The URL can be used to link to this page

Home My WebLink About027-360-195027-360--195 94-1013P,E(lnI) CORBITT, 'JANICE 8'1 FOUR JUNES WAY, ORJVILLE 'MOBILEHOME UTILITIES. �1! ELECTRIC y GAS. LINE COMPACTION TEST REQ ; SUPPORT STRUCT RE i 0 0;2 7- � �� 1� Chi i `C.QUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT �- �0(3 ASSESSOR PARCEL NUMBER 027-360-195 A5 ZONING BUILDING PERMIT OWNER JANICE CORBITT TELEPHONE 741-2766 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 36 MONTANA DR MARYSMILLE,95901 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS 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 $ 23.0 0 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Pealty $ BUILDING ADDRESS 81 FOUR JUNES WAY PERMIT FEE $ 23. 0 OROVILLE 1Z PLUMBING P MIT Filing Fee 20.00 Each Trap 7.00 IJV Solar or hea ump water heater 23.00 Water PpKg g 15,00 LOT NO. SUBDIVISION'S NAME PARCE MAP �j — p 52 Each as water heater or vent 15.00 USE OF STRUCTURE SF ❑ Duplex ❑ Mobilehome A Other SPECIFY G piping system 1 - 5 outlets 15.00 uilding sewer 15.00 Mobile Home 20.00 rn nn TYPE OF WORK New ❑ Addition ❑ Remodel ❑ UtilitiesR Installation ❑ Other O Describe Work: M%U 2 BEDROOM PERMIT FEE $ 80 00 Contractor ELECTRICAL PERMIT Filing Fee 20.00 OR LESS Main Service ( "' OR LESS ) 200. 23.00 22 00 Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( 3 ACC. BLDS. I s0. 3.50 ,. I declare under penalty of perjury (check one) CONTRACTORS LICENSE/ndeff ❑ 1 am a licensed under provisions of Chapter 9, of the Business and Professions Code and my license is in full force. License No. Classification 1, 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, 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 I @7.50 ( POWER APPARATUS I & SINGLE OUTLET CIR. x. Occup. ( OUTLET OR FIXTURES ) B20@1.00 E . Occu FIXEDAPPLNS. OR P- ( OUTLETS IRESID.1 EA. I 5.00 Te orary Service 23.00 Mobil Home Facilities 20.00 20.00 Misc. WI 'ng 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 lVCertificate of Consent to Self -insure. I 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 $ 63,00 Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling 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 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 .ndemnify and keep harmless the County of Butte against all liabilities, judgmen , c sts, and exp`en s which may in any way accrue against said Coun n conse en of he, an n of this permit. Date Sig ure of A p ant - Owner ❑ Contractor ❑ Agent A OSHA permit is required for excavations over 5"0" deep and demolition or nstruction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ HAZ. D. FEES IMP �- FLOOD 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. By Date PERMIT EXPIRES ON (betel 162464 Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT ^'may;i ^ b� ° � y" } , f'' "''~`S 1F�3I1�." a"r f w" i' .r^, {✓ �:� i�" " ry+v,r' �-.,� rt y^ -4, ) ,V, COUNTYOF BUTTE - DEPARTMENTOF DEVELOPMENTSERVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNl, �-V965 - TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER d A. P. ,9- Proposed Building Use Building Inspector Date'114 F1 I At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY All items have been submitted......................................... 2. Plot plans, 3/4 sets, signed by preparer of plans . .......................... 3, Complete plans, 3/4 sets, signed by preparer of plans . ...................... .4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form . ................. ....................... 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings. 8. Engineered truss details and layout in duplicate (required,�rior to plan check). . . 9. Mobilehome data and manufacturer's installation instru tions, 2 sets. 10. Fees of $ . .. ....... ... 11 ......... Impact fees as shown on attached schedule: i . 1 12. California Department of Forestry plan approvaes�. .......%............. 13: Blood elevation letter (100 year flood, b California Engineer. / ........:::::: Sanitation andbllot plan approval GJ Health Department. . 15. City of Chico plumbing permit. ................... ,/ ................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: ......... 18. ontact Land Development.about (A) Improvements (B) Drainage. , �J 9. Driveway permit (construction approval required,prior to occupancy).. pall`./4X .... �A 4 20. Pre -inspection for / required. .. ; Build 9 ospecor Date 21. Contractor's license information. (No., Name'Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23 Owner -Builder Verification (Given to owner , Mail to owner . ........... Recorded copy of Agricultural Acknowledgement Statement. .................. Letter of signature authorization. . 26. Copy of recorded deed of parcel creation d. and 60 right of way to a public road .... . 27. Letter of intent on building use' .....„.................................... 28. Mobilehome utility clearance . .........................: . 29. Documentation of legal access . ..................... :......... . 30. Documentation of 50% subdivision developed or .(A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan check list . ..................................................... 33. 34. " When you issue the permit, process as follows: Mit ow, er. Mail to contractor. Telephone - and hold for pickup at office. Deliver with inspector. Other Parcel Creation AcreagerF1plicantlDate Copy of Haz-Mat form sent Health Dept. Fie Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit Ifor above items No.-' 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone —mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works ` COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER O c� / C? J ZONA BUILDING PERMIT OWNER�-0J / TELEPHONE 711,2 SQ. FT. OCC. BUILDING VALUATION OWNER'S�NG DRESS A4,1f,n�'C yS , ON]�% / CONTAACTO N TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 0 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ . V Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDR - 0 / � d �/ / I PERMIT FEE $ ;;L, 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 15.00 USE OF STRUCTURE SFO Duplex O Mobilehome Other sPECIFv Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home W @20.00 1 TYPE OF WORK N Addition O Remodel ❑ Utilities( 'Installation ❑ Other O Describe Work: X/V ``v PERMIT FEE g Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service` OR LESS 200A OR LESS) 23.00 Main Service ( 200A TO IOOOA ) 46.00 NEW CONST. DWELLING OCCUP. OR ADONS. ( 6 ACC. BLDS. ) SO. 3.50 FT. CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) ❑ 1 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 O 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) ❑ I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) ❑ 1 am exempt under Sec. Business and Professions Code forthis reason -NEWCONST, MULTI -OUTLET NON-RESIID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) BA20 @ 1.000 Ex. Occup' ( OFIXED APPLNS. OR UTLETS (RESID.) EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 D Q Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. O I 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. O I 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 $ �Q Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling 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 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. 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 saidHAZ. County in consequence of the granting of this permit. X Date Signature of Applicant - O Owner O 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 coNsr. rrPE TOTAL FEE $ r D. FEES IMP FIOOD COF 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 /Dare/ Receipt No. WHITE•D.D. .•a. . CANARY•AS ESSOR PINK -INSPECTOR GOLDENROD -APPLICANT Return to: AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT 9 4_ 7 6 3 0 ( EDivision FOR RESIDENTIAL u::Wng DEVELOPMENT /� Secy 5u 26-8.1 of the Butte County Code requires this aclmowledgement_be ,recorded prior to issuance of a building permit. , 94-017630I Rec Fee 9.00 The :pr opety`described.herein is'adjacent to land or included ; I Check 9.00 within'an;arearzoned for agricultural purposes, and residentsRecorded I .of this,:property` may be subject- to`Anconvemences 'or Official Records I discomfort arising from; the ' use of agricultural chemicals, County o f I including, but, not' limited ,to herbicides; pesticides, and Butte I ` fertilizers ;and from,the •pursuit .of 'IF *agricultural operations Candace J. Grubbs I incluQ,' but not -limited to cultivation, plowing,, spraying, Recorder I pruning, ;; t, and ;I` , harvesting' which , occasionally "generate 9 ; 13 a m 20 -Apr -94 I P U B L X X 2 dust,smoke;noise, and odor::,,Butte County has .established agricidtural'zones which have'.as a priority use" for productive agricultural'pnrposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfortfrom normal,, necessary,+farm operations. All°,that= real ..property,;situaterin'the Counry�of'Butte, .State•of California, described as follows: x - ; . �. Date: State of California ) County of Butte ) On 4-20-94 before me, Daniel F. Hunt personally appeared Janice Corbitt pW0K310WtxaKK (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowle d to me that he/she/they executed the same in his/her/their authorized capacity(ies); and that his/her/t ei ' sign , s) o the instrument, the person(s), or the entity upon behalf of which the person(s) acted, ex to the i nt. ®®®®®lo®®®®®�a®®®®a®®®■®®B® WITNESS my han offici ® DANIEL P. HUNT NOTARY PUBLIC -CALIFORNIA ® Butte County Signature - Seal: ® My Commission Expires Oot.1,1994 A.Prc: U_�l 71_- , JW ` m• DESCRIPTION 9 4- 1 - 6 3 0 7. y �.t ALL THAT CERTAIN REAL PROPERTY„SITUATE IN THE STATE OF CA-LIFORNIA,- COUNTY OF BUTTE, DESCRIBED AS,FOLLOWS: PARCEL I: PARCEL 5, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED INTHE OFFICE -OF THE RECORDER OF THE COUNTY OF BUTTE, STATE' OF -CALIFORNIA, ON FEBRUARY 28, 1992, IN BOOK 125 OF MAPS, AT PAGE(S).50•THRU.'52.j- RESERVING THEREFROM THOSE CERTAIN RIGHT OF WAYS FOR ROAD PUBLIC-.. UTILITY EASEMENTS AS SHOWN'ON THE HEREIN PARCEL MAP. SUBJECT TO COVENANTS, CONDITIONS AND RESTRICTIONS, RECORDED MARCH 3, 1992, UNDER BUTTE COUNTY RECORDER'S SERIAL NO. 92-9036. PARCEL II• THOSE CERTAIN RIGHT OF WAYS AND PUBLIC UTILITY EASEMENTS, AS. SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF�THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON FEBRUARY 28, 1992, IN BOOK 125 OF MAPS, AT PAGE(S) 50 THRU 52. EXCEPTING THEREFROM ALL THAT PORTION LYING WITHIN THE BOUNDS OF PARCEL I, DESCRIBED HEREIN. 0 END OF DOCUMENT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT 0. APPLICATION AND PERMIT ��` Z029- ASSESSOR PARCEL NUMBER 027-360-195 A5 ZONING BUILDING PERMIT OWNER JANICE CORBITT TELEPHONE 741-2766 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 36 MONTANA DR MARYSVILLE 95901 CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS 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 $ `Z 3.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS r Penalty $ BUILD wc ADOR ass •" 81 FOUR JUNES WAY PERMIT FEE $ 43. 00 I h f. `/ 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 15.00 USE OF STRUCTURE SF ❑ Duplex ❑ Mobilehome M Other SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W 20'00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation CX Other ❑ Describe Work: MHI PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( 10V oR LESS ) 200A OR LESS 23.00 Main Service ( 200A To IOOOA ) 46.00 NEW CONST. DWELLING OCC UP. OR ADDNS. ( & ACC. OLDS. ) SD. 3.5C FT. CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) ❑ 1 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 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) ❑ 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 1 & SINGLE OUTLET CIR. I Ex. Occup. ( OUTLET OR FIXTURES ) g2 @ 1.00 50 Ex. Occup' ( FIXED APPWS. OR OUTLETS IRESID.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. �l I 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 Cooling 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 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. I also agree to save, indem nd keep harmless the County of Butte against all liabilities, judgmen�S, cost and a penses which in any way accrue against said nce the gr tin of thi p mit. nn a ounty "Applicark_0 Date —IeG —/ jignre of Owner ❑ Contr ctor O Agent 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 $ 100.00 Energy Inspection Fee $ OCC CONST. rrPE TOTAL FEES 143.00 HAZ- D. FEES IMP F100D CDF PARCEL PD �— HO 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 /Date/ Receipt No. 162464 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTYOF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTYCENTER DRIVE - OROVILLE, CALIFORNIA95965 - TELEPHONE (916) 538-7541 PERMIT APPLICATION -DATA SHEET OWNER co" A. P. No. 3t�-, Proposed Building Use Building Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing arta/or issuance: DATE RECEIVED BY 1. All items have been submitted . ........................................ 2. Plot plans, 3/4 sets, signed by preparer of plans . .......................... 3_ Complete plans, 3/4 sets, signed by preparer of plans . ...................... .4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form . ............................................. . 6. 'Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8�. ngineered truss details and layout in duplicate (required prior to plan check). ..... L___9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10 ees of $ .......... ........................ . 11. Impact fees as shown on attached schedule.(.-kPJC................... 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval Health Department . 15. City of Chico plumbing permit . ......................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). .. . . 20. Pre -inspection for required. .. to Building �� (Date) ) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner ). ........... .j_--1i;'_R_ecorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . Letter of intent on building use . ......................................... 28. Mobilehome utility clearance . ......................................... . 29. Documentation of legal access' .....................:................. . 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan check list..............................................� 33. 34. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone - and hold for pickup at 6�/% office. Deliver with inspector. Other Parcel Creation Acreage Applicant ate Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. ther� Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone -mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder - Copy - Department of Public Works COUNTY OF BUTTE — DEPARn4ENT OF DEVELOPKE MP SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE ZA 959t5 — TELEPHONE (916) 538-7541 OWNER C -o e -6 / 7 A. P. # PROPOSED BUILDING,USE MH1 DATE REC. # DATE REC V 1. CHOOL DISTRICT FEES (paid at District Office) ......................... 2. SHERIFF FEES (paid at Building Department) Residential ...... x unit amt. Commercial (sgft) z =$ sq.ft. amt. 3. URBAN AREA FEES (paid at Building Department) Residential (per unit) x =$ # units amt. Commercial (per sq.ft) x =$ sq.ft. amt. 4. RECREATION DISTRICT FEES (paid at District Office) ......................... 5. DRAINAGE DISTRICT FEES (Contact Land Development Division) .............. ,.6. SRA FIRE INSPECTION AND PLAN CHECK = $89.00....../(l/� (paid at Building Department) 7. OTHER 8. OTHER At'Ntime of permit application,I was advised the above fees are required to be paid prior to issuance of the permit. APPLICANT DATE 105 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 0._)7 !/ 9� zONING BUILDING PERMIT OWNER . 77— / TELE 1 NES O` SQ. FT. OCC. BUILDING VALUATION OWNF�B'$IWAIU ADORE ^// (� CONTRACTOR'S NAME TELEPHONE/j 7 Q CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ (f Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS AA Penalty $ BUILDING ADD]al "r- lxa PERMIT FEE $ _0 PLUMBING PERMIT Piling Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15,00 LOT NO. J SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SF O Duplex ❑ Mobilehom?,V Other SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 TYPE OF WORK New O Addition ❑ Remodel ElUtilities/O Installation Other ElContractor Describe Work: � / -T PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 LESS ) Main Service ( BoovORR LESS 200A O 23.00 Main Service ( 200A TO IOOOA ) 46.00 NEW CONST. DWELLING OCC UP. OR ADDNS. ( 8 ACC. BLDS. ) SO 3.5C FT.. 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 Professions Code and my license is in full force and effect. License No. Classification ❑ 1, 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) O I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) ❑ I am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI.OUTLET NON nESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS L & SINGLE OUTLET CIR. / Ex. Occup. ( OUTLET OR FIXTURES ) BAL. @x.50 Ex. Occu FIXED .OR p' ( OUTLETS (RESTRESID.) 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. ❑ I 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 Cooling 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 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. 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 O Contractor O 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 $ HAZ. D. FEES I IMP I FLOOD I CDF PARCEL PD HO 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 /Dere/ provisions to do work paid. ata Receipt No. 16,;Z , ` /6 q �' WHIT WHITE-D.D.S.-S.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT