HomeMy WebLinkAbout033-023-00433-023-4
Oscar B. Jetton
300 Fig St.., 10010, Oroville' - I
Permit #2332-77-P,E.(util.
EEC.
F.
GAS
T SUPPORT STRUCTURE REQ.
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BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION (IVR): (530) 538-4365
OFFICE: (530) 538-7541 FAX#: (530) 538-2140 -
ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds
PROJECT INFORMATION
Site Address: 166 GOLD AVE
Owner:
Permit NO: B08-1800
APN: 033-023-004
VANDEVENTER, CRRISTOPHE
Issued Date: 09/03/2008 By KCG
Permit type: MISCELLANEOUS
166 GOLD AVE
Subtype: Electric Panel
OROVILLE, CA 95966 _
Expiration Date: 09/03/2009
Description: REPLACE MAIN ELECT BOX
(530) 533-5761
Occupancy: Zoning: ARMH
Contractor
Applicant:
Square Footage:
VANDEVENTER, CH[RISTOPI
Building Garage Remdl/Addn
166 GOLD AVE
OROVILLE, CA 95966
Other Porch/Patio Total
(530)533-5761
FEE INFORMATION
DBE Single Phase Service-Resid $59.00
Total Charged: $59.00 Fees Paid: $59.00
Balance Due: $0.00 Receipt No: B8455
LICENSED _CONTRACTOR'S DECLARATION
OWNER / BUILDER DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance,
,
also requires the applicant for such permit to file a signed statement that he or she is licensed
I HEREBY 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
pursuant to the provisions of the Contractors License Law [Chapter 9 (commencing with Section 7000)
is in full force and effect,
of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
X 09/03/2008
the applicant to a civil penalty of not more than five hundred dollars [$5001;
Please check one of the following: '
Contractor's Signature Date
Ill I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE
COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR
WORKERS' COMPENSATION DECLARATION
OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractors License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
the work himself or herself or through his or her own employees, provided that such improvements
❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR
are not intended or offered for sale. If, however, the building or improvement is sold within one
WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the
year of completion, the owner -builder will have the burden of proof that he or she did not build or
performance of the work for which this permit is issued.
improve for the purpose of sale.).
❑I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by
I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code:
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
The Contractors License Law dows not apply to an owner of the property who builds or improves
My Workers' Compensation insurance carrier and policy number are;
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractors License Law.).
Carrier: Policy Number: Exp. Date:
(This section nee not a completed if the permit is for one hundred ($100) or less.
❑ I AM EXEMPT under Section B. & P.C. for this reason:
j� I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
L.ZUJSSUED, 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'X
09/03/2008
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
Owner's Signature Date
ovisions.
X r� 09/03/2008 .
I hereby certify that I have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
.y
Signature Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE
injury, including death, and property damage caused by, arising out of, or in any way connected with
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
ATTORNEY'S FEES.
County to enter the above mentioned property for inspection purposes. I hereby certify that I am the
!Winer authoriz t t o the pr arty o ers behalf.
�
CONSTRUCTION LENDING AGENCY
9 09/03/2008
xal
1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
N.Tme of Permi ee [SIGN] Print Date
the performance of the work for which this permit is issued. (3097 civ. code)
r�A
Owner 1:1Contractor OR; i YiAgent for Owner Agent for Contractor
FILE COPY
Lender's Address City - State zip
Butte County Department of Development Services-
TIM
ervices-TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroviite, CA 95965
(530) 538-7601 Telephone
(530) 538-2140 Fax
www.buttecounty.netldds
OWNER -BUILDER INFORMATION
p.2
An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified.
For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed
by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself you may protect yourself from
possible liability if that person applies for the.proper.permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They'are also required by
law to put their license number on all permits for which they apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and
protection:
° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $5UU or more for the entire
Project and such pumns-are-notdicensed!as contractorsor•subcontractors, then you maybe ancmployer.
° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal
a income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions.
There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance.
° For more specific information about your obligations under federal law, contact 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 acid the Division of bndustrial
Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees,
without a license contractor or subcontractor, only under limited conditions.
A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is
providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work
.personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone inf6rmation system at 1400=32 r
-CLSB (2752) or by accessing thier website at www.CSLB.ca.gov.
PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE
AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED.
OWNER BUILDER VERIFICATION
PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING
PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED.
.1. I PERSONALLY. PLAN TO PROVIDE THE MAJOR LABOR AND..MATF.RIALS�FOR CONSTRUCTION OF THE PROPOSED PROPERTY..
IMPROVEME S NO)
,*2. 1 (HAVE/16VE NO SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK
3.1 HAVE CONTRACTED WTTI I THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION:
NAME
ADDRESS CITY
PHONE CONTRACTORS LICENSE NO
4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE
THE MAJOR WORK:
NAME
ADDRESS CITY
PHONE CONTRACTORS LICENSE NO
S. 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
Description: REPLACE MAIN ELECT BOX
Reference Number: B08-1800
Applicant Name: VANDEVENTER, CHRISTOPHER
Owner's Name: VANDEVENTE C H AP #
-Signature of Property Owner: Date:
:033-023-004
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BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION*
OFFICE #: (530) 538-7541 FAX #: (530) 538-2140
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
Website: www.buttecounty.neVdds
PLEASE PRINT CLEARLY
PERMIT
NO.
BIN #
"When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information
related to this application is subject to public inspection and will be posted on the County's website for electronic access.
OWNER INFORMATION
Nae
First Name
e s
Mailing Address
City /
State
Zip
Phone 3 3 _s
Fax
E-mail
APPLICANT INFORMATION
CONTRACTOR
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Fax
E-mail
Lic. #
Class
APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Fax
E-mail
State License Number
APPLICANT INFORMATION
Name
Address
City
State
Zip
Phone
Fax
E-mail
PLICANT SIGNATURE
X �•
PROJECT LOCATION
AP# 3 -o2 3
Property Address 46 d ,
city P_0 -e
WORKER'S COMPENSATION
Policy Number
Carrier
IIf hiring anyone other than licensed contractors, a certificate of
worker's compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
DESCRIPTION OR SCOPE OF WORK.
Scl FT- Living Garage Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
For office use only:
Zoning
Flood Zone
SRA
Yes
No
Occ.
Type Const.
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 95965
(530) 538-7601 Telephone
(530) 538-2140 Fax
www.buttecounty.net/dds
"PERMIT APPLICATION DATA SHEET"
Reference Number:
B08-1800
Date:
09/03/2008
Location:
166 GOLD AVE
By:
KCG
Parcel Number:
033-023-004
Sub Type:
Electric Panel
Owner Name:
VANDEVENTER, CHRISTOPHER
Phone:
(530) 533-5761
Description:
REPLACE MAIN ELECT BOX
The above permit application has the following Clearances required prior to permit issuance. Please contact each department
indicated below regarding specific requirements pertaining to your permit application.
Yes No SEWER DISTRICTS
1:1 ❑ Thermalito Irrigation District, 410 Grand Avenue, Oroville CA 95965 - (530) 533-0740
❑ ❑ LOAPUD, 1960 Elgin Street, Oroville CA 95966 - (530) 533-2000
C] ❑ City of Chico, PO Box 3420, 411 Main Street, Chico CA 95927 - (530) 879-6700
PARKS & RECREATION DISTRICTS
El 71 Chico Area Recreation District, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711
Durham Park & Recreation District, 9447 Midway, Durham CA 95938 - (530) 345-1921
Feather River Recreaction & Park District, 1200 Myers Street, Oroville CA 95966 - (530) 533-2011
Paradise Parks & Recreation, 6626 Skyway, Paradise CA 95969 - (530) 872-6393
❑ 0 Paradise Unified School District, 6696 Clark Road, Paradise CA 95969 - (530) 872-6400
OTHER
0 ❑ Recorded copy of Agricultural Acknowledgment Statement- See Attached Instructions
91E]❑City of Biggs Planning Department, 3016 Sixth Street Biggs CA 9591 - (530) 868-5447
Other: Or 5
Other:q -b 51 am )ln � 1 r) Z�xx �1.�C Q
When fi
""led, this application and al supporting material becomes subject the tailifonila Public Records Act. All p blic
information related to this application is subject to public inspection and will be posted on the County's website for electronic
access.
Signature of Applicant:��� iV���� Date: 09/03/2008
FILE
SCHOOL DISTRICTS
0
❑
Biggs Unified School District, 300 B Street, Biggs CA 95917 - (530) 868-1281
❑
❑
Chico Unified School District, 1163 East 7th Street, Chico CA 95926 - (530) 891-3006
❑
❑
Durham Unified School District, 4920 Putney Drive, Durham CA 95938 - (530) 895-4675
❑
❑
Gridley School District, 429 Magnolia, Gridley CA 95948 - (530) 846-4723
Marysville School District, 1919 B Street, Marysville CA 95901 - (530) 741-6000
Oroville Elementary School District, 2795 Yard Street, Oroville CA 95966 - (530) 532-3000
❑
❑
Oroville Union High, 2211 Washington Ave, Oroville CA 95966 - (530) 538-2300 Ext: 105
❑ 0 Paradise Unified School District, 6696 Clark Road, Paradise CA 95969 - (530) 872-6400
OTHER
0 ❑ Recorded copy of Agricultural Acknowledgment Statement- See Attached Instructions
91E]❑City of Biggs Planning Department, 3016 Sixth Street Biggs CA 9591 - (530) 868-5447
Other: Or 5
Other:q -b 51 am )ln � 1 r) Z�xx �1.�C Q
When fi
""led, this application and al supporting material becomes subject the tailifonila Public Records Act. All p blic
information related to this application is subject to public inspection and will be posted on the County's website for electronic
access.
Signature of Applicant:��� iV���� Date: 09/03/2008
FILE
0 %3T TFo Department of Development Services
I ]Building Division
O o
7 County Center Drive
o Oroville, CA 95965
°C J - 0 (530) 538-7541 (530) 538-2140 FAX
UN www.butt.ecounty.net
FACSIMILE COVER SHEET
Date: At
To:
To: NOS pt..
From: K0114ri �m
Subject: tjt, Al Tf tk
Number of pages (including this cover sheet):_
Fax Number: 53D ' E -1 D10
If you do not receive all of the pages, please call (530) 538-7541 as soon as possible.
Special Instructions:
Review and respond accordingly. /
7t For your information only.
ij
- d
�Ibv--M 11111IMNUUMNEW as a i I •ria
Sincerely,
CONFIDENTIALITY NOTE: The information contained in this facsimile is confidential and may
also contain privileged information. The information is intended only for the use of the
individual of entity to whom it is addressed. If you are not the intended recipient, you are hereby
notified that any use, dissemination, distribution, of copying of this communications is strictly
prohibited. If you have received this facsimile, in error, please notify me immediately by
telephone, and return the original to me. Thank you.
K.-OuildingIBUILDING FORMSIBlank Fax Cover Sheet.doc
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 95965
(530) 538-7601 Telephone
(530) 538-2140 Fax
www.buttecounty.net/dds
OWNER -BUILDER INFORMATION
An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified.
For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed
by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from
possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by
law to put their license number on all permits for which they apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and
protection:
° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire
project and such persons are not licensed as contractors or subcontractors, then you may be an employer.
° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal
° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions.
There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance.
° For more specific information about your obligations under federal law, contact 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 lndustrial
Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees,
without a license contractor or subcontractor, only under limited conditions.
A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is
providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321
-CLSB (2752) or by accessing thier website at www.CSLB.ca.gov.
PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE
AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED.
OWNER BUILDER VERIFICATION
PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING
PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED.
+1. I PERSONALLY PLAN TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY
1 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 THE 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
Description: REPLACE MAIN ELECT BOX
Reference Number: B08-1800
Applicant Name: VANDEVENTER, CHRISTOPHER
Owner's Name: VANDEVENTER, CHRISTOPHER AP # : 033-023-004
Signature of Property Owner: Date:
. r !
14
PERMIT No. 2332-77P,F,
w. PERMIT EXPIRES
w� OWNER Oscar B. Jetton
CONTR. owner
LOCATION (A.P. 33=023-4
300 Fig St, lot #10, Oroville
X
Temp. Power Pole
Called PG&E
Temp. Elec. Serv. '°`
Called PG&E 6'
Temp. Gas Serv.
Called PG&E
J O B
FINALED 4 ✓ /
• - (Daley
6�
(Signature)
((2
7
_L17,9C C?
11
.A
t"XU14 ��O;
�W-ax-
� 7�
rtelnt. steel
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
• BUILDING INSPECTION RECORD
�d
Fixtures
BUILDING BUILDING (Cont'd)
PLUMBING
Se ack
F ewall
Ski Piping
Fork
PAVets
1 t Floor
Mailk Bldg.
Rest om Finish
2n Floor
Fo tins
Windo
3rd oor
Stem all
Siding
To out
Slab
Roof Shea in
Water Pi I
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footin s
Stemwal I
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Carport
Footings
Prov. for ph sical
handicapedy
Conformance of ex. V
V structure
Appliances
Gas Piping & Test
Temp. Gas
Slab
A Final A
Sanitation
Patio
REP ACE
Final
Footings
Footin 4
E ECTRIC L
Masonry Walls
I Thrnnt
o.....�
rtelnt. steel
Final X
Fixtures
Bond Bea
FIRE SPRINKLE
Motors
Framing
Test
Water Htr.
Stucco
Final
Subpanel nel
Mesh
MECHANICAL
Grd. It Prot.
Scra h
eatl
Servl
n
CoongB
TAO. Pole
nish D is nder round
I erior Lath 2S entilatian Permanent
oor Closer (nal Inal
MOBILEHOME UTILITIES Elec" Serviceloo Elec. Pedestal
Water Piping , Sewer Gas Piping(91�
E
ME INST LAT( N ti - - - - - - Support Elec. Continuity
Water Piping Drainage Gas Piping
i
DATE 4; o2 ` %�7 REMARKS OR CORRECTIONS
i4 ® K ,
L. dC
��z � > o�C
�&AfT X7-0 oZO <oo A 6ig-S iVC7. futf9 "0 5v..PPO&7-- ca osw►. S/�,�
7n�¢v c TSR- 0--/s) T,- TARS .� � Ff x 3�^ i C�//�iov%`/
(NOTE: An entry must be made on this form each time you visit the job site.)
K
E
" COUNTY OF 8'UTTE' — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — 6 ovi Ile, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
OU' lUJ &V IcNIUaVIIiauvca UI UIC UUUIIIY UI 6u(ttt W edict upon [ne
above-mentioned property for inspection purposes.
X X 6 Date y
Signature of Permiiteeel/or Agent
Receipt No. X 7 /
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 OFUBLIC WORKS
By Date r 2-0
Bu' ing permit expires Date S� ` 7?
BUILDING
Owner zg
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
y5
Telephone No.
'' .Z
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
PI an Checking Fee &/or Penalty
Telephone No.
Permit Fee $
Building Address �Q
`
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00 -7,60
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping
�'d� Gd onina Verificafion On
Each gas water heater or vent 1.50
A. P. No. �� s L
/�
Gas piping system 1 - 5 outlets 15ei"g
Each additional outlet .30
F
W e. San ' n FireDept.
Fire Zone
Use Permit
Building sewer .5. Q 0
EQA
I Parking
Plans -
arcel
Declaration
Pa el Ma P
60' R/W
Improvements
p ovements
Lawn sprinkler system 2.00
f
dg.`�P ns Recd
arcel Approval
PI Approval
Permit Fee $ 6
$
NEW ❑ ADDITION ❑ UTILITIES OTHER ❑
ELECTRICAL No.1 @ FEE
PERMIT FILING FEE $3.00
V OR
Main service io°o AMP ORSLESS 5.00
Main service EA. ADD•L too AMP 2.50
Single Family ❑ Duplex ❑ Mobil Home Others ❑
Main service 100 AMP OR LESS 25.00
Main service EA. ADD'L too AMP 1.00
NEW CONST. OR ADDNS. ( DWELLING
"OCCUP&
ACC'BL G. ) 2Tsgft
.
NEW CONSTR. MULTI.OUTLET
NON.RESID. ( BRANCH CIRCUITS) 12.50ea
NEW CONSTPOWER APPARATUS &
NON- R. 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:
y
Ex. Occup(OUTLETS OR FIXTURES)50 @25C
BAL01
Ex. Occu FIXED APP LNS. OR
P'(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 $ ,7, ()
$ .13
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.
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 PER IT FEE is
OU' lUJ &V IcNIUaVIIiauvca UI UIC UUUIIIY UI 6u(ttt W edict upon [ne
above-mentioned property for inspection purposes.
X X 6 Date y
Signature of Permiiteeel/or Agent
Receipt No. X 7 /
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 OFUBLIC WORKS
By Date r 2-0
Bu' ing permit expires Date S� ` 7?
This set of plans and-s{raific lii MUST be NOTE:—All Materials & Workmanshi -Shai1 Be in
ker.+ �n the iob at all times and it is unlawful to p
ri-r•'-^ nnt� chr�npes or altsi•ations on same without �_.. - .��`ccordance with Recognized Good Practices and
vu � ten erMission from tWDe artment;of Public of a quality prescribed for the Specified use in ,the
It p P _ "'UniformY$uilding,- PIum6�ng `St MechanicaC Codest'anc!
+Works;• <',.yr^tv of Butte. ,the Wtional Electrical Code.
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