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HomeMy WebLinkAbout030-270-019030-270-019 AG02-113 030-270-019 01-1348 BRITTON,VERN BRITTVERN n� l 5036 LARKIN RD., OROVILLE 5036 LARKf1 OROVILLE AG. BLDG. (20'X 30') r CONT: K DESIGNE YINYL SIDING t 030-270-019 04-1851 BRITTON, VERslq 5036 LARKIN RD, OROVILLE Cont OWNER ELE SER CH 1 i 4 W1 a 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. BP041861 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: 06/24/2004 APN'' 030-270-019-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 5036 LARKIN RD ORO Date: Contractor. Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: C/O MAIN ELECTRIC SERVICE PANEL 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' BRITTON VERN W & LOIS M JT to its issuance, also requires the applicant for such permit to file a 5036 LARKIN ROAD signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section OROVILLE, CA 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).): 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 (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: BRITTON VERN W & LOIS M JT 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:• and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Business and Professions Code Date4l:�*Owner: --41.4 License #: 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 carrier and policy number are: Carrier: Total Square Ft:,- 0 S. F. Policy #: Valuation: $0.00 Census Code: 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 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: G '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. a CONSTRUCTION LENDING AGENCY This p iiss h by'sss a d the ap licable provisions of the Butte Cnu ty Cod P a Nor I hereby affirm that there is a construction lending agency for the performance of the work for wfach this permit is issued (Sec 3097 Civ.)_, Res tion t w f r hi h f have been paid. O— Y---- Name: B y:+-2 _ ". Dater - PERMIT EXPIRES ON: Date Address: ❑ 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 document off Butte County. I hereby ^or authorize representatives of Butte County to enter upon the above mentioned property for inspection purpos Print Name: VV,---r/�`Yi( f i`l f� Signature: Date: Owner ❑ Contractor 0 Agent for Owner ❑ Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTIONM 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" APPLICANT NAME OWNER Last Name R n City first Name Address City City D State State C'9 450h P00 hooe. 3 B _ DSy Fax Fax E-mail Uc. # APPLICANT NAME CONTRACTOR Name City Address . Zip City Fax State Zip Phone Type Const. Fax E-mail Map Book Uc. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City Address . Zip City Fax State Zip Phone Type Const. Fax E-mail Map Book State License Number APPLICANT NAME Name Address City State . Zip Phone Fax E-mail APPLICANT SIGNATURE X .-eJ (15�1 For office use onI AP# ©-0/ Zoning Flood Zone SRA Yes I No Occ. LENDING AGENCY Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT _ B AV BIN # LOCATION AP# ©-0/ Property AddressCity Cross Street Uw" 12D .WORKER'S TIOM 11 Policy Number Carrier Nhiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: 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 OVER FOR SUBMITTAL REQUIREMENTS U K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 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. red by: Amount SRA Sheriff SMIP Other Total KtV ti-1ti-V4 O 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 Complete sets of plans, signed by the preparer. NO GRAPH PAPER! 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) (NO 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 stamped and wet -signed by the 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 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). ❑ 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 KAFORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 6-16-04 .: 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. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement: YES -W NO ❑ 2. I HAVE HAVE NOT ❑ signed an application for a building pemmit 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: NAMM 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 NOTA: This owner -Builder VerVxl a ion is required by Sec£ion 19831 and 19532 of the California Health and Safety Code. This MVxWon must be completed and returned to our office before we are pennttted to issuce the permit OWNER BUILDER INF OI4MA'I'I®N Dear Property Owner. An application far a bmlding Peank has been submitted in your na = listing yourself as the builder of property improvements specified. For your protection, You should be aware that as "owner bn� you are the respoasble party of record on such a penin: Building pemrits are not required in 6e signed by property owners unless they are persona.IIy performing thea own work. If your wank is being performed by someone other than youusei, you may protect yourself from possn)le HabRRY 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 oa all p=its for which they apP$• ifyon plan to do your own work with the exception of various trades brat you plan to subcontract yon should be aware of the fD11"Ing information for your benefit and protection: a if YOU employ or othm vise engage any Persons other than your immediate {amity, and the wodc Cmchuding materials and other costs) is $300 or more fDr the etre prqjec� and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an emplcow, yon must register with the Std and Federal Govt as an employer and you are subject to several obligations including state and ibderal income tax wifhholding, ipderal social security taxes, waw compensation insurance, disabMy insurance costs, and unemployment compensation coniribui ons. Tbere may be financial risks for YOR if you do not cagy curt dim with respect to worbes Obligations, and these risks are especially serious compensation insurance. ♦ For more specific mon about your obligations under Federal Law, contract the luteal Revenne Service (and, State Law contact tine D Business . • ). For more specific infomration about your: obligations under ePMtmM t of Benefit Payments and the Division of Industrial Accident. If the stmc!= is intended for sale, Property owners who are not licensed contractors are allowed to perfoIM. their workers. nally or through their own employees, bout a licensed contractor or subcontractor, only under limited conditi A frequent practice of unlicensed persons Pro , Pew erroneously mmP that fire to be contractors is m secure an "owner builder" building ng pemuts are not required to be PrOl Y O°= is providing his or her own labor and material personally. Building Iits am not about d to be signed by Piny owners unless they are performing their own work personally, ractars may be obtained by contact the Cos&actms State License Board is your or at 1020 N Street SamwnauW, CA. 95814. Please complete the "Owner Builder Venficaftan" on the reverse side of this form so that we can confirm that you are aware of these matters. The bmlding prmit wM not be issued umt:l the verification is resumed. Buzilding Inspection T. l NOZZ• Thin Owner-BaUer-P f nnadon is required by Seaton -13830 ofthe CWorala Health and Safety Code T FA BUILDING DIVISION COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE — OROVILLE, CALIFORNIA 95965 — TELEPHONE: (530) 538-7541 AGRICULTURAL BUILDING EXEMPTION PERMIT PERMIT NO. Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place used by the public. ASSESSOR PAROL NO. ® ®P 0 0 ZONING A - OWNER, - VFZN EKETTM PHONE NO. 36-) S33- 1359 OWNER'S ADDRESS D f� KID, RQ USLLE Ch 17SMS LocSIn � BulLlLi9 E K I-IV R a iny-AUDLE0 CA T'51/'7 USE OF BUILDING _ Ab,--) , -PE SIZE OF STRUCTURE a� 'X'= 600 SO. FT. TYPE OF CONSTRUCTION: WOOD FRAME X STEEL CONCRETE OTHER (Specify) T� IME AL, RG �O- _ i E ftL NG HL �- FLOQfj CAME LICE 1 E ESTIMATED COST OF CONSTRUCTION $ a soo AG Buildings -shall comply with the minimum front, side, and rear yard setback requirements of the applicable County Ordinances as follows: FRONT 5:5 SIDES ZO ' '" REAR r AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a mobilehome, and 23 feet from a commercial building. AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a mobilehome, and 40 feet from a commercial building. I declare under penalty of perjury that the building will be used as stated about, and the purposed use confirms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Building Division and obtain any necessary permits, inspections, and approvals to comply with the requirements in effect at that time and before occupancy. Date Signature of Owner / Permit Fee $60.00 Receipt No. The above described AG Building is exempt from a building permit I K:am," mmo Manager Building Division By Date y �Z White — DPW, Yellow — Assessor, Pink — B. I., Goldenrod — Applicant 030-270-019 01-134 BRITTON,VERN 5036 LARKIN RD. OROVILLE CONT: K DESIGNERS YINYL SIDING 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 d01`1349 ASSESSOR PARCEL NUMBER 030-270-019 ZONING AR - BUILDING PERMIT' OWNER BRITTOAI VERN TELEPHONE 5XI-1359 SO. FT. OCC. BUILDING VALUATION CONT 2006 00 . OWNERS MAILING ADDRESS 5036 LARKIN RD, OROVIIIE, CA 95966 COhrrRACTTORR'S NAME K -DESIGNERS (916)1631-9-300 TELEPHONE CONTRACTORS "UNG ADDRESS CONSTRUCTION LENDER !��:Fireplace I LENDER'S MPJUNG ADDRESS Total Valuation $12 006 00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 144.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 50-16 T F C t:1 Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF Gl Duplex ❑ Mobilehome ❑ OtherWatery SPECIFY . Solar or heat pump water heater 23.00 piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other O Describe Work: VINYL SIDING INSTALdAATION Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G W Q20.00 PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.00 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 i full force and effect. p. �j�� / License Class Lic. No. / Q (r'� OWNER -BUILDER DECLARATION I 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 Main Service 200A TO 1000A 46.00 NEW CONST. OWEWNG OCCUP. OR ADDNS. ( 6 ACC. BLDS. SO 3.50FT. ►NON-RESID. T. MULTI- OUTLET 97.50 POWER MPARATUS a SINGLE ourLET cIR. EX. OCCU . OUTLET OR FDCTURES .00 BAL @ 1.50 Ex. Occup.. ouTtEEDrsA RM.GEll 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 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 �C%/? f® .,,r. -011>1 Policy Number —Ada / O X7.5` 7 (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 becomessubject to- the workers' compensation provisions of section 3700 Of thejLiiiorlCo`de, I shall forthwith comply with those provisions. iTi r X Date (� •' b " _ Signature of Applicant - ❑Owner ontrector Agent An OSHA permit is required for excavations over 5'0" d ep and demolition or construction:yf//6 of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEPE $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 164.00 HAZ. .- D. FEES �- IMP .. FLOOD CDF ._ RCEL PA,,,, ,...- PD ... HD IS UE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON C f the applicable provisions Resolutions to do work been paid. ate U f b �..- e!e Receipt No. 3.Q go ! WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK•INSPECTOR GOLDENROD -APPLICANT COQ. JY 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 01-1348 ASSESSOR PARCEL NUMBER 030-270-019 ZONING AR - BUILDING PERMIT OWNER BRI'i'1GN P VEIRN TELEPHONE SQ. FT. OCC. BUILDING VALUATION O 7r� /� [ (�(� L+�I T 12006 a 00 . OWNERS MAIUNG ADDRESS .5-036 LARKI ? RD, OROVI'IU , CA 95966 CONTRACTOR'S NAME K-DESIG\?ERS 1631-9100 TELEPHONE CONTRACTORS MAIUNG ADDRESS H�'\ AT iSEPARK DR :� ,�I��IQ CORD( _ CA 95677 CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS Total Valuation $12 006.00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 144.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS TARKTiU� T r7 Energy Plan Checking Fee $ $ PERMIT FEE $ o LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF M 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 ❑ Ublides ❑ Installation ❑ Other Describe Work: VIi�1YL SIDING INSTALLATION Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home 9T'& W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 600VOR LESS Main Service zo.A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is i full fgrc and effect. ,� p C/r�� / License Class / Lic. No. %' / j} (�J OWNER -BUILDER DECLARATION I 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 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' c mpensation insurance carrier and policy numb r are: Carrier -/-- 0,61- L Main Service 200A TO 1000@ 46.00 NEW CONST. DWEWNG OCCUP. OR ( So 3.50 so NEW9 corS. . Mu=woCCS NON•RESID. @7.50 POWER APPARATUS a swGLE ounET aR. EX. Occup. OUTLEr OR FIXTURES 20 O I'50 BAL @ •50 Ex. Occup..OUTLEETS RESID.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FES $ Policy Number A 2 10 '7 (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 'rf I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall fo ith comply with those provisions. /� X Dat (p L� 6 L Si natur of Applicant - ❑ Owner ontractor Agent n OSHA ofis required for excavations over 60" d4ap and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST.ATYK❑ TOTALFEE$ 164.00 HAZ. IMP FLOOD CDF pARC0. PD HD Is UE This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions indicated above for which fees have been By PERMIT EXPIRES ON provisions to do work paid. 76� ate Receipt No. oZ WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT "'J" 1 T yr esu I TE - DEPARTMENT OF DEVELOPMENT 7 County Center Drive • Oroville, SERVICES - BUILDING DIVISION California 95965 • Telephone (530) 538-7541 12/96) (Rev. APPLICATION AND PERMIT PERMIT A881$8ORPAAf4.y NUY r 1—/NyO m�NO BUILDING PERMIT ERMIT / x/U / /2 /` 70— J TILEDIgN! — CC JJ OWNen• MA.04 ADDRESS S' 3d S� -j3 OCC. BUILDINQ VALUATION ,5 —0 CONT MAM! D /(sti� n TTI B44ON! g CONTRACTOR'S 6 O MAUNO ADDRE2$ _ °" `/ J C.1/L�/� P ��}2� �/2 �1fIAGa!1p OONfTAUCTION LlWEA COdAyis=. LlNoim,s wvUNO ADOREq Fireplace ARCNrrlCT04ENWNEER Total Valuation S LICENse No. Filing Fee S AACNRECT OR U�IONCER9 MAUNO Ao0RES9 20 00 Permit Fee S OURONOADOREfsPlan Checkin Fee S Energy Plan Checking Fee S S 1 IOTNO• sueonroxlNSNAM! ARCEL' MAP PERMIT FEE _ PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE Each Trap7.00 FSF0Solar Duplex O Mobilehome O Other or heat um water hea ter 23.00 spwr"Y Water I In 15.00 TYPE OF WORK New O Addition Each gas water heater or vent 15. Gas in ❑ Remodeli ❑ ���tion� ❑ m ste1 - 5 outlets 15.00 Describe Work: (/ /jr� t/���j/�, y d/ST�t/.¢Tial✓ Building sewer 15.00 / S G @20.00 PERMIT FEE S -- ELECTRICAL PERMIT Filln Fee 20.00 — - ---- Main Service r 800V ORR IS 23.00 Main Service I200A TO IOWA 48.00 NEW CONS O LLLAQ OCCUP• OA ADONs. A AOC. OLDS. 3.5¢R., NOIKRESID. MULTI- UTLET ARANQ () ' POWER APPARATUS A SNOLE OUTLET CIR. Ex. OCCu OUTLET OR PDnURES 0 I.Oo SAL.� t ITMO APPINS. Ex. OCCU OUTLETSEA 5.00 I Tem orar Servic 23.00 • Mobile acilities 20.00 .. Misc. Wirino 23.00 *PERMIT / PERMIT FEE S FEE PAID MECHANICAL PERMIT Fling Fee 20.00 SPA - - Heatin Coolin SHERIFF Hood 6.50 OTHER Ventilation PERMIT FEI= S Mobile Home Installation Fee S ---- Energy Inspection Fee L OCC OONST. TYPE AMOUNT RECQVE� I TOTAL FEE $ f 0. r> ® IMP nrD00 COP PARCEL PO Is This permit is hereby Issued under the applicable provisions (�% Q ' of the Butte County Code and/or Resolutions to do work Indicated *RECEIPT NVMRER 3 a 1 0 U above for which fees have been paid. * TO BE PVT INTO COMPUTER By Date • PERMIT EXPIRES ON t h MOMEMEMODEL'ING;LEAOER' 11 6-z��w �2 SUBJECT:O� JOB SITE ADDRESS: cSd 3l0 ��-a�ez,, �i PLEASE ACCEPT THIS AS YOUR AUTHORIZATION TO ACCEPT THIS APPLICATION AND ISSUE A BUILDING PERMIT FOR THE ABOVE DESCRIBED JOB SITE SUBMITTED BY A REPRESENTATIVE OF K -DESIGNERS. PLEASE NOTE THAT THIS AUTHORIZATION IS RESTRICTED TO THE ABOVE DESCRIBED JOB SITE ONLY AND NO OTHER PERMITS ARE AUTHORIZED HEREIN. 70HHIN E ULFRENCH SENIOR PRODUCTION MANAGER i 261 air:ri52 Park, Drive , Rancho Cordova. California 957=2 a (916) 63 11 -9300 o Fax 6.-.'. I