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Home My WebLink About027-082-015 027-082-015 03-1113 PRINCE, JOHN 27815 VILLA AVE. ORO. RICH LEATH & ASSOC. , WATER CHANGE OUT GAS -,HRT. o`P,� NEWW COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 7/a MIT NN (Rev. 12/96) APPLICATION AND PERMIT G 0-3-1J ASSESSOR PARCEL NUMBEfjI „'— ZONING BUILDING PERMIT OWNER M t�'2t n c.� TELEPHONESO, 533.41Ra FT, OCC. BUILDING VALUATION MTI ADDRESS OWNERU � -.? t h► :C,C a A to Ciro v I'� l CONTRA OR'S QIAME / TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS ^ 1. 0'((_(c,_ �( l�f , ( (_f� � Energy Plan Checking Fee $ n y -o U 1 Op PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF,C4' Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 rj, pU TYPE OF WORK New ❑ Addition ❑ Remodel ❑ U61ifies(r❑ Installation ❑ Other ❑ Describe Work: H ? ` . ka.4,c eta �1Cli'�,t Gas piping system 1 - 5 outlets 15.00 Buildingsewer 15.00 Mobile Home I S I G W @20.00 PERMIT FEE $2,5,00 / ELECTRICAL PERMIT Fling Fee 20.00 800V0LESS Main Service 20.A OR LESS 23.00 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 is in full force and effect. License Class tai :-z,[. 7 C� Lic. No. (. r �C (. OWNER -BUILDER DECLARATION I hereby a�irm 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 as their 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 TO lOooA 46.00So NEW CONST. DWELLING UP. I OR ADDNS. ( DIMING BIDS. SO 3.5¢FT. COT. MU _CJFTLET OU @7.50 POWPARATUS 8 SINGLERAPUTLET E OCIR. Ex. OCCUR. OUTLET OR FDRURES zo (9 1.00 BAL@ .50 FIAPPIM OR Ex. Occup. ounETs RESID. Ea 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 I J PERMIT FEE $ WORKERS' COMPENSATION DECLARATION I 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 I performance of the work for which this permit is issued. —0, 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 ' . , '- c C t,.r^ . \A'c . i ... u C ' Policy Number 0-:11 (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.)occ ❑ 1 certify that in the performance of the work for which this permit is issued, I shall 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 provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. ( ( X :� �o - \ + . Date t 1' �l Signature of'Applicant - ❑ Owner ❑ Contractor 13 Agent I j An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ 3 CONST. TYPE / TOTAL FEE $ 3 Cry HAZ. D. FEES IMP FLOOD CDF PARCEL PD HD ISSUE t/ 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. y Byf �) � ti i� C i� LCD Date / 03 `, PERMIT EXPIRES ON �' ate Receipt No. �� S moi/ /%— S`•G� WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT o COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILXDDIVISION 7 County Center Drive • Oroville, California 95965, • Telephone (53041 ® 17"0 • (Rev. 12/96) APPLICATION AND PERMIT G i' ASSESSOR PARCELNUM _ 0,3 O ZONING BUILDING PERMIT OWNER TELEPHONE 33-0 (8a SO. FT. OCC. BUILDING VALUATION OWNER IWID✓ - V , TV` 1 OVI•{' �gG\\GCC.��'' CONI TOR'S ME TELEPHONE CONTRACTORS MAIUNG ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER UCENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 11�(� �• v / I cU�- � V_/` C7CJ Energy Plan Checking Fee $ $ Oro u I' lie PERMIT FEE S LOT NO. SUBDNISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF)< Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00. I rj, 00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities IIns�tallationn ❑ Other ❑ Desccr�riibbe!e Work: 1, �t O,, (-�lj--WC/✓"fix- Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE S °O ELECTRICAL PERMIT Fling Fee 20.00 Main Service 2a0A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION 1 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' ,iJs' in full force and effect. �y License Class • �l� a :� Z Wim- ?�,ZJC., Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 1, as owner of the property, or my employees with wages as their 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 TO tOooA 46.00 WEE200A NEW CONST. DWELLING OCCUP. OR ADONS. ( a ACC. Blas. SO 3.50 FT. NONp6,p,' MULTI -NCHOUTLET 97,50 POWER APPARATUS a SINGLE OurLET CIR. Ex. Occup. OUTLET OR FORURES zo p 1.00 BAL @ .SO Ex. Occup. OFlxs R DOER 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 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 Ai 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 worker I co pens,ati-on insure ce carrie nd policy -number are: Carrier �L�tv�\ VL , - fl_"tiCL MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FES S _� Policy N 1'1 SN0. 1�7 C `Z (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall 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 provisions of section 3700 of the Labor Code, I shall fo hwith com wit those provisions- XZ - Sign ure o Applican - ❑ Owner ❑ Contractor gent An OSHA perm) squired for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ oc f 3 CONST. TYPE TOTAL FEE $ :3 -bo HAZ. I D. F IMP I FLOOD CDF pgRC0. I PD I HD SSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicate bove for which fees have been paid. B Date PERMIT EXPIRES ON 4/— /? –6!1 (D.9 ta Receipt No. 32 '-1`7 1 au WHITE-D.D.S.-B.D. =SS()R PINK -INSPECTOR GOLDENROD -APPLICANT