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r`a024=290-018 03-0822
VILLANUEVA, TERESA
66 HOLLIS, GRIDLEY
,ELECTRIC SERV. SEPTIC INAL
ED
5-7-03
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024=290-018 ;', 082
0324
VILLANUEVA,' TERESA
66 HOLLIS, GRIDLEY
ELECTRIC SERV., SEPTIC
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n
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - DING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (5/0)'538-7541 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT n� -neYa� P
ASSESSOR PARCEL NUMBER
024-290-018
ZONING
BUILDING PERMIT
J� 1�} ♦ /
OWNER"""^'_ , ( ILvc..�/��
TELEPHONE ` 7
ii I�
SO. FT. OCC. BUILDING VALUATION
OWNERS MAIUNG ADDRESS i
I. C iE �^—t Ct
t
CONTRACTOR'S NAME -
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $ 20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS 66 u j
Energy Plan Checking Fee $
$
PERMIT FEE $
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT Filing Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap 7.00
Solar or heat pump water heater 23.00
Water piping 15.00
Each as water heater or vent 15.00
TYPE OF WORK
New ❑ Addition ❑ Re/model [3 Utilities ❑ Installation ❑ Other [3
Describe Work: C! r C' t S� J fi r
� J
Gas piping system 1 - 5 outlets 15.00
Building sewer 15.00
Mobile Home S G W @20.00
PERMIT FEE S
ELECTRICAL PERMIT Fling Fee 20.00
Main Service ELE
2OOAOOV OR OR LESSSS 23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class Lic. No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
ED' 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.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
D 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 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
forth withrcomply,with those provisions.
L,-
X f- Date ..J� � �..a _
Sig`natLire.of:Applicant - ❑Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 5'0" deep and demolition or construction
of structures over 3 stories in height.
Main Service 200A TO 1000A 46.00
NEW CONST. DW EWG OCUP.
NCSO
OR ADDNS. ( 8 ACC. BLD S. 3.50FT;
NON-RESIOT' MULTI -OUTLET @7,50
7-50
POWER APPARATUS
& SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FIXTURES 20 L .50 '@'.00
BA
Ex. Occup. OUTLFLXEEDfB PRESIp.OEp 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wirina 23.00
PERMIT FEE $ 27„50
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ 27.50
HAZ.
D. FEES IMP
FLOOD
CDF
PARCEL
PO
HD
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated bove for which fees.have been paid.
��/�/
�a/��///`!C l iii til
By� �i' i ) Daatte,
PERMIT EXPIRES ON _ �-, // C X/
Dere
Receipt No. .Siwe S
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE
{, BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES h
411 Main Street • Chico, CA • (530) 891;-27M
-- 7 County Center Drive • Oroville, CA • (530) 538-7541
:CORRECTION NOTICE
U/ A /V U C, V & 3
OWNER PERMIT NO.
P A routine inspection indicates that the following violations of butte county Ordinances exist at the
above address and should be corrected. Please notice this office when correction of work is
' completed. If you have any questions pertaining to this matter, -or need additional explanation,-
please contact this olfice immediately.
L-
Date "—�� f Inspector
REV 10/92''
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
411 Main Street • Chico, CA • (530) 891-2751
7 County Center Drive • Oroville, CA • (530) 538-7541
CORRECTION NOTICE
(A
OWNER PERMIT NO.
A routine inspection indicates that the following violations of butte county Ordinances exist at the
above address and should be corrected. Please notice this office when correction of work is
completed. If you have any questions pertaining to this matter, or need additional explanation,
please contact this office immediately.
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REV 10/92
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COUNTY OF BUTTE
BUILDING DIVISION '
DEPARTMENT OF DEVELOPMENT SERVICES
411 Main Street • Chico, CA • (530) 891-2751
_ 7 County Center Drive - Oroville, CA • (530) 538-7541
r CORRECTION NOTICE
k O
J'( ( r--+ dvca L_ v v -t— U-> - u,a 4-
NER PERMIT NO.
A routine inspection indicates that the following violations of butte county Ordinances exist at the
above address and should be corrected. Please notice this office when correction of work is
completed. If you have any questions pertaining to this matter, or need additional explanation, -
p ease contact this office immediately.
c G C. eS,S
/I. -
(D
(D Gni`- t C_ i (2s'_yA / I-
11
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 R&�RM.,,IT NO.
(Rev. 12/96) APPLICATION AND PERMIT ?t?3 --09
ASSESSOR PARCEL NUMBER
024-290-018
ZONING
BUILDING PERMIT
OWNER --7 �y
J r
LEPHONE
TEs3e-
SO. FT. OCC. BUILDING VALUATION
. OWNERS I CADD S
�\
CONTRACTOR'S NAME
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
LENDER'S MAIUNG ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
—Filing Fee $
20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS
Energy Plan Checking Fee $
$
PERMIT FEE $
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
-
Solar or heat um water heater
23.00
Water piping
15.00
Each gas water heater or vent
15.00
TYPE OF WORK
❑
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation 1 ACT
Describe Work: e A n Se"r V t e. Ami �G/,J / G
L►/✓%��
Gas piping stem 1 - 5 outlets
15.001
Buildingsewer
15.00
Mobile Home I S I G I W
920.00
PERMIT FEE S
ELECTRICAL PERMIT
Fling Fee 20.00
0OR LE
Main Service . ' OR LESS
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.POWER
License Class Lic. No.
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
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.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
Main Service 200A TO 1000A
46.00NEW
CONST. DWELLING OCCUP.
OR ADDNS. ( a ACC. eros.
3.5QSO
p�IDT* MULTI.O RCIT
@7,50
APPARATUS
a SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FDCTURES
BAL @':0500
Ex. Occup. OUTLETs HE�SIO.OEE
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE $
97-50
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one 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 workers'
compensati aws of California, and agree that if I should become subject to the
workers' en ation provisions of section 3700 of the Labor Code, I shall
forth c ply ith those provisions.
j1,[�L
X Date r 0 -c.—
g h cant - ❑ Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FES $
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
It
TOTAL FEE w 27.50
HAZ.
D FEES IMP
FLOOD
CDF
PARCEL
PD
HID
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code /or Resolutions to do work
indicated bove for whic fees ave been paid.
// j
B Date /'J/'7i
PERMIT EXPIRES ON
Date
Receipt No. 375793
I
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
N
O.B.- I
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: YES4V NO ❑
2. I HAVEN 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: CONTRACTOR'S LICENSE NO.
4. I plan to provide portions of this work, but I have hired the following person to coordinate,
supervise, and provide the major work-
-NAME:
ADDRESS: CITY:
PHONE: CONTRACTOR'S LICENSE NO.
5. I will provide some of the work but I have contracted (hired) the following persons to provide
the work indicated:
NAME ADDRESS PHONE TYPE OF WORK.
SIGNED:
PROPERTYOWNER:�
SOCIAL SECURITY NUMBER:
DATE:
NOTE: This Owner -Builder Verification is required by Section 19831 and 19832 of the
California Health and Safety Code. This .verification must be completed and
returned to our office before we are permitted to issue the permit
OVER
OWNER BUILDER INFORMATION
Dear Property Owner:
O.B.-1
An application for a building permit has been submitted in your name listing yourself as the builder of property
improvements specified.
For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such
a permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business
license from the city or county. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should
be aware of the following information for your benefit and protection:
♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is '$300 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
♦ If you are an employer, you must register with the State and Federal Governments as an employer and you are
subject to several obligations including state and federal income tax withholding, federal social security taxes,
workers compensation insurance, disability insurance costs, and unemployment compensation contributions.
♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious
with respect to worker's compensation insurance.
♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and,
if you wish, the U.S. Small Business Administration). For more specific information about your obligations under
State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building
permits are not required to be signed by property owners unless they are performing their own work personally.
Information about licensed contractors may be obtained by contracting the Contractors State License Board in your
community or at 1020 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you
are aware of these matters. The building permit will not be issued until the verification is returned.
+rely,Vi ira,C.B.O.
uilding Inspection
NOTE. This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code
OVER
�eE-J.RLmBefwfi,J+ua;,..r u.-.
i
024 29' 0 018'
VILLANUEVAy`: 95-1181-;B
66Ho11is lane, Gridle
fjS
00
Y `
i
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES -
7 County Center Drive - Oroville, Catkornia 95965 - Telephone
APPLICATION AND PERMIT
BUILDING DIVISION
(916) 538-7541 �%�%T NO.
. / r
ASSESSOR PARCEL NUMBER 024-290-018
ZONING R1
BUILDING PERMIT
OWNER TERE,SA VILLANUEVA
846-4869
SO' Fr. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
66 HOLLIS IN GRIDLEY,
23 60 11,380000
-
CONTRACTOR'S NAME
UNKNOWN
TEIFPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNINOWN
Total Valuation Is
LENDER'S MAILING ADDRESS
Filing Fee $
20.00
Permit Fee $
33.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
�.
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
66 HOLLIS LN
PERMITFEE $
53.00
GRIDLEY
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Solar or heat pump water heater
23.00
USEOFSTRUCTURE
SF 9 Duplex ❑ Mobilehome ❑ Other
SPECIFY
Water piping
15.00
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00
Building sewer
1'5.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other1
Describe Work: _ REROOF
Mobile Home I S I GI W 1
920.00
PERMITFEE g
Contractor
ELECTRICAL PERMIT
Filina Fee 20:00
Main Service / 000V OR LESS
200A OR LESS )
23.00
Main Service ( 200A TO I000A )
46.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class Lic. No.
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ 1 as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
VI, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
NEW CONST. DWELLING OCCUP.
OR NS. ( 8 ACC. )
SO.
3.S¢ FT.
NEW CCONST. MULTI.OUTLETLE T
NON-RESID. ( BRANCH CIRCUITS )
97.50
( POWER APPARATUS )
8 SINGLE OUTLET CIR.
Ex. Occup. (OUTLET OR FIXTURES)
z0 p 1.00
BAL .00
Ex. Occup. (OUTLETSIXAPPLN . OR
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMITFEE $
Contractor
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
MECHANICAL PERMIT
Filing
9 Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMITFEE $
Contractor
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
�of one hundred dollars ($100) or less.)
®" 1 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 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
forXhwith comply it those provisions.
X' Date _ `�— /
-- C G
Sig a ure of Applicant - ❑•Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee Is
occ
f
CONST. TYPE
TOTAL FEE $ 53.00
HA2.
I D. FEES
I IMP
I FLOOD
I CDF
PARCEL
I PD
I HD
ISSUE
This permit is hereby issued under the applicable
in the Butte County Code and/or Resolutions
indicated bove for which fees have been
�(/ Date
PERMITE IRESON G
(&.)
provisions
to do work
paid.
J %
Receipt No. 180159
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive - Oroville, Califgthia 95965 - Telephone (916) 538-7541.�� �)T NO.
APPLICATION AND PERMIT �''// /
ASSESSOR PARCEL NUMBER 024-290-018
P.1 ZONING
BUILDING PERMIT
OWNER TERESA VILLANUEVA
TELEPHONE
846-4869
SO. FT. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS
66 HOLLIS LN GRIDLEY
-
CONTRACTOR'S NAME
UNKNOLIN
TELEPHONE
CONTRACTORS MAIUNG ADDRESS
Fireplace
CONSTRUCTION LENDER
UN -OWN
Total Valuation is
Filing Fee
$ 20.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
UCENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Penalty
$
BUILDINGADDRESS
66 HOLLIS LN
PERMITFEE
$ 53.00
GRIDLEY
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Solar or heat pump water heater
23.00
USEOFSTRUCTURE
SFU Duplex ❑ Mobilehome ❑ Other
SPECIFY
Water piping
15.00
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other �1
Describe Work: _ REROOF
Mobile Home I S I GI W 1
920.00
PERMITFEE
g
Contractor
ELECTRICAL PERMIT
Filinq Fee 20.'00
Main Service 800V OR LESS
( 200A OR LESS )
23.00
Main Service ( 200A TO 1000A )
46.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License ClassIL No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ 1 s 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.
'nis s owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
NEW CONST. DWELLING OCCUP.
OR ( 8 ACC. BLOS. )
SO.
3.50 FT.
CNS.
NEW CONST. MULTI -OUTLET
NON-RESID. ( BRANCH CIRCUITS )
97.50
ARATOUTLETUS )
( POWER PA
8 SINGLE CIR.
Ex. Occup. (OUTLET OR FIXTURES )
BAL 2 0 1.00
5050
Ex. Occup. ( OUFIXED TLETS (RESID.°EA)
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMITFEE
$
Contractor
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMITFEE
$
Contractor
Policy Number
he above sections need not be completed if the permit is for work of a valuation
-one 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 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
jfoWhwith complyi, t ose provisions.
X 74 Date _���
Signature of Applicant -'0- Owner ❑Contractor ❑Agent
An OSHA permit is required for excavations over 5'0" deep and demolition or construction4�
of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ 53.00
HA2.
I D. FEES
I IMP
I FLOOD
7F
I PARCEL I PD I HD
ISSUE
This permit is hereby issued under the
of the Butte County Code and/or
indicated bove for which fees have
r
PERMITE IRESON
applicable provisions
Resolutions to do work
been paid.
Date 67
(fie)
Receipt No. 180159
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -
7 County Center Drive - Oroville,,California 95965 - Telephone
APPLICATION AND PERMIT
BUILDING DIVISION
(916) 538-7541 PERMIT NO.
ASSESSOR PARCEL NUMBER a �a O ^
ZONING 4 /
BUILDING PERMIT
OWNER �j , //
T E
SO. FT. OCC. BUILDING
VALU TION
OWNERSU 0/RE`—
CONTRACTOR'S NXPE
TELELEPHO. NE
CONTRACTORS MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 20.00
LENDER'S MAIUNG ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
PERMITFEE
S
PLUMBINGPERMIT
Filing Fee 20.00
Each Trap
7.00
LAT NO.
S UBDNIS IONS NAME
PARCEL MAP
Solar or heat pump water heater
23.00
Water piping
15.00
USEOFSTRUCTURE
SFF Duplex ❑ Mobilehome ❑ Other
// `` SPECIFY
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other/*r'
Describe Work: 1�� )LI D0 �
Mobile Home IS I GI W
(—W20.00
PERMITFEE
$
Contractor
ELECTRICAL PERMIT
Filino Fee 20.00
Main Service OOOV OR LESS
( zooA OR LESS )
23.00
Main Service ( 200A To I000A )
46.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class Lic. No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ 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.
❑ 1, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
NEW CONST. DWELLING OCCURSO.
OR ADONS. ( 8 ACC. BLAS. )
3.5¢ FT.
NEW CONST. MULTI.OUTLET
NON-RESID.( BRANCH CIRCUITS )
97.50
( POWER APPARATUS )
d SINGLE OUTLET CIR.
EX. Occup. ( OUTLET OR FIXTURES )
2e @ I•eO
BAL Q .30
Ex. Occup. (oFIXEtDrs IAEs o.ORA)
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMITFEE
$
Contractor
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 1 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 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 Date
Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 50" deep and demolition or construction
of structures over 3 stories in height.
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMITFEE $
Contractor
Mobile Home Installation Fee Is
Energy Inspection Fee Is
occ 1
CONST. TYPE
TOTAL FEE $ _ 3 b
HAZ. 1 D. FEES I IMP
I FLOoo
CDF PARCEL
PD HD
ISSUE
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
By
PERMITEXPIRESON
the applicable provisions
Resolutions to do work
been paid.
Date
(Dare)
Receipt No. / �-o I S9
WHITE-D.O.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
_ a
�
4692-75 B P E M
PERMIT NO. a
M
1
P
1
E �.
M
MH UTIL.
PERMIT NO.
f
PERMIT EXPIRES
Bill-Pearsailb
OWNER
.o
4
owner
CONTR.
LOCATION (A.P. 24-29-18: )
s/s Hollis Lane ap5rp.,720 E. of Hwy. 99,
Gridley.' (rLOT 18)
l
I
_
;7
t
y�
4
'Temp.
Power 4RUPe
Called PG&E
Temp. Elec. Serv.
Called PG&E
Temp. Gas Serv.
,r
Called PG&E
• ' I
JOB
v
r
fi.
FINALED
(Date)
(Signatur
Footings
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION, RECORD
Footing _
BUILDING BUILDING (Cont'd)
Masonry Walls
PLUMBING
Setback p
% S� �'� Firewall Z
Soil Piping
Reinf. Steel
Forms
Parapets
1st Floor/6Q/
7 %S'
Main Bldg.
Restroom Finish
2nd Floor
Motors
Footings
Windows
3rd Floor
Test
Stemwal)
07 Sidin
To out7
5—
Slab
Roof Sheathing
Water Piping/j-1
23
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Service
Footings
i Garage Vents
Water Htr.
f
Stemwal1
Slab
Prov. for physically
handicapped
Heaters
Appliances
Carport
Footings
Conformance of ex.' y
structure
Gas Piping
Temp. Gas
& Test
Slab
02
Final <o ..
Sanitation
Patio
FIREPLAC ,
Final
Final
Footings
Footing _
ELECTRICAL
Masonry Walls
Throat
Rough
Reinf. Steel
Final
Fixtures
Bond Beam
FIRE SPRIN ERS
Motors
Framing !t.
z'�
Test
Water Htr.
Stucco
Final
Subpanels
Mesh
MECHANICAL
Grd. Fault Prot.
Scratch
�/ `� r
Heating
Service
Z.
Brown
Cooling
Temp. Pole
Finish
Ducts "/7
Underground
Interior Lath
Ventilation
Permanent
Door Closer /
G
Final
Final
5
DATE REMARKS OR CORRECTIONS
zz
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive,- groville, California 95965
Telephone: 534=4541
APPLICATION AND PERMIT
y
authorize representatives of the County of But
above-mentioned property for inspection purpos
961
:4 �_ C/,; ;,
Signature of rmitee or Agent
Receipt Nol 3 C,!m �2 °
White-D.P.W. — Yellow -Assessor — Pink -Inspector —
to to enter upon the This permit is hereby issued under the ap
es. the Butte County Code and/or resolutions
above for which fees have been paid.
at -
DIRECTOR RECTOR OF P LIC
By
Goldenrod -Applicant ding permit expires Date
plicable provisions of
to do work indicated
WORKS
Date --f ? 7 J
f=/7-76
BUILDING
Owner 131L �S 2 (, (_
OCC. BUILDING VALUATION
WQ.F
% %
Mailing Address W C3G� 'r/4
S%
!J e
Telephone N2 Z
Fireplace f
Contractor �t� M �-
Total Valuation 1,20�2
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee
Building Address $ ^�bLL/ ��
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
I
.20 �, pP I W
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No. .2i - `(�
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50 S "
Each additional outlet .30
Fde�*Gr.'
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
Parking ParcelLawn
EQA Plans Declaration
I P �86
1 60' R/W
I Improve ents
sprinkler system 2.00
Bld . PI n ec'
Parcel proval
PIa Approval
Permit Fee $ ..
NEW ADDITION ❑ UTILITIES ❑ OTHER ❑
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service incl. 1 meter
Additional meters, each 1.00
Sub-oarral (12 or less) (morethon 12) 4-1
-
Single Family rVT Duplex ❑ Mobil Home ❑ Others ❑
RarKge!Cook-top or Oven 1.00
Water4+eater or Space Heater 1.00
Light fixtures 2U(dd2 _
Receps„ switches & fix outlets
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:
Ho d, Ex. f an or F.A. Furt. Motor 1.00 3
Evap. cooler, gar. disp. or D.W. 1.00
Air conditioner or heat pump
Water pump / Alp.
Mobil Home Facilitie 5.00
Temp. Power Pole 5.00 Q/fe
License No. f 2a Classification
Misc. wiring
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $ 4 1E
$ q2
WORKMEN'S COMPENSATION INSURANCE
I am aware of the provisions, of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
❑ I certify that in the performance of the work for which this
permit ,is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation ^
Hood 2.00
Permit Fee $ —
$ —
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
TOTAL PERMIT FEE
$
authorize representatives of the County of But
above-mentioned property for inspection purpos
961
:4 �_ C/,; ;,
Signature of rmitee or Agent
Receipt Nol 3 C,!m �2 °
White-D.P.W. — Yellow -Assessor — Pink -Inspector —
to to enter upon the This permit is hereby issued under the ap
es. the Butte County Code and/or resolutions
above for which fees have been paid.
at -
DIRECTOR RECTOR OF P LIC
By
Goldenrod -Applicant ding permit expires Date
plicable provisions of
to do work indicated
WORKS
Date --f ? 7 J
f=/7-76