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HomeMy WebLinkAbout030-101-028• _ - - - 30-101-28 Ruth Bal dr idge /�. p► � - '. At ^ � � \ ./ ^^ / u s COUNTY OF BUTTE-- DEPARTMENT OF PUBLIC WORKS PERMIT NO. .7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 19 APPLICkTION AND PERMIT ASSESSOR PAROI CEL NUMBER ~ Q -) ZONING BUILDING PERMIT OWNED) `" j TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER�MAI LING ADD 1E(_ / ([ {� Ft 'r CONT�I!!JJRACTOR'S NAME 1 Y`. e TELEPHONE j CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER� C!''R UNKNOWN Total Valuation $ 14 Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 14,bo ARCHITECT OR ENGINEERLICENSE No. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS - PLUMBING PERMIT Filing Fee 10.00 Each Trap 1 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE % SF © Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New❑ Addition,❑ Remodel Utilities❑ installation, El Other ®''"_Contractor Describe work: k e W �.. n fY1Ra (D- Permit Fee $ ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 5.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 2.50 NEW CONST. ( DWELLING OCC UP. y\ 20 sq it OR ADDNS. ACC. BLDGS. CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ 1 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 Md 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 CONSTR. U TI.OUTLET 2,50 ea NON-RESID BRANCH CIRC ITS NEW CONSTR. / POWER APPARATUS b NON.RESID. %SINGLE OUTLET CIR. Ex. Occup OUTLETS OR FIXTURES BAL@1 00 FIXED APPLNS. OR Ex. Occup.(OUTLETS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 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. Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor 1 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. 1 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 inconsequence of the granting of this permit„ X °-- ff / ' - K . ••��' ! /�!'�f Date. 44, - ►- � � — `tractor ❑ Agent ❑ " Signa ure of Applicant Owner.Q Con An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures 3 storie--sin height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP TYPE OF CONST. PARCEL PD [71SSUE This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DlRECTORI OF PUBLIC WORKS By, � '�4 C�y- Date ��.� PERMIT EXPIRES Date — �ovver Receipt No. f l /n_") 2 WHITE-D.P.W.• YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPAR ENT OF PUBLIC WORKSPERMIT N�.Z, 7 County Center Drive - Oroville'C alifoi is 95965 - Telephone 916/534 -4541_ --- —?_?J 9 APPLICATIO,M, AW, PERMIT L---- ASS! SOR PARCEL NUMBER ZONING _ Q I — �— g BUILDING PERMIT OWNS LEPHONE V -3r0 7.s2r SQ. FT. OCC. BUILDING VALUATION 9 OWNER'S MAILING ADDPIG t COJ_R7cTOR SHAME - TELEPHONE ' CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ ^ Filing Fee. $ 10.00 LENDER'S MAILING ADDRESS - Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING A DRE S PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping . 5.00 Water piping LOT NO.SUBDIVISION NAME PARCEL MAP Each gas.water heater or vent 5.00 Gas piping system 1 - 5 outlets �� USE OF STRUCTURE SF P? Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New❑ Additio Remodel Utiliti ❑ Install ❑ Other Describe work: p Permit Fee - $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 OR Main service ao100 ov OR LESS OR LESS 5.00 Main service EA. ADD'L 100 AMP 2;50 NEW CONST. DWELLING OCCUP.y) OR ADDNS. ACC. BLDGS. 2¢sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): F1 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 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 CONSTR I -OUTLET 2,50 ea NON-RESID BRANCH CIRCU TS NEw .CONSTR. POWER APPARATUS 6 NONRESID. SINGLE OUTLET CIR. / TLE Ex. Occup OUTS OR FIXTURES a �� ITLE1E1 APPLNS. OR EX. DCCUp.�OUTLE TS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 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 shall n6t 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. 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 a to save, indemnify and keep harmless the County of Butte against all ilitie judgments, costs, and expenses which may in any way accrue against sa' Co my i onsequence of the granting of this mit X Dat Signature of Applicant — Owner. Contractor ❑ Agent ff An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 33sstories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP TYPE of CONST. PARCEL PD ND ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which IR CTO OF PUBLIC By ` PERMIT EXPIRES D e YQ,!- the .applicable, provi- resolutions to do fees have been paid. WORKS Date Receipt No. N 9:3 2-- WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA. 95965 Phone: 916-534-4541 OWNER -BUILDER VERIFICATION ' Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your build- ing permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no),e� 2. I (have/have not) signed an application for a building permit for the proposed -work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name �.. Address City Phone Contractors License No. I will provide some of the work but I have persons to provide the work indicated: Name Address 11 S igned : Property Owner- Social Security number Date 9-F- Z-2 contracted (hired) the following Phone Type of Work NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit.