HomeMy WebLinkAbout026-060-076COUNTY 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
ASSESSOR PARCEL NUMBER
SEE
ZONING
BUILDING PERMIT
OWNER
TELEPHONE
SO. Fr, OCC. BUILDING VALUATION
OWNERS MAULING ADDRESS
4190 PRJ. DR SAGRAMEITM CA 95838
CONTRACTOR'S NAME
TELEPHONE
1341-9473
CONTRACTORS MAIUNG ADDRESS
140 DYERS STREET CHICO CA 95928
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Permit Fee
$
Plan Checkin Fee
$
BUILDING A9DORESS
PALERMO LOCATIONS SEE ATTACHED
Energy Plan Checking Fee
$
$
PERMIT FEE
S
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 ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: PLACE CATV POWER SUPPLIES
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home ISIGIW
@20.00
PERMIT FEE
S
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service q OR LESS
9 23.00 207.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencingwith of of Business and Code,
ith Section 7000 )f Di3f thBid Professions
and my license in II �force and effect. ^/ / ` % ^
License Class f '� Lic. No. / �+ � rl t Lo
OWNER -BUILDER DECLARATION
I herebyaffirm under penalty of perjury that I am exempt from the Contractors License
P hY P 1 rY P
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
Main Service 200A TO 1000A
46.00
NEW CONST. DWELLING OCC
OR ACDNS. ( a ACC. BLDS. UP.
3,5¢S0.
FT.
NEW CONS I. MULTI -OUTLET
NON•RES10. GI
@7.50
POWER APPgRATUS
a SINGLE ourLtT cIR.
Ex. Occup. OUTLET OR FIXTURES
g20 @ 1.00
Ex. Occup. FIXEDAPPLNS. OR
ouTLErs RESID. EA
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE
$ 227.00
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 '
PERMIT FEE
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 if should become subject to the
isions of section 3700 of the Labor Code, I shall
forthw' rovisions.
workers' cW-0
_
X Date I
Signature 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.Ndk/
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $227.00
HAz.
D. FEES IMP
FLOOD
CDF
PARCEL
PD
HD
ISSUE
This 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.
D to oZ-
PERMIT EXPIRES ON
Da
ReceiptNo.
WHITE-D.D.S.-B. D. ARY• SSESS PINK•INSPECTOR GOLDENROD -APPLICANT