HomeMy WebLinkAbout033-052-005033-05-2-005 99-0845 BPEM
BRYAN, Charles
'331 Bonite, Oroville`,
ksiding/windows/hvac) SF s^4� _o1
A
A9111
033-05-2-005 00-0890
BRYAN,CHARLES
331 BONITA, OROVILLE
RENEWAL OF 99-0845 — 10�
SIDING/WINDOWS/HVAC VIA
033-052-005 04-1107
JOHNSON, BILLIE
331 BONITE ST, OROVILLE
Cont: GEORGE ROOFING
RE -ROOF 10 SQ
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.
BP041107
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: 04/20/2004 APN: 033-052-005-000
the Business and Professions Code, and my license is in full force and
effect.
License Class: S —3 Licejise Number: So'�,o1 t!O
Site Address: 331 BONITE ST ORO
Date:—o�O-�JJS� Contractor.
Map Index:
Description: REROOF 10 SQ
OWNER -BUILDER DECLARATION
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
permit to construct, alter, improve, demolish, or repair any structure, prior
Owner: JOHNSON BILLIE RUTH
to its issuance, also requires the applicant for such permit to file a
331 BONITA RD
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
95966-9211
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: JOHNSON BILLIE RUTH
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
Contractor: GEORGE ROOFING
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.).
6810 LINCOLN BLVD
❑ I am Exempt under Article 3 of the Business and Professions Code
OROVILLE, CA 95966
(530) 533-6393
Date: Owner:
License #: 452266
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ I 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
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:�I}p
Total Square Ft: 0 S. F.
Policy #: c+C ?oL 7 [o —9 :p—
Valuation: $0.00
Census Code:
❑ I 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 the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with tthose provisions.
Date: 'el —A,& —Gfy
� f l D • `� —
s
Applicant: _ AVRA-412
WARNING: Failure to secure workers' c mpensation 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
This permit is hereby issued under the ap 'cable provisions of the Butte Coun Code and/or
1 hereby affirm that there is a construction lending agency for the
Resoluti s t do vfork indica above f r h' fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
O
Name:
B • ate:
PERMIT EXPIRES ON:
Address:
D to
O 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.
O 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 authorized 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 the substance of any official form or document of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purposAs.
Print Name:al h`��C Y �L/�f�C�/� (l.� Signature:
Date:
❑ Owner 13 Contractor O Agent for Owner Agent for Contractor
( I z-
LkIL LkVA-10�
\1
C�alm /
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
PERMIT NO.
BP
f"d 110
ATE:
April 20, 2004
A
033 - osa-- o�
ZONING:
OWNER'S LAST NAME:
Montgomery
OWNER'S FIRST NAME:
Leesta
PHONE:
707-943-3741
STREET ADDRESS:
P.O. Box 560
FAX:
CITY, ZIP: Miranda, Ca. 95553
E-MAIL:
SITE ADDRESS: 331 Bonite St. 532-1919
CITY, ZIP: Oroville, Ca. 95966
NEAREST CROSS STREET:
TRACT/LOT#:
APPLICANT NAME: GEORGE ROOFING
PHONE: (530) 533-6393
STREET ADDRESS: 6810 LINCOLN BLVD
FAX: (530) 533-0287
CITY, ZIP: OROVILLE 95966
E-MAIL:
CONTRACTOR NAME: GEORGE ROOFING
PHONE: (530) 533-6393
STREET ADDRESS: 6810 LINCOLN BLVD
FAX: (530) 533-0287
CITY, ZIP: OROVILLE 95966
E-MAIL:
LICENSE NUMBER: 452266
LICENSE TYPE: B, C39, C43
ARCHITECT/ENGINEER NAME:
PHONE:
STREET ADDRESS:
FAX:
CITY, ZIP:
LICENSE NUMBER:
E-MAIL:
DESCRIPTION OR SCOPE OF WORK:
Tear -off and Reroof with 10 sq. Comp Shingles.
❑ Structure Built without permits
❑ Proposed Change of Occupancy (note previous use)
EXPIRATION OF APPLICATION
Applicatons 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 fees will be required.
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.
For office use only:
Notes:
Application Received By: Date:
Receipt number: Amount Received: to (o
Master application 34-04
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COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530),538-7541' � APER Mme.
(Rev. 12/96) APPLICATION AND PERMIT r- 6 M)
ASSESSOR PARCEL NUMBER 033-052-005
ZONING ARM
BUILDING PERMIT
1
OWNER
Charles Bryan
TELEPHONE
743-6075
SO, FT. , OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS4804 pacific AVe., Olivehurst, 95961
CONTRACTOR'S NAME . Omer
TELEPHONE
'
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER -
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $ 20.00
Permit Fee • Original $ 56.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDINGADDRESS 331 Bonite, Oroville ; '
Ener Plan Checking Fee $
Energy 9
$
PERMIT FEE $/b-UU
,LOT No.
; suaDNLslor�sru�ME rs. ,� s +t+t,sr+g� ;i s,:.,. „v,
PARCEL MAP` �n• �
y y ,PLUMBING'�PERMIT 't �A4RIing:Fee -20:00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other i
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 ❑
Describe Work: Renewal of BPS` 99-0845
R Sidirl3 - Windows — tl=
Gas piping system 1 - 5 outlets 15.00 Y
Building sewer 15.00
Mobile Home JT[GT W @20.00
PERMIT FEE S {
ELECTRICAL PERMIT Filing Fee 20.00
t
800VOR LESS
Main Service A OR LESS 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 Ucpnse
Law for 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
T.? WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty f 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 Lq'5or Code, for the performance of work for which this permit is issued.
My workers' `°compensation insurance carrier and policy number are: I
Carrier
Main Service 200A TO 1000A 46.00
NEW CONST. DWELLING OCCUR SO
OR ADDNS. ( a ACC. BIDS. 3.50FT:
=REOSIDT' MULTI -OUTLET 97,50
POWER APPARATUS
8 SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FIXTURES�0 @ ';00
Ex. Occup. DPuTLEED. RESID.CEA 5.00 -
Temporaiy Service ` 23.00
Mobile Home Facilities 20.00 .
Misc. Wiring • . 23.00
PERMIT FEE,
MECHANICAL PERMIT ' Filing Fee 20.00
Heating s
—Cooling
`
Hood a 6.50
Ventilation .�
t
'
PERMIT FEE $
Policy Number
(The above sections need not be completed if the permit is for work of_a valuation
of one hundred dollars ($100) or less.)
.157kI 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
forthwith comply with those provisions.
X i�f /f A4Date
Signature of Applicants Ownei Contractor ❑ Agent "^
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
x.11
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
COT. TYPE TOTAL FEE $ 76.00
=.A IMP
FLOOD
cDF
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.
_
e
By4V&Date
PERMIT EXPIRES ON
Dete
Receipt No. IV -10f 4 /
I
WHITE-D.D.S.-B. D.. �.cAN RY-A ES OR PINK -INSPECTOR GOLDENROD -APPLICANT
.. - _ . --l" . - ;-�.•;.dr, . 9Z'�:•') r•rs .• ^' : v --r •. -;• c,�r• • ... r: -,•-.--y1' .�-s �„yw,...• . .Y e.•.'s•
1 7,
033=05=2'005
99-0845 BPEMI.•
t BRYAN
, .Charles - t;
x 331- Bo
nite, Oroville'
siding/windows/hvac)'SF t' ;max
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COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County; Center Drive • Oroville, California 95965--• Telephone (530)538-7541 PERMIT NO.
(Rev. APPLICATION AND PERMIT I
v
ASSESSOR PARCEL NUMBER 033--052-W5
ARHM
BUILDINGPERMIT ,`
OWNER CdAnZS BRTA-N
TELEPHONE
743--6075
SO. FT. OCC. BUILDING VALUATION
• OWNERS MAILING ADDRESS 4804 PACIFIC AVE, OLIVEHHURST
CONTRACTOR'S NAME wWM -
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filin Fee
$ 20.00
Permit Fee 7
$72.00
ARCHITECT OR ENGINEERS MAIUNG ADDRESS
Plan Checking Fee
$
BUILDING ADDRESS
331 BONITS OROVItU
Energy Plan Checking Fee
$
}
$
PERMIT FEE
$92-00
.
LOT NO.
SUBDIVISIONS NAME -
PARCE MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
Each as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Unities ❑ Installation ❑ Other ❑
Describe Work: STD1N;—WTi %C-4itAr1
k
Gas piping system 1 - 5 outlets
15.00 15,00
Building sewer
15.00
Mobile Home S G W
@20.00
PERMIT FEE
S 35.00
ELECTRICAL PERMIT
Filing Fee 20.00
l
E00V ORLESS
Main Service 200.0, LESS
A M
23.00 23 .00
LICENSED CONTRACTOR'S DECLARATION '
1 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 Profeisions Code,
and my license is in full force and effect.I
License Class Lic. No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
® I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ 1, 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 0
reason_
Main Service 200. TO
46.00
CCU000A
NEW CONST. DWEWNG OCCUP.
OR ADDNS. a Acc. Bins.
SO
3.5QFT:
NEW CONST.
NO RES D. MULTI -OUTLET `
@7.50
POWER APUS
a sINGLE ovn ETPARATcIR.
Ex. Occu OUTLET OR FDRURES
20 @ 1.00
BAL Q .so
Ex. Occu 7 ours RAID °-a
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00 ,,,,
Misc. Wiring23.00
`+
i - PERMIT FEE
$ b8.00
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate 'of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued. '
❑ 1 have and will maintain workers' compensation Insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
MECHANICAL PERMIT
Filing Fee Q0
Heating
3220.
�� "'
Cooling
Hood
6.50
Ventilation
PERMIT FEE
$ 50.00
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.)
'0 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 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 omplF�, ose provisions:
G/
X�-/c�f � _ Date � �,� �
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 �+ j♦(
TOTAL FEE $
HAZ.
D FEES IMP
FLOOD
CDF
PARCEL
PD
HD
ISSU
t/
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.
�"i`� �?�
�By„ _ _44�&�il ..-D7ate �f �",,)
PERMIT EXPIRES ON
ate
Receipt No. 264-844
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
M
❑ B.I.N. REQUEST FOR INSPECTION Permit No.
��L2l�D
Location:_ R(on lin Oro VL, e
� _ r
• Owne ContractororTenant:
Complaint:,/-• _
> t
PLUMB/MECHj
/EL Q RICY
M.H.I./M.H.U.
PRE-
=orm
-rame/Underfloor
Stucco Lath
Stucco Brown
Fireplace
Bond Beam
Insulation
Rough = �
Top Out
Gas Piping/Test
Temp. Gas
Sewer Piping
Water Piping
Shower Pan
'Roug-h
Temp. Service
Service
Underground
Well Circuit
Light Niche
Corrections
Final
INSPECTION
Housing
Job Status
Permit Renewal
Verity Utilities
OTHER
Nailing
,C-'orrectionsy
Final---/ C
Corrections
Final C
Corrections
Final
r �
y
READY FOR -1 �� AM.
INSPE
INSPEC. ON 1 p,M,
Date: _ Time: Note:
PRE
INSPECTION REPORT
OWNER:�����c� A-�
LOCATION: - )�nn i ,r) ��r� v,Imo_
CONTRACTOR:— –� 'e
PRE-INSPETION FOR: 1 VY!, �, 'ex < nalq+IA /I 4-r) C, v, .
DATE:--!Z--1E 6
A.P. #��-�
ZONING: /R- M
DATE TO INSPECTOR: / PERMIT HISTORY:( ) NONE , ( ) AS FOLLOWS:
BUILDING INSPECTOR'S REPORT
Building Description:
Electric:
Gas:
Commercial/Usage:
Residential/# of Units:
Currently Occupied
Abandoned/Vacant
Yes No Electric currently On Off_
Condition of Electric
Natural Propane None Currently On Off
Obvious Problems:
Sanitation:
Plumbing Working
Well Working Potable Water
Obvious SewageProblems
Comments:
ACTION RECOMMENDED: ISSUE: HOLD
Inspector:
Sketch buildings on reverse and indicate location on property.
(Rev. 12/96)
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541
APPLICATION AND PERMIT
PERMIT NO.
ASS ESSOR PARCEL NUMBER 033-052-005
ZONING ARMH
BUILDING PERMIT
OWNER Charles Bryan
TE 743-6075
S4' Fr. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS 4804 Pacific Ave., Olivehurst, 95961
CONTRACTOR'S NAME Mer
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
CONSTRUCTION LENDER
Lfireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $
20.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Permit Fee 32 Ori inal $
56.00
Plan Checking Fee $
BUILDINGADDRESS 331 Bonite, Oroville
Energy Plan Checking Fee $
S
PERMIT FEE $
—76.00
LOT NO.
SUBDNISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
Each gas water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: Renewal of BP# 99-0845
Siding - Windows - HVAC
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home ISIGI Wl
@20.00
PERMIT FEE $
ELECTRICAL PERMIT I
Fling Fee 20.00
Main Service 000v OR LESS
sow oR LV
23.00
LICENSED CONTRACTOR'S DECLARATION
I 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,
( 9 )
and my license is in full force and effect.
License Class Lic. No.
OWNER -BUILDER DECLARATION
I herebyaffirm under penalty of perjury that I am exempt from the Contractors License
P hY P 1 ry P
Law for the following reason:
EK 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
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
Main Service 200 TO 1000A 46.00NEW
CONST. OWE111NGOCCUP. SO
OR ADONS. s ACC. OCS, 3.5¢Fr:
NCW— coND ' MULTI.OUTLET
NON•REsID. @7.50
POWER APPARATUS
a SINGLE oun.Er CII.
® 1000
Ex. Occup. OUTLET OR FIXTURES RAL .
Ex. Occup. FixEO APPRES. OR
OUTLETS LNS EA 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE _
MECHANICAL PERMIT Fling 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.)
I certify that in the performance of the work for which this permit is issued, I shallTOTAL
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 with those provisions.
X_
X Date
Signature of Applicant - JK 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 S
TYPEXK FEE $ 76.00
locc:CONST.
D. FEE'S IMP
I FLOOD
I COF
PARCEL
PO
HD
ISSUE
This permit is hereby issued under the applicable
of the Butte County Code and/or Resolutions
indicated above for which fees have been
By Date
PERMIT EXPIRES ON
provisions
to do work
paid.
ro
Receipt No.
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
033-05-2-005 99-0845 BPEM y
BRYAN, Charles
331 Bonite, Oroville
ksiding/windows/hvac) SF
033-05-2-005 00-0890
BRYAN, CHARLES
331 BONITA, OROVILLE
RENEWAL OF 99-0845 -
SIDING/WINDOWS/HVAC
y
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 /
(Rev. 12/96) APPLICATION AND PERMIT 0"D
ASSESSOR PARCEL NUMBER 033-052-005
ZONING ARMH
BUILDINGPERMIT
OWNER
Charles Bryan
TELEPHONE
743-6075
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
4804 Pacific Ave., Olivehurst, 95961
CONTRACTOR'S NAME Mer
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
LENDER'S MAIUNG ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $
20.00
Permit Fee 2- Original $
- 56.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS
331 Bonite, Oroville
Energy Plan Checking Fee $
$
PERMIT FEE S
LAT NO.
SUBDNISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
Each gas water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: Renewal of BP# 99-0845
Siding - Windows - HVAC
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home ISI GI W1
@20.00
PERMIT FEE S
ELECTRICAL PERMIT
Fling Fee 20.00
LESS
Main Service zo.A OR LESS
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000 of Division 3 of the Business and Professions Code,
( g )
and my license is in full force and effect.
License Class Lic. No.
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
EK 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
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
Policy Number
(The above sections need not be completed 0 the permit is for work of a valuation
of one hundred dollars ($100) or less.)
XK I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700. of the Labor Code, I shall
fort it co ply with those provisions.
X _ Date �'R 0 _
Signature of Applicant - wner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in heig t.
Main Service 200A TO 1000A 46.00
NEW CONST. DWELLING OCCUR SO
OR ADDNS. ( & ACC. BLDS. 3.5¢FT.
NEW CONS . MULTL•OUTLET
NON-RESID. 97.50
POWER APPARATUS
6 SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FLxTURLS �0 @ 1;00
Ex. Occup. DFlxuTIEETS Aa DRQ
5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring
23.00
PERMIT FEE S
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEt $
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ 76.00
HAZ.
I D. FEES I IMP
I FLOOD
CDF
PARCEL
PD
I HD
ISSUE
This permit is hereby issued under the applicable
of the Butte County Code and/or Resolutions
indicatedabove for which fees have been
B ;DatejReceiptNo.
PERMIT EXPIRES ON
provisions
to do work
paid.
to
�'
WHITE-D.D.S.-B.D. CANARY -A ES OR PINK -INSPECTOR GOLDENROD -APPLICANT
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 perrnit . la
be issued until this verification is received.
1. I personally plan to provide the major labor and materials for construction of -_the
proposed. propertyimprovement : YES[] NO[
Z. I HAVE[] HAVE NOT[ ]signed ari application:for a:bu ding permit for.the
proposed work.:::.:
3. I have contracted with the following "person (firm) to provide, theroposed
construction:
NAME:
ADDRESS:'*-----' . --_ :.:.: :..... _ CITY:
PHONE:'---- _------:._ :CONTRACTOR'S. LICENSE NO:'
4:- I plan"to4-provide• portions 'of this work i -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 folio*&-peisons to
provide the work indicated:
NAME ADDRESS PHONE TYPE OF WORK'`'
SIGNED:
�CPROPERTY OWNER:
// SOCIAL SECURITY NUMBER:
�DATE:T
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.
May 1995 2.26
U , v:.ti
O.B.-1
L'
Nim
Dear Property Owner: `(
An application fora 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 yourseli', 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'- lan to subcontract, -you ---
P
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 ` (mcluding -.. -
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 grid you. are
subject to several obligations including state and federal income tax withholding, federal social security faxes,
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 avers:: 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
Sincerely,
Michael 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.
May 1995 2'27
.r � COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 P MIT NO.
(Rev. 12/96) APPLICATION AND PERMIT 2v tel- J MR9
ASSESSOR PARCEL NUMBER
ZONI033-052-005 ARNG
BUILDING PERMIT
OWNER CHARLES RYAN
TELEPHONE 743-6075
SO. FT. OCC. BUILDING VALUATION
.OWNERS MAILING ADDRESS 4804 PACIFIC AVE; OLIVEHURST g6q(e f
CONTRACTOR'S NAME OWNER
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee 7
$72.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDINGADDRESS
331 BONITE OROVILLE
Energy Plan Checking Fee
$ '
$
PERMIT FEE
$ 92.00
LAT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
1 7.00
Solar or heat pump water heater
1 23.00
Water piping
1.5.00
Each gas water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: SIDING—WINDOWS—HVAC
Gas piping system 1 - 5 outlets
15-00 15.00
Building sewer
15.00
Mobile Home I S I G I W
920.00
PERMIT FEE
$ 35.00
ELECTRICAL PERMIT
Fling Fee 20.00
600VOR LESS
Main Service zo A OR LESS
23.00 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
Lawforthe 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
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
Main Service 200A TO IOOOA
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( 8 ACC. S.
SO
3.5¢FT_
=R.,. MULTI.OUTLET
@7.50
POWER APPAruTI>s
8 SINGLE OUTLET CIR.
Ex. Occu oLmEr OR FIXTURES
20 Q 1.00
BAL Q .ea
Ex. Occup. oirrLEEDTSA Ae�'ID°EA
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE
$ 66.00
MECHANICAL PERMIT
Fling Fee 20.00
Heating SPLIT
Ju. UU
Cooling
Hood
6.50
Ventilation
PERMIT FEE
$ 50.00
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
I 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
f hwithompl ose provisions.
_ L Date -�
Signature of Applicant- ❑ caner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or constructio
of structures over 3 stories in height.
Mobile Home Installation Fee
$
Energy Inspection Fee $
OCC
CONST. TYPE 243.00
TOTAL FEE $
HAZ.
I D. FEES IMP
I FLOOD '[7F_[7
PD
HD
IS U
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for h fees have been paid.
PERMIT EXPIRES ONS/v
Date
Receipt No. 264-844
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
(Rev. 12/96)
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541
APPLICATION AND PERMIT
PERMIT NO.
A°'�"OR°"gCQN1110"' �'_
ION
BUILDING PERMIT
O. FT. OCC. BUILDING VALUATION
jqCFl"C,
-�
CONTRWivows x4a
e
.
CONTRACTOR'S MAUNO ADOM
CON•TAuCTM LENDER
u:NOER'! YAILNG AOORE•s
Fireplace
Total Valuation E
ARCHrtEcr OR EMM"M
LICENSE NO.
Filing Fee S
20.00
ARCWTECT OR ENGINEER? MARINO ADDRES•
Permit Fee $
Plan Checkin Fee $
SUI DNOAWREs� / ,/ /
(// (�(J
Energy Plan Checking Fee $
$
PERMIT FEE $
tDTNO.
SUBINVISIDNaNAYE
°i � YAP
PLUMBING PERMIT Filing Fee
20.00
USEOFSTRUCTURE
S Duplex ❑ Mobilehome ❑ Other
•�CIF'
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 ❑
c
Describe Work:.5(4i YV '- W I ry3-- ffilAtf�_
Gas piping system 1 - 5 outlets 15.00
S
Building sewer 15.00
Moblle Home I S I G IW @20.00
PERMIT FEE S
ELECTRICAL PERMIT Filing Fee
20.00
Main Service So=OA COR 23.00
3
Main Service 200A TO 1000A 46.00
NEW CONST. DWELLM OOcuP. 3.5eSCL
OR ADa+s. a ACC. 81M.
N0IFRESIo.• RANCH FMX @7.50
POWER APPARATUS
a SNOtE OunAT cut
20
EX. Occup. OVTLET OR " nip", 0 so
6AL 0 SO
EX. OCCU MD A"U4 OR
ovnErs Esro. EA 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE S to
MECHANICAL PERMIT Fling Fee 20.00
Heating 30,
Cooling
Hood 8.50
Ventilation
PERMIT FEt S
Mobile Home Installation Fee S
Energy Inspection Fee S
occ
CONST. TYPE TOTAL FEE s
NAZ
0. FEES IMP
11000
1 COF
PARCEL
I PO
ND
BS UE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do
indicated above for which fees have been paid.
By Date
PERMIT EXPIRES ON
(Data)
work
Receipt No.
WHITE•O.O.S.•B.O.. SOR I PINK -INSPECTOR GOLDEN ROO-APPLICANT
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing your signa0ze.
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 tbis
verification is received..
"1. I personally plan to provide the major labor and materials for construction of the proposed
property improvement: YES NO ❑
�•-2• I HAVE X 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;.
XAME:
ADDRESS: CITY:
PHONE: CONTRACTOR'S LICENSE NO.
4. I plan to provide portions of thiswor but I have hired the'followin `
8 person to coordinatq .
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
SIGN PROPERTYOWNER: Alleeek
SOCIAL SECURITY NUMBER:_
DATE: G'�f•—®2
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
Q
I OWNER BUILDER INFORMATION I
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of property.
improvements specified.
For your protection, you should be aware that as "owner -builder" you are the responsible party of jecord 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 folio 'gin tion for your benefit and protection:
♦ If you employ r erwise eng ge any persons other than your immediate family, and the work (including materials
and other cos is 5300 or m re for the entire project, and such persons are not licensed as contractors or
subcontractors, n you may be an employer.
♦ If you are an empl er, you m t register with the State and Federal Governments as an employer and you -are
subject to several ob tions_ cluding state. and. federal income tax withholding, federal social security .tax es,
workers compensation insurance, disability insurance costs, and unemployment compensation contributions.; .
♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious
with respect to worker's compensation insurance. "
♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and,
if you wish, the U.S. Small Business Administration). For more specific information about your obligations under
State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building
permit, erroneously implying that the property owner is providing his or her own labor and rnaterial personally. Building
permits are not required to be signed by property owners unless they are performing their own work personally.
Information about licensed contrac9rs may be obtained by contracting the Contractors State License Board in your
community or at 1020 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" bn 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.
41rely,
'l C. Vi iia, CB.O.
r, Building Inspection
NOTE. This Owner-Builder,lnformation is required by Section 19830 of the California Health and Safety Coda
OVER
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❑ B.I.N. _ RE T FOR
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Locatio
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Owner.
Complaint:
:IN Permit No.'
PiIIAY114
ContractororTenant:
BLDG.
PLUMB/MECH
ELECTRIC
M.H.I./M.H.U.
PRE -
Form
Rough
Rough
INSPECTION
Frame/Underfloor
Top Out
Temp. Service
Corrections
Ho '
Stucco Lath
Stucco Brown
Gas Piping/Test
Temp. Gas
Service
Undepgrou d
Final
o
ermit Renewal
Fireplace`
Bond Bea
tion _\
Insulation �/U l
Nailing
Se er Piping
IP'
a
ell Circuit
Verify Utilities
TYIER
l
Corrections
Corre'on
rrec .ons
READY FOR A A�
INSPEC. ON 19_ P.M.
Final
Final
Final
Date: _, Time: __ Note:
(Rev. 12/96)
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER 033-052-005
ZONING ARMH
BUILDINGPERMIT
OWNER Charles Bryan
TE 743-6075
SO. FT. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS
4804 Pacific Ave., Olivehurst, 95961
CONTRACTORS NAME Owner
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDEA
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
FilingFee
20.00
ARCHITECT OR ENGINEER'S MAILING ADDRESS '
O�
Permit Fee la 1 inal $
Original
56.00
Plan Checking Fee $
BUILDING ADDRESS
331 Bonite, Oroville
Energy Plan Checking Fee $
$
PERMIT FEE t
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
Each as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: Renewal of BP# 99-0845
Siding - Windows - HVAC
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
@20.00
PERMIT FEE $
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service 60 .0.. OR LESS
. oR . s
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class Lic. No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
IK 1, 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
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'—Cooling
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
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.)
XK 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 it 1 should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions. Xy
_
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.
Main Service Zoon TO 1000A J 46.00
NEW CONST. DY;"NG OCCUP. so
DRADONs. a,, gips• 3.5¢x;
quip ' MULTI.OUTI Ei �a 7.50
POWER APPARATUS
8 SWGLE OUTLET C10.
Ex. Occup. OUTLET ORFIXTURES BAS@'.w
Ex. Occu , oars RISES o.OEA 1 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE $
MECHANICAL PERMIT Fling Fee 20.00
Heating
Hood 6.50
Ventilation
PERMIT FEP $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 76.00
HAz
D FEEs imp
ROOD
CDF
PARCEL
PD
I HD
I ISSUE
This permit is hereby issued under the applicable
of the Butte County Code and/or Resolutions
indicated above for which fees have been
By Date
PERMIT EXPIRES ON
(Date)
provisions
to do work
paid.
Receipt No.
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT