE scNooL FLOOD PARCEL PD No --[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 hich fees have been paid. ,pIRECT R P BLIC WORKS ^ oY B Datte_ PERMIT EXPIRES Da e s.-!14 / Receipt No. WNITE-O.P.W.. YELLOW-AB2E3e0 . PINK -INSPECTOR. GOLDENROD -APPLICANT r COUNTY OF BUTTE - Dep`artment of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: i " 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) 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 Signed: Property..Owner Social Security NLImber Date 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.