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Home My WebLink About030-200-05330=20-5 .F�r e-d—Mxm e r s "117 RofDrive, ov i e 01-- bd�e-,;�Qr-ov i I I e Perm, 2-7 e- 282 s g e family) N eWy() 6'Irta4.) 30=20=53 Gall 0. -1178 Mor"Dr. , lot #2, Upshaw Silb, Oro. Permit #172-77B,P,E,M(new single family) ,moi �I aw 01 030-200-053 06-0.247 GILBERT, BEVERLY A 1178 ROY RD, OROVILLE Cont: RISSE & SONS INC REPLACE WATER HEATER BUTTE COUNTY PERMIT NO. DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT BP060247 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 B. C. Building Permit 01-16-04 pg 1 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: 02/02/2006 APN: 030-200-053-000 the Business and Professions Code, and my license is in full force and effect. g a�; 5 License Class : License Number: Site Address: 1178 ROY DR ORO Date: �` a v G Contractor: ,2 55r M ee-/11 Map Index: Description: REPLACE WATER HEATER p 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: GILBERT BEVERLY A to its issuance, also requires the applicant for such permit to file a 1178 ROY DR signed statement that he or she is licensed pursuant to the provisions of OROVILLE, CA the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 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, B08iness and Professions Applicant: RISSE & SONS INC. pp Code: The Contractors' Stale License Law does not apply to an owner of property who builds or improves thereon, and who does PO BOX 67 such work himself or herself or through his or her own employees, RIO LINDA, CA provided that such improvements are not intended or offered for 95673 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 916-991-3030 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 Contractor: RISSE & SONS INC. not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed PO BOX 67 pursuant to the Contractors' State License Law.). RIO LINDA, CA ❑ I am Exempt under Article 3 of the Business and Professions Code 95673 916-991-3030 Date: Owner: License #: 264815 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. Engineer: til. I have and will maintain workers' compensation insurance, as 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: P'eP% d .F /lvP/Lvs T/Z 119--6 0 S. F. - Total Square Ft: G� y P2 l d S 3 Policy #: /� Valuation: $0.00 Census Code: ❑ 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 the workers' compensation laws of California, 0 and agree that if I should become subject to the workers' m compensation provisions of Section 3700 of the Labor Code, I shall -11„ N forthwith comply with those provisions. /-�►.-J• 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. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resol do s to do work indica ed a ove for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) . n -r, By: Date: L -06 Name: `/' V Address: PERMIT XPIRES ON: / (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. I hereby authorize representatives oof/Butte Countytocenter upon the above mentioned property for inspection purposes S Pte/ Print Name: [i/77� 1�//11 Signature: Date:. ❑ Owner ❑ Contractor ❑ Agent for Owner gent for Contractor B. C. Building Permit 01-16-04 pg 1 BUTTE COUNTY PERMIT DEPARTMENT OF DEVELOPMENT SERVICES NO. BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS /� 24 HOUR rNSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 BP06(Y2 OFFICE #: (530) 538-7541 A FEE WILL BEREQUIRED AT TIME OFAPPLICATION BW # Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name irst Name Address 0 $ D� City U odtrl ze Sta Z6104- 1p 9� `/ Phone 5_3,9L 3 a 7 O 6 7 Fax E-mail CONTRACTOR Name 12, 5 S-e�r Address -7�fS City (Lc d C� p� Sta� ZZI1Pp yrs 73 PhoneFax iG Ff/34 3 J E-mail Lic. # �r S Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name city %Lr v G/--- 0t4 Address � 7,3 City Fax State Zip Phone Map Book Fax " E-mail Planner State License Number.. APPLICANT INFORMATION Name Address 7a � �-- a� r/� 5 _I— city %Lr v G/--- 0t4 Sta � 7,3 Phone Fax E-mail APPLICANT SIGNATURE X � For office use only: Zoning Property Address 17 S'- 20 �- Flood Zone Cross Street SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K•%T:nPMC\RI III I'Mr, Fr)RhAC\RlrinAnnlCithRnmtc rine: PROJECT LOCATION AP# Oso 200 - 053 Property Address 17 S'- 20 �- City 02ov/Ile 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. Total LENDING AGENCY Name Address Description or Scope of Work: Sq FT- Living Garage Open Cov ❑ 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: 1v b. Amount: Bldg Receipt 0-15-79-5 Sheriff owckiloor SMTP Date: L' 06 Other Total Pane 1 of 2 a / R_17 nr SUBMITTAL & PERMIT 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 ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd'plans, all in duplicate ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and caics in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate,. wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Building Permit Application Without Required Clearances Form . ❑ 12. Hazardous Material Form (for Commercial Buildings only).. _ Remaining items needed to issue the permit. Additional itenfs`may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). . 119. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Legal. description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation and site plan'approval-from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the.person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs .are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 172-77B PERMIT NO. ,P,E,M c PERMIT EXPIRES OWNER Gallaway & Co. - r CONTR. owner LOCATION (A.P. 30-20-53 a 1178 Roy Dr., lot #2, Upahaw Sub, Oroville y , i' A Temp. Povyer Pole Called PG&E Tem .yElec. Serv. Called PG&E Tetp. Gas Serv. �J 7� Called PG&E ` JOB T FINALED (Da ( igna ure) I t Setback Forms Main Bldg. Footings Stemwa 19 - Slab Piers Garage Footings StemwaI r Slab_�i Carport Footings Slab Patio Footings Masonry Walls Reinf. Steel Bond Beam COUNTY -OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING Cont'd) PLUMBING % Firewall �— Z Soil Piping Parapets 1st Floor cYoZ Restroom Finish 2nd Floor Windows 3rd Floor f Siding . To out Roof Sheathin a Water Piping-// Roofing ^2z Aar, Sewer Fdn. Vents Fixtures Garage Vents Insulation % Water Htr. Heaters ' Prov. for physically �� handica ed Conformance of ex. structure Appliances Gas Piping & Test Temp. Gas Final 2 Sanitation FIREPLACE Final Footing k _ ELECT FIRE tPRINKLERS Motors Test Water Htr. Final N Subpanels Mesh MECHANICA Grd. Fault P A Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer ) Final Final DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) THIS IS TO CERTIFY THAT INSULATION HAS BEEN INS LLED IN CONFORMANCE WITH THE CURRENT REGULA- TIONS, CALIFORNIA ADMINISTRATIVE CODE, TITLE 25 STATE OF CALIFORNIA, IN\ THE BUILDING LOCtATED AT: Street Lot Number . Tract No. EXTERIOR WALLS �3�1- Manufacturer C ��L�- Thickness/Type/L , R Value / CEILINGS Batts: Manufacturer Thickness R Value Blown: Manufacturer Thickness S _' No. Bags 2 Z— Wt./Bag Sq. Ft. Covered R Value_ FLOORS Manufacturer Thickness/Type R Value SLAB ON GRADE Manufacturer Thickness/Type R Value Width of Insulation -inches FOUNDATION WALLS Manufacturer Thickness/Type R Value GENERAL CONTRACTOR LICENSE No. BY. TITLE — DATE INSULATION CONTRACTOR: HAWKINS INSULATION CO. LICENSEE 0. 215-925 BY TITLE GAJ DATE ��l 317 7 COUNTY OF°•BUTT,E — ~ DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — yoroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT / . ��2 -77- '70- � L'�_� cF1 Il ivaa l l,UulllY UI outtu to enter upon Ine a ntione ropert in ction purposes. X Da Signatur1e of /Permitee or Agent Receipt No. / 75: White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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. DIRECTOR PUBLIC WORKS BYwDate2- 7:7 ildinpermitepireg Date BUILDING OwnerG ffJ a SQ. FT. OCC. BUILDING VALUATION cc - Mai I ing Address ®29 to Y --- Z - �-Y Z 7 Tele hone No. L P7 Fireplace Contractor 10(U E E Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ pu Building Address y� l / 7� PLUMBING No. @ FEE PERMIT FILING FEE $3.00 �3 &u Each Trap 1.50 e Repair drainage or vent piping 1.50 Water piping 1.50 ��C3 �l 6r4o/n�p�,yeriPJc fio Onl Each gas water heater or vent 1.50 A _5-6 A. P..— y�j --j"� /� i Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fes I W. n n I Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA L. 121ans. Parking eParceion Parcel Map 60' R/W I Improvements Lawn sprinkler system 2.00 Parcel Approval Plans A4 rovol Permit Fee $ 74.• U $ NEW � ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE J$3.00 5% O(J Main service 100 AMP ORV OR LESS5.00 Main service EA. ADD -L too AMP 2.50 Single Family Duplex ❑ Mobil Home ❑ Others ❑ OVR 600V Main service 100E EAMP OR LESS 25.00 Main service EA. ADD'L 1000Q AMP 1.00 ,,gg OR ADDNS.NEW CONST. ( DWEACCLBLDGLING SO.C/ P�iV) 22sgft X00 NEW CONSTSL MULTI -OUTLET NON.RESID. ( BRANCH CIRCUITS) 2.50ea NEW CONST. POWER APPARATUS & NON- R RESID. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of Cali r 0 Business & fessions Code under the name St le Y Ex. Occup(OUTLETS OR FIXTURES) X256 BAL@1 FIXED APP LNS. OR Ex. Occup.(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 / Mobile Home Facilities 15.00 License No.3 r97 VY Classl ication Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ -5 t est; $3S' 7-30 WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability4600 for Workmen's Compensation. have placed on file with the County of Butte a certificate of Z.orkmen's Compensation Insurance. F1I 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 the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 socp Heating Cooling 415 8Y OTC 31 Uc� Ventilation Hood 2.00 Zuc3 Permit Fee $ OV $ Uv 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 L relay o building construction, and hereby CJ TOTAL PERMIT FEE $ SSC cF1 Il ivaa l l,UulllY UI outtu to enter upon Ine a ntione ropert in ction purposes. X Da Signatur1e of /Permitee or Agent Receipt No. / 75: White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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. DIRECTOR PUBLIC WORKS BYwDate2- 7:7 ildinpermitepireg Date THERMAL.ITO„ IRRIGATION DISTRICT 410 GRAND AVENUE OROVILLE. CALIFORNIA 95965 TELEPHONE 533-0740 CSA 26 SEWER SERVICE APPLICATION AND CONNECTION PERMIT Service Address: / Owner's Name: - �- Dae ' Address: % - %�- C.�r . Acct. No: A. P. No.:, i 41 Phone: /� No. Units: ��- Applicant/Agent: Agents Proof: Address: Fees: Phone: Application Arrearage Preliminary Review By: k - Date: - CSA 26 Remarks: !J SC -0R 1st mo. S.C. Other Total Fees Collected By: Date: Field Review By: Date: Remarks: MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON: ❑ Date of TID approval of completed building sewer (early connection). ❑ 30 days after date above, or on date of D.P.W. approval of completed building sewer, which ever comes first ("existing construction", prior to Mar. 5, 1974). ❑ 180 days after date above, or on date of D.P.W. approval of completed building sewer, which ever comes first ("new construction", after Mar. 5, 1974). DISTRIBUTION: WHITE - TID, YELLOW - APPLICANT, PINK - DPW, GOLDENROD - DPW to TID V.- - '- N This set of plans an specifications MUST _ == kept on the job at all_ P j es and it is unlawful i� make any changes or alterations on same withoal - =_ writfen permission from.+e Department of Public -= :Works, County of Butt+ r Acc 9 o f a or41ance �v of rials Unl f quaht h Re `� �V the /V Q1i dPrescr;6co g'14 edo"G ansh. S The Bldg. Setback shall be 5 ft. from the side property line and 50 ft. from the centerline of the road, permi•�'ing a maxi- mum of a 2 ft. eave overhang but entirely out of all easements. .. _ .... _ r°npl..Ej'9, Plumo! for the 0041 P" hall 8, . . i�ca/ Co e• Me h0n�ca d 4s� ee and it /codes the an41 I on file I& builditl IBUTTE COI (BUILDING DEP APPRO �—� A � l�•-.lam `•." ..' '., � .Y Gr' - ` CLAIMANT: ADDRESS: ennt* of iquue v OROVILLE, CALIFORNIA GENERAL CLAIM Frieda E. Hart 16 Leslie Lane CITY & STATE: Oroville, CA. 95965 IMPORTANT: DATE OF CLAIM: January 21, 1977 S ON REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM '(DESCRIBE FULLY TO AVOID DELAY) AMOUNT Decided not to build. (Owner: Fred Hinners - Permit Appin. #2822-75B - c - 30-20-53) Building permit fee ----- $100.00 Retain 173 of fee ------- 33.33 TOTAL AMOUNT OF REFUND DUE ---------------------------------- $66.67 i TOTAL $66.67 I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is true and correct as stated. Dated this .................................. day of ............................. 19....... at,Orovlle......... Calif..................................................................................... Signature of Claimant I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or de- livered and that there is a Budget Appropiiation D or Specific Board Approval ❑ (Check one) for the some. 24thJan. 77 Oroville Dated this .................................... day of ............................. 19......, et .............................. . Calif..................................................................................... Department Head or Authorized Deputy Dept. Exp. Code............................................ Code ................................................PAYABLE FROM ............................... :.................... ........................................ FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY VENDOR CODE DEPT. & SUB. PROD• SUB. 0BJ. CLAIM NO. INVOICE NO. INVOICE DATE DISC. GROSS AMOUNT ENCUMB. SUB -DIST. 5E INSTRUCTIONS: to 'CLAIMANTS All claims against the county must be itemized, giving dates and character of service rendered or work performed, quantities, de- scription and unit prices of articles furnished or delivered. Claims must be certified by the claimant and submitted to .the De- partment head for approval. Upon approval the Department head will forward claim to County Auditor for payment procedure. Do not file with the County Auditor first. Claims should be presented to officials for approval immediately upon completion of services requested or material ordered. Claims are paid every Tuesday; however, same must be approved by officials and in Auditor's office before preceeding Wednesday noon. Compliance with above will expedite payment of claim, failure to do so may delay payment considerably. • COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Telephone: 5:4-4541 APPLICATION AND PERMIT C above-mentioned property for inspection purposes. X�`- Date Signature of Permit/tee or Agent Receipt No. J�j�f� %%,? White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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. DIRECTOR OF PUBLIC WORKS By Date Building permit expires Date BUILDING OwnerSQ. /A/,Ve FT. OCC. BUILDING VALUATION 19) D Mailing Address i L Telephone No. I Fireplace Contractor t ad .4 F /��l4 ►�! 7i8B �j� S A G �� Total Valuation Liz,C Permit Fee Mailing Address A. Plan CheckingFee-&/or Penalty 0 0 vt 1 Telephone No. 53 —686'7 Permit Fee $ r00 02 Building Address 2OV �lr PLUMBING No. @ FEE �—r--, PERMIT FILING FEE _$3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 r O U Each gas water heater or vent 1.50 A. P. No. ,3p.—� C� �3 Zoning 8 Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 es Sanitation, Fire Dept. Fi�reyZone Use Permit Building sewer 5,00 EQA Plans Declaration it Pr�I t 60' R/W Improvements Lawn sprinkler system 2.00 y� c Idg. Plans Recd �/� ''Aar�T'Ap oval Plans Approval Permit Fee $ $ NEW � ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE J$3.00 Main service 100 AMP ORV OR LESS5.00 Main service EA. ADD'L too AMP 2.50 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Main service 100 ARMP OR LESS 25.00 Main service EA. ADD'L 1LING 00 AMP 1.00 OR ADDNSNEW T ( DACCLBLOGS./ /a�(20Sq ft NEW CONSTR. MULTI -OUTLET NON.RESID. ( BRANCH CIRCUITS) 2.50ea NEW CONSTR. POWER APPARATUS & NON -REST D. (SINGLE OUTLET CIR. ) CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: I' — Ex. Occup(OUTLETS OR FIXTURES)�'� BAL@1 FIXED APE s Ex.Occup.(OUTLETSP(RESID.)REA) 2.00 Temporary service 10.00 License No. __ Classification Mobile Home Facilities 15.00 Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ an p y y person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No.1 @ FEEPERMIT FILING FEE J$3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 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 a"thnri7n rn r .oh1 ,..,.. ,.r .I - TOTAL PERMIT FEE $ �v00 above-mentioned property for inspection purposes. X�`- Date Signature of Permit/tee or Agent Receipt No. J�j�f� %%,? White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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. DIRECTOR OF PUBLIC WORKS By Date Building permit expires Date FILE.MEMO OWNER AP NO. At time of permit application, the applicant was advised the following data or information must be submitted -prior to permit processing and/or•issuance: 1. 2. 3. 4. 5. 6. -7. ofi=?9 . 10. • • 1.1. 12. 13. 14. 15. 16. 17. 18. By All items have been submitted. Plot plans in duplicate/triplicate. Complete plans in duplicate/triplicate. Complete engineered plans and calcs. Fees of $ Letter of signature authorization. Sanitation approval. Planning approval Workmen's Compensation Insurance Certificate. Contractors license -information. Parcel declaration. t Access declaration. Aunt Minnie information. Deed of access. Deed of parcel creation. Parcel map. Pre -inspection request for Other Date ?—&°-76 Bldg. Inspector saamamaaammsasmaamsmsaosssssmasmaoaaasmaaaamamaaammmaaaaasmmamaassmmmaamsnmasassmasasasssssssss� When permit is issued, process as follows: 1. Mail to owner. 2. Mail to contractor. 3. Deliver with inspection. 4. Telephone ,j 3 3 7 and hold for pickup. 5. Other aaaooeamaoaaaaaeaoamaaaaoaaaaaaaacaaaoaaaasea°aaaaaaaaaooaoaooaaoaaaaaaaaeaoaaacaaaaaoaaaaeazaa During plan checking,process, the following data or information must b sub itted rior o permit issuance:. �f 1. Index permit for items 2. Applicant,.Advis,4 by t red above. �cig ne we ed c- V 3. Send letter to applicant. We need 4. Pre -inspection for NOT verified. (Index) 5. Other 6. Plans checked and/or approved by Date re=eaeoaa�aceaea==aae.a`naa=oaanam.ca=aaa aaaa maaaaa as maaasaaaaommasmassoasmsssssasssassasss Additional Processing or Notes: �� C