HomeMy WebLinkAbout030-072-059COUNTY 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
ASSESSOR PARCEL NUMBER
SEE ATTACHED
ZONING
BUILDING PERMIT
OWNER
COMCAST COMMUNICATIONS
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
4350 PELL DR SACRAMENTO CA 95838
CONTRACTOR'S NAME
WESTCOA.ST COMMUNICATIONS343-2473
TELEPHONE
CONTRACTORS MAILING ADDRESS
140 M=S ST CHIM CA 95828
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 $
BUILDING ADDly OROVILLE LOCATIONS (SEE ATTACHED
Energy Plan Checking Fee $
$
PERMIT FEE $
LAT 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 gas water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: PLACE CATV POWER SUPPLY
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
@20.00
PERMIT FEE S
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service 200A OR LESS 2
23.00 276.0
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 ' in full force and effect. t''']/_ 9 /
License Class I. Q Lic. No. 1 {p_S 771(.-(J
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,
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
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
Main Service 200A TO t000A 46.00
NEW CONST. DW:. OCCUP. s0
OR ADDNS. ( a ACC. BLD S. 3.5¢Fr.
NEW CONS
NO.ESID. MULTI.OUTLET @7.50
POWER APPARATUS
a SINGLE OUTLEr CIR
20 @ 1.00
Ex. Occup. OUTLET OR FIXTURES BAL @ .so
Ex. Occu . D�LEtDis Rao,°El 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE $ 296-00
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Policy Number
(rhe 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' oo pensation provisions of section 3700 of the Labor Code, I shall
forthwft o ply wi o ovisions.
i Z — h
X __ Date _ y
Signature of pplica t - ❑ wner Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Receipt No.
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ 296.00
HA2.
D. FEES IMP
I FLOOD
I COF
PARCEL
I PD
HD
SSUE
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
PERMIT EXPIRES WONO'Zfl�