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HomeMy WebLinkAbout030-350-0911 30-35-91 ALAN BLOWER1307 Grand Avenue, Oroville Permit#3609-86B(reroof/SF) 030-350-091 'PERMIT#97-1170• BLOMKER,, Alam 1.307'�Grand Ave. Oroville ' � Reside/SF 030-350=091 PERMIT#97-1170 BLOMKER, Alan 1307 Grand Ave., Oroville Reside/SF �1G4 l� COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION " #*" 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. (Rev.1,2/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMB", 030.-35-091 ZONING BUILDING PERMIT OWNER AL N BLOWER TELEPHONE SO. FT. OCC. BUILDING VALUATION 2,500-00 OWNER'S MAILING ADDRESS 3360 HEATHERnELD DR HACIENDA IiGTS, 917,,,45 CONTRACTOR'S NAME TELEPHONE ' CONTRACTOR'S MAILING ADDRESS .s CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAIUNG`ADDRESS r Plan Checkin Fee $ BUILDING ADDRESS 1J07 GRAND AVE Energy Plan Checking Fee $ $ OROVIM PERMIT FEE $/4-UU LAT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF 0 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 O Describe Work: RE -SIDE WITH PLYWOOD Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI GI W1 920.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 Main Service i..AOR. S 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. License Class LIC. No. OWNER -BUILDER DECLARATION 1 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, 1 ,1 will do the work, and the structure is not intended or offered for sale. i ❑ 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 CCU000A NEW CONST. / DWELLING OCCUP. SO DWE200ALLING OR ADDNS. \ a ACC. BUDS. 3.5QFT, NON-RNEWCONSESIDT RANCI-OCUTLETS 97.50 POWER APPARATUS b SINGLE OUTLET CIR. OUTLET:0 FIXTURES 20 @ I'50 Ex. Occup. BAL @ .se PPLNS Ex. Occup. OUTELETSRES D.OEA. 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 MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ 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.) 'f 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'FEES 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'�� %% r.,�.G'L4'!y _.Date _ �•_/1 FS grfettur6 of`App ant-f`�Owner [I Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction(711,44 of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ CONST. TYPE TOTAL FEE $ 74.00 VThis IMP FL000 CDF PARCEL PD HD ISSUE l� ermit ishereby issued under the applicable provisions e Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By Da�t�e PERMIT EXPIRES ON Date Receipt No. WHITE-D.D.S.-B. CANAR -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT %V COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California, 95965 - Telephone (916) 538-7541PERMIT NO. (Rev.12/96) - APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 030-35-091 � ZONING BUILDING PERMIT (!fj OWNER ALAN BLOMKER TELEPHONE SO. FT. OCC. BUILDING_VALUATION OWNERS MAILING ADDRESS 3360 HEATHERFIELD DR HACIENDA HGTS,, 91745 CONTRACTOR'S NAME TELEPHONE ' CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation is ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 1307 GRAND AVE Energy Plan Checking Fee $ OROVILLE $ PERMIT FEE LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water h6ater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other IN Describe Work: RE—SIDE WITH PLYWOOD Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI G1 W @20.00 PERMIT FEE 4 ELECTRICAL PERMIT Filing Fee 20.00 Main Service zoos oa mss 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, ( g ) and my license is in full force and effect.POWER License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law r 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 W:L200A OCU000A NEW CONST. DWELLING OCCUP. OR ADDNS. ( a ACC. B.S. SO so 3.5¢x, NEW CONST. MULTI.OUTLET NON-RESID. =OUTLET CU /�1 @7.50 APPARATUS a SINGLE OUTLET CIR. Ex. Occup.OUTLET OR FIXTURES 20 ° I °° BAL @ .50 ED APPLNS. Ex. Occu OUTLETS RES D.OEA 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 MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ 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.) i 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 fort with comply with those provisions. �Y/�l Date �`�! -- bigknnat,re of pplicant A -Owner ❑ Contractor '❑ Agent An OSHA pe it is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TV PE TOTAL FEE $ 74.00 HAZ. I D. FEES IMP I FLOOD c0F PARCEL Po HD IssuE 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. By �yDa G b / PERMIT EXPIRES ON Date Receipt No. WHITE -D. D.S.-B. . CANARY• SSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT ra'yt`y-_tw,c+m►4.�'ii'Lnta.ai`'�iit��j�{$�:;Cj: f.^�t tr° COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLEVbdW:'-6RNIA 95965 - TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER:.n m {ciCJ� ASSESSOR RARCEL NUMBER: Proposed Building Use: Building Inspect r: Date: At time of permit application, I w dvised the following data must be submitted prior to permit processing and/or issuance: Date Received By ❑ 1. All items have..been submitted .----.--------------------------------------------------------------------------------- ❑2. Plot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------ ❑ 3. Complete plans, 3/4 sets, signed by the pr'I arer of plans. ----------------------------------------------------- ❑4. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. ------`- ❑ 5. Engineered truss details and layout ih duplicate (required prior to plan review) No faxes! ------------------ 't 41c 06. Energy Design Compliance and supporting documentation. ------------------------------------------ - ------ `N1_ ❑ 7. Statement of Intent for Non -Heated and A/C Buildings. --------------------------------------------------------- ❑ 8. Hazardous Material Form. ------------------------------------------------------------------------------------------ ❑9. Manufactured Home data and installation instructions including Tie Down Specifications ------------------- El 10. Fees of $ ' El Pl,!--Impact fees as shown on the attached schedule. ------- El 12.;California Department of Forestry plan approvaUfees. ❑ 13. Flood elevation certificate. ------------------------------- ❑ 14. Sanitation and plot plan approval Health Department. ------------------------------------------- ❑ 15. City of Chico plumbing permit. --------------------------------------------------------- I------------------------ ❑ 16. Plot plan and business license approval from the City of Biggs. ---------------------------------------------- ❑ 17. Planning approval for (A) Use: (B) Parking: --------------- _---------- Ell 8. ________.❑18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ----------------------- ❑ 19. Encroachment Permit for driveway (construction approval prior to occupancy). ---------------------------- E120. Pre -inspection for required. Request to Building Inspector on (Date) 021. Contractor's license information. (Number, Name Style, Classification). ------- -- - r �}-------------------- t025. Workers' Compensation carrier and policy number. ---------------------- -- - ----------------------- Owner-Builder Verification (Given to owner ❑, Mailed to owner. --- S---------------------------- 6 Jam= Letterof signature authorization. --------------------------------------------------------------------------------LRecorded copy of Agricultural Acknowledgment Statement. -------------------------------------------------- ❑26. Letter of intent on building use.----------------------------------------------------------------------------------- . a ❑27. Manufactured Home utility clearance.------------------------------------------------------------------------ -- ❑28. Existing violations and/or expired permits. ---------------------------------------------------------------------- ❑29. ❑433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ . --------------- 030. Other: 4 -_--___ Wh you issue the permit, process as follows ❑ Mail to owner, ❑Mail to c actor. ;Telephone 5 - 173 and hold for pickup at ` office. ❑ Deliver with inspector. Applicant ✓% W����`��' Date: Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Polluti Date:: By: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By: 1. Index permit application for the above items numbered: 2. Additional items required: ❑ Plan Check List Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Plans reviewed by: Date: Plans approved by: Date: Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: Yellow Copy - Department of Development Services, Building Division. �ez e cc VP�ucrn MY ow a Is1a- I s��y ��, X99 � �c 1447 e,7 -,0 e D � �o�'� I SF -P 13 1997 O B• I Mj4 ^ i� Coi,J1. iJILDING DIV.- t u 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 NO 11 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 PT-TnNT. TVvv nr xwnw SIGNED: PROPERTYOWNER: SOCIAL SECURITY NUMBER: - DATE: 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. OVER OWNER BUILDER INFORMATION I 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 parry 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, if you 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 contrac9rs 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. i rely, i�-_, Mic el C. Vi ira, C.B.O. Ma ger, Building Inspection NOTE. This Owner -Builder Information is required by Section 198.10 of the California Healtli and Safety Code- OVER ode OVER RECEIVED JUN .+ 8 1997 .B.- I 1U1 TTE COUNTY DING nixgSION 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 NO ❑ 2. I HAVE/0 HAVE NOT ❑ tigned an application for a building permit for the proposed work. 3. i have contracted'with-the' foiiowing person'(rirm)"to provide -the proposed construction: NAME: a ADDRESS: CITY• ` f 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: SIGNED: PROPERTYOWNER: SOCIAL SECURITY NUMBER:_ " DATE: 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. OVER 1 O.B.- l OWNER BUILDER INFORMATION I 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 6enAit 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, if you 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 cormnunity 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. i rely, Mic el C. Vi ira, C.B.O. Ma ger, Building Inspection NOTE. This Oivner-Builder Information is required by Section 19830 of the California HealAi and Safety Code OVER Permit#3609-86B Alan Blomker 1307 Grand Avenue$ Oroville COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville,4alifornia 95965 - Telephone 916/534-4541 J APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER - Alan Blorrk:er 813— TELEPHONE 969 -1777I,Jf' SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING tl� ADDRESS U 1 Z I f 1 TT t3 'f- l-, a r f l r-% l r, Y TT;3 r, 1 xt n -1 a %M 4 f3V1 f' c ;"n CONTRACTOR'S NAME - r.. -n . cr ,, Pno f inn 'TELEPHONE — 1 q i CONTRACTOR'S MAILING ADDRESS P.O. Time 72q (1 ovi le Fireplace CONSTRUCTION LENDER UNKNOWN 2 Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ { ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 e Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE .'SF [I Duplex❑ Mobilehome ] Other ' SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Installation❑ Other Q Describe work: Pnof i na _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service GOOV OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): © I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. t1C 76 (+�. '; (] License No. ? Classification Fl 1, 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 CONST. / DWELLING OCCUP.N OR ADDNS. ( ACC. BLDGS. , /20sq ft NEW CONSTR. MULTI -OUTLET 2,50 ea NON.RESID BRANCH CIRC ITS POWER APPARATUS tr (SINGLE OUTLET CIR. Ex. Occup(S 200300 OUTLETS OR FIXTURE 9 eAL3o \\ Ex. Occup. OUTLETS FIXED P(RESID )R EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. © I have placed on file with the County of Butte Building Department .. a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 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. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date 7. 1_ ' i,E Signature of Applicant — Owner ❑ Contractor ❑ Agent N An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ Occup, CONST.TYPC I I FLOOD PARCEL PD I NO ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which IOIRECTOR OF PUBL'IC'WORKS By I =�i�,, � �,:1✓i2s - PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. Date % -) / S,'0 nnI �-'.!, Receipt No. /�—.i. i (� WNITC-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County'Center Drive - Oroville, Caiforniaj'35965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. / ASS CEL N1J VBJR (/,J ZONING BUILDING PERMIT , OWNERTELEPHONE Alan Blomker 818- 968-8777 SQA FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 3360 Heatherfi CONTRACTOR'SNAME George Roofin T.DRESS ELEPHONE 533-6393 - CONTRACTOR'S MAILING P.O. BOX 729 Oroville Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS. 1307 Grand Ave - permit fee! $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ElDuplex❑ Mobilehome ] Other g i 1 SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home I S] G JW I 10.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ® Describe work: Roofing _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 110.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD -L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check.one): ® I am licensed under provisions of Chapt. 9, Div. 3 of the BuslneSS and Professions Code and my license is in full force and effect. License No. 452266 Classification C-39 ❑ 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 CONST. DWELLING OCCUP.N S. , sqft A NEW OU �50ea CONSTR.( UC TI LET NON.RES10 BRANCH CIRC ITS 2.50 ea POWER APPARATUS 6 (SINGLE OUTLET CIR. Ex. Occup(ouTLETS OR FIXTURES 20a50t eALO 30 FIXED PR Ex. Occup. OUT LETS (RESID.)EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. byirin 15.00 9 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C.'laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling g Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby tauthor(ze.representatives of the Countyot• Butte to enter upon the above-meritioned property'for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said county in consequence of the granting.of this permit. %� Date 1 1 —25-86 Signature of Applicant — Owner ❑ Contractor ❑ Agent ® An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ OCCu P. CONST.TYPEJ FLOOD PARCEL PD Ho 59UE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which IRECZ PUBORKS BY PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. Date o`10 Receipt No. WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF RUTS: DEPT_ OF PUBLIC WORKS DEC 1 v 1 4R 9V61 r r r r COUNTY OF RUTS: DEPT_ OF PUBLIC WORKS DEC 1 v 1 4R 9V61