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HomeMy WebLinkAbout030-192-01530-192- /5"� Alex W. Mingus 1154 Dodge Avea To'fwlb , 'Oroville Permit #2369-81B(new pri.det.garage) 030-192-015 03-rL D SCRUBY, DAVID M. 1154 DODGE AVE., OROVILL REROOF/SF �f ti � ,,,,,°"�'r`-herr-4>'�/:"'!i"iJ+,-, r•'t'►.h+w��'r�M._�...a+tr?tc9nar��,r+-�..�'',.rt',�tid.*_�i"`. 030-192-015 h 03:1994 SCRUBY, DAVID M. f 1154 DODGE AVE., OROVILLE REROOF/SF ' 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 0s - 1"4.y ASSESSOR PARCEL NUMBEF�, U3U-1�!L -U15 ZONING BUILDING PERMIT OWNERTEEPHONE SCRUBY DAVID M. SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 50 WALLY B LANE OROVILIE CA 95966 11 NRFS 660.00 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ 660.00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 19.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 1154 DODGE AVE. OROVIUE9 CA 95966 Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF El Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other [a Describe Work: RE ROOF WITH WMP Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home IS I G I W @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 aOLE 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.POWEPPARATUS License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law Jor 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 I000A 46.00 NEW CONST. DWE UNG OCCUP. OR ADDNS. ( 6 ACC. BLDS. sO 3.5¢FT. CONST.MULTI-OUTLET @7,50 6 SINGLER AOUTLET CIR. EX. OCCU OUTLET OR FIXTURES BAL Q I. 0 Ex. Occup. (OUTLETSas °� 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 FEE S Policy Number (The above sections need not be completed if the permit is for work of a valuation !4, 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. X Date 0 15 10indicated Signature of Applicant - Owner Of Conactor ❑ Agent An OSHA permit is required for excavations ova 5'0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 39.00 MAZ. D. FEES IMP I FLOOD I CDF PARCEL I PD HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work above for which fees have been paid. y 3� -1l //, % 40, Date ay 1�-t/�-�f PERMIT EXPIRES ON Date Receipt No.823t/t9.0ii WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 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 cx3-I -w ASSESSORPARCEL NUMBER 030-192-015 ZONING BUILDING PERMIT OWNER SCRUBY DAVID M. TELEPHONE 89-3046 SO. FT. OCC. BUILDING VALUATION 11 SQUARES - 660.00 . OWNERS MAILING ADDRESS WALLY LANE OROVILLE CA 95966 CONTRACTORS50 B OWNER TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS Total Valuation $ 660.00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 19.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 1154 DODGE AVE. OROVILLE CA 6 Energy Plan Checking Fee $ $ PERMIT FEE S 39,00 LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF 10 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 1% Describe Work: RE ROOF WITH COMP Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home IS I G I W 920.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service z�oon oA '.ss 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.P License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law or 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 To 46.00 NEW CONST. DWEW EE NG OCCUCUP. OR ADONS. ( & ACC. BUDS. SO 3.50FT. NON•RESIO MULTI.OUTLET 97,50 SOWER APPARATU 8 SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FDMAES 20 @ 1.00 BAL @ .SO Ex. Occup. DFIxLITE�D�ARa oE., 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S 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.) 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' ce mpensation provisions of section 3700 of the Labor Code, I shall forthwith ply with a provisions. n X Date 1 Signature of Applicant -AOv7ner EVCo actor ❑ Agent An OSHA permit is required for excavations ov 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating —Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ HAZ. D. FEES IMP FLOOD CDF PARCEL pO HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON I the applicable provisions Resolutions to do work been paid. Date 3 -3 I ate Receipt No. _lag 3Ii(�$39.nn WHITE-D.D.S.-B.D. C NARY -AS SSOR PINK -INSPECTOR GOLDENROD -APPLICANT O.B.-1 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 at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit' will be issued until this verification is received. Y. I personally plan to provide the major labor and materials for construction of the proposed property improvement : YE NO ❑ `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: CONTRACTOR'S LICENSE NO. 4. 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: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTYOWNER: DATE: 03 NOTE. This Owner -Builder Verification is required by Section 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 O.B.- I I OWNER BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner builder" you are the responsible party of record on such a permit Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is '$300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. ♦ If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, ifyou wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the.Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. r rely, Mc 1 C. Vi ira, C.B.O. M ger, Building Inspection NOTE. This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. OVER PERMIT NO. 2369-81B PERMIT EXPIRES OWNER Alex W. Mingus CONTR. owner ASSESSOR PARCEL 30-192-7 LOCATION 1154 Dodge Ave., oroville Temp. Power Pole_ CalledPG&E/— Temp. Elec. Service Called /G&E— Temp. Ga.-P4kv-ice' Ca/ed PG&E ) te (D JO FINAL D D (D te Signatur 4 J = OK 0 = Nqt OK 1 - = Not Applicable MOBILEHOMES MISCELLANEOUS = Not Ready Date MOBILEHOME UTILITIES (Plans) OK except p's 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 2. Footings; Size -Depth -Spacing -Connectors - 3. Sewer; Location -Test -Fall -C/0 -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4.Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap:/ P'L"ft./ /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. Card -BI Date Card -BI Date `.gin Iv? Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except N's Card -BI Date Date Card -BI Date _ POOLS (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements 1. Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH.Test-Demand-Valve-Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances• 4, Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/0 to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip.w/5'-Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card B -I Date Card -BI Date Card -131 Date Card -BI Date t 4 J OK O = Not OK - = Not Applicable RESIDENTIAL (Single and = Not Ready Duplex) ' Date UNDE LOOK Plans; OK except #'s Date FRAMING -(Continued) Zoning requirements -Setbacks -Easements 48�erty Line Firewall & Openings 2. F g., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth . Ext. Doors -One 3' -Check Garage -3rd story, 2 exits C,VFtg., Garage; Soils -Steel- / /" Ftg. Depth f! . W, dth-Headroom-Rise-Run-Landing-Fire Protection 4. ks; Soils -Steel- / /"Ftg. Depth wood on Roof Overhang -Attic Vents -Rafter Outriggers ain; I-Blockouts-Wrapped-Slab . Siding -Nailing -Veneer s, Garage; lab 63. Sturr-o Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. SteelS4_rea- lass Protection -Skylights -Plastic 8. gs-Test-2 way C/O -Sewer Test ling -Bolts 9. ipe; S _iz-e--7Gnchors 10. es - nchors-Regulator-Service Test 11c rrc; nderground ' 12-Rlemrms&-Ducts; 13 Clearance -Material -Support -Ins. - - Bolts -Joists -Vents -Cripples Card1jfj#V Date ' Card -BI Date Card -B Date Card -BI Date ' Card -BI Date Card -BI Date Card-B!g Date 7 Card -BI Date Date FINAL (Plans) OK except N's Card -BI Date I Card -BI Date Date PLUMBING (Permit) OK except p's 14. Water HL; Vent -Access -Combustion Air 56. Ext. Steps -Door & Sidelight Protection -Landings 57. 58. Smoke Detector Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 15. 16. Water Pipe; Test & Anchors -Nail Protection D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels . 19. Gas Pipe; Size & Anchors 62. 63. 64. Stairs & Rails Fireplace or Stove; Clearances -Hearth Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter . Date ELECTRICAL Permit OK except p's 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper 20. Fixture &Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection l 21. Elec. Receptacles Spacing -Lights & Switches at Doors 22. Size Boxes & No. of Conductors -Stapled 70. Plb., Elec. & Mech. Equip. Listed for Location - 23. Romex Installed Close to Edge of Studs & C.J. 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. Insulation -Foam -Looked in Attic E] Yes 25. 2 Appliance Circuits in Kitchen &Conductor Size 73. Guard Rails & Deck Construction -Post Caps _ 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral []Yes (:1 No 75. Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑Yes ❑No 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77. A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B-1 Date Card -BI Date 81. Ventilation throughout House £ Card B-1 Date Card -BI Date 82. Glass Protection - Date MECHANICAL (Perrnit) OK except N's 31. A.C. Ducts; Insulation & Support 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 85. Water & Sewer Connected -C/O to Grade -HD Approval _- 32. Vent Fan; Exhaust above Insulation 86. Energy Compliance Certificate -Other Certificates _ 33. Condensate Drain & Overflow; Size & Grade 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic Card -BI _ Date _ Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FRA NG(Plans) OK except N's Comments at Final: S' s; Proper Material & Anchors Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound _ -- in a s over Girders & Floor Nailing ---- proof) 49. --Fir -f=aREtJ'C'e,Tings-Stairs-Chases-Tub 42r eader &_B_eam-Size & Bearing nc o�nnectors otst -M ti, rae runrn-Root-Bt'3c.-Truss-ShI . -q p ace ie e -Fireplace Throat 455-. ccess: Size & Romex Protection -Draft Stop -Ins. Baffles _ 4 n ows or Exiting Doors -Sill Hgt. & Dimensions ro ecuon rammg (NOTE: An entry must be made each time youvisit jobsite) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT . r - 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND. PERMIT r fl ASSESSOR PARCEL NUMBER 3 a —/?p,—o7 ZON G --Z BUILDING PERMIT OWNS 4-414 TELEPHONE SQ. FT. OCC. BUILDING VALUATION 0 OWNER'S MAILING DRESS L01 NVE! CON RACTOR'S NAME ' her TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ,VrO ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO.SUBDIVISION b NAME $G PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRU URE SF ❑ Duplex❑ Mobilehome❑ Other f SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New Ka' Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP OROR LESS5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST.( DWELLING OCCUP.(!11 OR ADDNS. ACC. BLDGS. I 2Q sq ft CONTRACTORS LICENSE LAW I declare under penaltyof perjury p f y (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 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 NOW BRANCH PIRA IS CONREST NEW RESID. (POWER APPARATUS D� NON -R ESI D. SINGLE OUTLET CIR. Ex. Occup OUTLETS OR FIXTURES a 10C kt 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 FiIirig 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. PQ1 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 Countyot 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 wa accrue against s id Count in conse5pence of the granting of this perTA. X DateG f Signotur. of Applicant 0 er [� Contractor ❑ Agen. An OSHA permit is required for exca'v'ations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ occ P GROUP I TYPE OF CONST. F PARCEL PD NO ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECT OF PUBLIC PE EXPIRES Date_ the applicable provi- resolutions to do fees have been paid. WORKS Date G [ �^y� �•-Z7�0 Receipt No.Jso3 23 —2 --BY WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, OroviIle — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext' 57 CORRECTION NOTICE s- Ll E),n Ave BUILDING OR PROP -ERI ADDRESS A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, 'please contact this office immediately. n Inspector ' �'Ar��`� ' 1 . �:r Date �'