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,Yf COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT_ NO.
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION XND'PERMIT -
ASSESSOR PARCEL NUMB;ER�,
30 G % - `�
ZONING
BUILDING PERMIT
OWNER
4 PHON//E
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS _
CONTRACTOR'S NAME ! !/�'
TELEPHONE
CONTRACTOR'S MAILING ADDRESS -
CONSTRUCTION LENDEI9il-0- UNKNOWN
'
Firenlace
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINE -ER,
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILD%.AO GESS / 7',h 57..
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Repair drainage or vent piping
5.00
Water piping
LOT NO.SUBDIVISION
NAME
PARCEL MAP
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
/ 10
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome�Other
SPECIFY
Building sewer
Lawn sprinkler system
5.00
TYPE OF WORK
New ❑ Addition ❑ /Re odeeII F1 Uti lities Installation ❑ Other l
Describe work: /� '"` N, /1 S E/e-V
Permit Fee
$ 00
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 100 AMP 00V OR ORSLESS
5.00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. ( DWELLING OCCUP.51
OR ADDNS. ACC. BLDGS. /
2� Sq ft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
F1 I am licensed under provisions of Chapt. 9, Div. 3 of the Business50
and Professions Code and m license is in full force and effect.
y
License No. Classification
Q I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONSTR I-Ou LET 2,50 ea
NON-RESID BRANCH CIRCUITS)
NEW CONSTR / POWER APPARATUS 6
NON-RESID. %SINGLE OUTLET CIR.
@ 25C
EX. Occup(OUTLETS OR FIXTURES 100
Ex. Occup.(OUTLETS (RESID.)REA.
2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 7.50
1 '
Permit Fee $
Contractor
MECHANICAL PERMIT
FiIirig Fee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
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.
Heating
Cooling
Hood
3.00
Ventilation
Permit Fee
S
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 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 1i�-2+-�`JG,�f".���h�� Date %�-��� /X�
Signature of Applicant — Owner ElContractor ElAgent❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures overstories in height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE $ :7-0 00
OCCUP. GROUP
I TYPE OF CONST.
PARCEL
PD
1 ND
1 ISSUE
This permit is hereby issued under
sions-of the Butte County Code and/or
work indicate above for which
DIRECTOR OF PUBLIC
/
By ;.� '�
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
c33
Receipt NO. 5 G' / 406
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
V l
COUNTY OF BUT -TE -DEPARTMENT OF PUBLIC WORKS PERMIT N0�
7 County Cente,' Drive - Oroville, California 95965 - Telephone 916/534-4 1
APPLICATION AND PERMIT
ASSESS9� PAR L UM R -
�5O —
ZO NG" �
BUILDING PERMIT
/AILIIy�A
///3
SQ. FT. OCC. BUILDING VALUATION
Z ES 0,eev1GL04JJ9J S7
CONTRACTORS NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
C ONSTRUC.TION LEND
UNKNOWN
Total Valuation $
Flling Fee
10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGIN R
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENG NEER'S MAILING ADDRESS
Permit fee
$
BUILD%%j L D ESS
Z ST
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Repair drainage or vent piping
5.00
Water piping
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Each qas water heater or vent
5.00
Gas piping system 1 -5 outlets
.�
USE OF STRUCTURE
SF ❑ Duplez❑ Mobilehomeg---O-ther
SPECIFY
Building sewer
Lawn sprinkler system
5.00
TYPE OF WORK
New Addition❑ /Redel p, tilities �1 sootallation❑O,,trrerR
Describe work: /� �'"' L �J ��i�Vl
Permit Fee
$ Bpd
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 100 AMP 01V OR ORSLESS
5.00
Main service EA. ADD•L 100 AMP
2.50
NEW -CONST. /DWELLING OCCUP.M\
OR ADDNS. \ ACC. BLDGS. /
20 sq ft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
El am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONSTR T -OUTLET 2,50 ea
NON.RESID BRANCH CIRCUITS
NEW CONSTR. POWER APPARATUS
NON -RESID. ( 6
SINGLE OUTLET CIR.
Ex. Occup OUTLETS OR FIXTURES_ a ��
FIXED APPLNS. OR
Ex. Occup.(ouTLETS (RESID.I EA. 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 7.50
Permit Fee $
Contractor
MECHANICAL PERMIT
FiIingFee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
\ 1 shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Heating
Cooling
Hood
3.00
Venti lation
permit Fee
$
Contractor
1 certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
X Datesi
Signature o pplicont — Owner ElContractor ElAgent
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 $
TOTAL PERMIT FEE $
OCCUP. GROUP
I TYPE OF CONST.
PARCEL
PD
HD ISSUE
This permit is hereby issued under
f the Butte County Code and/or
w rk di to above for which
ECTOR OF PUBLIC
BY
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date 2-11-�r
K
/Z —//_�+
Receipt No. 5 8 70
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT