HomeMy WebLinkAbout025-220-059' ��
'
/
TOM HUFF
2440 Lone Tree Rd. 0 ovill.e
`
�
|------
` .
|2440 LONETREE,AROON'
\CO*NTR. OWNER
`
'
�}
�
^
`
`
} �
Lo
'41
6
I
f,
v
025-22-0-059 "1- �,(. � ►t y 00-2944
KL)AINARK ARGON
2440 LONETREE; OROVILLE
CONTR: OWNER y
PROPANE TANK `
OFFICE COPY
Addres
GAS
Meter By DayGs —lj�a
ELE.CTRIC
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT fid" I JfW
ASSESSOR 9,2VB v5g
ZONING
BUILDING PERMIT V
OWNERA
ARGON iZLAINARK
TELEPHONE
��v-.889
SO. FT. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS ll �t
O V♦ME 95965
CONTRACTOR'S NAME
OWER
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $ 20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDINGADDRESS
24413 R
Energy Plan Checking Fee $
PERMIT FEE $
LOT NO.
SUBDNSIONSNAME
PARCEL MAP
PLUMBING PERMIT Filing Fee 20.00
USEOFSTRUCTURE
SF El Duplex ❑ Mobilehome ❑ Other
-" SPECIFY
Each Trap 7.0023.00
Solar or heat um water heater
Water piping 15.00
Each as water heater or vent 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ OtherY❑P-Buildin
PROPANE TANS; TO GO TO HOUSE WASHER
Describe Work: •
AND DRYER
Gas piping system 1 - 5 outlets 15.00
sewer 15.00
:Mobile Home S G W @20.00
PERMIT FEE $ 3 •
ELECTRICAL PERMIT Fling Fee 20.00
Main Service A OR LESS 23.00
LICENSED CONTRACTOR'S DECLARATION
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 effect.S
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:
El' 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.)
.❑ 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 d I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
L
X /t r'rr�,} r (, �V'-- Date
Signature of Applicant'O 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 +000A 46.00
NEW CONST DWELLING occUP. 3.5Q SO.
OR FT
NEW9 °O MU..
NON•RESID. 97.50
PSINGOUTLET COWERLE APPARATUS
IR.
20
Ex. Occup. OUTLET OR FDmJRES SAL I . 0
Ex. Occup. .=RD,°E 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE t
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEIE $
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ 35,00
HAZ.
D. FEES
IMP
FLOOD
CDF
PARCEL
PD
HD
I$$SIE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for � hich fees have been paid.
i 1
By �7 , Date f f✓V
PERMIT EXPIRES ON
Dale 1
Receipt No. ^
WHITE-D.D.S.-B.D. CANARY-ASSESSO _PINK -INSPECTOR GOLDENROD -APPLICANT
C COUNTY OF BUTTE
BUILDING DIVISION : c`
—DEPARTMENT DEPARTMENT OF DEVELOPMENT SERVICES _
411 Main Street • Chico, CA • (530) 891-2751
7 County Center Drive • Oroville, CA'* (530) 53&7541
CORRECTION NOTICE
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 ,a
completed. If you have any questions pertaining to this matter; or -need additional explanation,
please contact this office immediately.
• r,i
LAS
Date _
REV 1
Inspector
.'r+^.-.'►�.�..r �-»..---••`�-..,w..,--......-Y.---,,..�-...--.ti-..r�:.i.�-�'^.'r-w.r�v-=----.�,rV-.r.v v.-�...�r .-Y....-r-
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO.
_ . --
(Rev. 12/96) APPLICATION AND PERMIT A®—,
ASSES,JT9 JRCRNUMBB�59
ZONING
BUILDING PERMIT
GWNERARROONNLKLAINARK
IT41 °"J889
SO. FT. OCC. BUILDING VALUATION
. OWNERS MAILING ADDRESS
2440 LONETREE, OROVILLE 95065
CONTRACTOR'S NAME
OWNER
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Fling Fee $
20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAIUNG ADDRESS
Plan Checkin Fee $
BUILDINGADDRESS
Energy Plan Checking Fee $
PERMIT FEE $
LOT NO.
SUBDNISIONSNAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee
20.00
USEOFSTRUCTURE
SF R3 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 ❑ Remodel ❑ Utilities ❑ Installation ❑ OtherAZI
Describe Work: PROPANE TANK TO GO TO HOUSE, WASHER
AND DRYER
Gas piping stem 1 - 5 outlets
15.00 15
oo
Building sewer 15.00
Mobile Home ISI GI W1 920.00
PERMIT FEE $
35.00
ELECTRICAL PERMIT
Fling Fee
20.00
Main Service 2o0A 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.
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:
,18 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 permitis 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'
compensation laws of California, and agree that f I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwth comply with these provisions.
X Date
SignVar ofAp lic nt - 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 iOOOA 46.00NEW
CONST. DWELLING OCCUR SO
OR ADDNS. ( a ACC. MDS. 3.5QFT;
NON".gESID ' MULTI.OUTLET @7.50
POWER APPARATUS
8 SINGLE OVILET CIR.
.00
FIXTURESEX. Occup. OUTLET OR FIXTURES BAL Q I. 0
LNS
Ex. Occup. otmEFis RES 6.OEA. 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wirina 23.00
PERMIT FEE S
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEL: $
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ 35.00
HAZ.
D. FEES
IMP
FLOOD
CDF
PARCEL
PO
HD
S E
In
This permit is hereby issued under the applicable
of the By a Coun Code and/or Resolutions
in ate for hich fees have been
B Dat
PERMIT EXPIRES ON
provisions
to do
paid..
e
work
4
l/l
Receipt No. / y
WHITE-D.D.S.-B.D. CANARY.ASSESSO PINK-INSP�EC OA GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
,: 7 County Center Drive a Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO.
2/96)
APPLICATION AND PERMIT
a.oRP ru>ea 6� Z 7 ' ZOM"a BUILDING PERMIT
�7 ��
s SO. FT. OCC. BUILDING VALUATION
m iMW..#* .a4�a 1 n tr, n r)r71l h n "( 7 i� l r,
Moors rwu+o �ooR�sa
acMrreeT oa a+a►e�
acarecr oR Dow FVVS uAuw AooRess
u�ono
Or NO. tu*ONeIONtKM!
USEOFSTRUCTURE
iF O Duplex O Mobiiehome O Other
TYPE OF WORK
New O Addition "model O LMN"�O Q Installation O Other O
Describe Work:
*PERMIT FEE PAID $
Total Valuation is
Fling Fee
Permit Fee
Plan Checking Fee
Energy Plan Checking Fee
PERMIT F
PLUMBING PERMIT
Each Trap
Solar or heat pump water heal
Water piping
Each gas water heater or vent
Gas piping system 1 - 5 outlets
Building sewer
Mobile Home I S I G IW
20.00
ling Fee 20.00
7.00
23.00
15.00
15.00
15.00 115-
15.00
@20.00
PERMIT FEE
_ -�
ICAL PERMIT
Filing Fee 20.00
rkM%alinrvice °so00o� oORRuss
23.00rvice
soon To IOWA
46.00T.
/ owEui+o occuP. 1
3.5Qo:
SRA
$
SHERIFF
OTHER
$
WP
I F1.000
I COO:
I PARCEL
Po I MO
$
AMOUNT RECEIVED
i ZT7�D
�._
* UMBER
RECEIPT N
* TO BE PUT INTO COMPUTER
Ex. OCCU . Ovrty oR FomJREs
FMO APPLM. OR
n
Ex. Occup. OuErs Es10. EA
Temporary Service
Mobile Home Facilities
Misc. Wiring
PERMIT FEE _
MECHANICAL PERMIT
Heating
Ventilation
Mobile Home Installation Fee 1 $
5.00
23.00
20.00
23.00
6.50
20.00
0C° ,
CONST.TYPE
TOTAL FEE $ -
K#Z
o. FEES
WP
I F1.000
I COO:
I PARCEL
Po I MO
I ssuE
This permit Is hereby issued under the applicable provisions
of the Butte County Code and/or Resolution* to do work
Indicated above for which fees have been paid.
By Date
PERMIT EXPIRES ON
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.
r� 1 personally plan to provide the major labor and materials for construction of the
�- roposed pr erty improvement: YES[v f NO[ ].
2. 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: CONTRACTOR'S LICENSE NO.
4. I plan to provide portions of this work, but I have hired the following peisoh- 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. fersons to
provide the work indicated:
NAME ADDRESS PHONE TYPE OF WORK'
SIGNS
PROPER OWN R.
DATE: w�-•-� % a —�1 � -
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.
Dear Property Owner:
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:
0 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.
0 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.
0 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.
0 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. R
A frequent practice of unlicensed persons professing to be contractors is to secure an "ownerbuilder"
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.
i 4Vifira,
M c telC.B.O.
ger, Building Inspection
NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
Permit#3428-8
T Huff
61 Fa �0 �/
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION -AND PERMIT
ASSESSOR PARCEL NUMBER. ,
ZONING
BUILDING PERMIT
OWNER I
TELEPHONE
S0. FT. OCC. BUILDING
VALUATION
OWNER'S MAILING ADDRESS +
CONTRACTOR'S NAME
r)y Y
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER1
/�/ ' Y'
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$ /) r�
BUILDING ADDRESS _ +
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Solar Water Heater
20.00
} I
Water piping
5.00
LOT NO. SUBDIVISION NAME
PARCEL MAP
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
5.00
USE OF STRUCTURE
SFE]' Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer
5.00
Mobile Home S G W
10.00 e
TYPE OF WORK
New❑ Addition❑ Remodel❑ Utilities❑ Installation❑ Other Q'
Describe work: t t 1 > �'_� r ►� Il ?'�)� s'
V
V
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. ( DWELLING OCCUP.&\
OR ADONS. ACC. BLOGS. II
2'h¢SQft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (Check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the BusinessEx.
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 CONSTR (MULTI -OUTLET 2,50 ea
NON.RESID BRANCH CIRC ITS
NEW CONSTR. // POWER APPARATUS &'
NON-RESID. 1SINGLE OUTLET CIR.
Occup(ou TLETS OR FIXTURES BA 030Q
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
MECHANICAL PERMIT
Filing Fee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Heating
Cooling
Hood
3.00
Ventilation
Permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
X Date
Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct.
ion of structures over 3 stories in height.
Mobile Home Installation Fee
$
TOTAL PERMIT FEE $ � Ir J c1
OCCUP. GROUP
I TYPE OF CONST.
PARCEL
PD
HD
ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
/DIRECTrOR OF PUBLIC
� " '
By A- "'y �_�
PERMIT EXPIRES Date / f`
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date /17 ".
f '
Receipt No. ' ?
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATIONAND PERMIT
PERMIT 0.
'ASSESSOR PARCEL NUMBE ZONING
BUILDING PERMIT
O WNE TELEPHONE
3e(-'
SQ.FT. OCC, BUILDING VALUATION
OWN R' MAILING ADDRESS
O
CONT ACTOR'S NAME +� 0-7
ELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNK o
Total Valuation $ 1 0"
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS -
Permit Fee
$ ^
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADEFRESS
Permit fee
$ $;'10
BUILDING ADDRESS
`49,
PLUMBING' PERMIT
Filing Fee 10.00
Each Trap
2.00
Solar Water Heater
20.00
Water piping
5.00
LOT NO. SUBDIVISION NAME
PARCEL MAP
Each qas water heater or .vent
-5.00
Gas piping system 1 - 5 outlets
5.00
USE OF STRUCTURE
SF Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer
5.00
Mobile Home S G W
10.00 e
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other
Describe work: �.19ay,cl bury,ty.0
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2:50
NEW CONST. DWELLING OCCUP.&
OR ADDNS. ( ACC. BLDGS.
2/20sgft
CONTRACTORS LICENSE LAW
I declare under penalty of perj Ury (check one):
❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the BusinessEx
and Professions Code and my license is in full force and effect.
icense No. Classification
P 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 coNsrR U TI -OUTLET 2.50 ea
NON.RESID BRANCH CIRCUITS.
NEW CONSTR. POWER APPARATUS &'
NON-RESID. SINGLE OUTLET CIR.
. Occu i0®s0C
p�OUTLETS OR FIXTURES 6AL®30
FIXED APPLNS. OR
Ex. OUTLETS (RESID.) EA. 2.00
-Occup.
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
3;JoyCt to Self -Insure.
m�f shallall not employ any person in any manner'so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shal I be deemed revoked.
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 Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabili ies, judgments, costs, and expenses which may in any way accrue
a ainst sCounty in con eque a of t e granting of this p rmit.
X Date
Signature of Applicant — Owner C ntractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
structures over 3stories in height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE $ r^J
OCCUP. GROUP
I TYPE OF CONST,
I
PARCEL
PD
I ND
I 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.
C ' OF PUBLIC WORKS
�43eipt
BY r14
��te "�E-D.P.W.,
PERMIT EXPIRES Ilate
Lio.n,Cof
No.oC
YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT