HomeMy WebLinkAbout033-067-003BO%-100% D33-W7 - 00`3
260 Fernwood A*- oroviUe
Demo Unoft Sirudot(Raus-ocol)
owft'di ,,mit, (uconn4d)
CoNTR: mlltr ConskviA6on co .
510/ / / / �/,
'� ��� --- Oma-✓ .cv�o� owe
OWNER:
't
PRE -INSPECTION
- v
LOCATION: 2-CoO
sh�r�
DATE q 1 O
A.P. #
CONTRACTOR: ZONING
PRE -INSPECTION FOR:
' j
DATE TO INSPECTOR hkon Ll1qj/e?
PERMIT HISTORY: F1 NONE Q AS FOLLOWS:
TYPE OF OCCUPANCY
FIELD - INFORMATION
BUILDING USAGE: l�✓� S S�
TENNANT:
OCCUPIED HAS ELECTRIC F] HAS GAS IAS SANITATION FACILITIES
HEATED -COOLED // PERSON CONTACTED /
OTHER COMMENTS:
ACTION RECOMMENDED: Val
ISSUE � HOLD FOR In "- 'O cy �r�o1
OTHER: -� ��tic 2 Z L S �.y r -S o %2 /iyt ci ; / //La 2a( i to rte i. i �a Joy ✓;
BY
DATE /1 �9
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NC
(Rev. 12/96) APPLICATION AND PERMIT
A°°a°DRP'I"`d"�(D�,
zomm
BUILDING PERMIT
'*—
w
TELOIgNe
SO. FT OCC. BUILDING VALUATION
OWNRI wane A60RM
r -n
CONTRACTOR? NAME
TELEPHONE
CONTRACTOR? MALUM ADOMS
CONSTft=T N LEMER
LENDER'S MAMM ADDRESS
Fireplace
Total Valuation Is
AAcW EcT OR Lwwal 1
tx:EHSE NO.
Erin Fee
$
20.00
ARCNTEcr OR 09MEM S WAJNo ADDRESS
Permit Fee
S
.-2o oo
Plan Checkin Fee $
SUtDM ADDRESS
Energy Plan Checking Fee
S
PERMIT FEE i
WT H&
PARcn MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF 1hDuplex O Mobilehome O Other
°�
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
Each na water heater or vent
15.00
TYPE OF WORK
New O Addition ❑ Remodel O UtIWes O Installation ❑
Describe Work:
Other
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
Q?20.00
7-1
PERMIT FEE $
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service OR rEs°
sow oR LEss
23.00 ?a O Q
Main Service low TO 1000A 48.00
NtW CONST• O aim op:UP. SO
OR ADONS. a ACC. d.Do. 3.SC FT.
NON.REMM MUITI.OVTIET (P7.50
POWER APPAAATUe
a 9SIOLE OIrRtT p0.
Ex. Occup. ounET oR mrruAm ao 0 I.00
SAL a .50
EX. OCCU %0 AMP S. OR
OUTLETS ESIO. EA 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wirino 23.00
PERMIT FEE _ 604016D
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 8.50
Ventilation
PERMIT FEt? S
Mobile Home Installation Fee S
Energy Inspection Fee S
occ
CONST. TYPE TOTAL FEES �U
HAZ.
0. FEES IMO
I RGOO
I COO'
PARCEL
I Po No I ISSIA
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
W14YMoOD
oo
COUNTY OF BUTTE
Oroville, California
GENERAL CLAIM
CLAIMANT:
ADDRESS:
CITY & STATE:
DATE OF CLAIM: IMPORTANT.•
SEE INSTRUCTIONS
SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES ON REVERSE smF
DATE
DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY)
AMOUNT
1
TOTAL
'
1, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is true
and correct as stated. �---�
Dated this day of , 19_, at , C( alif. "
-T Sign e o Claimant
I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or delivered and
that there is a Budget Appropriation [ I or Specific Board Approval [ I (Check one) for the same.
Dated this day of , 19_, at Calif.
Department Head or Authorized Deputy
Dept. Code Exp. Code PAYABLE FROM FUND
Dept. Code Exp. Code PAYABLE FROM FUND
Dept Code Exp. Code PAYABLE FROM FUND
DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY
DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSS AMT.
INSTRUCTIONS TO CLAIMANTS
All claims against the county must be itemized, giving dates and character of service rendered or work
performed, quantities, description and unit prices of articles furnished or delivered.
Claims must be certified by the claimant and submitted to the Department head for approval. Upon
approval the Department head will forward claim to County Auditor for payment procedure. Do not file
with the County Auditor first.
Claims should be presented to officials for approval immediately upon completion of services requested
or material ordered.
Compliance with above will expedite payment of claim, failure to do so may delay payment
considerably.
November 3, 1998
Raymond J. Owens
260 Fernwo
Oroville, CA 95.965
Dear Mr. Owens:
Co,
L A N D O F NATURAL WEALTH AND 'BEAUTY
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965-3397
TELEPHONE: (530) 538-7541
FAX: (530) 538-2140
RE: Request for Refund
A.P. #033-067-003
Your request for refund was received by this office. No refund is due, because of the fact that
you paid for the work that was already done by this office.
Should you have any questions concerning this matter, please contact our office at (530)538-
7541.
Your very truly,
.1
MjcMic ael C. eira, C.B.O.
M ager, Building Inspection
MCV:aam
(Rev. 12/96)
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541��`
APPLICATION ANDPERMIT
2_69t O -
ASSESSOR PARCEL NUMBER 033-067-003
ZONING
BUILDING PERMIT
OWNER OWENS, RAYMOND J.
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
.OWNER'S2�6ffADNWOOD, OROVILLE
CONTRACTOAH,7f KW
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $
20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS
260 FERNWOOD
Energy Plan Checking Fee $
OROVILLE
$
PERMIT FEE $
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF gI 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: RETAG ELECT.
Gas piping stem 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
H�
@20.00
PERMIT FEE S
ELECTRICAL PERMIT
Filing Fee 20.00
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,
and my license is in full force and effect.POWER
License Class LIC. NO.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law fo the following reason:
— V ', 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 TO
46.00
NEW CONST. DWEWNG OCCUCUP.
EE
OR ADDNS. ( 6 ACC. BLDS.
SO
3.5QFT.
�µpOIp MULTI.OUTLET
@7,50
APPARATUS
S SINGLE OUTLET CR.
Ex. Occup. OUTLET OR FDRUREs
200 1'00
BAL o .so
Ex. Occup. GimFEDTs A�SI6.1 EA
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
P RE INSPECTION
23.00
PERMIT FEE $
66.00
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
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
:.f one hundred dollars ($100) or less.)
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.
�irnFi✓✓� Date �_
X ��
Signatur of Applican wner ❑ Contractor ❑ Ageht
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
OCC
CONST. TYPE
TOTAL FEE $ AA no
HAZ.
D. FEES IMP
FLooD
CDF
PARCEL I
PD
HD
sSUE
This permit is hereby issued under the applicable provisions
in the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
By Date
PERMIT EXPIRES ON
eta
Receipt No. 250516
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
R
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541PERMIT o.
(Rev. 12/96) A.,, APPLICATION AND PERMIT Q$_
ASSESSOR PARCEL NUMBER 033-067-003
ZONIN°
BUILDINGPERMIT
OWNER OWENS,�, RAYMOND J.
TELEPHONE
, SQ. FT. OCC. BUILDING VALUATION
OWNERSIv "°i`i:NWOOD, OROVILLE
CONTRACTOA18,iW
TELEPHONE
CONTRACTTTIOR-��511\\ MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAIUNG ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
UCENSE No.
Filin Fee $
20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS 260 FERNWOOD
Energy Plan Checking Fee $
$
OROVILLE
PERMIT FEE S
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF Ig 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 O Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: RETAG ELECT. - . `
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home Is I G1 w
@20.00
PERMIT FEE S
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service .AOR"s.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.POWER
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:
— V1, 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. owELUNG OCCUP.
OR ADDNS. ( DIE= BLDS.
SO
3.50 Ft.
NEWT.
N RE ID. RANCHO CIRCUITS
CUIT
97.50
APPARATUS
8 SINGLE OUTLET C1 R.
Ex. Occu OUTLET OR FIXTURES 4
20 Q t. 00
BAL. @ .w50
Ex. Occup. GuT,EF°Ts(RRM.Io.C.R,
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PRE INSPECTION
PERMIT FEE $
66,00
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:
CarrierPERMIT
,
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
FEt $
Policy Number A
(rhe above sections,need not be completed if the permit is for work of a valuation
. bof one hundred dollars ($100) or less.)
/l certify that in the performance of th�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.
0 /r 9 �
X 4�� Date / !
Signatur of Applicadf - gwowner ❑ 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 Is
Energy Inspection Fee is
Occ
CONST. TYPE
TOTAL FEE $
HAZ.
D. FEES IMP
I FLOOD
I COF
PARCEL PD
HD
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
By Date
PERMIT EXPIRES ON
ate
Receipt No. 2770,976
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
�►.3we..�sr- �anN+..r. - ��.+,..-..e...� .'., , w.:�•iaxx+�v.�. �...w.:_ve-,. v�y.,, ..��.....,.-w^1,e�.ttx.���a.g.v-.,.. i .. ��:r-.�.,> up.�w.M Fa..--- .r.» .. _�,r-7
033-067-003 a #98 2055'? ax.
,a...OWENS, RAYMOND .'� ''• ; ,r . ��_,''' .
'260 `FERNWQOD �r ft7 r'
' ,OWNER OROVILLE`!.
1'
RETAG :ELECT:
1
. COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT_JV0.
(Rev. 12/96) APPLICATION AND PERMIT qi?- ms's GGA
ASSESSOR PARCEL NUMBER 033-067-003
ZONING
BUILDING PERMIT
OWNER (1WENS, RAYMOND T•
JOROVIL
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNERsvn„,-,,.,,,aG "M, VsaWOOD��,, M
CONiRACT^g�.*
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAIUNG ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDINGADDRESS 260 FERNWOOD
Energy Plan Checking Fee
$
$
OROVIUE
PERMIT FEE
$
LAT NO.
SUBDNISION'S MIME
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 gas water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Udlifies ❑ Installation ❑ Other ❑
Describe Work: RETAG E=.
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I G I W
@20.00
PERMIT FEE
S
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service A OR LESS
23.00200A • JIL
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:
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 if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
..`] fl 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 1 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 �, rr , — .� i w : y _ Datl C% 1 %'
Signature of Applicant'- P*Owneir ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 60” deep and demolition or construction
of structures over 3 stories in height.
Main Service TO
46.00
NEW CONST. DWEWCC
WEE NG OUP. SO
OR ADONS. ( a ACC. BLAS. 3.5Qs,
rNON.FESID. MULTI -011.1. @7,50
OWER APPARATUS
8 POW
GLE 011.11 CIR.
Ex. Occup. OUTLET OR FIXTURES @''00
BAL .00 20
Ex. Occu . oFlxul�rs AES )LNS E 5.00
Temporary Service 23.00
Mobile Home Facilities
20.00
Misc. Wiring 23.00
PRP 1N5 L
PERMIT FEE $ 66 00
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $
HAZ.
p. FEES IMP
FLOOD
I COF
PARCEL PD
HD
ISSUE
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
By
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
Date
Date
Receipt No. ..,v� v 1
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
h
a, - 4-0 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Croville, California 95965 • Telephone (530) 538-7541 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT ' ?0`�, t_
ASSESSOR PARCEL NUMBER 033,,,*7—W3
w�wJJ.-'vvV
ZONING
BUILDING PERMIT
OWNER AY -USS PAYM
�JjDt
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNERS 29&,W Dkfe% OROVILU
CONTRAC� R`b AME
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAIUNG ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Fee
$ 20.00
—Filing
Permit Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDING ADDRESS
200 FUND
Energy Plan Checking Fee
$
$
OWV=
PERMIT FEE
$
LAT NO.
SUBDNIS IONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF [11 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: RnAG MJ='
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I G I W
920.00
PERMIT FEE
S
ELECTRICAL PERMIT
Fling Fee 2,0.00
800VOR LESS
Main Service 200A 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.41N..WER
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:
.. ❑ P 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 aelf-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 if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
.. ❑ 1 certify that in the performance of the work for which this Dermit is issued, I shall
' not employ an person in an manner so as to become subject to workers'
p y Y P Y �
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of ie Labor Code, I shall
forthwith comply with those provisions.
X Date �.� r ./
Signature of Applicant - 'Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and dersolition or construction
of structures over 3 stories in height.
Main Service 200A To 1000A
46.00
NEW CONST. DWELLING OCCUP. SO
OR ADDNS. ( 8 ACC. S.3.5¢FT_
. LTI-OUTLET @7,50
=REOSIUTMU
APPARATUS
OUTLET C1 R.
OUTLET OR FIXTURES 20 Q 1.00
Ex. Occup.BOL @ .50
Ex. Occup. ourlEEis a IESIEs 6.DE/L
5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring
23.00
PRE INSPEiMOK 23.00
PERMIT FEE $ 66.00
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE S
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 6601W
HAZ.
I D. FEES IMP
I FLOOD
CDF
PARCEL p0
HD
ISSUE
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
By
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
Date
Date
Receipt No. �vV
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
033-067-003 #98-205 5
OWENS, RAYMOND OROVILLE'
260 FERNWOOD
OWNER
RETAG ELECT.
033-067-003 #98-2055 r` '
OWENS, RAYMOND
260 FERNWOOD , OROVILLE
OWNER
III-- RETAG ELECT. �"
COUNTY OF BUTTE
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING DIVISION
NOTICE
Post this job card In a safe, conspicuous place. Do
not remove until all required inspections are made and
bu,itfit 'lo .eneare d rov oocuntncy. `Placa must oe
av,:i7r1033.067`--0O3to. 498-2055
OWENS ;" RAYMOND
A. P. N 3,,-2 60 KFERNWOOD r.9 ..OROV1L-L-E 4+- ►
Own'e OWNER,
• f
RETAG' ELECT.:,
Contras..-- -- _ - --- —
Permit No. Expires
PERMITTEE MUST CALL
FOR INSPECTIONS
INSPECTION I DATE I INSPECTOR
Piers
Conduit
Pre-Gunite
Underfloor Plumbing
Underfloor Electrical
Underfloor Mechanical
Underfloor Framing
Slab
Sewer Service
Water Service
Pool Final
Plumbing Final
Electrical Final
Mechanical Final
Buildinq or M.H. Final
DO NOT OCCUPY UNTIL
ALL THE ABOVE IS SIGNED
AND THE BUILDING OR MOBILE HOME
IS APPROVED FOR OCCUPANCY
.................
>Ad .e yes ............................In. n........4..Hr...ls :_<<>
>.............. _.................... _....... _.....................
Oroville - 7 Count Center Drive 538-7541 538-7636
Chico - 411 Main Street 891.2751 891-2834
Revised 7/94
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541a&`2p
(Rev.12/96) APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER C) 2 -5
J
zOwNo
BUILDINGPERMIT
OWNER .,� ^ �"
o
TELEPHONE
8O. Fr, OCC. BUILDING VALUATION
. OWNERS MAIUNO =b
CONTRACTOR'S NAME /(gyp
vW
TELEPHONE
CONTRACTORS MAiJNO ADDRESS
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $
20.00
ARCHITECT OR ENGINEERS MAJUNG ADDRESS
Permit Fee $
Plan Checkin Fee $
BULDINGADDRESs '2 (� ^ ,� �
Energy Plan Checking Fee $
$
- PERMIT FEE $
LOT NO.
SUBDNBIONSNAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
--
SF Duplex ❑ Mobilehome ❑ Other
sPECFv
Each Trap
7.00
Solar or heat um 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: ��Q �L
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I G1
(920.00
PERMIT FEE $
ELECTRICAL PERMIT I-Filing'Feel
20.00
Main Service p°av� oA LESS
23.00 2-P7,O
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:
❑ 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'
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.)
❑ 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 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 Date
Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 50' deep and demolition or construction
of structures over 3 stories in height.
Main Service 200A TO 1000" 46.00
NEW CONS,
OR ADDNS.T ( DWELLING
� BLDS P' 3.50FT.
NEW CON'
NC.E.SID. ' ANCHOtmtT @7,50
POWER APPARATUS
8 SINGLE OUTLET At
Ex. Occup. OUTLET ORNTITURES RpLa .0
A
'Ex. Occup. � ES,,� .) 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wirin_q 23.00
z�
PERMIT FEE $ (o(p.0p .
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEt $
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ �j�j,rOQ
,,,�
D FEES IMP
FLOODcDF
PARCEL
PD
HD
NssuE
This permit is hereby issued under the applicable
of the Butte County Code and/or Resolutions
indicated above for which fees have been
By Data
PERMIT EXPIRES ON
provisions
to do work
paid.
re
Receipt No. 2_1 550 k
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing your signature.
Please complete and return this information at your earliest opportunity to avoid unnecessary delay
in processing and issuing your building permit. No building permit will be issued until this
verification is received.
1. I personally plan to provide the major labor and materials for construction of the proposed
property improvement: YES NO ❑
2. 1 HAVE 0-` 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:
N..Av1E:
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:
NAIME:
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
SIGNED:
PROPERTYOWNER:
__99,�_/��
SOCIAL SECURITY NUMBER:
DATE:_._'
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
• ;
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 oflecord on such
a permit. Building permits are not required to be sighed by property owners unless they are personally perforniitig 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 5300 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 Governments as an employer and you are
subject to several obligations including state and.federal income tax. withholding, federal social security,taxes,x
workers compensation insurance, disability insurance costs, and unemployment cpmpensation 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. kl "r
♦ 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.
7
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 undeiliuiited
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 material personally. Building
permits are not required to be signed by property owners unless they are performing their own work personally.,
Information about licensed contrac!prs 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.
Irely,
el C. Vi ira, C.B.O.
ger, Building Inspection
NOTE. This Owner-Builder.Information is required by Section 19830 of the California Health and Safety Code:
OVER
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