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Home My WebLink About026-190-004(C 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 n `� ASSESSOR PARCEL NUMBER SEE ATTACHED ZONING ..� 9 -111110119 BUILDING PERMIT OWNER COMCAST CONNINICATIONS TELEPHONE Sp. FT, OCC. BUILDING VALUATION OWNER'S MAILING ADDR=SS 4350 PRI, DR SACRAMEN10 CA 95838 CONTRACTOR'S NAME TELEPHONE Z_ CONTRACTORS MAILING ADDRESS 140 MEYERS STREET CHICO CA 95928 CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation is ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 9 PALERMO LOCATIONS SEE ATTACHED Energy Pian Checking Fee $ $ PERMIT FEE $ LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other sPEclw 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 ISI GI W1 920.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 800VOR LESS Main Service 200A 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 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license ' in II force and effect. /_- License Class t �—� � Lic. No. r7LO � rl i LO 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 astheir 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. DW8 AC1:1JNG 0CCUP. OR ADDNS. ( C. BLOS. sO 3.50FT. NOh"ESIDMULTI-OIurLET RCUITS @7,50 POWER APPARATUS & sINOLE OUTLET CIR Ex. Occup. OUTLET OR FIXTURES 20 00 BAL @';50FIXTURES Ex. Occup. ou�TLEEDTs RES D.GEa 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 ,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.) 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 JlEovisions of section 3700 of the Labor Code, I shall forthwo ply w' th rovisions. X Date I I.- i Z - D Signature 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.A MECHANICAL PERMIT Filing Fee 20.00, Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE HAZ. D. FEES IMP FLooD I COF I PARCEL PD HD ISSUE 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. C Nhlkl�'f pp�� D to o� V PERMIT EXPIRES ON Da ReceiptNo. WHITE-D.D.S.-B.D. NARY- SSESS PINK -INSPECTOR GOLDENROD -APPLICANT