The URL can be used to link to this page

Home My WebLink About030-080-020COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 03- W/O 7 County Center Drive Oroville, California 95965 • Telephone (530) 538-7541 OA&M. (Rev., 2/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER D /o_0 0 D J ZONING BUILDINGPERMIT OWNER �_ J�,�/I INGCJ/AAD. TELEPHONEJqt4 SQ. Fr, OCC. BUILDING VALUATION C D .0W ERSSSl//MAILI DRESS , ` �, � sy C RACTOR'S NAME TELEPHONE X33—(o3`l3 C RACTOR MAI MDRE � D CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ oZ r QD ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ ILDINGADDRESS / co Energy Plan Checking Fee $ $ PERMIT FEE $ 100 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF )�, Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 - Solar or heat um water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ __Uttilities ❑ Installation Other 13 Describe Work: RIPA&�4- .41 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 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. / / r�^ // License Class C —13 9 Lic. No. 7saa IV, it, OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: O 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 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' compensati insur a carrier and policy number are: Carrier -1eML_f_0 Main Service 200A TO 1000A 46,00 NEW CONST. DWELLING OCUP. C OR ADDNS. ( a q�, gLDS. S° 3.50f7. N RE°MULTI. SIDT .R... 97,50 POWER APPARATUS a SINGLE OUfLEr CIR. EX. Occup. OUTLET OR FIXTURES BAL t yo Ex. Occup. purrs Ra,D,°� 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FES $ Policy Number a7A—$9 — 02 (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' compensati n pr ions of section 3700 of the Labor Code, I shall forth ' comply wi tho rovisions. p Date / `o�S-6 "3 _ Pgnature of Applic t - wner Contractor ❑ Agent An OSHA permit is requiF d for excavatio over 5':P"deep and demolition or construction of structures 3 to 'sin Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 1//, pp HAZ. D FEES IMP FLOOD CDF PARCEL PD HD ISS This permit is hereby issued under the applicable provisions of ke Butte County Code and/or Resolutions to do work indica d a f r w h fees have been paid. /®� B at `/416 3 PERMIT EXPIRES ON I �m 4 Dete Receipt No. ' —U WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT ,.,�.�.�*T'^«'.'Cir!�a.�y,'r'.VF•Fr,+.�7�,+�r:.;.qyq,.m..._.�.,,y:7•�g{.,�++i:�?n" � .�. ,, - , _ ` . •. _ , ,�, . ,,. �. •� ..