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Home My WebLink About035-200-007AP 35-20-7 Douglas Anthony ;p/ao /i% SW Corner Myers & fersan—• ,Oro. Permit 4922-8 ii./, ' ELEC. < GAS SUP ST Q. COMPACTION ST REQ. I J �E I L COUNTY OF BUTTE - DEP✓��ARTNtyNT OF PUBLIC WORKS ,7 County Center Drive - Oroville, CGliforni 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT N0. A OR ARCEL NUMBER ZOPIN"G -- �- ��C / '" BUILDING PERMIT OWNER (1 L�S '7.QAJl/ `WI �� I��7/ .SO. FT. OCC. BUILDING VALUATION � OWNER',lAILINGr'A7RESS S- 4M v v{.�f..-•Y CONTRAC T. O R''JJ//B,(�r//N//AM �ll///� �% I �- TELEPHONE ' CON-TRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER UNKNOWN Fireplace Valuation $ LENDER'S MAILINGADDRESSTotal Permit Fee $ ARCHITECT OR ENGINEER - 41116"ARCHITECT LICENSE NO. Plan Checking Fee ' $ ` Penalty $ OR ENGINEER'S MAILING ADDRESS Permit fee $ G A DR SS coRver—) CjU� /�S XfMe-S PLUMBING PERMIT Filing Fee /,000 FBUL5DI ® ' `5/ Each Trap 2.00 Repair drainage or vent piping 2.00 Water piping 70m LOT NO. SUBDIVISION NAMEPARCEL MAP Each qas water heater or vent 2.00 Gas piping system 1 - 5 outlets ,Q USE OF STRUCTURE SF ❑ Duplex❑ MobilehomeaJo`-6ther SPECIFY Building sewer Lawn sprinkler system 2.00 TYPE OF WORK New❑ Addition Remodel❑ Utilities nstallation❑ Other E:1 Describe work: — Permit Fee Contractor ELECTRICAL PERMIT Filing Fee 1000 Main service 100 AMP OR00V OR LESS5.00 Main service EA. ADD -L. 100 AMP 2.50 5-0 NEW OR ADDNST ( DWEACCLBLDGLING OCCUP.&) 2¢sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEWCONSTNON. RESID RI. BRANCHCIRCTITS 2.50 ea NEw CONSTR POWER APPARATUS &) NON.RESID, (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 50@� BAL@1 FIXED APPLNS. OR Ex. -Occup.( 0 UTLETS (RESID,) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 _00 Misc. Wiring 6.25 Permit Fee $ 03Z-90 Contractor WORKMEN'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a•Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 3.00 Heating Cooling Hood 2.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue agains iid County in cousequence of the granting of this permit. XDate -�i = ft: 7— Signature o pplicont — Owner ractor ❑ Agent An OSHA rmit is required for excavati s over 5'0" deep and demolition or construct- ion of structures over 3 s ories in height. Mobile Home Installation Fee $ Land Development Fee $ TOTAL PERMIT FEE $ OCCUP, GROUP I TYPE of CONST. I JP:rLJLPD ND 1550E This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC BY PERMIT EXPIRES Date the applicable provi-" resolutions to do fees have been paid. WORKS Date Receipt No. 3690 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE — DEPARTMI NT OF PI BLIC WORKS — BUILDING DIVISION 1 7 County Center Drive — 0roville, AiiYo'-�o ,rriia 95965 — Telephone 534-4541 PERMIT APPLICATION DATA SHEET Permit No. OWNER D006 AS ACJ_ 'PQ1V A.P. No. OE5- 2®r-% Proposed Building Use /lil. /,i. UT/[._. / Permit fee based upon Complete Contract Price �PW Valuation (plain) Building Inspector Date Ar7 e At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: I DATE RECEIVED APPROVED 1.. 'All items have been submitted................................................................... L 2. Plot plans in duplicat. tripflcate.............................................................. 3. Complete plans in duplicate/triplicate................................................... 4. Complete engineered plans and calcs..................................................... 5. Plans with Energy Design Compliance Statement ............................ 6. State Energy Forms No. .................... 7. Statement of Intent for Non -Heated & AC Buildings ................... 8. Fees of $.................................................. Letter of signature authorization.... ......................................... Sanitation approval from U� ljeaIth-Kept-- d' kJ 11. Planning approval for 12. Certificate of"rk��ie 's Compensation Insurance x'13. Co Hca o.rKL�� e ��mation (no., name style, classification) ............................. . 14. Improvements may be required. Contact Land 1 Development Section of Dept..Public Works (see addressbelow)................................................................................................. 15. Pre -inspection for required. Pre-inspec. request to 16. Other bldg.inspector (date) When yod'issue the per, process as follows: Mail to owner Mail to contractor. �elephone 6_?mit- '7 an Id _,' r pickup at Ac -(Z office. Deliver w/inspection. Other Applicant _ � . n 1' 15;1, -)Date - a , Copy of plans sent Health Dept., Fire Dept., Other Date- During ate,During the plan checking process, the following data must be submitted prior to permit issuance: if (For required items not checked above at time of acati ircle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone Mail Other By Date Plans checked by Date Plans approved by Date OTHER: Copy/DPW 1 , 1 Telephone { 533-2000 North Burbank Public Utility District 1960 Elgin Street OROVILLE, CALIFORNIA 95965 DISTRICT APPROVAL AND' 233=80 VERIFICATION OF INSPECTION BUILDING SEWERS This verification form must be submitted to the Butte County Department of `Public Works - Building Department prior to issuance of a building or occupancy permit, whichever is applicable. Prior to final approval by Butte County of a Building or an Occupancy Permit, a copy of this verification form, signed off by North Burbank Public Utility District, must be submitted to Butte County. Applicant: Applicant Address: Applicant Phone No.-: DOUGLAS ANTHONY 2287 West Hies Gridlev Road;.Gridlev. CA 95948 846-2412 Property Location (s): 4120 Myers Street, Orovi lle Leg Higgins Tract, Lot9.46 A. P. No. (s): 035 -20 -'0 -00? -0 • Fees Paid: SCOR Facility Charge of $800.00 and Connection Fee of $250.00 payable be fi alized Application for service approved: North Burbank October 14, 1980 Public Utility District Inspection(s) made and successful test(s) observed: Location: Date: By: North Burbank Public Utility District release to close permit: Date: M