HomeMy WebLinkAbout031-260-037JOHN Bo FAIRLEY 31-26-37,
1536 12TH. ST• OR0V I LL
PERMIT #6329-75P(INST• SEWER LIN
F
031-26-0-03794-2222 E ✓
MURPHY, Mary
1536 12th. Street, Oroville.
• (relocate elec ser/Fox Electric)
X031-260-037 01-1368
HAGLER, JOSEPH
1536 12TH ST. OROVILLE
CONT: OWNER hLE
REMODEL
03 , .260-03
HAI--LER JOSEPH 04-3100
iSZ( 1Z rH STREET, OROV
IL
LECont: GiLLAGHERS HEAT
NEW MN•� 1
v• /A1)4
lt��
Co
m (Lf) G -P1 NCS (12 0 Ff)
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rm
BUTTE CO NTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAX#: (530)538-2140
WEBSITE: www.buttecounty.neAdds
LICENSED CONTRACTORS DECLARATION
1 hereby affirm under penalty of perjury that 1 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. /� cC'' %
License Class( [_ License Number. /
Date:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' Stale License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
to its Issuance, also requires the applicant for such permit to file a
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law -(Chapter 9 commencing with Section
7000) 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 the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ 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 (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
provided that such improvements are not: intended or offered for
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
proving that he or she did not build or improve for the purpose of
sale.):
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
❑ I am Exempt under Article 3 of the Business and Professions Code
Date: Owner:
WORKERS' COMPENSATION DECLARATION
I 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.
I have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
insurance
carder and policy number are:
Carrier: d"'I Zr L l—' -- y 1 ILS /� I
Policy #: 1 ( act aZ5 5- ! � V i".{-
❑ 1 certify that in the performance of the work for which this permit is
issued, I shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith Imply with those provisions.
Date: _5- Q
Applicant:
WARNING. Failure . , secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY --
I hereby affirm that there is a construction lending agency for the
performance of the work for which this permit is issued (Sec 3097 Civ.)
Address:
PERMIT .NO.
BP043100
Issued Date: 10/25/2004 APN: 031-260-037-000
Site Address: 1536 12TH ST ORO
Map Index:
Description: NEW HVAC ROOF UNIT
Owner: HAGLER JOSEPH W
1536 12TH ST
OROVILLE, CA
95965
Applicant: GALLAGHER'S HEATING & AIR
E. HWY 99
LOS MOLINAS, CA
800-892-3556
Contractor: GALLAGHER'S HEATING & AIR
E. HWY 99
LOS MOLINAS, CA
800-892-3556
License #: 777334
Architect:
Engineer:
V-
Total Square Ft: 0 S. F.
Valuation: $0.00
Census Code: b�
cl
This-porait-is h reby issued under the applicable provisions of the Butte County Code and/or
Resokions do work indicated above for which fees have been paid. I,
�G • ��:s
By: ,� 1 Date:
PERMIT EXPS ON: I Z) ` �� U 5>
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I aiqx thorize agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter theform or ment of Butte County. I hereby
IF
authorize representatives of Butte County to enter upon the above mentioned property for inspectPrint Name: \Ae—�f L it, LLi+ Signat
Date: 10 all / 0 N
❑ Owner ❑ Contractor ❑ Agent for Owner VAgent for Contractor
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAX#: (530)538-2140
WEBSITE: www.buttecounty.net\dds
PERMIT NO.
BPO43100
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
Issued Date: 10/25/2004 APN• 031-260-037-000
the Business and Professions Code, and my license is in full force and
effect. /�1x
License ClassC.l I :- License Number? �J
Site Address: 1536 12TH ST ORO
Date: d�'ontractor./�
Map Index:
Description: NEW HVAC ROOF UNIT
OWNER -BUILDER DECLARA N
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
Owner: HAGLER JOSEPH W
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
1536 12TH ST
signed statement that he or she is licensed pursuant to the provisions of
OROVILLE, CA
the Contractor's State License Law (Chapter 9 commencing with Section
7000) of Division 3 of the Business and Professions Code) or that he or
95965
she is exempt therefrom and the basis for the alleged exemption. Any
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ 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 (Sec. 7044, Business and Professions
Applicant: GALLAGHER'S HEATING & AIR
Code: The Contractors' State License Law does not apply to an
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
E. HWY 99
provided that such improvements are not intended or offered for
LOS MOLINAS, CA
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
800-892-3556
proving that he or she did not build or improve for the purpose of
sale.).
O I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
Contractor: GALLAGHER'S HEATING & AIR
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
E. HWY 99
LOS MOLINAS, CA
❑ I am Exempt under Article 3 of the Business and Professions Code
800-892-3556
Date: Owner:
License #: 777334
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 self4nsure for
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
Architect:
is issued.
Engineer.
I have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier: W)'1C
Total Square Ft: 0 S.F.
Valuation: $0.00
1-7 a 01 QZ- Q10 O `T
Policy a:
Census Code:
❑ 1 certify that in the performance of the work for which this permit is
issued, 1 shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith mply with those provisions.
Q
Date: -5-10
Applicant:
WARNING. Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dela ($100,000),in addition 0 the cost of
ovide 0 for
compensation, damages as provided for in Section 3706 of the Labor
/
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permit is reby issued under the applicable provisions of the Butte County Code ?nrVor
Resol ions do indicated for fees have been
I hereby affirm that there is a construction lending agency for the
the for this is issued 3097 Civ.)
work above which paid.
, v
performance of work which permit (Sec
By: Date: 1/G ,�
Name:
)b -9—S-
o5
Address:
PERMIT FJ( ON:
Date
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification fortes.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorize agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to atter the sub nce of any official form or ument of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspecti pu is.
Print Name:,)1 Signa e:
Date: t
❑ ❑ Contractor E3 Agent for Owner Agent for Contractor
Owner
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
"PLEASE PRINT CLEARLY"
OWNER
Last Name�y ( e r
v'�
Name
irst Nam
-f-h
Address 1!
t
1 I
City Oro v ilk
ll
!
State 0_t
Zp
Phone
Fax
E-mail
Class
CONTRACTOR
Name
Name
V
Address 3
City
's Moll nn
State
TipQl S
-Phone
-Fax
E-mail
Lic. #
Class
-APPLICANT SIGNATURE
r office use nl :
ARCHITECTIENGINEER
Name
r
`
Address
�{
City
M f , nos
I1
State
Zip
Phone
aver
Fax
E-mail
E-mail
State License Number
-APPLICANT SIGNATURE
r office use nl :
APPLICA T NAME
Name
r
`
Address
�{
City os
M f , nos
I1
State C` l�
rp
Phone
aver
Date:
Fax
E-mail
Total
-APPLICANT SIGNATURE
r office use nl :
Zoning Flood Zone SRA I Yes I No
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
PERMIT
NO.
BP
BIN #
LOCATION
2 V
AP# o I —2 0
Property Address City O l I I
Cross Street l
WORKER'S COMPENSATION
Policy Number 1-7oZ9 O
Carrier
If hiring anyone other than Ilcense contractors, a certificate of worker's
compensation must be shown at the time of penult Issuance.
LENDING AGENCY
Address
Description or Scop of Work:
Received by: Amount:
CLI I new s
+Cry -1
Sq. Footage
Yl OYI_I-A�-Y
❑ Structure_Built-vAtho
units --P--"
❑ Proposed Change of Occupancy
(Note previous use):
aver
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
K:\FORMS\BUILDING FORMS\BIdgApplSubRgmts.doc Page 1 of 2
REV 7-27-04
Received by: Amount:
Bldg
SRA
Receipt #:
Sheriff
SMIP
aver
Date:
Total
K:\FORMS\BUILDING FORMS\BIdgApplSubRgmts.doc Page 1 of 2
REV 7-27-04
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit.
INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK
❑
1.
Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paperl
❑
2.
Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paperl) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑
3.
Engineered truss details and layouts in duplicate (if required). No faxesl
❑
4.
Energy compliance design and supporting documentation in duplicate. (Note: Not required for additions to
mobile or modular homes.)
❑
5.
Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑
6.
Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down
or fnd plans, all in duplicate.
❑
7.
Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑
8.
Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑
9.
Site plan and business license approval from the City of Biggs.
❑
10.
Letter of intent for non-residential buildings.
❑
11.
Detached Accessory Building Form filled out by the owner (if required).
❑
12.
Hazardous Material Form (for Commercial Buildings only).
❑
13
-anitafiorLand-site-plan_approvaiJr_om_the-EnvironmentaLHealth-Department.
Remaining
items needed to issue the permit. Additional items may be required after Plan Check and Planning
review
(May require additional plan review upon receipt of the following items.)
❑
1.
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑
2.
Impact Fees.
❑
3.
California Department of Forestry plan approval (if required).
❑
4.
NPDES Form.
❑
5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑
6.
Contractor's license information. (Number, Name Style, Classification).
❑
7.
Worker's Compensation Carrier and Policy Number.
❑
8.
Owner -Builder Verification (if required).
❑
9.
Letter of Signature authorization (if required).
❑
10.
Recorded copy of Agricultural Acknowledgment Statement.
❑
11.
❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner (for 433A's).
If you have questions or would like additional information regarding this process, contact a Permit
Application Assistant at (530)538-7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance. for permits
issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 RE/ 7-27-04
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive o Orovi�llle, California 95965 * Telephone (530) 538-754 NO.
(Rev. 12/96) APPLICATION ION AND PERMIT �,'���E�
ASSESSOR PARCEL NUMBER (ZONING
031-260-037
OWNER TELA+'
OWNERS MAILING ADDRESS
1536 1?TH RT
CONTRACTOR'S NAME
OWNER
CONTRACTORS MOVING ADDRESS
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
BUILDING PERMIT
SO. FT. OCC. I BUILDING VALUATION
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Film Fee $ 20.00
Permit Fee $ 63-00
ARCWrECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDINGADDRESS
1_536 19TH ST, OROVIIIE
Energy Plan Checking Fee $
$
PERMIT FEE $
LOT No. SUBDNISpNS NAME
PARCEL MAP
PLUMBING PERMIT Fling Fee 20.00
USEOFSTRUCTURE
SF ❑X Duplex ❑ Mobilehome ❑ Other
sPMFY
Each Tra 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
Describe Work: REPLACE 8 WINDOWS, EXTERIOR DOORS, SIDING
AND INSULATION
Gas piping system 1 - 5 outlets 15.00
Building sewer 15.00
' Mobile Home S G W @20.00
PERMIT FEE
ELECTRICAL PERMIT Fling Fee 20.00
Main Service z�ow oA L.ss 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.
OWlNER-BUILDER DECLARATION v
I herebyaffirm under penalty of perjury that I am exempt from the Contractors License
w f9t the following reason:
I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
Main Service 200A TO 1000A 46.00
NEW CONST. DWELLNO OCCUP. SO
OR ADONS. a ACC. BLDS. 3.50Fr.
NEW GUNS 1.
NON-RESID. RANCH) OUI @7,50
TS
POWER APPARATUS
a SINGLE OUTLET C"
Ex. Occup. OUTLET OR FvruREs eAl '0 ®' 00
.so
MD APPLIIS. OR
Ex. Occup., ounETs ESIo. EA 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 Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEPE $
Policy Number
4The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
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
fo with comply wit provisions.
X Date ((� (ZJ I
N_SIg ure Applicant - ❑ Owner ❑ Contractor ❑Agent
An OSHA permit 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. TYPE
TOTAL FEE $ 83.00
HAZ
D FEES IMP
I FLOOD
I CDF
PARCEL
I PD
rID
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
Indicto above for which fees have been paid.
/ O
ch Dat (Q
PERMIT EXPIRES ON
to
Receipt No. /$83.00
WHITE-D.D.S.-B. D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
• COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT
7 County Center Drive • Oroville,
SERVICES - BUILDING DIVISION
California
95965 • Telephone (530) 538-7541
(Rev. 12/96) PERMIT
APPLICATION AND PERMIT
ASSESSOR PARCEL NIUM801 O
GINNER ZONING
—
b_
BUILDING PERMIT
TELlP11p C
53 5
SO. Fr. OCC.BUILDING VALUATION
15p
Sm
COMRACTOR'9 NIANNE�
TELEPHONE
CONTRACTOR'S MAJUNG ADDRESS
CONSTRUCTON LENDER
LENDER'S MAILING ADDRESS
Fre IQCe
OR ENOINEEq
Total Valuation E
LICENSE NO.
Fee $
OR ENGINEER'S MAILING ADDRESS
20.00
Per
Permit Fee
[CHMECT
DRESS r3Plan
JEnergy
Checkin Fee $
Plan Checking Fee $
SUSONISDN'SNAME PARC L MAP
PERMIT FEE i
PLUMBING PERMIT Filing Fee 20.00
USEOFSTRUCTURE
Each Trap 7.00
SF Duplex 13 Mobilehome ❑ Other
Solar or heat pumpwater heater 23.00
SFY
PBC
Water piping 15.00
TYPE OF WORK
Each gas water heater or vent 15.00
New ❑ Addition ❑ Remodel ❑ UdGties ❑ Instagation ❑ Other
Gas piping System 1 - 5 outlets 15.00
Describe Work:
Buildin sewer 15.00
-
Mobile Home S G W Q20.00
iAi►�,
PERMIT FEE $
ELECTRICAL PERMIT Flin Fee 20.00
----- -�--�-
Main Service MW OR LESS
xaA OR LESS 23.00
Main Service 200A TO 1000A 48.00
NEW C0NONS3 T. DWELLING OCCUP. SO.
OR
a ACC. aLns. 3.50Fr.
NONFR6ID. MULwounlT
Q7.50
'
POWER APPARATUS
6 SWGLEO CIR.
Ex. Occup. OVTLEr OR FIXTURES 200 1.00
aAL .50
Ex. occup. OAPPLNI S
1 SS CS10. EA 5.00
f Temporary Service 23.00
Mobile Home Facilities
' 20.00
.-
Misc. Wirinu 23.00
PERMIT FEE _
"PERMIT FEE PAID
MECHANICAL PERMIT Fling Fee 20.00
SRA - -
Heatin
Cooling
SHERIFF
Hood 8.50
OTHER
Ventilation
PERMIT FEI: t
Mobile Home Installation Fee S
----
I Energy Inspection Fee S
! OCC CONST. TYPE
TOTAL FEES g
AMOVNT RECEIVED
�• D. FEES IMP
FLOOD CDF PARCEL PO ND 6SUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
*RECEIPT NVMBER L
indicated above for which fees have been paid.
" TO BE PVT INTO COMPUTER
By
Date
PERMIT EXPIRES ON
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 permitwill
be issued until this verification is received.
1. I personally plan to provide the major labor and materials for construction of the
proposed pro erty improvement :YES ] 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: 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
SIG D: �
PROPERTY OWNER:
SOCIAL SE ER:
DA=
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
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 pUn to subcontract, you
should be aware of the following information for your benefit and protection:
0 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.
0 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.
0 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.
0 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 "ownerbuilder"
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 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.
Sinarel ,
A;
Micha 1 C. Vieira, C.B.O.
Manager, Building Inspection
NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
OVER
J
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
- 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 01j PERMIT N
APPLICATION AND PERMIT 4
P
ZP,
ASSESSOR PARCEL NUMBER" 031-260-037
ZONING AR
BUILDING PERMIT
OWNER MARY MURPHYX
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS 2140 6TH ST OROVILLE, 95965
CONTRACTOR'S NAME FOX ELECTRIC
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER NONE
N
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee $
20,00
Permit Fee $
ARCHITECT OR ENGINEER NONE
ucENSE No.
Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee $
Penalty $
BUILDING ADDRESS 1536 12TH ST
PERMIT FEE $
OROVILLE
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 SIX Duplex ElMobilehome ❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
@20.00
TYPE OF WORK
New C3Addition L)Remodel ElUtilities NX Installation ❑ Other C3
Describework: RELOCATE ELECTRIC SERVIXCE
PERMIT FEE g
Cont ractor
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service` OR LESS
I 200A OR LESS )
23.00 '
Main Service ( 200A TO 1000A )
46.00
NEW CONST. DWELLING OCCUP.
OR ADONIS. 1 & ACC. BLDS. 1
3.50 FT_BO-
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one)
❑ I 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
❑ 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)
❑ I am exempt under Sec. Business and Professions Code
forthis reason
NEW CONST. MULTI -OUTLET
-NON-RESID. 1 BRANCH CIRCUITS 1
@7.50
( POWER APPARATUS 1
S SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES )
20 @ 1.00
SAL. .50
FIXED APPINS. OR
Ex. Occu p' OUTLETS (RESID.) EA. 1
(
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23 00
PRE—INSPEC. 1
120.00
WORKER'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ 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
Certificate of Consent to Self -insure.
f� 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 S
63.00
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
liabilit dgments, costs, an expenses which may in any way accru/ag 'nst said
Counsquence of ranting of this permit.Date C
Signature ofpli - Cl Owner ❑ Contractor AAgent
An OSHA Oermit is required for excavations over 5"0" deep aJ demolition or
construction of structuresover3 stories in height.
Mobile Home Installation Fee 1$
Energy Inspection Fee $
OCC
CONST. TYPE
TOTAL FEE $ 63.00
HAZ.
D. FEES
IMP
FLOOD
CDF
PARCEL PD
HO
ISSU
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 A�r Date
PERMIT EXPIRES ON // ^ C
Z_/J_
!Do re/
ReceiWo.
p 1611161 / /G
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
APPLICATION AND PERMIT
PERMIT NO.
ZONM
BUILDING PERMIT
owNER,A
TFiG
LEPHONE �a
SO. FT. OCC. BUILDING VALUATION
OWNER' AjIdJQ Ess �L../ ( �`y1��
't V
CONTRACTOR'S NAME
ax C -f r '
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CON9TRUCTI LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee $
20.00
Permit Fee $
ARCHITECT I WEER
uceisE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADOR j ro
PERMIT FEE $
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
SFI Duplex O Mobilehome O Other
SPECIFY
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
20.00
TYPE OF WORK
New ❑ Addition O Remodel ❑l Utilities Installation O Other O
DescribeWork: [ C_L'{ '>`�� e t1 ! C_
_
Y, , / i ii C
V l_�
PERMIT FEE g
Contractor
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service ( 'v OR LESS
200A OR LESS )
23.00 . O
Main Service ( 200A TO 1000A )
46.00
DWELLING OCCUP.
NEW CONST. DW8,
OR ADDNS. ( ACC. BIOS. )
gO ,
3.50 FT.
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one) u
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
Cl 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)
O 1 am exempt under Sec. Business and Professions Code
forthis reason
NEW CONST. MULTI -OUTLET
-NON-RESID. ( BRANCH CIRCUITS )
@7.50
( P.0WERAPPARATUS )
8 SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES )
RAL.L @ 1.50
Ex. Occup.FIXED APH LHS. OR
( OUTLETS HRESID.) IA. )
5.00
Temporary. Service
23.00
Mobile Home Facilities
20.00
Mi25. Wiring
23 00
Fee y
Q
WORKER'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ This permit is for $100.00 (valuation) or less.
❑ 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.
O 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.
If PERMIT FEE $
63,001
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 Date
Signature of Applicant - O 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 $
GCC
CONST. TYPE
TOTAL FEE $ G 3
HAZ.
D. FEES
IMP
FLOOD
COF
PMCEL PD
MD
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
lOerol
Receipt No.
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
EU tie
Count
J D O F N A T U R A L W E A L T H A N D B E A U T Y
PERSONNEL DEPARTMENT
County Administration Building
25 County Center Drive
OroviIIe, California 95965-3387
916/538-7651
ty Employees
actor -Personnel
LLMENT DEADLINE
� rr� d '•: .�s� Li'"ti.dr�LrrY ... t .: •- ,;r .. ,f.MvSd'eti
:`r�,'`',��4'""^(y.:V1fy'✓y�U"'in-+.F1�IM-��F`}J�i3^ •��/`r v}��.:�iff�,^�l.A.i.vi'F1utiv'�riri�`"�' f!"..."��vT...•�
COUNTYOF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION
7COUNTYCENTERDRIVE- OROVILLE,CALIFORNIA95965 -TELEPHONE (916) 538-7541
PERMIT APPLICATION DATA SHEET
OWNER �l d� 1 �� A. P. No. 013 "' d ' �a
Proposed Building Use /--Building Inspector Date
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 schedule. ............................. .
12. California Department of Forestry plan approval/fees. ....................... .
13. Flood elevation letter (100 year flood) by California 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). `
20. Pre -inspection for �► /� ; C� - required. Prey" �"meq°
T_L q to Buil ing' spedor - - (Date)
21. Contractor's license information. (No., Name Style, Classification) . ............ . .
22. 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 you issue the permit, process as follows: Mail to owner. � Mail to contractor.
Telephone S, 3-/�,a� �d hold for pickup at rwi //P office. Deliver with inspector.
Other
Parcel Creation
Acreage Applicant Date
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air P011u ion Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submitted prior to permit issuance: (Circle new item not checked above).
1. Index permit for above items No.
2. Additional items required:
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
i
_._
f
_._
.�_ �_-�..r_
S
_ (
� -. , _ _
_
_ __ _ � , _ _.
��
G
iS
PERMIT NO. 6329-75P
P
t
E
M
MH UTIL.
PERMIT NO.
t
? PERMIT EXPIRES 12/15/76
OWNER JOHN B. FA I RLEY
;CONTR. OGINER
:'LOCATION (A. P. 31 —26—�7 )
1536 12TH. ST., OROVILLE
i
r
i
Temp. Power Pole
Called PG&E
Temp. Elec. Serv.
Called PG&E
Temp. Gas Serv.
Called PG&E
JOB
FINALED
(Date
(Signature)
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING
BUILDING (Cont'd)
PLUMBING
Setback
Firewall
Soil Piping
Forms
Parapets
1st Floor
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
Stemwall
Siding
To out
Slab
Roof Sheathing
Water Piping
Piers
Roofing
Sewer
Garage
Fdn. Vents
Ffxtures
Footings
Garage Vents
Water Htr.
Stemwall
Slab
Prov. for physically
handicapped
Heaters
Appliances
Carport
Footings
Conformance of ex.
structure
Gas Piping & Test
Temp. Gas
Slab
Final
Sanitation
Patio
FIREPLACE
Final
Footings
Footing
ELECTRICAL
Masonry Walls
Throat
Rough
Reinf. Steel
Final
Fixtures
Bond Beam
FIRE SPRINKLERS
Motors
Framing
Test
Water Htr.
Stucco
Final
Subpanels
Mesh
MECHANICAL
Grd. Fault Prot.
Scratch
Heating
Service
Brown
Cooling
Temp. Pole
Finish
Ducts
Underground
Interior Lath
Ventilation
Permanent
Door Closer
Final
Final
DATE REMARKS OR CORRECTIONS
THERMALITO IRRIGATION DISTRICT
410 GRAND AVENUE
OROVILLE, CALIFORNIA 95965
TELEPHONE 533-0740
CSA 26 SEWER SERVICE APPLICATION AND CONNECTION PERMIT
Service Address: I -,-T A ST
Owner's Name:
Datemr- 5�
0
Address: � �� �'
Acct. No: 'XA W
0fR:2) OAe EA1,3
A. P. No.: P-,� Z6- 7
Phone: "d
No. Units:
Applicant/Agent: %/
y
Agents Proof: �9
Address:
Fees:
Phone:
Application $ ;
Arrearage
Preliminary Review By ' � � d. --` Date :a AM -2 0G ������
CSA 26-
���
Remarks:
SC -OR
1st mo. S.C.
Other
Total Fees
Collected By:
Date:
Field Review By: Date: .
Remarks:
0 .r-1
MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON:
Date of TID approval of completed building sewer (early connection).
❑ 30 days after date above, or on date of D.P.W. approval of completed building sewer, which ever comes
first ("existing construction", prior to Mar. 5, 1974).
❑ 180 days after date above, or on date of D.P.W. approval of completed building
sewer, which ever comes
first ("new construction", after Mar. 5, 1974).
DISTRIBUTION: WHITE - TID, YELLOW - APPLICANT, PINK - DPW, GOLDENROD - DPW to TID
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Oroville, California 95965 ��
Telephone: 534-4541
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes. �t
� 11 � . J ` Date/a —rr„� Sr
:
VSignature of Permitee or Agent
Receipt No. f ��� 6:1 --
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.
DIRE 7R OF PUBLIC WORKS
By
l/lI\\ Date
Bcri iag permit expires Date � IS
/
BUILDING
Owner ��
SQ. FT. OCC. BUILDING VALUATION
Mailing Address —�'ri
Telephone No.
S-33"
Fireplace
Contractor t`�2
Total Valuation
Mai I Ing Address
Permit Fee
P I an Checking Fee &/or Penalty
Telephone Na.
Permit Fee $
Building Address �3 Z s fi-
PLUMBING No.1 @ FELE
PERMIT FILING FEE $3.00
�^.I
C.
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1:50
A. P. No. -37
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
FLe,'W.
arA a6on
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
Declaration
Parcel Ma p
60' R/W
Improvements_
Lawn sprinkler system 2.00
'
Bldg. Pis Recd
Parcel Approval
Plans Approval
Permit Fee $
$
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service 1000V OR 0 AMP ORLESS5.00
Main service EA. AOD'L 100 AMP 2.50
Main service OVER s 25.00
100 AMP O OR LESS
Single Family Duplex ❑ Mobil Home ❑ Others ❑
Main service EA. ADD -i- 100 AMP 1.00
NEW CONST. OR ADDNS. (ACCLBLDGSLING 0 CCUP. &� 2�sgft
.
NEW CONSTR MULTI.OUTL T
NON -REST D, BRANCH CIRCUITS 2.50ea
NEW CONSTR. (POWER APPARATUS .&)
NON RES,D, 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) AL01
FIXED APPLNS. OR
Ex. Occup. (OUTLETS (RESIO.) 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 $
$
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.
EJI have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
j I certify that in the performance of the work for which this
1� 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
$ —'
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes. �t
� 11 � . J ` Date/a —rr„� Sr
:
VSignature of Permitee or Agent
Receipt No. f ��� 6:1 --
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.
DIRE 7R OF PUBLIC WORKS
By
l/lI\\ Date
Bcri iag permit expires Date � IS
/
a-.
001
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDIJMG DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATION AND PERMIT 9A1__:2 -2,Q
ASSESSOR PARCEL NUMBER 031— 60 37
"—
ZONING AR
BUILDING PERMIT
OWNER MARY H[7fdPM
V,'>18
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS P1406TH ST OROVIL EQ 95965;•..
ti'Y .l. • ,a •�"+ y
'
CONTRACTOR'S NAME FOR Ei�.�GMIC
, TELEPHONE
CONTRACTOR'S MAILING ADDRESSI
}
Fireplace
CONSTRUCTION LENDER NONE
i 1V.G
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee $
20.00
Permit Fee $
ARCHITECT OR ENGINEER DIONE
LICENSE NO.
Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee $
Penalty $
BUILDING ADDRESS 1536 %2,H ST
PERMIT FEE $
OROVIIIE
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
SFi Duplex ❑ Mobilehome ❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
@20.00
TYPE OF WORK
New ❑ Addition ElRemodel ❑ Utilities 31Installation D Other ❑
Describe Work: RELOCATE URIC SERVIR E
PERMIT FEE g
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service( 200A OR LESS )
23.00 UU
Main Service ( 200A TO 1000A )
46.00
NEW CONST. DWELLING OCCUP.
OR AOONS. ( & ACC. BLDS.
3.50 FTg0. _
NEW CONST. MULTI -OUTLET
NON- B
RESID. ( RANCH CIRCUITS /
@7.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one)
❑ I 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
D 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)
rE7 I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
O I am exempt under Sec. Business and Professions Code
forthis reasoncri
( POWER APPARATUS )
BSINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES )
2001.00
BAL. 60
Ex. Occup.FEDAPPWS. OR
(OUTLIXETS (RESID.) EA.
5.00
Temporary Service
23.00
Mobile Home Facilities
20 00
Misc. Wiring
23.00
o
WORKER'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ This permit is for $100.00 (valuation) or less.
❑ 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 $
o
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
Iiabili;ies^jVdgments, costs, and expenses which may in any way accrue ag inst said
County in consequence tfie of of this permit.
�"� Date
Sig ture of pplicant/ ❑ Owner ❑ Contractor A 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 $ 61000
HAZ
D. FEES
IMP
I FILOOD
COF
PARCEL PD
Ho
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.
.f
By _A01s� Y' Date
PERMIT EXPIRES ON
(Date)
Receipt
Receipt dr <
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
F)
t i
031-26-0-037 - --_
194-2222 E
1536 12th, Street'
(relocate Oroville
elec ser/Fox Electric)
OFFICE COPY
Address
GAS
Meter By 4 Dat
ELECTRIC
Meter By_ Z
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive -o Oroville, California 95965 • Telephone (530)-538-7541. EIT No.
(Rev. 12/96) APPLICATION AND PERMIT° �'
ASSESSORPARCELNUMBER
D�
ZONING -
-
BUILDING PERMIT
OWNERTELEPHONESQ.
'•Yj-<Ih11b
FT. OCC. BUILDING VALUATION
. OWNER'S MAILING ADDRESS
CONTRACTOR'S NAME
TELEPHONE
.
CONTRACTORS'MAIUNG ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS -
Total Valuation $ o 0
ARCHITECT OR ENGINEER _
LICENSE NO.
Filing Fee $ 20.00
Permit Fee $
ARCHITECT OR ENGWEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS
}7
Energy Plan Checking Fee $
$
PERMIT FEE $
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
PLUMBING PERMIT Filing Fee 20.00
USEOFSTRUCTURE
SF CE Duplex ❑ Mobileh'ome ❑ 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 4
Describe Work: a2pX/�Clg a i>X2OS,'' ` O�MORS, S2MgW
MD
Gas piping system f - 5 outlets 15.00
Building sewer 15.00 -
ile Home I S I GI W1 Q20.00
PERMIT FEE $
ELECTRICAL PERMIT Filing Fee 20.00
Main Service ow OR 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,
and my license is in full force and effect
License Class Lic. No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law f f the following reason:
IV1, 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.
\ ❑ I am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
I 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.
❑ have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permitis issued.
1 My workers' compensation insurance carrier and policy number are:
Carrier
Main Service 200A TO 1000A 46.00NEW
CONST. DWELLING oc.. P. sO
OR ADDNs. a Acc. BLOB. 3.5¢Fr:
NON -R CSINEW D. T. MULTI -OUTLET 97.50
POWER APPARATUS
d SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FDTTURES20 ® 1.00
BAL ® .s0
FIXED APPLNS.
Ex. Occup.,CUTLETS a,D. OR Ea, 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE S
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FET: S.
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.)
(�Z111certify 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
forthwith comply wit o6e provisions.
aof
Date V
Signature of Applicant -'❑ Owner ❑ Contractor ❑ Agent
An OSHA permit 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 TYPE
TOTAL FEE $
�.
IMP
FLOOD
CDF
. PARCEL
Po
HD
ISSUE
This permit is hereby issued under the applicable provisions
the Butte County Code and/or Resolutions to do work
Indic ted, above for which fees have been paid.
t
f J
By i Date Aw
PERMIT EXPIRES ON
' to
Receipt No.1�0 ° UU
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT I
P31-260-037
70 03 - 01-1368
HAGLER, JOSEPH
11536 12TH ST. OROVILLE.
iCONT: OWNER
REMODEL
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