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Home My WebLink About033-200-003COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER SEE ATTACHED ZONING BUILDING PERMIT OWNER COMCAST COMMUNICATIONS TELEPHONE SO. FT. OCC. BUILDING VALUATION . OWNERS MAILING ADDRESS 4350 PELL DR SACRAMENTO CA 95838 CONTRACTOR'S NAME WESTCOAST COMMUNICATIONS343-2473 TELEPHONE CONTRACTORS MAILING ADDRESS 140 MEYERS ST CHICO CA 95828 CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADD y OROVILLE LOCATIONS (SEE ATTACHED) 11 Energy Plan Checking Fee $ $ PERMIT FEE $ 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 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: PLACE CATV POWER SUPPLY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI GI W @20.00 PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.00 Main Service 200A OR LESS 1.2 23.00 276.0 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 ' in fu1 f rce and effect. a A License Class Lic. E 111RRL YYYI f/ (oS 7 lip OWNER -BUILDER DECLARATION 1 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 Main Service 200A TO 1000A 46.00 NEW CONST. DWELLINGOCCUP. OR ADDNS. ( 8 ACC. BLDS. s0 3.50FT. NO" Np�ID." MULTI -OUTLET 97,50 POWER APPARATUS 3 SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES BAL Q .50 Ex. Occup. owners aE�ssID.DEw 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 29 .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 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' corAipensation provisions of section 3700 of the Labor Code, I shall forthwit o ply w ovisions. tl _ i 7 — h 2 X Date fy`J Signature of Applicaht - ❑ Owner XContractor ❑Agent An OSHA permit is required for excavations over 5'0" 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 FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 296.00 HOZ. D. FEES IMP I FLOOD I COF PARCEL I PD HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By U41 Ly EXPIRES ON I the applicable provisions Resolutions to do work been paid. ate Ie Receipt No. -yrPERMIT WHITE-D.D.S.-B.D. CANARY -ASSESSOR YPINK-INSPECTOR GOLDENROD -APPLICANT ®®®®® i� •. ®MF® AW AMWAMrAMrAW ANW N VCI Telcom, Inc. A. Subsidiary of Quanta Services, Inc. July 29, 2003 Butte County Department of Public Works 7 Court Center Drive Oroville, CA 95965 Re: Authorized Signer To Whom It May .Concern: Please accept this letter as a request to designate project manager, Bill Green of VCI TELCOM, INC. d/b/a Delaware VCI Telcom, Inc. as an authorized signer for all permits and forms pertaining to VCI's business in all areas of Butte County. Should you need further information or clarification, please feel free to contact my office at (909) 949-1350 extension 1.17. Thank you, 1921 W. 11th Street, Upland, CA 91786 (909) 946-0905 - Fax (909) 946-0924 California State License 765716 AOORD: DATE NiouDo/YYI _ 07/29/03 PRODUCER JOHN L. VYORTHAM &SON, L.L.P. TEEN¢ CERTIFICATE IS ISSUED AS A MATTER OF WVRMATWN ONLY AND CONFERS NO RKWS UPON THE CERTIFICATE HOLDER. TINS CUITIRCATE DOES NOT AMEND, EXTEND OR P.O. BOX 1388 ALTER IME COVERAGE AFFORD® BY THE POLCIB6 SOW. HOUSTON, TEXAS 77251-1388 C+ONIPANIES AFFORDIAN3 COVERAGE COUPANY OTI555-00090-2004A-000492 SM!/Em 1/1 A OLD REPUBLIC IUMMICE COMAMY suallow VCI TELCON, INC. aupANT B AMOC. ELECTRIC i GAS INS. SERVICES LIMITED 1921 WEST 11TH. STREET COMPANY mum, CA 917x6 C COMPAW D THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE LISTED BMW HAVE SM ISSUED TO THE NSURED HAMM AOM FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY AE13UMAE1NT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUA49UT WITH RESPECT TO WHICH THIS CERTIFICATE I&AV BE ISSIOR MAY PERTAK THE INSURANCE AFFORDED BY THE POUCIES DI?9CRBED HEREIN B SUBJECT TO ALL THE TERMS, OCCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEER fIMCED BY PAID C3ANAS. t TR TYNE OF INSURANCE POLICY MJM�i om QTS A OHBGLIIANUTY NRY555734 03101faS 08/01/2005 GEN MALAGA REM -1E N 1 750 000E PRODUCTS -NxMP/OPAGO • i 750 000• x COMMS CM43 NERALU AllflU Y CLARAS MADE Eil occuR SELF-111IRM RETENTION 5250,000 PERSONAL a ADV NMIRY • 750,0000 EACH OCCURRENCE • 750 COD* owT�rs i CONTAACTONS FNROT FSE DAMAGE WM air awl N 750 000° OF SELF-INSUR121) MED OP VWY one P 1 • EXCUAED RETENTION A AITONOMUAINUFY ANY AM IYTB18597 03/01/1003 08/01/2005 SSNGtP LIMIT • 1,000,000 BO Ps� , X ALL OWNED AUTOS ® SCHEMA AUTOS BO , X tow AUTOS X NO"WNEO AUTOS FROPETIY DAMAGE M GARAGE LIASMITY AUTO ONLY - FA ACCIDENT ANY AUTO OTHER THAN Aura ONLY: MW=M;x::. EACH ACCIDENT • AGGREGATE S Hcas9 UANUTY CLAIMS MADE RETRD DATE 08/01/2002 EACH OCCURRENCE N S 000 000 AGBnBOATE M S.000.000 B Ip LANTIRIM Rx X20'MU03 04/01/•1003 OV01/2004 • oTHrILTHawui aiNEUA Pow A wommCONPeI:FAI AND MMOSS54 00 03/01/2003 08/01/2005 X TSTATUrORYLIMM EACH ACCIDENT • 1,000,000 EMMOVEW UAllum DISEASE - POLICY LAW • 1 000 000 THE PROPRIETOR/ x NCL DISEASE . EACH E,IPLAYEE 111 1.000.0010 O ARE: Dom of oN tT6iN SEE ATTACHED SHMD ANY OF THE AWN DECFMIW POLICES SE CAICLILEO IIEFM THE EU MVM DATE TI®EDP. THE LSS NIG CONPANV naa DOXXwR TO MAL BUTTE COUNTY 30 OILY' HLSmE1 NOTICE To THE CERTLPCINE HIOLOM Num 1+0 THE LEFT, DEPT. OF PUBLIC WMKS SUT FARIIRE TO MwL SUM NOTICE SHOAL INOSE NO OSLIOATHON OR UANNTT 7 COUNT CENTER CR. OF MY KM INIONTHE COMPANY. ITS OROVILLE. CA 95M /�OR/R�EfRESEITATMM- o/ra ot. VVo�rnz � xom. . ,f. ATTACHMENT TO CERTIFICATE OF INSURANCE NO. 071555-OOM-2004A-00%92 SMM/ECB 1/1 CERTIFICATE HOLDER: INSURED - BUTTE COUNTY VCI TELCON, INC. GENERAL LIABILITY POLICY INCLUDES CERTIFICATE HOLDER AS AN ADDITIONAL INSURED WHEN REQUIRED BY WRITTEN CONTRACT BUT ONLY AS RESPECTS LIABILITY ARISING OUT OF MANED INSUREDdS WORK FOR ADDITIONAL INSURED. AUTO LIABILITY POLICY INCLUDES CERTIFICATE HOLDER AS AN ADDITIONAL INSURED WHEN REQUIRED BY WRITTEN CONTRACT. V COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION - 7 County Center Drive o Oroville, California 95965 • Telephone (530) 538-7541PERMIT NO. (Rev. 12/96) 4bAPPLO C/rs1TION AND PERMIT ASSESSOR PARCELNUMBER EE ATTACHED ZONING BUILDING PERMIT OWNER TrATIONS TELEPHONE Se. Fr. OCC. BUILDING VALUATION . OWNERS MAILING ADDRESS CA 95838 CONTRACTOR'S NAME WESTCOAST CATIONS CI TELEPHONE 343-2473 �l^ �' $ $ $ $ $ $ 9(p $ ® CONTRACTORS MAWNG ADDRESS 95928 NEW CONST. DYVEIUNG oocUP. 3.5¢x. a Ace. a= CONSTRUCTION LENDER POWER APPARATLS b SINGLE OIlRET d0. Fireplace LENDER'S MAILING ADDRESS Total Valuation '$ ARCHITECT OR ENGINEER LICENSE NO. $ 20.00 'Pilin Fee Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS _ - - Plan Checking Fee $ BUILDING ADORESS r �k.o Energy Plan Checking Fee $ $ PERMIT FEE S LOT NO. SUBDIVISIONS 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 13 Addition 13Remodel❑ Utilities 11Installatio ❑ Other ❑ Describe Work: l: CATV/ - Gas i in m 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S J G I W I @20.00 ISSUE PERMIT FEE S ELECTRICAL. PERMIT Firing Fee 20.00 Main Service ,n i oDRR 29.00 .0 _ PERMIT: FEE PAID SRA SHERIFF OTHER 0 AMOUNT RECEIVED DATE RECEIVED �l^ �' $ $ $ $ $ $ 9(p $ ® Main Service -zA To IMA 46.00 NEW CONST. DYVEIUNG oocUP. 3.5¢x. a Ace. a= NO ESLDONS. CONST. MUM-Ouru r @7.50 ND�RE$m. D POWER APPARATLS b SINGLE OIlRET d0. m @ t.50 Ex. Occup. OVnEr OR FIXTURES EAL FTxm APPLNS. oA 5.00 Ex. Occup. olmETs Esro. Ea Temporary Service 23.00 Moblie Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S oZ .00 MECHANICAL PERMIT Firing Fee 20.00 Heating Coots Hood 6.50 Ventilation PERMIT FEt S Mobile Home Installation Fee $ Energy Inspection Fee $ COD CONST'TYPE TOTAL FEE $ HAZ 0. FEES LMP FIDOD COF PARCB P 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