HomeMy WebLinkAbout030-080-034030-080-034 PERPIIT#95-575
VAUGHN, Eileen
1656 Sweem St., Oroville
Cont; George Roofing' �fi I��
Reroof/SF / /' l
030-080-034 04-1686
MARTINNAUGHN, RAY/EILEEN
1656 SWEEM ST, OROVILLE
Cont: RAY MARTIN
NEW SIDING (VINYL)
030-080-034 04-2228
MARTIN, INA RAY
1656 SWEEM ST, OROVILLE
Cont: K DESIGHNERS
VINYL SIDING (500)
F 11
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAX#: (530)538-2140
WEBSITE: www.buttecounty.net\dds
PERMIT NO.
BP042228
LICENSED CONTRACTORS 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
Issued Date: 07/27/2004 APN' 030-080-034-000
the Business and Professions Code, and my license is in full force and
effect.
License Class.c Licensee N�umbber:!2 !2
Site Address' 1656 SWEEM ST ORO
Date: ontractor: /T_G1'f cD,
Map Index:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Description: VINYL SIDING (500) ADD TO BP 04-1686
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
Owner: MARTIN INA RAY B SS
to its issuance, also requires the applicant for such permit to file a
VAUGHN EILEEN B SS 852176500
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commencing with Section
1656 SWEEM ST
7000) of Division 3 of the Business and Professions Code) or that he or
OROVILLE, CA 95965
she is exempt therefrom and the basis for the alleged exemption. Any
Violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ 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 (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
Applicant: MARTIN INA RAY B SS
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
proving that he or she did not build or improve for the purpose of
sale.).
❑ 1, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
Contractor:. K DESIGNERS
and who contracts for such projects with a contractor(s) licensed
2440 GOLD RIVER DR
pursuant to the Contractors' State License Law.).
GOLD RIVER, CA
❑ 1 am Exempt under Article 3 of the Business and Professions Code
95742
916-631-9300
Date: Owner:
License #: 498806
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
Architect:
is issued.
❑ I have and will maintain workers' compensation insurance, as
Engineer:
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
insurance carderand policy number are:
�/9`
Carrier. yi�2" a_1
Total Square Ft: 0 S. F.
Policy #: / e�� C2 62 412
Valuation: $0.00
❑ I certify that in the performance of the work for which this permit is
Census Code:
issued, I shall not employ any person in any manner so as to
become subject to the 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.
,
Date:
Applicant:
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
j I , , ^ �� t I ��% �•�
�,l"�� �j Y► (. J
(y
. ---- -- CONSTRUCTION LENDING AGENCY — -
-This pprmi 's her issued under the applicable provisions of the Butte County CodA an(vor
I hereby affirm that there is a construction lending agency for the
Resoll do t work i dicated above for which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
/ .
Name:
BY: Dat
Address:
PERMIT EXPIRE 0 t
Date
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. thereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes.
Print Name: V Signature:
Date:
❑ Owner ntractor ❑ Agent for OwnerAgef� nt for Contractor
-* .4 I
JUL 27 2004 2:51PM HP LASERJET-3200 li
A I. It
Imp
SUBJECT-.-,
JOB SITE ADDRESS
o iza 1)),
/&S,o
PLEASE ACC ' EPT THIS AS YOUR AUTHORIZATION TQ ACCEPT THIS
APPLICATION AND ISSUE A BUILDiNG PERMIT FOR THE ABOVE.
DEG-CRIBED'JOB SITE SQBMITTED BY A.REPRESENTAT
lVE-QE K-iDE&GNERS,
SEE LIST BELOW OF AUTHORIZED PERSONNEL.
ALSO PLEASE NOTE THIS AUTHORIZATION IS RESTRICTED TO TE-IEABOVEDESCRIBED-JOB-SITE ONLY -AND -NG OT--PEiUlMITS ARE AUTHORIZED
HEREIN.
AMMON. DkN
A-NIkVEG4-D-A-NN- -
BIRD, RUSS
BOWEN, TEFF
BOWKER, JACK
GRIST, BILL '
FOSTER, TROY
KRASNODE.MSKIY, TONY
LEDINGHA-�lyl, DONALD
-N,IYALIK, .4uNDPLEY
NT F -T- SQ N, DON
N,
m
JOHN FRENCH
SENTOR-FIRODUC-T [ON-N+lk-Nr-AGER-,
NOLAN, JAMES
ROOLEY, ROB " '
ROSS, WMISON
SUSHINSKIY, ILYA
SUSHINSKIY'lv.-vx
TALBOTT, DAVE
REYNOLDS, STEVE
RL YCHURVICTOR.-
UMFLEET, AARON
'vV-MT-FlELD-1-JOlW-- -- -
Si 61L
P.1
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQ UIRED AT TIME OF APPLICATION
"PLEASE PRINT CLEARLY"
OWNER
Last Name r 1
ame
Ci
Address
cit)01(oi. \\e
St tg
zip qhs
PCO— 533-S33Z
Fax
E-mail
CONTRACTOR
Name _ (� S l �r, P_LS
'Address �- � �
Ci
Stat. •
S a
P e _
Fa"Ct l lo- to 31—G
E-mail
ic. �� Class I
APPLICANT NAME
ARCHITECT/ENGINEER
Name
Ci '`.\6 ` rkvx (
Address
'(02, t^g360
City
E-mail
State Zip
Phone
Subdivision Name Map
Fax
E-mail
Lot #
State License Number
APPLICANT NAME
Name / _ Y ,,(,
Addres
Ci '`.\6 ` rkvx (
Stat
'(02, t^g360
— Co31 -osz
E-mail
APPLICANT SIGNATURE
X
For office use only:
Zoning
Property Addres
Flood Zone
Cross Street
SRA
Yes
No
Occ.
Type Const.
Subdivision Name Map
Book
Page
Lot #
Planner
IDate Approved:
PERMIT
BIN #
LOCATION
Property Addres
City,Q
���
Cross Street
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
Descr'ption or Scope of Work:
�U
Sq. Footage
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order•to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Regeived by:
41y
Receipt #:
Date j,/o
Amount: Bldg
SRA
Sheriff
SMIP
r
Other
Total
REV 6-16-04
SUBMITTAL REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply
for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE
LEGIBLE AND IN INK.
Residential, New, Remodels, Additions, and Accessory Structures:
❑ 1- 3 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPHPAPER! r
OR 3 Sets Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed
calculations.
❑ 3. 2 Engineered truss details and layouts (if required), (1VO FAXES!).
❑ 4. Letter from Engineer or Architect for truss design review.
❑ 5. 2 Energy compliance design and supporting documentation. (Note: Not required for additions to
mobile or modular homes.)
❑ 6. .2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑ 7. Detached Accessory Building Form, filled out by the property owner (if required).
❑ 8. Sanitation and site plan approval from the Environmental Health Department.
❑ 9. Metal Buildings: (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 stam ed and wet -signed by the en 'neer.
Mobile, Manufactured, or Modular Homes:
❑ 1.
3 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑ 2.
2 Data sheets and installation instruction manual.
❑ 3.
2 Marriage line information..
❑ 4.
2 Floor plans.
❑ 5.
2 Engineered Tie Downs or Foundation plans.
❑ 6.
Sanitation and site plan approval from the Environmental Health Department.
❑ 7.
2 Flood Elevation Certificate, wet -stamped and signed (if required).
Commercial, New, Additions and Remodels:
❑ 1.
4 Site Plans, signed by the preparer. NO GRAPH PAPER!
❑ 2.
4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations,
with code analysis.
❑ 3.
2 Engineered truss details and layouts (if required) (NO FAXES!).
❑ 4.
Letter from Engineer or Architect for truss design review.
❑ 5.
2 Energy compliance design and supporting documentation (if required).
❑ 6.
2 Flood Elevation Certificate, wet -stamped and signed, (if required).
❑ 7.
Statement of Intent for Non -heated and A/C (if required)- " F
❑ 8.
Metal Buildings: (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 stam ed and wet-siged by the engineer.
❑ 9.
Letter of intent.
❑ 10.
Hazardous Material Form.
❑ 11.
Sanitation and site plan approval from the -Environmental Health Department.
If you have questions or would like additional information regarding this process, contact a Permit
Application Assistant at (530) 538-7541.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMSMILDING F0RMS1BIdgApp1SubRgmts.doc Page 2 of 2 REV 6-16-04
I
BUTTE COUNTY
DEPARTMENT OF' DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAX#: (530)538-2140
WEBSITE: www.buttecounty.net\dds
PERMIT NO.
BP041686
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perl'ury that I am licensed under
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
Issued Date' 06/10/2004 APN' 030-080-034-000
the Business and Professions Code, and my license is in full force and
'
effect. �O�o
License Class :/oY License Number:_
Site Address: 1656 SWEEM ST ORO
Date: (JVle Contractor. ��-���/GivF�2S
Map Index:
Description: vinyl siding (1400)
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
Owner: MARTIN INA RAY B SS
to its issuance, also requires the applicant for such permit to file a
VAUGHN EILEEN B SS 852176500
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commencing with Section
1656 SWEEM ST
7000) of Division 3 of the Business and Professions Code) or that he or
OROVILLE, CA 95965
she is exempt therefrom and the basis for the alleged exemption. Any
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ 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 (Sec. 7044, Business and Professions
Applicant: MARTIN INA RAY B SS
Code: The Contractors' State License Law does not apply to an
pp
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her. own employees,
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
proving that he or she did not build or improve for the purpose of
sale.).
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
Contractor: K DESIGNERS
and who contracts for such projects with a contractor(s) licensed
2440 GOLD RIVER DR
pursuant to the Contractors' State License Law.).
GOLD RIVER, CA
O I am Exempt under Article 3 of the Business and Professions Code
95742
916-631-9300
Date: Owner:
License #: 498806
WORKERS' COMPENSATION DECLARATION,:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I 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
Architect'
'
is issued.
,Zr I have and will maintain workers' compensation insurance, as
Engineer:
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier:%f9
Total Square Ft: 0 S. F.
Policy #: �/� I �- I---,
Valuation: $0.00
❑ 1 certify that in the performance of the work for which this permit is
Census Code:
issued, I shall not employ any person in any manner so as to
become subject to the 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, 1 shall
forthwith comply with those provisions.
Date: C2 �lD41-0L7'-
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and -one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
6,1I O�O 'Q -
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the applicable provisions of the Butte County Code anrvor
I hereby affirm that there is a construction lending agency for the
Resolutions to do ork indicated above fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
�fo"rrw�which
= �/•l . / to • / D • O
Name:
By: ' �'_�"'__ Date:
' OS
Address:
PERMIT RES ON:
Date
❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes.
Print Nan Ae EA /6+e-_/4�4- 441 Signa' /
Date: _1�', /!'5 e�,Q
❑ Owner ❑ Contractor Agent for Owner ❑ Agent for Contractor
t
ie
.J
n
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING -PERMIT -APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 - CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OF APPLICATION
OWNER
�CONTRACTOR
Addres
City
Address
Zip
R;k=Al
State
Zip
APPLICANT NAM
�CONTRACTOR
Name
City
Address
Zip
City
State
Zip
14�107) MEN
Fax
E-mail
State License Number
Lot #
Planner
Date Approved:
W W �I� f1-2,
APPLICANT NAM
ARCHITECT/ENGINEER
Name
City
Address
Zip
City
State
Zip
Phone
Fax
E-mail
State License Number
APPLICANT NAM
Name
Address
City
State
Zip
Phone
Fax
E-mail
APPLICANT SIGNATURE
X
For office use only-
nl :Zoning
Zoning
Flood Zone
--T-SRA7
Yes
I No
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
PERMIT
NO.
04=MPf1a
BP
BIN #
LOCAT N
AP#
Property Address / �/
SCross Street (Q fes,
WORKER'S COMPENSA TION
Policy Number /� / .15—/
Carrier % v�
�J5��
If hiring anyone other than licensi 9britractors, a certificate of worker's
compensation must be shown aW6 time of permit issuance.
LENDING AGENCY
Name
Address
Des Option or S pe of Wor :
S�
Sq. Footage
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Received by: 4 --Amount: Bldg
Receipt#: 4-0l,3.s&
Date: b/ 4D
SRA
Sheriff
SMTP
Other
I q a Sd Total
KAFORMSWILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 REV 4-30-04
J►
Y
SUBMITTAL REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply
for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE
LEGIBLE AND IN INK.
Residential, New, Remodels, Additions, and Accessory Structures:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER!
❑ 2. 3 Complote.sets of plans; signed'by the preparer. NO GRAPH PAPER!
❑ 3. 3 Engineered plans (if requited) -With wet signature on plans AND 2 sets of stamped and signed'''
. calculations.
❑ 4.. ` 2 Engineered truss details and layouts (if required) (1V0 FAXES!):
❑ 5. Letter'from Engineer or Architect for truss design review.
❑ 6. 2 Energy compliance design and supporting documentation: (Note: -Not required for additions to
mobile or.,modular homes.).
❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑ 8. Detached Accessory Building Form, filled out by the property owner (if required):
❑ 9. Sanitation and site plan'approval from the Environmental Healthbgp' artment.
❑ 10. Metal Buildings: (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 byrythe engineer.
Mobile, Manufactured, or Modular Homes:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER!
❑ 2. 2 Data sheets and installation instruction manual.
❑ 3. 2 Marriage line information.
❑ 4. 2 Floor plans.
❑ 5. 2 Engineered Tie Downs or Foundation plans.
❑ 6. Sanitation and site plan approval from tfie Environmental Health Department.
❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
Commercial, New, Additions and Remodels:
❑ 1. 4 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑ 2. 4 Engineered plans with wet-, signature on plans AND 2 sets of stamped and signed calculations,
with code analysis.
❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!).
❑ 4. Letter from Engineer or Architect for truss design review.
❑ 5. 2 Energy compliance design and supporting documentation (if required).
❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑ 7. Statement of Intent for Non -heated and A/C (if required).
❑ 8. Metal Buildings: (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.
❑ 9. Letter of intent.
❑ 10. Hazardous Material Form.
❑ 11. Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, contact a Permit
Application Assistant at (530) 538-7541.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2
REV 4-30-04
t �
030-080-034 PERMIT#95-575
a' VAUGHN, Eileen
1656 Sweem St.•, Oroville
Cont; George Roofing
Reroof/SF
Z
r
f
wl.
COUNTY.OFBUftE -DEPARTMENT OF-DEV&LOPME14T. SERVICES - BUILDING DIVISION
ounty Zehter- -DriVe - Orbville, 0a,lYoThla, 95965. - Telephone - (9:16)53V
,8-75,,PERMIT NO.
APPLICATION AND PERMIT"
ASSESSORPARCEL NUMBERZONING
0 0
BUILDING PERMIT
OWNER
TELEPHONE-,_,
SO. FT. OCC. BUILDING VALLIATi6N,
OWNERS MAILING ADDRESS
LC
CONTRACTOR'S NAME
TELEPHONE
CONTRACTO
,,7'KAAIU DRK�
I , ': � -,, vv A c ��'tc ,N1J k, 0�,(n
Dr 1�-, -\r
Fireplace -
I -
CON NDER
UN TOWN
Total Valuation $
Filing Fee $ 20.60
LENDER'S ESS.
MAILING ADDRESS
Permit Fee
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Penalty $
BUILDIN GADDRESS
PERMITFEE $
Cer(
PLUMBINGPERMIT Filing Fee 20.00
Each Trap 7.00
LOT NO.
S UBDIVIS IONS NAME
PARCEL,MAP
Solar or heat pump water heater 23.00
Water piping 15.00
LISEOFSTRUCTURE
Mlehome 13. Other %
SF 4;5�- Duplex oVi
SPECIFY
Each, gas water heater or vent 15.00
Pasi.piping system. 1, p -1
Building sewer 15.00
TYPE OF-,WORK@20.00
NeW'[D -Addition 0 Remodel0 Utilities 0- Installation 0 Other mG
Describe Work: r(7
Mobile Home ISI GI W1
PERMITFEE $
Contractor
ELECTRICAL PERMIT Filina Fee 20.00
•
8VOR LESS
Main Service 20000A OR LESS 23.00
Main Service 200A TO 1000A 46.00
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 Divisi -on 3 of the Business and Professions Code,
and• my license is im-full.force and effect.
cy- ;5cf
License Class Lic'. No-.' 62
OWNER -BUILDER DECLARATION
I hereby affirm* under penalty of'perjury that I am exempt.fromi the Contractors License
Law for the following reason:
0 1, as owner of the property, or my employees With wages as their sole compensation,
will do the work, and the structure is4in"'ot intended or offered for sale.
0 1, as owner of the property, am exclusively contracting with licensed contractors
to construct the project..
0 1 am exempt under Sec. Business and Professions Code for this
reason
NEW CONST. DWELLING OCCUR a
OR ADDNS. & ACC. BILDS. 3.50 FF
NEW CONST. MULTI -OUTLET
NON-RESID. BRANCH CIRCUITS @7.50
&POWER APPARATUS
SINGLE OUTLET CIR
OUTLET OR FIXTURES 20 @ I..
Ex. Occup. - ( aAL Q .50
Ex. Occup. FIXED APPLNS. OR
OUTLETS (RESID.) EA 1 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMITFEE $
Contractor
WORKERS' ,COMPENSATION DECLARATION
I hereby affirm under pena1t;`o4'perjuW;'onie' of the following declarations:
0 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.
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' comperlsation insurance carrier and I' number are:
Carrier jo icy
ME9HANICAL PERMIT n 20.00
Fili g Fee
Hea'tingJ'-
Cooling ti
Hood 6.50
Ventilation
PERMITFEE $
Contractor
Policy Number
(The above sections need not be completed if lthe� permit is for work of a valuation
of one. hundred'dollars ($100) or less.)
f the work for which this permit is issued, 1, shall .
0 1 certify, that in the performance of
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
f (With Comply with those provisions.
X Date —7' 'X
Sibnafd`r'e--6f Applicant O—OWner 0 Contractor -.Et,Agent
An OSHA permit is.required for excavations over 60" deep and demolition or construction
of structures over 3 stories in Keight.
Mobile Home Installation Fee
Energy Inspection. Fee $
Occ
CONST. TYPE
TOTAL. FEE,
HAZ. I
D. FEES]
IMP FLOOD
-
I CO7CEL PDHD
Lsst�€
This permitis hereby issued under the applicable provisions
of the Butte County Code and/or Resol6tions to do work
indicated above for which fees have been paid.
By Date'
RMITEXPIRESON
PE V
I I . . "
Receipt No.
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE- DEPARTMENT OF DEVELr. 110MENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-75� ����E�T NO.
APPLICATION AND PERMIT `y� c7 ,
ASSESSOR PARCEL NUMBER d ® _ 3
v+
ZONING
BUILDING PERMIT
OWNER
TELEPHONf,
J.
SO. FT. OCC. BUILDING VALUATION
OWNERS AM D SS
I li1
�a
CONTRACT NAME TELEPHONE
1
CONTRAC) S IUy6.�DD
``J `
Fireplace
CONS TRU ON LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee
$ 20,00
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDINGADDRESS
'
PERMITFEE
$ ( Gr__1
cz
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
LOT NO.
SUBDIVISION'S NAME J
PARCEL MAP
Solar Or heat pump water heater
23.00
USE OF STRUCTURE
SF C Duplex ❑ Mobilehome ❑ Other
SPECIFY
Water piping
15.00
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other
Describe Work: —
Mobile Home S I G W
920.00
PERMITFEE
y "
Contractor
ELECTRICAL PERMIT
Filina Fee 20:00
Main Service 5 OV OR LESS
( 2o0A OR LESS )
23.00
Main Service ( 200A TO I000A )
46.00
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 i fulll r and effect.
A p
License Class Lic. No. �-/�� �O %J
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
NEW CONST. DWELLING OCCUR \
OR ADDNS. ( a ACC. BLDS. /
SO .
3.50 FT.
NEW CONST. MULTI -OUTLET
NON-RESID. ( BRANCH CIRCUITS )
@7.50
POWER APPARATUS
(a SINGLE OUTLET CIR.)
Ex. Occup. (OUTLET OR FIXTURES)
2U
BAL 0 1_w
EX. OCCU FIXED APPWS. OR
p (OUTLETS (RESID.) EA)
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMITFEE
$
Contractor
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.
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.
workersers' c a n insurance c�cier a olicy number are: I
Carrier 1 ��,
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMITFEE
$
Contractor
Policy Number �Q��— 6��G
(The above sections need not be completed rf 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' compensation provisions of section 3700 of the Labor Code, I shall
fo with comply with those provisions.
X Z Date 113—�_
S re of Applicant - ❑ Owner ❑ Contractor Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
f��
TOTAL FEE $ v
HA2.
D. FEES
IMP FLOOD
C$ PARCEL' PD HD
Iss
This permit is hereby issued under the
of the Butte County Code and/or
indicated above for which fees have
By
PERMITEXPIRESON
applicable provisions
Resolutions to do work
been paid.
Q
D to
3 9�
a<e)
Receipt No. �2,3 1K
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
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