HomeMy WebLinkAbout031-234-0294
02-9
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M.L. HEMENWAY
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1780 6-T H -.--'S T;F
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PERMIT
31-234-1:2
09
Permit #1090-78E (ele ser c1
31-234-X,9-9--" 825-91P
.FARNSWORTH, Joe
1780 6th,St, -Oroville IF
(gas test -new line)SF
031-234 029 PE #94=3254
MOORE, DARLENE.
w, "Of
1780,6TH.ST. VILLE
ADD COVE
9RC!i/SF
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Meter By — Date .
COUNTY OF BUTTE - DEPARTM$NT OF PUBLIC WORKS MIS' Nab v'
7 County Center Drive - Orovllle, Celifornle`1i6685 - Telephone: 918/638.7541 �" ��
APPLICATION AND-P911MIT
'
BUILDING PERMITOWNKR
268—ONS
A%ffA4 Ila
JwN D
22754 id a Auburn 5603
3O. FT. OCC. BUILDING VALUATION
C N
Owner
6 M NK
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN "`
$
Total ValuationNone-
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 oville
1780 6th St.,
Permit fee
$
PLUMBING PERMIT FllingFee 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
SFK. Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00 5.00
Building sewer
5.00
Mobile Home S I G I W
0.00 ea.
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Uti lities g Installation❑ Other ❑
Describe work: gas test—new line _
Permit Fee Minimum
$ 25.00
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V OR LESS
100 AMP OR LESS
10.00
Main service EA. ACC'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.
License NO. CIaSSIflCatlOn,
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)
❑ 1 am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. / DWELLING OCCUP.&)
OR ACDNS. l ACC. BLDGS. I
, �Z�SQft
NEW CONSTRESID. BRANCH
NON -R ESID BRANCH CIRC ITS
2.50 ea
(POWER APPARATUS e
(SINGLE OUTLET CIR. I
Occup(OUTLETS OR FIXTURES
Ex. Occu
20 a 50a
aAL@30
FIXED APPLNS. OR
Ex. Occup. OUTLETS (RESID.) EA.I
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
t� of Consent to Self -Insure.
IXI 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
FiIingFee 10.00
Heating
Cooling
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 authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
1 also agree to save, Ind mnify and keep harmless the County of Butte against
all liabilities, judgme costs, and expenses which may in any way accrue
against aid C my i `onsequence of the gra ing of this permit.
X /� Date
`
$ignatur�e of Appli " nt — Owner ,COp/RQ�tOr Agent ❑
An OSHA permit ireuared f r excavations over �0 ' ep and demolition or construct-
ion of structures ove 3 sto in h 'ght.y
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST TYPE
—
TOTAL FEE $ 25.00
HAL
CUA- PARK
SCHL
FLD
CDF
PAR
PD
I HD.
ISSiE
I/
Thi$ permit is hereby issued unaer the applicable provi-
sions of the Butte County. Code and/or resolutions to do
work indicated above for which fees have been aid.
p
D RECTOR OF PUBLIC WORKS
ByV12Date 7
PE MIT EXPIRES Date �j�77Z•--
Recei t . _ 33
WHITE-D.P.W., YELLOW-A3�Le9 ;<P.IMR-1 - R DENROD-APPLICANT
COUNTY OF BUTTE - DEPARTMENT OP PUBLIC WORKS MI NO
7 County Center Drive - Orovllle, Call4ornla 95965 - Telephone: 916/538-7541
__. APPLICATION AND PERMIT
�SSE234-27 SSOR PARCEL NUMBER
_
ZONING
BUILDING PERMIT
OWNER
Joe Farnsworth
TELEPHONE
268-1337
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
227 4 unset Ride Auburn 5603
C ONTRACTOR'5 NAME
nwnpr
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
Nnnp
UNKNOWN
Total Valuation Is
Filing Fee
$ 10,00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER Nonp
LICENSE No.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
17Rn 6th St, Oroville
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
Each TrapWaesr
2.00
Solar or heat pump
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping5.00
Each qas water hea5.00
USE OF STRUCTURE
SFU Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system15.00
5.00
Building sewer5.00
Mobile Home
O.00ea I
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Uti lities n Installation❑ Other ❑
Describe work: gas test—new line
Permit Fee Minimum
$ 25.00
Contractor
=
ELECTRICAL PERMIT
Filing Fee 10.00
600V OR LESS
Main service 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.
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-
ontract-
ors.(Sec. 7044)
ors.
I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUP.91
OR ACDNS. (ACC. BLDGS.
,/z2sgft
NEW CONSTR U TI -OUTLET
NON.RESID BRANCH CIRC ITS
2,50 ea
POWER APPARATUS &)
(SINGLE OUTLET CIR.
_
Ex. OCCUp(OUTLETS OR FIXTURES
20050C
BAL03o
FIXED APPLNS. OR
EX. OCCUp. OUTLETS (RESID.) EA.)
2.00
Temporary service
10.00 .
Mobile Home Facilities
15.00
Misc. Wiring
g
15.00
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
Filing Fee 10.00 I
Heating
Cooling
g
r
Hood
I—
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 authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
1 also agree to save, ind mnify and keep harmless the County of Butte against
all liabilities, judgmer� costs, and expenses which may in any way accrue
ag ns aid C my irt' onsequence of the gra ing of this permit.
X.,
Date
Signet We of Applicant — Owner Contractor Agent F]work
An OSHA permit is required for ex c vations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $ 25.00
HAz.
CUA-
PARK
scHL
fLD
cDF
PAR
PD
I HD.
IS_s.
f✓
This permit is hereby issued under the
sions of the Butte County.Code and/or
indicated above for. which fees
D TO OF PUBLIC
J
Z
By l
PE MIT EXPIR / Date %�
applicable provi-
resolutions to do
have been paid.
WORKS
ate
�2
Receipt No. 88233
WHITE-D.P.W.. YELLOW-ASSCSSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Orovlllq, Callfornle 95985 - Telephone: 916/538-7541
APPL'CATION AND PERMIT
ASSES PARC L NUM ER
/—!/
ZONING
BUILDING PERMIT
OWNER
--J-0e lv S wo2Trf
TE H E
7
SO. FT. OCC. BUILDING VALUATION
-
OWNER'S MAI �NG ADDRESS
CON'T RACTOR'SSNAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation is
Filing Fee $
LENDER'S MAILING ADDRESS
Perm;! Fce $
ARCHIT!_CT OR Ll",INEER -
LICENSE NO.
Plan Che:::(ng Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING A�Q%
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 t*_ Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
'Building sewer
5.00
Mobile Home S G W
10.00ea
TYPE OF WORK
❑ Addition ❑ Remodel ❑ Uti lities4!�J Installation❑ !her ❑
Describe work: &2 (J �t 11e
41New
Permit Fee $
Contractor
ELECTRICAL PERMIT Filing Fee 10.00
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 Business-
and Professions Code and my license Is In full force and effect.
License No. Classification.
F1 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..)
OR ACDNS. ACC. BLDGS.
,/2ltSgft
NEW
NON-RESID R. BRANUrTCH CIRCTITS
2.50 ea
_ POWER APPARATUS e
�— (SINGLE OUTLET CIR.
Ex. Occup( OUTLETS OR FIXTURES
ezo®soe
AL030¢
FIXED APLNS
Ex. Occup. OUTLETS P(RESIO )REA.)
1 2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc.4virin g
15.00
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 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 Date
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 $
occ
CONST TYPE
TOTAL FEE $
HALCUA
PARK SCHL
FLD
CoF
PAR PD
i Ho.
ISSUE
This permit is hereby issued unaer the applicable provi-
sions of the Butte County. Code and/or resolutions to do
work indicated above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By Date
PERMIT EXPIRES Date
�^
Receipt No. J 8
WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT
COUNTY OF BUTTE - Department of Public. Works
7 County Center Drive, Oroville, CA 95.965 Phone: 916-538-7541
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 'aterials for construction of
the proposed property improvement (yes or no)
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 Contractors 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 Contractors 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 _
Social Security " umber
Date 01
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 per-
mitted to "issue the' permit.
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 RMI�to.
------- APPLICATION AND PERMIT ��-��=-
ASSESSOR PARCEL NUMBER 031-234-029
AR ZONING
BUILDING PERMIT
OWNER
DARLENE & DON MOORE
TELEPHONE
533-8761
SQ, FT, OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
OWNER
143 1,859.00
CONTRACTOR'S NAME
TELEPHONE
CONTRACTORS MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
LENDER'S MAILING ADDRESS
Filing Fee $
20.00
Permit Fee $
43.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
27.95
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
1780 6M ST
PERMIT FEE $
90.,5
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
.y
SF l!' Duplex ❑ Mobilehome O Other
t;PECIry
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G 1 W
@20.00
TYPE OF WORK
New ❑ Addition &X Remodel ElUtilities ❑ Installation ❑ oth/e�E]
Describe Work: COV •
PERMIT FEE $
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
\
Main Service ( 'OVOR LESS )
200A 0R LESS
23.00
Main Service ( 200A TO 1000A )
46.00
OR ADDNS.T ( D LLIN&EACCGBLOS. )
3.50 FT.
-
CONTRACTORS LICENSE LA
I declare under penalty of perjury (check one)
O 1 am a licensed under provisions of Chapter 9, D• ision 3 of the Business and
Professions Code and my license is in full force a d 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 ffered for sale. (Sec 7044)
❑ I, as the owner, am exclusively contracting wit 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 )
BAL. @ 1.00
Ex. Occup.FIXED APPLNS. OR
(OUTLETS HRESID.I EA. )
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) or less.
O 1 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.
1 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
County in consequence of the granting of this permit.
X Date/ �(
Signature of Applicant - Owner ❑ Contractor ❑ 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 $
Energy Inspection Fee $
OCC
CONST. TYPE
TOTAL FEE $ 90.95
HAZ-
D. FEES
IMP
^—
FLOOD
COF
PARCEL PD
--
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 i'` Date
PERMIT EXPIRES ON
lDetcl
ReceiptNo. 170903
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER O _ ^ 1 NING �/f
BUILDING PERMIT
OWNS TELEPHONE -y761 .
SO. FT. OCC. BUILDING VALUATION
OWNER'' /1AIUN DRESS ` �`®! 8
S 7 WTELEPHONE
CONTRACTOR'S NAME
11 r-. i_
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee $
20.00
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
.aa
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee $
Penalty $
BUILDING ADDRESS � 11 _ v �� 7 y /% 6, /' S U
PERMIT FEE $
� Gf
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
Solar or heat pump water heater
23.00
LOT NO.
SUBDIVISION'SNAME
PARCEL MAP
Water piping
15.00
Each gas water heater or vent
15.00
USE OF STRUCTURE
SF 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 O Addition Remodel ❑ Utilities O Installation O Other ❑ j
9 �_c�� �, � / Tam
Describe Worl -�, ,
PERMIT FEE $
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
Main ServiceBOOV OR LESS
( ZOOA OR LESS )
23.00
Main Service ( 200A TO IOOOA )
46.00
NEW CONST. DWELLING OCCUP.
OR ADONIS. ( & ACC. BLOS. )
3.50 FgTO,.
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check 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
O' 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)
❑ I, 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. MULTI.OUTLET
NON RESID. ( BRANCH CIRCUITS )
@7.50
POWINGLE OUTLET ER APPARATUS
(8 SCIR. )
Ex. Occup. ( OUTLET OR FIXTURES )
20 @ 1.00
BAL. 50
Ex. Occup.FIXED APPNS. OR
(OUTLETS IRESID.1 EA. )
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) or less.
O 1 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.
❑ 1 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
enteH 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 conse uence of the granting of this permit.
X Date 4A �p 5
Si nature of Applicant - Owner O Contractor O Agent
An OSHA permit is requir d for excavations over 5"0" deep and demolition or
construction of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ (J .
HAZ.
I D. FEES
I IMP
I FLOOD
CUF
I PARCEL PD
I 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 Date
PERMIT EXPIRES ON
(Dare)
Receipt No. / ;?)-r �� �
WHITE-D.D.S..B.D CANARY •ASS ISOR PINK -INSPECTOR GOLDENROD -APPLICANT
I
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COUNTYOF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION
7 COUNTY CENTER DRIVE "OROVILLE,CALIFORNIA95965 -TELEPHONE (916) 538-7541
PERMIT APPLICATION DATA SHEET
OWNER i�Ld�2Y� P No.
Proposed Building Use Building Inspector Date
14
At time of permit application, I was advised 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 preparer of plans . ..........................
3. Complete plans, 3/4 sets, signed by preparer of plans . ......................
4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . .............
5. Hazardous Material Form . ............................................
6. Energy Design Compliance and supporting documentation . ..................
7. Statement of Intent for Non -Heated and A/C Buildings . ......................
8. Engineered truss details and layout.in duplicate (required prior to plan check). ....
9. Mobilehome data and manufacturer's installation instructions, 2 sets. ...........
10. Fees of $--"''
11. Impact fees as shown on attached chedule. ..............................
12. California Department of Forestry plan approval/fees.
13. Flood elevation letter (100 year flood) b��lrf�rnia Engineer . ................. .
14. Sanitation and plot plan approval ((,,// Health Department . ............
15. City of Chico plumbing permit . .........................................
16. Plot plan and business license approval from City of Biggs/Gridley. .............
17. Planning approval for (A) Use: (B) Parking:
18. Contact Land Development about (A) Improvements (B) Drainage. .......... .
19. Driveway permit (construction approval required prior to occupancy). . .
Fre-Inspection requ�-
20. Pre -inspection for required. .. to Building Inspector (Date)
21. Contractor's license information. (No., Name Style, Classification) . ..............
Certificate of Workmans Compensation Insurance . ............... :...........
23. Owner -Builder Verification (Given to owner , Mail to owner _) ........... .
24. Recorded copy of Agricultural Acknowledgement Statement . ..................
25. Letter of signature authorization . ........................................
26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .....
27. Letter of intent on building use . .........................................
28. Mobilehome utility clearance . ..........................................
29. Documentation of legal access . ..................... :..................
30. Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning area and frontage requirements . ...............
31. Existing violations/expired permits . ......................................
32. Plan check list . .....................................................
33.
34.
When yo i sue the permit, process as follows:\Mail to owner. Mail to contractor.
elephone and hold for pickup at office. Deliver with inspector.
Other �jt%�/ [ 44
Parcel Creation
Acreage Applicant Date
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submitted prior to permit issuance: (Circe new item not the ked above).
1. Index permit for above items No. G(/ �t�'��2
2. Additional items required: V S ml 1 - -' �S
Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date
Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date
Plans checked by Date Plans approved by Date
Sets of plans on hold in File cabinet AP folder',.,,
Copy - Department of Public Works
1!
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Oroville, California 95965
Tel ephan,e: 4t,34541
APPLICATION AID PERMIT
Pr
authorize representatives of the County of Butte to enter upon the This permit is hereby issued under the applicable provisions of
above-mentioned property for inspection purposes. the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
L.)
Signature of Permitee or Agent
Receipt No.
White-D.P.W.
Date
— Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
DIRECTOR OF PUBLIC WORKS
By Date_
,,Building permit expires Date
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Contractor
Mailing Address �'0 mac/
Fireplace
Total Valuation
Telephone No.
Permit Fee
Building Address � /�. ; /, f �, i �
Plan Checking Fee&/or Penalty
-
Permit Fee
PLUMBING No.1 @ FEE
PERMIT FILING FEE $3.00
Each TraD 1.50
r
Repair drainage or vent piping 1.50
A. P. No.
Zonin & Planning
Water piping 1.50
Each gas water heater or vent 1.50
Fees
W. C.
Sanitation
FireDept.
Fire Zone
Use Permit
Gas piping system 1 -5 outlets 1.50
EQA
Parking
Plans
Parcel
Declaration
Parcel Map
60' R/W
Improvements
Each additional outlet .30
Building sewer 5.00
Bldg. Plans Rec'd
Parcel A royal
Plans Approval
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ❑
Permit Fee $
$
• ,�f- t 'I
ELECTRICAL No. @ FEE
J
PERMIT FILING FEE $3.00 r
Main service 600V OR LESS --
100 AMP OR LESS 5.00
Single Family ❑ Duplex ❑ Mobil Home ❑ Others ❑
Main service EA. ADD•L 100 AMP 2.50
Main service OVER 25.00
100 AMPP OR LESS O
Main service EA. AOD'L 100 AMP 1.00
NEW OR ADDNS. ( ACCLBL GSCCUP. 5) 20sgft
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
T
NEW CO ID ( BRANCH CIRCUITS) 2.50ea
NEW RESID, BRANCH CIRCUIT
NEWCONSTR. (POWER APPARATUS 8
NON. RESID. SINGLE OUTLET CIR.
Ex. OCCUD(OUTLETS OR FIXTURES g * ,5
FIXED APPLNS. OR
Ex. Occup. (OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring - 6.25 ,
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $ JO '
MECHANICAL No @ FEE
WORKMEN'S COMPENSATION INSURANCE
I am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑1 have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
I certify that in the performance of the work for which this
. permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
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
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
Land Development Fee
$
$
TOTAL PERMIT FEE
$
authorize representatives of the County of Butte to enter upon the This permit is hereby issued under the applicable provisions of
above-mentioned property for inspection purposes. the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
L.)
Signature of Permitee or Agent
Receipt No.
White-D.P.W.
Date
— Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
DIRECTOR OF PUBLIC WORKS
By Date_
,,Building permit expires Date
COUNTY OF BUTTE — D.EPARTMENT OF PUBLIC WORKS
7 County Center Drive 'S E''oville, California 95965
Telephone: 53'414541
r=
APPLICATION AND PERMIT
/090 7�
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mailing Address_
Telephone 09.
Contractor
Mailing Address
Fireplace
Total Valuation
Telephone No.
Permit Fee
Building Address 70 r
Plan Checking Fee&/or Penalty
Permit Fee
PLUMBING No.1 @ FEE
PERMIT FILING FEE $3.00
Each Trap 1,50
Repair drainage or vent piping 1.50
h-
A. P. No. —' v -�
Zoning & Planning
Water piping 1.50
Each gas water heater or vent 1.50
Foes
W
SarrFtatiarf
Fire Dept.
Fire Zone
Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking
Plans
Parcel
Declaration
Parcel Map
60' R/W
Improvements
Each additional outlet .30
Building sewer 5.00
Bld9_P+wrr-RV"
Parcel Approval
Plans Approval
Lawn sprinkler system 2.00
NEW ❑ ADDITION UTILITIES ❑ OTHER
Permit Fee $
is
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00,3,67 0
600V OR L
Main service ESS
too AMP LESS 5.00
Single Family Duplex Mobil Home Others
❑ ❑ �
-L
Main service E4. ADD100 AMP 2,50
Main service OVER e 25.00
100 AMP OO R LESS
Main service EA. ADD'L 100 AMP 1.00
NEW CONST. DWELLING OCCUP, B
OR ADDNS. AGC. BLDGS. 2�sgft
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
st le of:
%�
NEW CONSTR BRANCH CIRCUITS)
NON-RESID (MULTI BRANCH CIRCUITS) 2.50ea
NEW CONSTR. (POWER APPARATUS 8
NON-RESID. `SINGLE OUTLET CIR.
30 @ 259t
EX. OCCUD(OUTLETS OR FIXTURES BAL@10Q
Ex. QCCU FIXED APPLNS. OR
Occup.(RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25 Ti
I am exempt from the Contractors License Laws of the State of California.
Permit Fee $ 45
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
Elhave placed on file with the County of Butte a certificate of
'workmen's Compensation Insurance.
I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
'California.
MECHANICAL lNO. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
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
Land Development Fee
$
TOTAL PERMIT FEE
$ / b
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
& I, e
Signature Sof Permitee or Agent
/
Receipt No. _733F�Zy
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
�bIRECT(?B_QPUBLIC WORKS
By Date
Big permit expires Date _����
OROVILLE, CALIFORNIA
GENERAL CLAIM
CLAIMANT: n.L, H
ADDRESS: 1780 4th 'St's
CITY & STATE: OravIZl@, CA" 95363 IMPORTANT:
DATE OF CLAIM: 9, SEE INSTRUCTIONS
ON REVERSE SIDE
SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES
DATE
DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY)
AMOUNT
Unable :to Ume ga=it at time of Application aim Mv Thexmal ,p
01:11, perfam In
(Pe mit. x`702.766, Receipt ` -01 39. AP ' 1.• 94• :
• - PloftbirLs.permit .w�r�a•+►r�a�wMYa��yp.+a�►�+•mar iran�s. r}.p'.:.►.�s.:
48.00
TOTAL
$
OD
I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this
claim is true and correct as stated.
l9tih KAY7-6 ��ille
Datedthis .................................. day of ..............;.............. 19......-, at...... ................. Calif.....................................................................................
Signature of Claimant
I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or de-
livered and that there is a Budget Appropriation[] or Specific Board Approval a (Check one) for the same.
Dated this ...................... day of .......... ......... 19.. r et .............................. , Calif.....................................................................................
• Department Head or Authorized Deputy
Dept. - Exp.
Code............................................ Code ................................................PAYABLE FROM................................................................................. FUND
DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY
VENDOR
CODE
DEPT.
& SUB.
PROD
SUB.
OBJ.
CLAIM
NO.
INVOICE
NO.
INVOICE
DATE
DISC.
GROSS
AMOUNT
ENCUMB.
SUB -DIST.
r
s
INSTRUCTIONS -to - CLAIMANTS
All claims against the county must be itemuized, giving dates and
character of service rendered or work performed, quantities, de-
scription and unit prices of articles furnished or delivered.
Claims must be certified by the claimant and submitted to the De-
partment head for approval. Upon approval the Department head
will forward claim to County Auditor for payment procedure. Do
not file with the County Auditor first.
Claims should be presented to officials for approval immediately
upon completion of services requested or material ordered.
Claims are paid every Tuesday; however, same must be approved by
officials and in Auditor's office before preceeding Wednesday noon.
Compliance with above will expedite payment of claim, failure to do
so may delay payment considerably.
/ � , . - -L .'� -i ..:.--�-•; -+ate:.:;#. y;'��' �''•'�' `*"''•tx-.�'.�y •"" ;.� pRr;; t R: • - -
V `
COUNTY OF BUTTE — .b DEPARTMENT_ OF PUBLIC WORKS
• 7 County Center Drive.Ciroville, California 95965 /
'Telephone: 554-4541 74
:
APPLICATION AND PERMIT`
BUILDING
Owner c, ( SO. FT. OCC. BUILDING VALUATION'
Mailing Address
- a
• .
Telephone No.
y' �/ 03 Fireplace
Contractor Total Valuation
MailingAd-dress Permit Fee
,.Pl an Checking Fee &/or Penalty
' Telephone No. -
Permit Fee
PLUMBING No. @ FEE
Building Address `
-�� PERMIT
,
FILING FEE $3.00
Each Trap 1.50
j Repair drainage or vent piping 1.50
'.Water piping 1.50
Each gas water heater or vent 1.50
A. P. No. r
Zoning & Planning
Gas piping system 1 = 5 outlets 1.50
,Each additional outlet 30
Fees
W.C.
Sanitation
FireDept.
Fite Zone
Use Permit
Building sewer 5.00
EOA
Parking
Plans
Parcel
Declaration
Parcel Ma P
60' R/W
Improvements
P
Lawn sprinkler system 2.00
Bldg. Plans Recd
Parcel Approval-
Plans Approval'
Permit Fee $
$ "`
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ❑
ELECTRICAL No. @ FEE
,PERMIT FILING FEE $3.00
-600V
►� .
OR LESS
Main'service 100 AMP OR LESS 5.00
Main service EA; ADD'L 100 AMP 2.50
Single Family Duplex Mobil Home E] Others ❑
Main service OVER 600V
too AMP OR LESS 25.00
Main service EA. -L 100 AMP 1.00
-+ -
NEW CONST. DWELING
OR ADDNS. ( ACCLBL GS. OCCUP, &) 2¢sgft -
NEW CONSTR. MULTI -OUTLET
NON.RESID, ( BRANCH CIRCUITS) '2.50ea
- -
_ -
'
NEW (POWER APPARATUS &
NON-RESID, SINGLE OUTLET CIR.
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name,
style of: ,
,�- -
,
Ex. Occup(OUTLETS OR FIXTURES)50 @253
BAL@1
Ex. Occ�,L FIXED APPLNS, OR
tyfr•(0 'TLETS (RESID,) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
'Misc. Wiring 6.25
fUl I am exempt from the Contractors License Laws of the State of California.
Permit Fee
WORKMEN'S COMPENSATION'INSURANCE
I am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation. ..
❑ I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
'm j 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 Workmen's Compensation Laws of
California.
.MECHANICAL- No• @ FEE
-
-
PERMIT FILING FEE $3,00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
I certify that I have read'this application and'state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and ,hereby
TOTAL PERMIT FEE
$ G
•. ••- •••r ����•••-•�•�,+vvun.y v� uu uc iu alRol URUII UIC
above-mentioned property for inspection purposes.
.. a
a
Signature of Permitee or. -Agent
'Receipt No. EaK 3 _
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF. -PUBLIC WORKS
Building. permit expires Date
Date
1
ksi
Ll
Naw -.ate J�!