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Home My WebLink About030-270-077MISCELLANEOUS • -Electric Panel REPLACE ELECTRICAL PANEL 5034 LARKIN RD MCELROY WILLIAM A &, I Carl Vollersen I e/s Larkin Rd. opp. Mosquito. Abatement 1 Office, Orovllle MISCELLANEOUS • -Electric Panel REPLACE ELECTRICAL PANEL 5034 LARKIN RD MCELROY WILLIAM A &, A. P. Carl Vollersen e/s Larkin Rd. opp. Mosquito. Abatement Office, Orovllle Permit 124 -71B (reframe roof & parthl siding) J_/.2 -?y j 030-270-077 PERMIT#94-2935 SMITH, MARVIN; 5034 LARKIN RD., OROVILLE REROOF/ SF' 41 ' 030-270-077 B08-0917 MISCELLANEOUS • -Electric Panel REPLACE ELECTRICAL PANEL 5034 LARKIN RD MCELROY WILLIAM A &, BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION(IVR)#: (530) 538-4365 OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 5034 LARKIN RD Owner: Permit No: B08-0917 APN: 030-270-077 MCELROY WILLIAM A &, Issued Date: 5/20/2008 By GLB Permit type: MISCELLANEOUS P O BOX 362 Subtype: Electric Panel GRIDLEY, CA 95948 Expiration Date: 5/20/2009 Description: REPLACE ELECTRICAL PANEL Occupancy: Zoning: Contractor Applicant: Square Footage: NACHO'S ELECTRIC NACHO'S ELECTRIC Building Garage Remdl/Addn 219 SHELDON AVENUE 219 SHELDON AVENUE GRIDLEY, CA 95948 GRIDLEY, CA 95948 Other Porch/Patio Total (530) 846-0655 (530) 846-0655 FEE INFORMATION DBE Single Phase Service-Resid $59.00 Total Charged: $59.00 Fees Paid: $59.00 Balance Due: $0.00 Receipt No: B7399 LICENSED_ CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License NACHO'S ELECTRIC 898854 / C10 / 6/30/2009 Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed I HEREBY AFF15KUNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing Section 7000) of Divisi 3 of the iness and Professions Code, and my license pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) is in full for a effect. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects 5/20/2008 the applicant to a civil penalty of not more than five hundred dollars [$5001; Please check one of the following: t ors Signature Date ❑ 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 WORKERS' COMPENSATION DECLARATION OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractor's License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). Carrier: Policy Number: Exp. Date: (This section need not be completed if the permit is or one hundred dollars ($100) or less.) ❑ I AM EXEMPT under Section B. & P.C. for this reason: ❑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' CompensatiN Laws of California, and agree that if I should become subject to the workers' X 5/20/2008 compens on provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owner's Signature Date provisio - 5/20/2008 I hereby certify that I have read this application and state that the above information is correct. I agree n Date to comply with all City and County ordinances, rules, regulations, and State laws relating to building W ING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal A SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, including death, and property damage caused arising out of, in any way connected with HUNDRED THOUSAND DOLLARS $100,000 , IN ADDITION TO THE COST OF COMPENSATION, ( ) t is the issuance his permit. I hereby acknowledge that issuance of this permit does not authorize the a DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occu cy of any sidewalk, eet, or sidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to r the above ntio _pr for inspection purposes. I hereby certify that I am the Property err or am a n a property owner's behalf. iff QW 5/20/2008 CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency f e ermittee ISM) Print Date the performance of the work for which this permit is issued. (3097 civ. code) Owner ❑ Contractor OR. ElAgent for Owner ElAgent for Contractor FILE COPY Lender's Address City State Zip BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES PERMIT BUILDING PERMIT APPLICATION" NO. � OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.net/dds BIN # PLEASE PRINT CLEARLY "When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. OWNER INFORMATION Last NameceFz4v I F' t Name Mailib1 ress 6.vkl . CitydCJvv� f l e Sta Zip PhGAeOc7 _7 Fax E-mail CONTRACTOR Name nia p/S / G Address � O � Off( 1107 City 6� r/!oI e 90, ate S&4--( Zip's w Pho Fax E-mail Lic. # �90 �7J� Class G `v APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Fax E-mail Open Cov State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail PROJECT LOCATION Pro , dress City WORKER'S COMPENSATION Polic Number�,�® Carrie X25 If hiring anyone other than licensed contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address ES /PTION OR SCOPE OF WORK. Zoning A/r y/e-7eq SRA Yes No Occ. st. Sq FT- Living Garage Open Cov ❑ Structure Built without Permits6D❑ Proposed Change of Occup � (Note previous use): 1,11 For office use only: Zoning FloodZ�Type SRA Yes No Occ. st. 030-270-077 PERMIT#94-2935 :SMITH, MARVIN,' •5034 LARKIN RD.,,OROVILLE REROOF/SF i COUNTY OF BUTTE - DEPARTMENT OFpDEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 030 ^7 77 ZONING BUILDING PERMIT *�A S MTH OWNER n�f VIN T.iR TELEPHONE SO, FT, OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS PO BOX 102 JOHN ` MIT— 525.00 CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $17.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS 5034 1URIN RD PERMIT FEE s37.00 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Water piping 15.00 Each gas water heater or vent 15.00 USE OF STRUCTURE ppyy SF'C]' Duplex O Mobilehome O Other SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G I W @20.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Otherri�] Describe Work: ROILED ROOF PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( `OR LESS ) 200A OR LESS 23.00 Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( & ACC. BLDS. ) 3.50 FT'.'_ CONTRACTORS LICENSE LAW I declare under penalty of perjury (check oriel ❑ I am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and my license is in fill force and effect. License No. Classification I, as the owner, 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) O I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) ❑ I am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET .NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) B2 @1.00 PLNS. OR Ex. Occup. FIXED APIRESID.1 EA. ( OUTLETS ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE I declare under penalty of perjury (check _one): ❑ This permit is for $100.00 (valuation) o� less. ❑ I have placed on file with the County of Butte Dept. of Development Services, Building Division 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 Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 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 Butte County Ordinances and California 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 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 in consequence of the granting of this permit. / X >J!,tAW' i ; J' ' Date `��% .X�/ y'� Signature of Applicant -❑ Owner ❑ Contractor ❑lAgerit An OSHA permit is required for excavations over '5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ DCC CONST.TVPE TOTAL FEE $ 37.00 HAZ. I D. FEES IMP FLOOD I CDF PARCEL I PO NO J75E This; permit is hereby issued under the applicable provisions of the Butte County Code and/or Res lutions to do work indicat d'O ve for hick fees have een paid. Bic Date ? T PERMIT EXPIRES ON ��/�� (Da tel [Receipt No. 170451 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD-APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELQPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, CalLf9rnia 95965 - Telephone (916) 538-7541 PERMIT No. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 030-27-0-077 ZONING BUILDING PERMIT OWNER M -ARVIN T. TELEPHONE SQ. FT. OCC. BUILDING VALUATION ��17SMITH `J OWNER'S MAILING ADDRESS 770 BOX lOG r BROWNS1111121 95919 CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 20.00 Permit Fee $ 17-0 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS 5034 LARKIN RD PERMIT FEE $:37 ' UO PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Water piping 15.00 Each gas water heater or vent 15.00 USE OF STRUCTURE SF V Duplex O Mobilehome ❑ Other SPECIFY Gas piping system 1 5 outlets 15.00 Building sewer 15.00 Mobile Home S G I W @20.00 TYPE OF WORK New O Addition ❑ Remodel 1:1 Utilities Utilities O Installation D OtheX Describe Work: ROLLED ROOF PERMIT FEE g Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service 'OV OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 NEW CONST, DWELLING OCC P. OR ADDNS. ( & ACC. BLOS. ) gO, 3.5C FT. CONTRACTORS LICENSE LAW I declare under penalty of perjury (che one) O 1 am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and my license is in full force and effect. /License No. Classification '$l I, as the owner, 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) ❑ 1, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) O I am exempt under Sec. Business and Professions Code forthis reason NEW CONST. LTI-OUTLET •NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 @ 1.00 BAL. @ .50 Ex. Occu FIXED APPwS. OR p (OUTLETS IRESID.) EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (cbggk onel: ❑ This permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a VCertificate of Consent to Self -insure. I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 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 Butte County Ordinances and California 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 Countyin consequence of the grantingof this permit. X �0I �+tiL�� .��c ///G K'I0—' d Date�0 Signature of Applicant - D Owner O Contractor D Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee S Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ HA2. I D. FEES IMP I FLOOD CDF PARCEL PD HD I ISS This permit is hereby issued under the applicable provisions of the Butte County Code and/or Res I tions to do work indicate ve for w is fees hav n paid. B Date PERMIT EXPIRES ON 119 I�S`! (Date Receipt 170451 .D. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT �: COUNT`-.' 6F`3UTTE Department of Development Services Building Division Oroville: 7 County Center Dr., Oroville CA 95965 Ph: 916-538-7541 Chico: 1469 Humboldt Rd., Chico CA 95928 Ph: 916-891-2751 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 or no) �' / 2. I (have/have not) ! k 1/ 2 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: Property Owner l A rV i rt T S YY, � T �� (� / / M Date � (��9� 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. PERMIT NUMBER _ B 1242-71 f P V �I PERMIT EXPIRES OW4ER Carl Vollersen ' CONTR: '{ owner y� LOCATION`(A.P. 30-27-17 1 e/s Larkin Rd. opp. Mosquito Abatement, { Oroville I COUNTY OF BUTTE Department' of Public Works BOILDING ,INSPECTION RECORD Zoning Setback Forms Foundation Piers & Girders Fireplace Rgh. Plumbing Bond Beam Lath & Plaster_ Rein. Steel -Gas Piping & Test Found. Vents Framing Plmg. Topout Rough Elec. Wir. Htr. Furnace Kitchen Vent _ Firewall Garage Vents Sanitation & Water ELECTRIC GAS BUILDING Temporary Temporary Cert. of Occup. _ Final Final Final DATE REMARKS OR CORRECTIONS I NEW D ADDITION E:1 REPAIRS 0 OTHER Others - -., �t — ► r Single Multi USE OF STRUCTURE Family Duplex E] Dwelling E] Others FOUNDATION a r MATERIAL EXTERIOR ,` {PIERS Width at Top . Q ' Width at Bottom COUNTY OF BUTTE It SQ. FT. DEPARTMENT OF PUBLIC WORKS BUILDING VALUATION R.W. PLATE (Sill) t 7 County Center Drive - Oroville, California 95965 SPAN Phone: 533-1230, Ext. 259 Girders APPLICATION AND BUILDING PERMIT Permittee Owner *t ' A. P. No. 0 Mailing Address Joists - 2nd Floor Fire Zone Zoning Joists - 'Ceiling � Qj`o •�� Contractor . ` i Sanitation Exterior Studs Planning Mailing Address Permit FeeInterior Plans --I Fees W.C. _ 'a \� - Plan Checking Fee &/or Penalty ! J Roof Rafters ;) 0 BLDG. Address / - Total Permit Fee R/W Bearing Walls Encroachment < NEW D ADDITION E:1 REPAIRS 0 OTHER Others - -., �t — ► r Single Multi USE OF STRUCTURE Family Duplex E] Dwelling E] Others FOUNDATION a r MATERIAL EXTERIOR ,` {PIERS Width at Top . Q ' Width at Bottom Depth in Ground SQ. FT. OCC. BUILDING VALUATION R.W. PLATE (Sill) SIZEa S Cl SPAN Girders C& < joists - 1st Floor Joists - 2nd Floor Fireplace Joists - 'Ceiling � Qj`o •�� Total Valuation t'rr) �� Exterior Studs LQ Permit FeeInterior Studs 'a \� Plan Checking Fee &/or Penalty ! J Roof Rafters ;) 0 t Total Permit Fee Bearing Walls < CONTRACTORS LICENSE LAW r , A. LICENSED CONTRACTORS COMPLETE THE FOLLOWING: I am licensed under the provisions of Chapter. 9, Div. 3, of the State of California Business & Professions Code under the name style of.............................................. ......................:............................................................................................................:..... License -No. ..............Classification,,,,,,,,,,,,,,,,,,,,,,,,,,,,,..,,,, and certify that the aforesaid license is in -full force and effect. i \ ........ B. OWNER -BUILDER & OTHERS COMPLETE THE'•FOLLOWING: Ham exempt from the Contractors License Laws of the State'& California under Sec. 7031.5 because (check one): ' Q I am the owner of the above property and I will contracts to have all of the above work performed by licensed contractors. (Sec. 7044). Q I am the owner of the above property ,and_ do not intend to offer it for sale for one year from the date of completion of the improvements. (Sec: 7044). (r T 1'l ' ' Q Basis, if any, for other statutory exemption................................................................................................................................: ................................. ......................•......`....................................................................... �............................................................................................................................................................ WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section 3700 of the California Labor Code which requires every employer to be insured against liabil- ityfor Workmen's Compensation. I have placed on file with the County of Butte a certificate of compliance or proof of exemption pursuant to Section 3800. 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. X................................................................'...... �.."..•D ate ............................... SIGNATURE OF PERMITTEE OR AGENT ReceiptNo......................................................................................................... This BUILDING PERMIT is hereby issued under the appli- cable provisions of County resolutions and/or ordinances. DIRECTOR OF PUBLIC WORKS By............................•................................................... Date ................... Permit Expires Date,,,,,,,,,,,,,,,,,,,, t A r Co- Permittee Owner Mailing Address Contractor yr+ -r•': .� . , n, .,r ::JfE.� ': [.'titi .:r: •fy,� •-; a . �f. � 1�_. y.�-a •e,,,`: � �•�..• ; Y gr�� h COUNTY OF BUTTE / DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville; California 95965 ✓ PNOVE: 533-1230, Exit. 259 APPLICATION AND ELECTRICAL PERMIT Mailing Address/ BLDG. Address '�� V „ DESCRIPTION OF WORK `. No._ Fee PERMIT FILING FEE «.. $2.00 • I NEW F-1 ADDITION 0 METER SERVICE OTHERS: O Remarks: USE OF STRUCTURE Single Muld Family �Q _Duplex Q Dwelling Q OTHERS: Remarks: Supplementary Filing Fee 1.00 Main Service ' (12 or (more than Sub -anal P less) 12)- Z /� Each , /��.� �•l. " Range Dryer or Water H6a er Each L00 Oven, Cook -Top or Space Heater Each ,..50 Light Fixtures g First 20 .20 Each Additional 10 S Receptacle ., Switches & Fixture Outlets First 20 20 Each Additional .10 Hood, Exhaust Fan or F.A. Furor Motor Each .50 Evap. Cooler, Gar. Disp. or Dishwasher Each .50 Air Conditioner or Heat Pum Water Pum Misc. Wiring TOTAL FEE CONTRACTORS LICENSE LAW A. LICENSED CONTRACTORS COMPLETE THE FOLLOWING: I am licensed,under the provisions,of CKapter 9, Div. 3, of the State of California Business & Professions Code under the name styleof....................................................................................................................................................................................._................................................._.. . License No. �,_S �� l! Classification and certify that the aforesaid license is in full force and effect. ................... ......... f .... / L B. OWNER -BUILDER & OTHERS COMPLETE THE FOLLOWING: I am exempt from the Contractors License Laws of the State of California under Sec. 7031.5 because (check one} Q I am the owner of the above property and I will contract to have all of the above work performed by licensed contractors. (Sec. 7044). I am the owner of the above property and do not intend to offer it for sale for one year from the date of completion of the improvements. (Sec. 7044). ' F-1 Basis, if any, foLother statutory exemption. WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section 3700 of the California Labor Code which requires every employer to be insured against liabil- ity for Workmen's Compensation..I have placed on file with the County of Butte a certificate of compliance or proof of exemption pursuant to Section 3800. I certify that I have read this application and state that the above in- formation is correct. I agree to comply with all County ordinances and State Laws relating to building construction, and hereby authorize repre- This ELECTRICAL PERMIT is hereby issued under the appli- sentatives of the County of Butte to enter upon the above mentioned cable provisions of County resolutions and/or ordinances. property for inspection purposes. DIRECTOR OF PUBLIC WORKS ' X t •. . -/K ' r - Date SIGNATURE OF PERMITTEE OR AGENT r ' j Date ................... By ............:.................................... ..... Receipt No. f r 1 { 1