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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 ------------------- 4 t i r � + a � � OFFICE COPY #i Address + GAS ' Meter By �� `. 7 ELECTRIC Dat > Meter By — . Date } i , 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