HomeMy WebLinkAbout027-070-027ti -
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ROZ,A,,;;Johnorov lle
6635. Upper ,Palermo rd ,'
. y_ 9'q3
-..reroof./sfJ&) 4,
COUNTY OF BUTTE - DEPAR-HENT OF PUBLIC WORKS
7 County Center Drive - Orovllle, California 95965 - Telephone: 916.'538-7541
APPLICATION AND PERMIT
PERMIT NO.
C)
ASSESSOR PARCEL NUMBERZONING
027-070-027
APM'2.A
BUILDING PERMIT
OWNER
JOHN ROZA
TELEPHONE
533-0099 '
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
6635 UPPER PALERr10 ROAD OROV =
h c
25 SO
11500
CONTRACTOR'S NAME
0WM
TELEPHONE
`
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER ..
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee
$ 15,00
Permit Fee
$ 30.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee
$
Penalty
$
BUILDING ADDRESS
6635 UPPER PALERMO ROAD OROVILLE
Permit fee
$ 45.00
PLUMBING PERMIT
FilingFee 15.00
Each Trap
5.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
7.00
Each qas water heater or vent
7.00
USE OF STRUCTURE
SF ® Duplex[] Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home I S I G JW I
@ 15.00
TYPE OF WORK
New ❑ Addition 0 RemodeIE Utilities❑ Installation❑ Other ❑
Describe work: ROOF WT"` OX14P
Permit Fee
$
Contractor
ELECTRICAL PERMIT
FilingFee 15.00
LESS
Main service 200AORLESS
18.50
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 .Jo. 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
Main service 200ATO1000AI
37.50
NEW CONST. ( DWELLING OCCUP.&\
OR ADDNS. ACC. SLOGS. //
3.64 sq.ft.
NE w CONSTR ULT' -OUTLET
NON -REST BRANCH CIRC ITS
@ 5.00
POWER APPARATUS e
(SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES
20 7611
FIXED
Ex. Occup. OUTLETS P(RESID )REA.)
I 3.00
Temporary service
15.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00
Permit Fee
$
—
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.
O 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.
Contractor
MECHANICAL PERMIT
FilingFee 15.00
Heating
Cooling
g
Hood
6.50
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 A + � Date 4 7 — C� ..
`,.
Signature of Applicant — Owner.❑,i 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 S
Energy Inspection Fee $
OCC
CONST TYPE
TOTAL FEE45.00
HAz
1 11 FEES I
IMP
I FLOOD
I CDF
PARCEL
I PD
HD
ISS
This permit is hereby issued under the applicable provi-
sions of th e Butte County Code and/or resolutions to do
+ ti ,
Work indicated above or which feehave been paid.
DIRE66 rbF PUBLIC feel, WORKS Ji
BY .t J Date
PERMIT EXPIRESDate a `� r1 )1r41e2
•' ' f �..IT
Receipt No. 117069 45.00
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,'538-7541
APPLICATION AND PERMIT
PERMIT N0.
q -4(4
ASSESSOR PARCEL NUMBER
027-070-027
ZONING
,ARM*H 2.5
BUILDING PERMIT
OWNER
JOHN ROZA
TELEPHONE
533-8099
SQ. FT. OCC.1 BUILDING VALUATION
25 S
1 500
OWNER'S MAILING ADDRESS
6635UPPER PALERMO ROAD OROVILLE
CONTRACTOR'SM
OWNER
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
1.500
Filing Fee
$ 15.00
LENDER'S MAILING ADDRESS
Permit Fee
$ 30.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS UPPER PALERMO ROAD OROVILLE
6635
Permit tee
$ 45.00
PLUMBING PERMIT
Filing Fee 15.00
Each Trap
1 5.00
Solar or heat pump water heater
1 20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
7.00
Each qas water heater or vent
7.00
USE OF STRUCTURE
SF ® Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home ISFGTW
@ 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work: REROOF WITH COMP
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 600VORLESS
200A OR LESS
j$,50
Main service 20GATO 1000A)
37.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury check one):
P Y P 1 Y ( )
❑ 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
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 CONST. / DWELLING OCCUP.5d)
OR ACDNS. l ACC. BLDGS. //
3.60 sq.ft.
NEW CONSTR OUTLET
NO--RES-D`; BRANCH CIRC ITS
@ 5.00
POWER APPARATUS 6
SINGLE OUTLET CIR. )
EO
Ex. ccu
Occup(OUTLETS OR FIXTURES
20 76
EX. Occup. OU LETS P(RESID. IFIXED APLNS. REA.)
I .3.00
Temporary service
15.00
Mobile Home Facilities
15.00
Misc. Wiring
g
15.00
Permit Fee
$
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.
LrJ�f 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.
Contractor
MECHANICAL PERMIT
Filing Fee 15.00
Heating
Coolin g
rHood
6.50
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 liabi ties, judgments, costs, and expenses which may in any way accrue
agains aid C my in conseq ce of the granting of this permit.
X l —12 — �
Date
Si4nreof Applicant — Own Contractor ❑ Agent ❑sions
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 S
Energy Inspection Fee
$
occ
CONST TYPE
TOTAL FEES 45.00
HAz
0FEES
IMP
FLOOD
CDF
PARCEL
PO
HD
Iss
This permit is hereby issued under the
of th Butte County Code and/or
work in Ic ed aVvr which a
DIRF PUB
BY
PERM I EXPIRE Date
applicable provi
�
resolutions to do
have been paid.
ORKS
Date
Receipt No. 117069 65 -nn
WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone: 916.'538-7541
APPLICATION AND PERMIT
ASSESSOR PARCELNUMB R ZONING
_ Q -� 2-7 %H 2.5
BUILDING PERMIT
OWNER � Al o ( TELEPHOtJE
OH
SO. FT. I OCC. BUILDING VALUATION
yl 3S—ING _ ESS � A� \ MQ D- 0Q_6V(LLe_
OWNER'993S—_0
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $ 0
LENDER'S MAILING ADDRESS
Filing Fee $ 15,00
Permit Fee $30Fo
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING A,OORESS
Penalty $
BUILDING ADDRESS X ^^
�L
Permit fee $ f�
PLUMBING PERMIT Filing Fee 15.00
Each Trap I 5.001
Solar or heat pump water heater 20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping 7.00
Each pas water heater or vent 7.00
USE OF STRUCTURE
SF % Duplex❑ Mobilehome❑ Other
• SPECIFY
Gas piping system 1 - 5 outlets 5.00
Building sewer 15.00
Mobile Home I S I G JW 1 615.00
TYPE OF WORK
New❑ Addition' Remo I❑ UtilitiesD Installation❑ Other,
Describe work: LAA I MN co -m
Permit Fee $
Contractor
ELECTRICAL PERMIT Filing Fee 15.00
00V OR LESS
Main service 200AOR LESS 18.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
F1I 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
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
Main service 200ATO1000A) 37.50
NEW CONST. DWELLING OCCUP.8i 3.6Q sq.f[.
OR ADONIS. ACC. BLOGS.
NEW CONSTFL •^ ULTI-OUTLET @ 5 00
NON-RESIO• BRANCH CIRC ITS
/POWER APPARATUS Q
(SINGLE OUTLET CIR. )
Ex. Occup(OUTLETS OR FIXTURES 20 76d
R
FIXED APLNS.
Ex. Occup. OUTLETS PRESID )REA.) 1 3.00
Temporary service 15.00
Mobile Home Facilities 15.00
Misc. Wiring '15.00
9
-H
Permit Fee $
-
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.Contractor
Contractor
MECHANICAL PERMIT Filing Fee 15.00
Heating
Cooling
9
rHood 6.50
Ventilation
Permlt Fee $
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 said County in consequence of the granting of this permit.
X Date
Signature of Applicant — Owner❑ Contractor ❑ Agent ❑
An OSHA
ion of structures toverr 39storries ineheight ions over 5'0" deep and demolition or construct-
Mobile Home Installation Fee $
Energy Inspection Fee $
OCC CONST TYPE
!
TOTAL FEE $ ��
F—IL11AZ
0FEES
IMP
FLOOD
CDF PARCEL PD
HO
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.
DIRECTOR OF PUBLIC WORKS
By Date
PERMIT EXPIRES Date
Receipt No. (7 06 q Li -500
WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT
COUNTY OF BUTTE - ~Department of Public Works
7 County Center Driver Oioville, CA 95965 Phone: 916-538-7541
OWNER -BUILDER VERIFICATION
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. -
1: I personally plan to provide the major labor and materials for construction'of
the proposed property improvement (yes.or no)
2. I (have/have not) signed an app cation 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 _ Contractors License -No.
4: :1 plan to -provide- portions -of this work -,--but I have- hired the 'following person
to'coordinate, supervise, and provide the major work:
Name
Address City
Phone-. Contractors,License No.
5.. I will provide so.me-,of the work.but I•have contracted (hired) the following.
persons •to"provide=.the work indicated: .
Name Address Phone- Type of Work
Signed :
Property Owner
Social S curit
Date
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and
19832 of the California Health and•Safet.y Code.
This verification must be completed and returned to -our office before we, are per-
mitted to issue the permit.