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Home My WebLink About026-182-007<� �� ,r _ _ \ a •t Coll r CN COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT / PER IT NO. ASSESSOR PARCEL NUMBER ZONING 'Q a— 0 7 BUILDING PERMIT O NER TELEPHONE + r _11N. l 60 SQ. FT. OCC. BUILDING VALUATION O Is MA G ADORE sS �j t ! b Q� CONTRACTOR'S NAME Qr TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing'Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $42, ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADORES r S PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 W , _71 Water piping LOT NO. VISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUgVRE 1�5--) S�raQ� SFDuplex❑ Mobilehome❑ Other -1 SPE FY Building sewer Lawn sprinkler system 5.00 TYPE QF WORK New ❑ Additio R odel Util' ' s Installation Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600 AMP LOR ESS 5.00 r Main service EA. ADD'L 100 AMP 2;50 NEW CONST.( DWELLING OCCUP.E7� OR ADDNS. ACC. BLDGS. 2� sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ 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 CO IDR BRA cH CIRCTITS 2.50 ea NEw CONSTR POWER APPARATUS &) NON.RESID, (SINGLE OUTLET CIR, EX. OCCUp OUTLETS OR FIXTURES 5 625 IXED APPLNS. OR Ex. Occup.(ourL ETS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 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. 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 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 s •d County in con equ nce oyJthe granting of this permit. / ?/?/71 Signature of Applicant Owner ® Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures ovjer 3 -stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ r OCCUP. GROUP I TYPE of CONST. PARCEL PO 1 ND I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. (n 1_/ j WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPART�MENT,OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/534-4541 PERMIT APPLICATION DATA SHEET c Permit No. OWNER n A. P. No.�-�i Proposed Building Use Permit Fee Based Upon: Complete Contract Pric �PW Valuation Ot er xplain) Building Inspector. Date At time of (permit application, I was advised t e following data must be submitted prior to permit processing and/or Is aance: DATE RECEIVED APPROVED ,All items have been submitted. . . . . . . . . . . . 2. Plot.plans in duplicate./triplicate. . . . . . . . . . . t Complete plans i uplicate./ 'plicate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. State Energy Forms No. 7 statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . 9. Letter of signature authorization. . . . . . . . 10. Sanitation approval from Health Dept. 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ ) 15. Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . . . . Pre-Inspec. request to 17. Pre -Inspection for Required. Building Inspector (Date) 18. Other When you i-ssue the permit, process as follows: Mail to owner. Mail to contractor. !/Telephone .33,&/6 and hold for pickup at QH) office. Deliver w/inspector. Other Applicant�,a Date s S Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance. (For required items not checked above mime of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor,, Designer, ner) was advised of above requiredat lephone Mail Other ByV Date Plans checked by. Plans approved by Other Copy—C PW Date Date COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA. 95965 OWNER -BUILDER VERIFICATION Attention Property Owner: Phone: 916-534-4541 An "owner -builder" building permit has been applied for in your name 'and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay iri processing and issuing your build- ing 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) y/ �j 2. I'(have/have not) �;.�; signed an application for a building permit for the proposed work. 3. I havcontracted with the following person (firm) to provide a proposed const tion: Addres Phone 4. I plan to provide person to coordinate, Name Address Phone Contractors License N ions of this work, bu /I have hired the following supervise, and pro ide'the major work: tors License No. C ity 5. I will provide some of the ork t I have contracted (hired) the following . persons to provide the w k indicat Name Addr ss Phone Type of Work Signed: Property Owner Social Security number 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 permitted to issue the permit.