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HomeMy WebLinkAbout026-010-052SHANER,LARRY 467 LONE TREE RD., OROVILL� �\ CONTR: NA "/e\L \dl� REROOF / HOTMOP ��V 1'y r COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 P MIT NO. (Rev. 12/96) pct�.e I APPLICATION AND PERMIT C', l,D-1 �0 ASSESSOR PARCEL NUMB`/"/'Fj� A OCl ^ O5_^C/— ZONING BUILDING PERMIT OWNER SADAWL5 TELEPHONE 3-3 '� SO. FT. OCC. BUILDING VALUATION T-3 90-100 .OWNER'S MAW AD RES Y� �, 1 t CONTRACTOR' NAME TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ (� ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $V34D6 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS 40 Energy Plan Checking Fee $ $ PERMIT FEE $ LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling 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 gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: a0Kz1J_R_ k,&t % ,&p Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ 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 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 L3a "I t Lic. No.,30 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. ❑ 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 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' co pens tion insurance carrier and policy number are: Carrier ,.- Main Service 200A TO 1000A 46.00 NEW CONST. DWELLINGOCCUP. OR ( 3.5Qso CONST." MLIL�Tcov�rLEST =R61D. 7.50 POWER APPARATUS 8 SINGLE OUTLET CIR. �(, OCCU OUTLET OR FIXTURES SAL 1:� FIX Ex. Occup. oimETs REESIo.OP.A 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 2 0. 00 Heating Cooling Hood 6.50 Ventilation PERMIT FES S 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 f I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall with rcoith those provisions.This Date % -7�"� Signature of Applicant - wrier AContractor ❑ Agent An OSHA permit is require for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TYPE TOTAL FEE $ g'3, loccCONST. •D P FLOOD coF pARC0. pD HD SUE permit is hereby Issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicate above for which fees have been paid. By Date PERMIT EXPIRES ON ate Receipt No. 369 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 0 026-010-052 00-306.0 SHANER, LARRY 467 LONE TREE RD., OROVILLE CONTR:NA REROOF/HOTMOP y .-N COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 FERMI NO. (Rev.12/96) ; 1. APPLICATION AND PERMIT C:. ,�'��' ASSESSOR PARCEL NUMBER ^ � .y .. !l 2— ZONING BU I LD I N G P ER M IT OWNER e >Z1 '3-hary TELEPHONE 5 SO. FT. OCC. BUILDING VALUATION � OWNERS MAILING ADDRESS �- .1 d . tom'? ou'!le CONTRACTOR'S NAME TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUC-ION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ Q 0 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checkin Fee $ BUILDINGADDRESS L/ F,,� ^ C Energy Plan Checking Fee $ $ F' rt I L PERMIT FEE S LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.0023.00 USEOFSTRUCTURE SF ;+ Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat um water heater Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: Pc `ryyi-4 -4 �t` pl'r%t4 kx t O'� t,_6 Gas piping system 1 - 5 outlets 15.00 Buildingsewer 15.00 Mobile Home I S I G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 Main Service 200A 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. - h •. -` License Class � :` S l 1 ! i Lic. No. � � `� I l OWNER -BUILDER DECLARATION I 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. ❑ 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 46.00 NEW CONST. DW0.LMX� OCCUP. OR ADONS. ( a ACC. BLos. SO 3.5¢FT; IpµF6,T. MULTI- OUTLET , CIRCUITS @7,50 POWER APPARATUS a SINGLE OUn.ET CIR. Ex. Occup. OUTLET OR FIXTURES 20 Q 1.00 BAL ® 50 Ex. Occu . D�T'ILIT Ao OE 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 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. I 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 I, N I1%el Policy Number L H I 14.A (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 C" i 'ti�_ -� Date o? •i Signature of Applicant - ❑,Cwner A -Contractor ❑ Agent - An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEI= $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $. HAZ. D FE MP FLOOD CDF PARCEL PD HD ISSUE V 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. �+/ By � �,� i(P� F. F z1a Date PERMIT EXPIRES ON ' �)I I Date ReceiptNo. ` 'ti �� r Ay WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT