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HomeMy WebLinkAbout029-250-03129-25=31r 2805=91B ti a LINDAHL' Mer m, } 1248 Lindale; Richval'e (reroof/SF) Rinkydink Bldrs 029-250-031 , 02-2096 1516B STONE, GARY psi SUSAN LINDAHL, Elmer 1z45P 0 1 1248 LINDALE AVE., RICHVAL INALE 1743E f CONT: BOB CARPER - ---- REMODEL KITCHEN Lots 14 & 15, Lindale Ave . , Thengvall Trac-,,.�.... Richvale fI CONTR: - Moseley & Hill, ' Rt. 4, Box 4556, oil°o I .� :� ' �. 'J r ' .., e W � y 3ii.ib'ei•r�-`.a. `res^. �:f:;fhna;c.".!`-�:a'�a:��ai�t-:��:..'���,;,.,,(:,�,.:�xwac.u��rn:m�^�- ,. �. -� ` N COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT' ham. (Rev. 12/96) APPLICATION AND PERMIT iU; AVSG�R�JIJ'VBl ZONING AR BUILDING PERMIT OMNEt GARY AND SUSAN T882-4204 FT. OCC. BUILDING VALUATION (`(SO. CONT 10,000.00 OWNE�S MAILING ADDRESS P. . FOX 342 RICHVALE CA 95974 CONTRACTOR'S NT� 1J B Q"ERt TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ 10 000.00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 126.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 23.00 BUILDING ADDRESS 124$ LINUALE AVE. RI Energy Plan Checking Fee $ $ PERMIT FEE $ 169.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 1 7.00 7.00 USEOFSTRUCTURE SF )] Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 1 15.00 L5.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel )b Utilities ❑ Installation ❑ Other ❑ Describe Work: KITCHEN REMODEL Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ 42.00 ELECTRICAL PERMIT Filing Fee 20.00 Main Service '.*."A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter (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: 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. ❑ 10 exempt under Sec. Business and Professions Code for this reason 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'HAz. 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 wilb those provisions. C^of D e 9 _ �A _ Q Signature of Applicant - wner ❑ Contra Agent An OSHA permit is requi d for excavations over 5'0" deep and demolition or construction of structures over 3 st -les in hei ht. Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. 8 ACC. BLDS. so 3.50FT. CONST.9 1NJONRESID MULTI -OUTLET @7.50 0rAPPARATUS .1INGLE OUTLET CIR. .00 Ex. Occup. OUTLET OR FIXTURES BAL @ 1 .50 FIXED APPLNs. OR Ex. Occup. ounFTs REBID. EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 23.00 . PERMIT FEE $ 43.00 MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ 254.00 ., D. FEES IMP FLOOD X CDF PARCEL PD HD ISSUE This permit is hereby issued under the Butte County Code and/or indicated above f fees have By PERMIT EXPIRES ON ��Lw the applicable provisions Resolutions to do work been paid. Date Date Receipt No. 360ty WHITE-D.D.S.-B.D. CANARY=AS ESSOR PINK -INSPECTOR GOLDENROD -APPLICANT o�P 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 e L UUYS ORP SC 031 ZONING BUILDING PERMIT OWNER STONE, GARY AND SUSAN TELEPHONE 882-4204 SO. FT. OCC. BUILDING VALUATION CONT ES T 10,000.00 . OWNERS MAILING ADDRESS P.O. BOX 342 RICHVALE CA 95974 CONTRACTORS NAME BOB CARPER TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS Total Valuation $ 10 000 .00 ARCHITECT OR ENGINEER LICENSE NO. Filen Fee $ 20.00 Permit Fee $ 126.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 23.00 BUILDING ADDRESS 1248 LINDALE AVE,$ Energy Plan Checking Fee $ PERMIT FEE $ 169.00 IAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 1 7.00 7.00 USEOFSTRUCTURE SF 10 Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 1 15.00 L5.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodels] Utilities ❑ Installation ❑ Other ❑ Describe Work: KITCHEN REMODEL Gas piping sy2tem 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G W @20.00 PERMIT FEE $ 42,00 ELECTRICAL PERMIT Filing Fee 20.00 Main Service 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. 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: 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 200A TO 1000A 46.00 NEW CONST. OWEWNG OCCUP. OR ADDNS. ( 8 ACC. ,LDS. SO 3.5¢FT. NEW T. NEOSID MULTI -OUTLET @7.50 POWER APPARATUS 8 SINGLE OUTLET CIR. Ex. OCCU OUTLET OR FORURES .50 BAL. PPLNS. FIAOR Ex. Occup. ourLErs RESID. EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirin 1 23.00 23.00 PERMIT FEE $ 1-00 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. VE0 I 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. _ D e Signature of Applica7-wner ❑ Contra Agent An OSHA permit is reqexcavations over 5'0" deep and demolition or construction of structures over 3 step ht. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEP_ $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 254.00 HAZ. D. FEES IMP FLOOD X CDF PARCEL PD _ I HD — I ISSUE Ix This permit is hereby issued under of the Butte County Code and/or indicated above f f es have By PERMIT EXPIRES ON!v the applicable provisions Resolutions to do work been paid. Date Date Receipt No. . oil WHITE-D.D.S.-B.D. CANA Y -AS ESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 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 GWNER: ASSESSOR PARCEL NUMBER Proposed Building Use: d'd Counter Technician: Date: _fir .-^rj Items required in order to apply for a permit. All boxes MUST be checked O marked NA in order to apply. .. Plot plans, 3 or 4 sets, signed,�y the preparer of the plans. d Complete plans, 3 or 4 sets, signed by the preparer of the plans. D 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. 04. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Energy compliance design and supporting documentation in duplicate. ❑ 6. Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or foundation plans, all in duplicate. ❑ 7.. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The.permit will be indexed and returned to the plan review line-up when required items are received. Date Received By ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................ ❑ 9. Plot plan and business license approval from the City of Biggs .................................... ❑ 10. Letter of intent for non-residential buildings......................................................:.. ❑ 11. Detached Accessory Building Form tilled out by the owner ..................................... ❑ 12. Hazardous Material Form............................................................................... _ ❑ 13. Other .... Remaining items needed to issue the permit. (May require additional plan review upon receipt of the followinj items.) ❑ 14. Fees as shown on the attached Schedule of Fees Due Sheet ....................................... ' ❑ 15. Statement of Intent for Non -heated and A/C Buildings ............................................. ❑ 16. Sanitation and plot plan approval from the Environmental Health Department in ❑ 17. City of Chico Plumbing permit........................................................................ ❑ 18. California Department of Forestry plan approval ❑ paid. Sent. by: ...................... ❑ 19. Planning approval for (A) Use: (B)Parking: (C) Parcel Check: ❑ 20. Contact Land Development about ❑ Improvements, ❑ Drainage ............................... ❑ 21. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 22. Pre -Inspection for required ................ ❑ 23. Contractor's license information. (Number, Name Style, Classification) ...................... ❑ 24. Worker's Compensation Carrier and Policy Number ..............:.............................. ❑ 25. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner).....................I ❑ 26. Letter of Signature authorization.................................................................... ❑ 27. Recorded copy of Agricultural Acknowledgment Statement .................................... C 28. Manufactured home utility clearance............................................................... D 29. Existing violations and/or expired permits......................................................... °D 30. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ :1 31. Other: When issued Telephone and hold for pickup. [ have been informed of the above items and requirements for obtaining a building permit. Applicant: Date: 1. Index permit application for the above items numbered: Plan Check Letter 2. Additional items required Contractor, designer, owner, was advised cf the above, data by.. ❑ phone, ❑ mail, ❑ counter, by Date: _ Contractor, designer, owner, was advised of the above data: l y:t-'D, phone, ❑ mail, ❑ cou tr, by ' Date: Plans reviewed by: Date: ' }!':';Plans;approved by: Date: Structural reviewed by: Date: rStructural approved by: Date. Note transfer by: Date: ",�� Yellow: Buildiri`g';Di;v.•s1ori:4`_,.. ... COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, Callforni8 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. r ASSESSOR PARCEL NUMBER 29-25-031 ZONNGto AR. v MH BUILDING PERMIT OWNER •® TELEPHONE 882-4318 S0. FT. OCC, BUILDING VALUATION 36 C 150 5 400.00 OWNER'S MAILING ADDRESS 1248 Lindale. Richvale 95974 CONTRACTOR'S.NAME R TELEPHONE 663-338 7 M CONTRACTOR'S ADDRESS P.O. Newcastle CA 951658 Fireplace CONSTRUCTION LENDER None UNKNOWN Total Valuation 1$5,400.00 Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 56.50 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $66.50 PLUMBING PERMIT Filing Fee 10.00 1248 TAndale, P Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping , 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF MK Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other Describe work: RerOOf with Aluminum Shakes Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD -L. 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): 1741-- I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. k7� License No. 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) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING OCCUP.8d) OR ADDNS. l ACC. BLDGS. +h0sgft NEW R. MULTI-OUT NON•RESID, BRANCH CIRCUITS) 2,50 ea (POWER APPARATUS e) SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 0@50�) eA 030 EX. Occup. OUTLETS (RESID.)FIXED APPLNS. REA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 have 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 ❑„ 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. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 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 Countyof 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 cons@quence of the granting of this permit. � / X 2g ��f ��----��Date /' Z Artl Signature Of Applicant — Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of struc'ures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 6650 HALcuA PARK SCHL FLD coF PAR PD 1 HD. ISSUE This permit is hereby issued under the applicable provi- sions of the Butte Pounty.Code and/or resolutions to do work Indic d a ve f which fees have been paid. DI OF PUBLIC WORKS By <'''r D e P 7/l/ PERMIT EXPIRES Date Receipt No. 97084 WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT � 11. /. ' . COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ERMIT NO. ASSESSOR PARCEL NUMBER 29-25-031 ZONING - ARMH BUILDING PERMIT OWNER TELEPHONE 882-4318 SO. FT. OCC, BUILDING VALUATION 36 150 5 400.00 OWNER'S MAILING ADDRESS 124 n 1 i by 1 95974 R'S AME CONTRACTON TELEPHONE 663-3387 CONTRACTO 'S MAILING ADDRESS P.0 -Box 1250 Newcastle A 95658 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ 5,400.00 Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ 56.50 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ 66.50 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping - 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF [f( Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G 1 10.00 ea' TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other [ Describe work: Reroof with Aluminum Shakes _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD•L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penaltyof perjury p I y (check one): ,��( 117�F—I am licensed under provisions of Chapt. 9, Div. 3 of the Business Ire and Professions LCode%and my license Is In full force and effect. License No. ��• / �+ �( 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) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. / DWELLING OCCUP.61) OR ADDNS. ( ACC. BLDGS. , /Z Osq It NEW CONSTRMULTI-OUTLET NON.RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS .&) (SINGLE OUTLET CIR. Ex. Occup( OUTLETS OR FIXTURES 2AL93 t "ALoso FIXED PR Ex. Occup. OUT LETS (RESID IEA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. �yirin g 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have 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. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 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 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 cons quence of th granting of this permit. X „(P� nate Signature of Applicant — Owner El Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 66.50 HAz. can PARK SCHL FLD coF PAR PD ) HD• ISSUE This permit is hereby issued unser the applicable provi- ode and/or resolutions to do sions of3cd work Inwhich fees have been paid. RvePUBLIC WORKS By D e 8 `r q� PERMIT EXPIRES Date 9 qzlr, _ eceipt No97084 F HITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT �{ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916.538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL UMBE e�— — o��—� 2 1 BUILDING PERMIT OWNER Flee TELEPHONE dl3�p a SO. FT. CC. BUILDING VAL TION OWNER'S MAILING A.pf D�RES� �,,� A/ �, /���015`l i /�/` CONTRACTOR' NAE Nt 1_ TELEPHONE ��3 338`7 CONTRACR'S MAILI G AOD ESS p /� , OX 256 euj 4te f,l't q,6&5(7p Fireplace CONSTRUCTION LEND R UNKNOWN Total Valuation is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ,J ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ' Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS enalty Penalty $ BUILDING ADDRESS 121 /(57 Z , Alp Permit tee $e r PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SFQ41 Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00 ea TYPE OF WORK New ❑ Addition❑_ Remodel Utilities ❑ InstallaltionC Other [ Describe work: `e �v 1AJ I l��l .��lih /Af(IM Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service eDov OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification. 17I, 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) ❑ I am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.&) OR ADONS. ACC. BLOGS. / , /20sgft T LET NEW CONSTR ULNC. CIRCU NO N.RE"0 BRANCH CRC ITS �2.50ea POWER APPARATUSe SINGLE OUTLET CIR. Ex. Occup( FIXTURES 8AL!3t eAL_ so: FIXED APLNS Ex. OCCup. OUTLETS (RESI11)KEA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 9 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have 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. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g LHood 3.00 I 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 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. XThis Date Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for cavations over 5'0" deep and demolition or construct- ion of structures over 3 stories i eight. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE ' y� TOTAL FEE $ S v HAZ CUA I PARK SCHL fLD coF PAR Pp H ! I i i, o. Issue permit is hereby issued unaer sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provl- resolutions to do have been paid. WORKS Date Receipt No. WNITE•O.P.W., Y LLOW-ASeE330 . PINK -INSPECTOR. GOLDENROD -APPLICANT d I P.0, Box 1250 Newcg.tle, CA 95658 S.C.L. #336878 (�16) 663-3387 (916) 268..0525 1716 J- P -S T D f -I .107 C? -Y k, I T6 27c/ a c -.j . 777777`7 ��2Y�a-z ,'-I a i io 1V F 41,1 y L -L) ctio + La lu I L 1.).. 50 L.r - 1 � ON W 0 t> ro. v 6 i� P Pla -X--- I BUTTE COUIC T BUILDING DEPARTMENT APPROVED F -F Ln P P?-- Pia. Q1 AR fty A. N . 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