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Home My WebLink About027-310-024P ' OWNER: LOCATION: CONTRACTOR: REASON FOR PRE- DATE TO INSPECTOR: PRE -INSPECTION R 0 EPORT DATE: I A.P. # D oZ-7 —3 10 ZONING: PERMIT HIS'T'ORY (V) NONE ( ) SEE ATTACHED BUILDING INSPECTOR'S REPORT Building Description: Commercial/Usage: Residential # of Units: Currently Occupied ( ) Yes Abandoned/Vacant: Electric: Electric Currently ( ) On ( ff Condition of Electric Gas: Currently ( ) On ( ) Off Condition Sanitation: Plumbing Worldng ( ) Yes ( <o Obvious Sewage Problems ( ) Yes (4?6 ACTION RECOMMENDED: ISSUE (') Yes Hold for permits or verify: iza 4 Mobile home # of Units: j—`f Al—, 027-310-024' 04-0186 MARTINEZ LOUIS AVE, PALERMO Cont: UNKNOWN ELE FOR WELL & LOT DEVEL ( i-? o Inspector• Date: Z' SKETCH BUILDINGS ON REVERSE AND INDICATE LOCATION ON PROPERTY. COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 5325q=DA_1 (Rev.12/96) APPLICATION ANIS PERMIT OA,- ZOMNG BUILDINGPERMIT fSSESSORPARCELNU616ER �� SO. FT. OCC. BUILDING VALUATION OWNER 1� /1)/1 1 n vJ. \ % I �/l . COISTAUCr10N LENDER • LIME" MARAG "DDRB —Fireplace I Total Valuation $ _ LICENSE N0. FGn Fee $ 20.00 ARCIinECr OR ENGINEER $ Permit Fee AACHm= oA BIGI+EM 1AAu1NG ADDRESS Plan Chetlin Fee $ Energy Plan Checking Fee $ BuaDING ADOAEss $ PERMIT FEE S PARCEL ""'� PLUMBING PERMIT Frog Fee 20.00 tDTr�. mumsusomsroNs 7.00 Each Trap USEOFSTRUCTURE Solar or heat pump water heater 23.00 Water i Ing 15.00 SF E3Duplex C3Moblehome E3 Other sPicwy Each gas „rater heater or vent 15.00 TYPE OF WORK Gas piping system 1 -5 outlets 15.00 New [3 Addition ❑ Remodel ❑ UhTi6es ❑ ❑ Other ❑ Building sewer S G W1 15.00 @20.00 Mobile Home I i I Describe W ric PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service 2mowil CCR L _t:23.00-Ft 46.00 Main Service 20" To I�°-A riEw coNsr. ( Dwaurio EUP.)3.54 .PERMIT FEE PAID $ SRA $ SHERIFF $ OTHER $ AMOUNT RECEIVED $ DATE RECEIVED Ex. Occup. Dun r OR FIXTURES eAL - -Se FI® APPu15. OR 5.00 Ex. Occu D. ovT' EM XREsID.) FA Temporary Service 23:00 Mobile Home Facilities 20.00 NNsc. Wiring 23.004 PERMIT FEE $ Coorin 6.50 20. PERMIT FEt S Mobile Home Installation Fee $ Energy Inspection Fee $ XcC `oN�T'' TOTAL FEE $ MAL 10. FEES I DAP I FLDOD I =F I PARCa PD 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. By Date COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-75q nNO, APPLICATION AND PERMIT ^'-L 107 ti96� K�)r)/I O� ZONING BUILDING PERMIT ESSORPARCELNU10131 KON SO. FT. OCC. BUILDING VALUATION NEa OWNER'S MAIUNG ADD�V f 1 J V V HONE co S NAME CONIRAC R5 MADING DRESS coNSTRUCnON LENDER Fireplace LENDER'S MALING ADDRESS Total Valuation Is LICENSE N0. Firm Fee $ 20'00 ARCHITECT OR ENGINEER $ Permit Fee A McTECT OR E3IGWEFRS MA6JNG ADDRESS Plan Checkin Fee $ Energy Plan Checking Fee $ SU6DUM ADDRESS PERMIT FEE $ PARCEL MAP PLUMBING PERMIT Firmg Fee 1 20.00 LOT N0. SUBDNISIDN'S NAME Each Trap 7.00 USEOFSTRUCTURE Solar or heat pump water heater 23.00 Water i ing 15.00 SF ❑ Duplex ❑ Mobilehome ❑ Other sPEcffr Each gas water heater or vent 15.00 TYPE OF WORK Gas piping system 1 - 5 outlets 15.00 New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installa13Olher ❑ 15.00 Building SiG W @20.00 Mobile Home Describe W rk: PERMIT FEE ELECTRICAL PERMIT Filing Fee 20.00 Main Service i o Doa LF= 23.00 . (�6 Main Servicezoa► TD , 46.00 NEW CONST.ovvEtt.ING OTxUP. 3.50 OR ADDNS. a ACC. BLDs. NEw corns • MULrwvn&I @7.50 NON�srD. PERMIT FEE PAID $ �°""ER"°°"R'�`� a srNGtF ovn� aR � e N Do Ex. Occup. CXIW OR FXTURES BAL. @ .50 FDO ES. OR EA 5.00 Ex. Occup.Ovnms SID. SRA $ Temporary Service 23.00 Mobile Home Facilities 20.00 Ntisa. Wiring 23.00 SHERIFF $I "-PERMIT FEE - MECHANICAL PERMIT Firmg Fee 20.00 OTHER $ Heating Cooling Hood 6.50 Ventilation $ PERMIT FEI: S Mobile Home Installation Fee $ Energy Inspection Fee $ CO WK TOTAL FEE $ MAL 0, FEES DAP FLDDD CDf PARCEi PD � 55UE AMOUNT RECEIVED $ 1 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. DATE RECEIVED 09 By Date COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET (� OWNER: M601,'�ASSESSOR PARCEL NUMBER () -7 Proposed Building Use: Counter Technician: CAA��we tJ Items required in order to apply for a permit. 1AII boxes MUST be checked OR marked NA in order to apply. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ❑ 14. Hazardous Material Form ❑ 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. ❑ 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........ ❑ 20. Erosion Control Plan Required........................................................................ ........ ❑ 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 22. City of Chico Plumbing permit........................................................................ ❑ 23. California Department of Forestry plan approval ❑ paid. Sent by: ............. ❑ 24. Planning approval (A) Use: (B)Parking: (C) Parcel Check: ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... ❑ 26. NPDES Form............................................................................................. ❑ i L 1 27. 28. Encroachment Permit f r driveway fro the Public W • rks Dept ........................... Pre -Inspection for required....... ❑ 29. Contractor's license information. (Nu Mer, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number ................................ .......:.. ❑ 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ 32. Letter of Signature authorization.................................................................... ❑ 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 34. Manufactured home utility clearance............................................................... ❑ 35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction......................................................................................... ❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ❑ 39. Other: When issued Telephone nd hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. / Applicant: � � Date: < -� �` a� 1. Index permit application for the above items numbe e : Plan Check Letter 2. Additional items required Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Plans reviewed by: Date: Plans approved by: Structural reviewed by: Date: Structural approved by: Note transfer by: Date: Yellow: Building Division Date: Date: Date: Date: (Rev. 12/96) COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER TELEPHONE SO, FT, OCC. BUILDING VALUATION OWNERS MAULING ADDRESS CONTRACTOR'S NAME TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS Energy Plan Checking Fee $ $ PERMIT FEE _ LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE S ELECTRICAL PERMIT I Fling Feel 20.00 Main Service zoo.' oa DESS 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 is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License w 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. 1, 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 46.00NEW CONST. DWEwNG OCCUP. OR ADDNS. ( a ACc. Bins. So 3.5QFr: NEW NONREOSI�T. MULTI -OUTLET 97.50 POWER APPARATUS a SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES 20 BAL a �.w Ex. Occup. OuM'. RE�sID.DeA. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE S 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 If the Labor Code, for the performance of work for which this permitis 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.) I 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 to (9 ure of Appli ant - ❑ Owner Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEI= $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ HAz. D FEES IMP I FLOOD I CDF PARCEL PD HD ISSUE This permit is hereby issued under the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date Date ReceiptNo. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 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 w ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS CONTRACTOR'S NAME 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 Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDN6roN'S 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 as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service 2o0A 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 is in full force and effect. License Class Lic. No. °. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: QO 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 46.00 Yn200A CCU000A NEW CONST. OWEWNO OCCUP. OR ADDNS. ( a ACC. BLAS. SO 3.5QFT, NON -R SID TU ', CIRCUITS 97,50 POWER APPARATUS a SINGLE OUTLET clq. EX. Occup. OUTLET OR FIXTURES .00 BAL @ I. 0 Ex. Occup. OFuc�EE'An'.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S 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.) I certify that in the performance of the work for which this permit is issued, I shallTOTAL 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. ate /'- "/ g atuure of Appl cant��I`l ❑ Agent 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 $ Occ CONST. TYPE FEE $ HAZ. p. FEES IMP I FLOOD I CDF PARCEL PO 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. By Date PERMIT EXPIRES ON a Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT o6: (Rev. 12/96) COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER TELEPHONE SO, Fr, OCC. BUILDING VALUATION .OWNERS MAILING ADDRESS CONTRACTOR'S NAME TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Flinn Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS Energy Plan Checking Fee $ $ PERMIT FEE S LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other sPECIFv 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: Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G W @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service 000V OR LESS 200A 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.PSINGLE License Class 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: ❑ I, as owner of the property, or my employees with wages as their sole compensation, 'C' 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. DWELLING OCCUR OR ADD S. ( 6 ACC. BLDS. so 3.50FT. NON-RESID. MULTI.OUTLET H CIRCUITS 97.50 8 OUTLET OWER APPARATUS Ex. Occu ovrLEr OR FIXTURES 20 � , 00 BAL @ .50 Ex. Occup. DFIx Ds Aa DRQ 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S 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 0 the permit is for work of a valuation of one hundred dollars ($100) or less.) .. I 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 Gsr1/I/ism �g /Or '�rD°ate / C' 0/-/ Signature of Appli6an4 - ❑ Owner ❑Contractor 0 Agent 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 FEE S Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE w HAZ. D. PEES IMP I FLOOD I CDP PARCEL PDHD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date Date Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT (Rev. 12/96) I # SII COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER TELEPHONE SO- FT, OCC. BUILDING VALUATION . OWNERS MAIUNG ADDRESS CONTRACTOR'S NAME J- TELEPHONE CONTRACTORS MAILING ADDRESS Ar CONSTRUCTION LENDER i L LENDER'S MAILING ADDRESS Fireplace ' Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS Energy Plan Checking Fee $ $ PERMIT FEE S LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ 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 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service *.A DR 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 is in full force and effect.P License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perj�ry,that I em 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, 't 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 LuooA 46.00 NEW CONST. DWELLING occuP. ADDNS. ( CC. aCDC 3.5Qso. FT. NOR EW CONST. MU NON•RESID. 97.50 OWERAPPARATUS a SINGLE OLmET R. EX. OCCU OUTLET OR FDRUREs .00 BAL @ I. 0 XED APPLl S. Ex. Occup.ouFlTLETs RESID.OERA 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 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.) ,,. I 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. 7 f _/f •� s /) " r r --< • :' . Date / - _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. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ HAZ D FEES IMP I FLOOD I CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions indicated above for which fees have been By Date PERMIT EXPIRES ON provisions to do work paid. Te ReceiptNo. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 0 SOUTHERN I VIONIM40 C\l 76 o Q) c6 0 U) INN cr- U) Co SOUTHERN I VIONIM40 C\l 76 o Q) 0