HomeMy WebLinkAbout027-080-018> AP 27-08-18
Michelle Waterbury
7110 Upper Palermo Rd., Palermo
(INSPECTION FOR EQ DAMAGE TO FIREPLACE)
27-08-18 _-
> Lawrence G. Alley
7110 Upper Palermo Rd., Palermo
c'ontr: Polly Pools, Oroville
Permit #0332-80B.�
,E(hew ri.swimming /
pool) %f►/'� �A�
027-08-0-018 93-3563 P,M
FRANKLIN, HELEN
7110 UPPER PALERMO, OROVILLE _ 1IG `�
CONTR: JESSEE H&AC Y 7
FURNACE & 14TR HTR/SF • N
;/
,-&-.- kk3L� 4tiAv,,�4
�11�OZlvnunui Richard M. 3476B -
2772P
3 0 E
7110 U 27-08-18
Aper Palermo Rd., Palermo
(new, single family)
SIMPSON, G.B. 493�7
a-7- Q. — 1 4769
o '1
Upper Palermo Rd., Palermo'
( remodel)
r
o'
April 11, 2002
North American Mortgage
525 Wall St.
Chico, CA 95928
ATTN: Jeff Carlson
�iutfe count,
LAND OF NATURAL WEALTH A N D B E A U T Y
PLANNING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
7 COUNTY CENTER DRIVE • OROVILLE, CALIFORNIA 95965-3397
TELEPHONE: (530) 538-7601
.FAX: (530) 538-7785
Re: Burn down letter for 7110 Upper Palermo Road (AP 027-080-018)
Dear Mr. Carlson:
The above referenced parcel is currently zoned AR -1 (Agricultural -Residential, 1 acre parcels). This
zone allows for a single-family dwelling.
Should the dwelling be catastrophically destroyed it may be reconstructed to the same exact footprint
within one year, provided it will not be placed within the required building setback areas and meets
sanitation codes in effect at the time of reconstruction.
The setback requirements for the AR -1 zoning are 50 feet from the center of the road and 10 feet side
and rear yard property lines.
This parcel is not located within a (SRA) State Responsibility Area fire hazard designated area.
Should you have any further questions, please contact this office between the hours of 8:00 a.m. and
4:00 p.m., Monday through Friday, at 530-538-7977.
Sincerely,
Diana Shuey
Planning Technician Il
�CC: Building Division
NButte Countv /Department of Development Services /Planning Division AF
15
r
027-08-0-018 93-3563 P,M
FRANKLIN, HELEN
{' ti 7110 UPPER PALERMO, OROVILLE
CONTR: JESSEE H&AC
,z FURNACE & WTR HTR/SF
-------------------
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COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 ; Telephone (916) 538-'7541 PERMIT NO
APPLICATI(�IV AND PERMIT ��--�
ASSESSOR PARCEL NUMBER 027-080-018
ZONING
BUILDING PERMIT
OWNER
Helen Franklin
TELEPHONE
533-1225
SQ, FT, OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
7110 Upper Plaermo Rd., Oroville 95965
CONTRACTOR'S NAME
Jessee Heating & Air Cond.
TELEPHONE
891-4926
CONTRACTOR'S MAILING ADDRESS
3025 Southgate Lane Mit`..,o 95928
Fireplace
CONSTRUCTION LENDER ✓ 1
UNKNOWN
Total Valuation Is
LENDER'S MAILING ADDRESS
Filing Fee $ 20.00
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE N0.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
PERMIT FEE $
7110 UPDer Palermovill s
PLUMBING PERMIT Filing Fee 20.00
Each Trap 7.00
Solar or heat pump water heater 23.00
_Water piping 15,00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Each gas water heater or vent 1 --15.00 15.00
USE OF STRUCTURE '
SFXQ Duplex ❑ Mobilehome.❑ Other-
1 1 SPECIFY
Gas piping system 1 - 5 outlets 1 15.00 15.00
Building sewer 15.00
Mobile HomeS G W @20.00
TYPE OF WORK I
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other CX
Describe Work: New Forced Air Furnace & Water Neater
PERMIT FEE $ _50.00
Contractor
ELECTRICAL PERMIT Filing Fee 20.00
Main Service ( 8001 ORLESS ) 23.00
200A OR LESS
Main Service ( 200A TO 1000A ) 46.00
'
NEW CONST. DWELLING OCCUP. FT
OR ADDNS. ( & ACC. BLDS. ) 3.50 So
CONTRACTORS LICENSE LAW
I declare under'.penalty of perjury (check one)
❑ I am a licensed under provisions of Chapter 9, Division 3 of the Business and
Prof essionslCode and my license is in full force and effect.
License No. Classification
❑ I, as the owner, or my employees with wages as their sole compensation, will do
,the work, and the structure is not intended or offered for sale. (Sec 7044)
9 I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
❑ 1 am exempt under Sec. Business and Professions Code
forthis reason
NEW CONST. MULTI -OUTLET
-NON-RESID. ( BRANCH CIRCUITS ) @7.50 '�-
( POWER APPARATUS )
S SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES ) BALO. @ 1.50
Ex. Occup' FIXED APPLNS. OR
( )
OUTLETS (RESIO.1 EA. 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
WORKER'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ This permit is for $100.00 (valuation) or less.
❑ 1 have placed on file with the County of Butte Dept. of Development Services,
Building Division a Certificate of Workmen's Compensation Insurance or a
Certificate of Consent to Self -insure.
10'lshall not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California.
Notice to Applicant: If after making this statement, should you become subject to the
Worker's Compensation provisions of the Labor Code, you must forthwith comply with
such provisions or this permit will be revoked. I
`
PERMIT FEE $
Contractor
MECHANICAL PERMIT Filing Fee 20.00
Heating 1 15.00 15.00
Cooling
Hood 6.50
Ventilation
PERMIT FEE $35.00
Contractor
I certifythat I have read this application and state that the above information is correct.
I agree to comply to all Butte County Ordinances and California 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.
1 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 inconsequence of the,granting.off this permit. _
X ��'� �"i' , :, �-- �. Date /— /1— 17-;?
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.
Mobile Home Installation Fee $
Energy Inspection Fee $
OCC
CONST. TYPE
TOTAL FEE $ 85.00
HAZ.
1 D. FEESIMP
FLOOD
I 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
indicated above for which fees have been paid.
DIRECTOR OF
OF PUBLIC WORKS
By� 'lI',J t , Date
PERMIT EXPIRES ON
(Date)
Receipt No.
WHITE-D.D.S.-BSD. "— C"ANA'RRY;ASSESSOR PINK -INSPECTOR % %GOLDENROD -APPLICANT
'
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT
APPLh'ATION AND PERMIT
ASSESSOR PARCEL NUMBER
027-080-018
ZONING
U
BUILDING PERMIT
OWNER
Helen Franklin
TELEPHONE
533-1225
SQ. FT. OCC. BUILDING VALUAT
OWNER'S MAILING ADDRESS
7110 Upper Plaermo Rd. Oroville 95965
CONTRACTOR'S NAME
Jessee Heating & Air Cond.
I TELEPHONE
891-4926
CONTRACTOR'S MAILING ADDRESS
3025 Southgate Lane Chico 95928
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
Filing Fee
$ 20.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
PERMIT FEE
$
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Each gas water heater or vent
1 15.00 15.00
USE OF STRUCTURE
SF)Q Duplex O Mobilehome O Other
SPECIFY
Gas piping system 1 - 5 outlets
1 15.00 15.00
Building sewer
15.00
Mobile Home S G W
20.00
TYPE OF WORK
New O Addition O Remodel ❑ Utilities El Installation O Other Cjt
DescribeWDrk: New Forced Air Furnace & Water Heater
PERMIT FEE
$ go, 00
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service ( BOOV OR LESS )
2OOA OR LESS
23.00
Main Service ( 200A TO 1000A )
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( a ACC. BLDS. )
SO.
3.5C FT.
CONTRACTORS LICENSE LAW(
I declare under penalty of perjury (check one)
O I am a licensed under provisions of Chapter 9, Division 3 of the Business and
Professions Code and my license is in full force and effect.
License No. Classification
❑ 1j as the owner, or my employees with wages as their sole compensation, will do
/the work, and the structure is not intended or offered for sale. (Sec 7044)
1� I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
O 1 am exempt under Sec. Business and Professions Code
forthis reason
NEW CONST. MULTI -OUTLET
.NON-RESID. ( BRANCH CIRCUITS )
@7.50
POWER APPARATUS )
& SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES )
B20AL. @ 1.00
Ex. Occup.FIXED APPLNS. OR
(OUTLETS (RESID.I EA. )
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
WORKER'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ This permit is for $100.00 (valuation) or less.
❑ 1 have placed on file with the County of Butte Dept. of Development Services,
Building Division a Certificate of Workmen's Compensation Insurance or a
cIertificate of Consent to Self -insure.
shall not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California.
Notice to Applicant: If after making this statement, should you become subject to the
Worker's Compensation provisions of the Labor Code, you must forthwith comply with
such provisions or this permit will be revoked.
PERMIT FEE
$
Contractor
MECHANICAL PERMIT
Filing Fee 20.00
Heating
1115.00 15.00
Cooling
Hood
6.50
Ventilation
PERMIT FEE
$ 35.00
Contractor
I certify that I have read this application and state that the above information is correct.
I agree to comply to all Butte County Ordinances and California 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.
1 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 th granti this permit.
X Date —//�_
Signature of Applic caner O Contractor O Agent
An OSHA permi 's required for excavations over 5"0" deep and demolition or
construction of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 85.00
HAZ.
I D. FEES
IMP
I FLOOD
CDF
I PARCEL PD
NO
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.
DIRECTOR OF P LIC WORKS
BY Date
PERMIT EXPIRES ON /
/ ate/
y ��,
Receipt No. / '�i�f
WHITE-D.D.S.-B. AN -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE, CA 95965 -
2004-0039464
Recorded
OfficialRecords
Count
BUTTOf
E
CANDACE J. 6RUBBS
Recorder
ROSEMARY DICKSON
Assistant
02:52PM 29 -Jun -2004
REC FEE 13.00
Kathy
Page 1 of 3
AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT
FOR RESIDENTIAL DEVELOPMENT
Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building
permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes,
and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals,
including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations
including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust,
smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on
adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm
operations.
All that real property situate in the County of Butte, State of California, described as follows:
Date �oz--�% —D 7 -- ------ - - --- -
State of Calif nia
County of Z(117 -e-
On (pza //'o `'/ before me,
1 ,4 /(A CV -22-1) I—YL WV)�,ey Am
dawn-te��fbr ) to be the person(i) whose name(s) Ware subscribed
to the within instrument and acknowledged to me that hcf/she/they executed the same in hid/h'or/their authorized
capacity(ies), and that by his/Mr/their signature(s) on the instrument, the person(s) or the entity upon behalf of which
the person(s) acted, executed the i strument.
WITNESS my ha an fci s al
' C° v COMM # 3999GAYLA E6
Signatu a Seal: NOTARY PNL # 1 9916 IA
BL COUNTY n
2 COMM. IXP. FEB. 22, 20071
A.P. # 0'L'1 OC2 -6 t�'
L
Order No. 00215880-001
EXHIBIT A
THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS:
ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF
CALIFORNIA, DESCRIBED AS FOLLOWS:
PARCEL I:
LOT 8, IN BLOCK 67, IN SUBDIVISION NO. 1 OF THE PALERMO CITRUS TRACT AND BEING
SHOWN ON THE MAP OF SAID SUBDIVISION NO.1 OF THE PALERMO CITRUS TRACT,
FILED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF
CALIFORNIA, FEBRUARY 23,1888.
AP NO. 027-083-018
PARCEL II:
A RIGHT OF WAY FOR ROAD AND UTILITY PURPOSES 30 FEET ON EACH SIDE OF THE
CENTERLINE OF THE EXISTING ROAD, EXTENDING NORTHERLY AND WESTERLY TO A
POINT ON THE EASTERLY BOUNDARY LINE OF CITRUS AVENUE. SAID RIGHT OF WAY IS
FOR THE BENEFIT OF AND APPURTENANT TO THE LAND DESCRIBED IN DEED TO THE
PLUMAS COUNTY, A PARTNERSHIP, RECORDED MAY 9,1969 IN BOOK 1565 OF BUTTE
COUNTY OFFICIAL RECORDS, AT PAGE 689, AND SHALL INURE TO THE BENEFIT OF, AND
MAY BE USED BY ALL PERSONS WHO MAY HEREAFTER BECOME THE OWNERS OF SAID
APPURTENANT PROPERTY OR ANY PARTS OR PORTIONS THEREOF.
PARCEL III:
AN EASEMENT FOR ROAD,' PUBLIC UTILITIES AND WATER PIPELINE OVER A STRIP OF
LAND 60 FEET IN WIDTH, LYING 30 FEET ON EACH SIDE OF THE FOLLOWING DESCRIBED
CENTERLINE:
BEGINNING AT A % INCH IRON PIPE AT THE INTERSECTION OF THE CENTERLINES OF
SOUTH VILLA AND OLIVE STREETS, AS SHOWN ON THE MAP OF ADDITION TO
SUBDIVISION NO. 1 OF THE PALERMO CITRUS TRACT, RECORDED IN THE OFFICE OF THE
BUTTE COUNTY RECORDER ON FEBRUARY 28, 1888, NORTH 00° 41'21" WEST, 839.62 FEET;
THENCE ALONG A TANGENT CURVE TO THE LEFT, HAVING A RADIUS OF 400 FEET,
THROUGH A CENTRAL ANGLE OF 170 28'13", THE ARC LENGTH OF WHICH IS 121.97 FEET;
THENCE NORTH 180 09'3411 WEST, 458.97 FEET; THENCE ALONG A TANGENT CURVE TO
THE RIGHT, HAVING A RADIUS OF 100 FEET, THROUGH A CENTRAL ANGLE 52° 54'38-, THE
ARC LENGTH OF WHICH IS 92.35 FEET; THENCE NORTH 34° 45104" EAST, 113.41 FEET;
THENCE ALONG A TANGENT CURVE TO THE LEFT, HAVING A RADIUS OF 150 FEET,
THROUGH A CENTRAL ANGLE OF 230 45'53" THE ARC LENGTH OF WHICH IS 62.22 FEET;
THENCE NORTH 100 59' 10" EAST, 304.05 FEET; THENCE ALONG A TANGENT CURVE TO THE
RIGHT, HAVING A RADIUS OF 100 FEET, THROUGH A CENTRAL ANGLE OF 52° 11'50" THE
ARC LENGTH OF WHICH IS 91.10 FEET; THENCE NORTH 630 11' 00" EAST, 114.52 FEET;
THENCE ALONG A TANGENT CURVE TO THE RIGHT, HAVING A RADIUS OF 350 FEET,
Order No. 00215880-001
THROUGH A CENTRAL ANGLE OF 090 31'34", THE ARC LENGTH OF WHICH IS 58.19 FEET;
TH'�NCE NORTH 720 42'34" EAST,182.11 FEET; THENCE ALONG A TANGENT CURVE TO THE
RIGHT HAVING A RADIUS OF 100 FEET, THROUGH A CENTRAL ANGLE OF 74° 49'09"9 THE
ARC LENGTH OF WHICH IS 130.58 FEET; THENCE SOUTH 32° 28116" EAST, 145.37 FEET TO A
POINT ON THE SOUTH LINE OF LOT 8 OF BLOCK 74 OF AFOREMENTIONED SUBDIVISION
ABOVE, FROM WHICH POINT THE SOUTHWEST CORNER OF SAID LOT 8 BEARS SOUTH 89-
19' 12" WEST, 105.10 FEET, SAID POINT BEING THE END OF THIS DESCRIPTION.
Owner:
Address:
Tenant:
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS
SPECIAL INSPECTION REPORT
A. P. # �>/, U
Date of Inspection /aATAV
Inspector
Building Location:_ _7110,�¢2�t
Type of Inspection requested:
1. Housing / / 2. Financing 3. Change of Occupancy to
/) 4. Other (specify)
Present use of buildin
A. Sanitation (Housing)
1. Water closet:
2. Lavatory:
3. Bathtub or shower:
4. Kitchen sink:
5. Hot and cold water to fixtures:
6. Heating facilities:
7. Natural light and ventilation:
8. Room and space requirements:
9. Bedroom window or door for second exit:
10. Infestation of insects, vermin, or rodents:
11. Connection to sewage disposal:
12. Connection to water supply:
13. Rubbish and garbage facilities:
14. Comments:
B. Structural
1. Piers and footings:
2. Floor construction:
3. Wall construction:
4. Ceiling and roof construction:
5. Fireplaces: Z.�
6. Comments: /?/��
C. Electrical
1. Service
2. Recepta
3. Fusing:
4. Comment
D. Plumb in
1. Fixtures connected and vented:
2. Gas water heater:
3. Gas heating vents:
4. Comments:
E. Other
1. Maintenance and repair: �' T
2. Fire hazards:
3. Safety hazards:
4. Weather protection:
5. Underfloor and attic ventilation:
6. Comments•
F. Commercial Buildings
1. Roof covering:'
2. Distance to property lines:
3. Physically handicapped:
4. Restroom floors and walls:
5. Exits•
6. Improvements•
7. Zoning:
8. Comments•
G. Field Problems or Violations
1. Problem or violation (give complete description):
2. What action taken (give complete description):
3. What action recommended:
A. Information only - file.
B. Hold for ten (10) days, then write letter.
C. Write letter.
7 D. Other•
l
PERMIT NO.
PERMIT EXPIRES !7110 VI
r,
OWNER I,awranca r Alley
Polly Pools, Oroville
CONTR.
LOCATION (A.P. 27-08-18
7110 Upper Palermo Rd., Patermo
Temp. Power Pole
Called PG&E _
Temp. Elec. Serv..
Called PG&E _
Temp. Gas Serv. _
Called PG&E _
JOB
FINALED
(Date)
(Signature)
COUNTY OF BUTTE — DEPARTMEN-f OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont'd) PLUMBING
Setback
Firewall
Soil Piping
Forms
Parapets
1st Floor
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
Stemwall
Sidina
To out
Slab
Roof Sheathing
Water Piping
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
StemwaI l
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Carport
Footings
Prov. for physically
handicapped
Conformance of ex.
structure
Appliances
Gas Piping & Test
TemD. Gas
Slab
Final
Sanitation
Patio
FIREPLACE
Final
Footings
Footing
ELECTRICAL
Heinf. steel I Final I Fixtures
Bond Beam _I FIRE SPRINKLERS I Motors
atucco
Final
Subpanels
Mesh
MECHANICAL
Grd. Fault Prot.
Scratch
Heating
Service
Brown
Cooling
Temp. Pole
Finish
Ducts
Underground
Interior Lath
Ventilation
Permanent
Door Closer
Final
Final
MOBILEHOME UTILITIES ------------------
Elec- Service
Elec. Pedestal
Water Piping
Sewer
Gas Piping
BILEHOME INSTALLATION - - - - - - - - - - - - - -
Support
Elec. Continuity
Water Piping
Drainage
Gas Piping
P 9
DATE
REMARKS OR CORRECTIONS
(NOTE: An entry must be made on this form each time you visit the job site.)
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
` 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT NO.
a�
ASSESSO PARCEL N BER
f% 7 �J QQ�
O ING
Z _
a/)\
BUILDING PERMI
OWNER
iL�/lel
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNER'S LING A DRESS
CONTR O 'S N ea!
:� P ,ON
^ /
CONTR.&CTO. AILDDRES
t_ 'S Ma1 ve' Ccl
CONSTRUCTION LEN ER
`,e_
UNKNOWN
Fireplace
Total Valuation Is
LENDER'S MAILING ADDRESS
Permit Fee
$ ,cep
ARCHITECT OR E (NEER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS '
Permit fee
$ tf
BUILDING ADDRESS� �
W/® a, /L Alewyo-ZIC
PLUMBING PERMIT
Filing Fee 3.00
Each Trap `
2.00
Repair drainage or vent piping
2.00
Water piping
LOT NO.SUBDIVISION
NAME
PARCEL MAP
Each qas water heater or vent
2.00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE/7
SF [:1Duplex❑ Mobilehome❑ Othery��•�l
SPVFCIFV
Building sewer
Lawn sprinkler system
2.00
TYPE OF WORK
New N Addition ❑ Remodel ❑ Uti lities ❑ Installation ❑ Other ❑
Describe work: —
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 3.00
Main service 100 AMP ORV OR LESS5.00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. DWELLING OCCUP.&
OR ADDNS. ACC. BLDGS.
20 sq ft
CONTRACTORS LICENSE LAW
I declare un er penalty of perjury (check one):
I am licensed under provisions Of Chapt. 9, Div. 3 of the Business
and Professio Cod y and m license is in full f rc{�e and effect.
�^l
License No. � 7 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)
❑ ram exempt under Sec. , Business and Professions Code
for this reason
NEW CONSTR. ULTI.OUTLET 2,50 ea
NON-RESID BRANCH CRC"
NEW CONSTR ( POWER APPARATUS & 1
NON-RESID. SINGLE OUTLET CIR. /
Ex. Occup(OUTLETS OR FIXTURES B AL
AL0C
1 @
Ex. Occup.(OUTLETS FIXED P(RESID )REA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiringe:Z „� 6.25 �5
Permit Fee $ J
Contractor
MECHANICAL PERMIT
Filing Fee 3.00
WORKMEN'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
ave 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.
Heating
Cooling
Hood
2.00
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 Countyot
Butte to upon the above-mentioned property for inspection purposes.
I also gree o save, indemnify a keep harmless the County of Butte against
all Iia ilit' s, dgmen costs, nd expenses which may in any way accrueF
against ( C ty in eq en the granting of this p`errm.it/ fy�
X C Date /6'O V
Signature of Applicant — Owner ❑ Contractor Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
of structures over 3 stories in height.ceipt
Mobile Home Installation Fee $
Land Development Fee $
TOTAL PERMIT FEE $ 7 ,��
oc CUP. GROUP
TYPE of CONST.
PARCEL
PD
ND
SSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTO PUBLIC
P IT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date 7 / o —�'y'ynno
�"��% - Tr
Lion
No.By
TE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT