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Home My WebLink About035-215-012I ( BUTTE COUNTY DEPARTMENT OF DEVTLOPMENT SERVICES INSPECTION CARD 24 Hour Inspection Line: (530) 538-7636 (Oroville) (530) 891-2834 (Chico) Office: (530) 538-7541 Fax: (530) 538-2140 Website: www.buttecounty.net/dds I Permit No: B06-2605 Issued: 11/28/2006 Address: 1932 ROSE ST OROVILLE APN: 035-215-012 Permit Subtype: Remodel Owner: JR INVESTMENT PROPERTIES, INC. Applicant: SCOTT SMITH Description: REMODEL- ADD BATH & BEDROOM (952) MUST BE ON JOB SITE JOB SHALL BE READY PRIOR TO CALLING FOR INSPECTION. THE INSPECTION CARD AND APPROVED PLANS MUST BE AVAILABLE FOR EACH INSPECTION OR THE INSPECTION WILL NOT BE MADE AND A RE -INSPECTION FEE MAY BE ASSESSED. ALL PLAN REVISIONS MUST BE APPROVEU BY THE COUNTY BEFORE PROCEEDING Inspection Type IVR INSP DATE Setbacks 132 Foundations / Footings 111 Pier/Column Footings 122 Grade Beams 114 Eufer Ground 216 Forms/Steel/Holdowns 122 Do Not Pour Concrete Until Above are Signed Pre -Slab 124 Gas Test 404 Masonry Grout 120 Masonry Bond Beam 119 Underfloor Framing 149 Underfloor Ducts 319 Shear Transfer 136 Under Floor Plumbing 412 Under Slab Plumbing 411 Gas Piping 403 Do Not Install Floor Sheathing or Slab Until Above Signed Rough Framing 128 Rough Plumbing 406 Rough Mechanical 316 000ll_ Rough Electrical 208 Gas Piping 403 Roof Nail 129 Shower Pan/Tub Test 408 Fire Sprinkler 702 Do Not Insulate Until Above Signed Wall Insulation 117 Ceiling Insulation 118 Do Not Cover Until Above Signed T -Bar Ceiling / C 145 Gas Test 404 f .- Stucco Lath 142 Stucco Scratch 143 Stucco Brown 144 Building Final 802 Electrical Final 803 Mechanical Final 809 Plumbing Final 813 P Inspection Type IVR INSP DATE NOTES ---�__._..-_•OF11_FICE COPY -- - _ - _ Bldg Permit:' - ' Address: GAS +By: �I�J — Date'." ,-.. Electric By. y - -y------ - 11 ..% roject Final 801 7 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE. IF WORK HAS COMMENCED, YOU MAY PAY FOR A 1 YEAR 0RENEWAL 30 DAYS PRIOR TO EXPIRATION Inspector Copy r COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive • Oroville, CA • (530) 538-7541 J .wTM CORRECTION NOTICE - J ►2 �. ��C til �r� �0 OWNER PERMIT NO. 1 11 A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please call for re -inspection when correction of work is comp) ed. If you have any questions pertaining to this matter, or need' additional explanatio lease contact the Building Inspector as indicated below. ; n n: Date ` 2 v Inspector REV 4/05 Phone # FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 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 PROJECT INFORMATION Site Address: 1932 ROSE ST Owner: permit No: B06-2605 APN: 035-215-012 JR INVESTMENT PROPERTIES Issued Date: 11/28/2006 By KCG Permit type: MISCELLANEOUS 5155 WARING ROAD Subtype: Remodel SAN DIEGO, CA 92120 Expiration Date: 11/28/2007 Description: REMODEL- ADD BATH & BEDRO( (619) 229-2420 Occupancy: Zoning: RN Contractor Applicant: Square Footage: HANKS CONSTRUCTION SCOTT SMITH Building Garage Remdl/Addn 7475 CAREZZA DRIVE 10660 WALMART RD 952 SACRAMENTO, CA 95822 WILTON, CA 95693 Other Porch/Patio Total (916) 425-6861 (916) 687-0336 952 FEE INFORMATION Remodel - Residential $934.83 Total Charged: $934.83 Fees Paid: $934.83 Balance Due: $0.00 Receipt No: B779 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractors License HANKS CONSTRUCTION 791151 / B / 02/28/2007 Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license pursuant to the provisions of the Contractors License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects X 11/28/2006 the applicant to a civil penalty of not more than five hundred dollars [$500]; , Please check one of the following: Contractor's Signature Date ❑ I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR WORKERS' COMPENSATION DECLARATION OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of the property, who builds or improves thereon, and who does I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements E]I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). ❑I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractors License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the state fund 1748258 06/01/2007 Carrier: Policy Number. Exp. Date: Contractors License Law.). (This section nee not be competed if the permit —is orondollars ($100) or ess. ❑ 1 AM EXEMPT under a B. 8 P.C. for this reason: lx�_ THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ,rkERTIFY ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compens on I of CalifoInd a if I should become subject to the workers' X 11/28/2006 compens t rov ions of 0 o he bor Code, I shall forthwith comply with those provisio wners Signature Date X 11/28/2006 I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Sign re Date WARNING: FAILURE O SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, including death, and property damage caused by, arising out of, or in any way connected with HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, the issuance of this permit. I h reby acknowledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or ccupancy of ny s' Ik, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. Cou o r th a en oned property for inspection purposes. I hereby certify that I am the pro a er a riz d toall5Von the props wners behalf. CONSTRUCTION LENDING AGENCY L, - 11/28/2006 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for e o mi GN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) Owner 1:1 Contractor OR. y� gent for Owner Agent for Contractor FILE COPY Lenders Address City State zip Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 Fax www.buttecounty.net/dds PERMIT APPLICATION DATA SHEET Reference Number: B06-2605 Date: 11/06/2006 Location: 1932 ROSE ST By: KCG Parcel Number: 035-215-012 Sub Type: Remodel Owner Name: WHITE, DALE ETAL Phone: Description: REMODEL- ADD BATH & BEDROOM (952) The above permit application has the following Clearances required prior to permit issuance. Please contact each department indicated below regarding specific requirements pertaining to your permit application. Yes No DRAINAGE DISTRICTS Thermalito Irrigation District, 410 Grand Avenue, Oroville CA 95965 - (530) 533-0740 LOAPUD, 1960 Elgin Street, Oroville CA 95966 - (530) 533-2000 City of Chico, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711 PARKS & RECREATION DISTRICTS Chico Area Recreation District, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711 Durham Park & Recreation District, 9447 Midway, Durham CA 95938 - (530) 345-1921 El Feather River Recreaction & Park District, 1200 Myers Street, Oroville CA 95966 - (530) 533-2011 Paradise Parks & Recreation, 6626 Skyway, Paradise CA 95969 - (530) 872-6393 L; ■ u ■ Biggs Unified School District, 300 B Street, Biggs CA 95917 - (530) 868-1281 Chico Unified School District, 1163 East 7th Street, Chico CA 95926 - (530) 891-3006 Durham Unified School District, 4920 Putney Drive, Durham CA 95938 - (530) 895-4675 Gridley School District, 429 Magnolia, Gridley CA 95948 (530) 846-4723 Marysville School District, 1919 B Street, Marysville CA 95901 - (530) 741-6000 Oroville Elementary School District, 2795 Yard Street, Oroville CA 95966 - (530) 532-3000 Oroville Union High, 2211 Washington Ave, Oroville CA 95966 - (530) 538-2300 Ext:105 Paradise Unified School District, 6696 Clark Road, Paradise CA 95969 - (530) 872-6400 OTHER Recorded copy of Agricultural Acknowledgment Statement- See Attached Instructions City of Biggs Planning Department, 3016 Sixth Street Biggs CA 95917 - (530) 868-5447 Other: Atr p f sl a n (lfi lre2j bz l C� Other: (-,1'A r1 l (Neer l - Vriv,f n 1± !V. (rVAt-- k r. Other: Signature of Property Owner: FILE Date: 11/06/2006 LAKE OROVILLE AREA PUBLIC UTILITY DISTRICT 1960 Elgin Street ♦ Oroville, CA 95966 ♦ (530)533-2000 + (530)533-1750 fax SEWER CLE4R4NCEAUTHOR/L4 T/ON No District Permit Required "Applicant", being the property owner or owner's agent desiring Lake Oroville Area Public Utility District, hereinafter referred to clearance for the property(ies) below. _, hereinafter referred to as sewer clearance, hereby requests as "District", to authorize sewer Property address: l7� &2Q A. P. #: D S S-- Subdivision: �� *04LOIt #:has Block #: e No. of E.D.U.'s at this location: Multiplication Factor: Monthly Charges: Service currently provided: Residential Residence of Owner ❑ Apartment ❑ Industrial Rental (single family) ❑ Commercial ❑ Rental (duplex) ❑ Site plan reviewed ❑ Jobsite reviewed The sewer clearance applied for hereby shall be in accordance the ordinances, rules, regulations and policies adopted, or to be adopted, by the Board of Directors of District, all of which Applicant agrees to abide by and fully perform. The proposed project shall in no way impact the current sewer service provided by the District or encroach upon any i trict utility easements. 4.197 AW Z 17 int uthorized District Signature 1�; - Applicant Print Name Applicant Mailing Address �Jr-LIF7-0.33 L Applicant Phone Number Applicant -Faro Number Date of Clearance Butte County Department of Development Services TIM SNELLINGS, DIRECTOR. PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 Fax www.buttecounty.net/dds NOTICE TO BUILDERS Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental Health, and the California Department of Forestry for their clearances and approvals. There are some things you can do to expedite your permit: 0 Make sure your application is complete. 0 Be responsive to requests from County departments for any additional materials or requirements. The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes without a complete application adds to processing time. Every permit issued by the Building Official shall expire and become null and void if the work authorized by such permit is not started or completed within one year from the date of issuance of such permit. A permit may be renewed (for a fee) prior to expiration an indefinite number of times, provided construction progress has been documented by the Building Division during each year during scheduled inspections. No changes may be made in the original plans and specifications for such work. In order to reinstate action on a permit after expiration, the permittee shall pay a new full permit fee and additional plan checking and documentation may be required. Upon completion of work covered by this permit, please contact this office for final inspection. As a reminder to you, it is illegal to occupy this building or any portion of the building for which this permit is issued without a final inspection. EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY Application for which a permit has not been issued will expire one year after date of application. Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications (not yet issued) must be requested within two years from the date of fee payment. Fees paid at the time of application are for Plan Check and administration. The Plan Check portion of fees is refundable only if the permit is cancelled or withdrawn before any plan checking is done. Building Division costs will be deducted prior to authorizing a refund and a charge of $54.99 to process the refund application will be assessed. Refunds on permits (issued) may be requested prior to the expiration of the permit, provided no work has been done pursuant to the permit. An Inspection may be required (and deducted from any refund amount) to determine no work was done. Fee/refund information can be read on-line at hqp://municiDalcodes.lexisnexis.com/codesibutteco/ Reference Number: B06-2605 Location: 1932 ROSE ST Parcel Number: 035-215-012 Date: 11/06/2006 Owner Name: WHITE, DALE ETAL Phone: REMODEL- ADD BATH & BEDROOM Signature of Property Owner: FILE Date: 11/06/2006 BUTTE COUNTY FEE SUMMARY 7 County Center Drive Oroville, CA 75965 Permit Number: B06-2605 Job Address: 1932 ROSE ST Contractor: OWNER Department of Development Services Phone (530) 538-7541 Fax (530) 538-2140 Printed: 11/06/2006 10:45 am Fee Description Account Number Fee Amount Paid Date Pmt Amt Remodel - Residential 0010-440001-4210500-1010 $934.83 11/06/2006 $934.83 Printed By: Kourtni Graham 934.83 $934.83 Balance Due: $0.00 At the time of permit application, I was advised t e above fees are required prior ro issuance of the permit. These fees may be changed during the plan checking process. Signature: Date: 11/06/2006 Pursuant to Government code Section 66020, you are herby notified those items listed above may been imposed on your project. You have 90 days from the date of approval of the project or from the impostion of the above referenced items during which you may request a protest. The requirments for a protest are specified in Government Code Section 66020(a). BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name Name Mailing Address �— rp {— Address City� tate C Zip s12 Phone - Z 2 ` 2C(Z Fax E-mail --- - — APPLICANT INFORMATION CONTRACTOR Name - Address Zip fs-6 j HWAZII 0 Address Zip City Name State Zip Phone ��- Fax E-mail Lic. It --- - — APPLICANT INFORMATION ARCHITECT/ENGINEER Name City(A)• Address Zip fs-6 j City F ��G �� fl�37 State Zip Phone Name Fax E-mail Lot # State License Number --- - — APPLICANT INFORMATION Name _S''66'1,� - � & Address 106)(00 City(A)• State e Zip fs-6 j Phone 9G �7�3 F ��G �� fl�37 E-mail NATURE KAN, For office use only: I - Zoning — Flood Zone X I SRA Yes I N Occ. Carrier metre_ C aril S Type Const. Subdivision Name Name Map Book Page Lot # Planner Date Approved: PERMIT NO. BIN # PROJECT LOCATION AP# --- 2rS'.- 0 12 D o Property Address l City , lercOV Cross Street WORKER'S COMPENSATION Policy Numbe ' U .0 Nue6TN--,,m— D h`tS Carrier metre_ C aril S If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: 1 �` aro►-� �v� '�2. Sq FT- Living Garage Open Cov ❑ Structure Built without Permits. ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications 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 fee will be 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. Received by: b . Amount: Bldg Receipt #: 8TT Date:.I 1 -6 -DG Sheriff SMIP otal COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION, 7 County Center Drive • Oroville, California 95965 - Telephone (530) 538-7541 �p o (Rev. 12/96) APPLICATION AND -PERMIT �3 �ITV ASSESSOR PARCEL NUMBER ZONING BUILDINGPERMIT OWNER .OWNERS MAILING AD ESS CONTRACTOR'S NAME - % TELEPHONE rj 934- 9195 TELEPHONE SO. FT. OCC. BUILDING VALUATION 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 $ BUILDING ADDRESS Energy Plan Checking Fee $ 9 $ PERMIT FEE $ LAT NO. SUBDNISIOWS 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: /n 200 Anna 9LEGroT �+ �+�.T��7T��+�A �TLU -�-v�_ rrct'�T�Y�Lc'V'1"Gu—TI�'PI'T Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ T) rly� �+�+ 7�rT� /'+�T��7 D/� CK M ISSUE' RIM_ 34RY RPeMN ELECTRICAL PERMIT Fling Fee 20.00 Main SBfVICe a00V OR LESS ) 200AORLESS 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.POWERLE 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 reason Main Service zooA To I000A 46.00 NEw CONST. DWELLING OCCUP. S. ( OR 3.5Q FT. co MuircoS. ppµRESID, Eu., @7.50 APPARATUS a SIN .. OUTLET CIR. Ex. Occu OUTLET OR FIXTURES 20 1'00BAL @ .50 Ex. Occup. DFlxLmETS Aa DR. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring23.00 PERMIT FEE t L 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.) Yd I certify that in the performance of the work for which this permit is issued, I shall not a ploy any person in any manner so as to become subject to workers' com ensation laws of California, and agree that if I should become subject to the noers' compensation provisions of section 3700 of the Labor Code, I shall hwith comply those pro 'sio X Date gn ture of Applicant - ❑ Owner ❑Contra for ❑ Agent An OSHA permit is required for excava ' ns over '0" deep and demolition or construction of structures ov r r'e i i ht. 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. D. FEES IMP FLOOD CDF PARCEL PD HD _JJISS This permit is hereby Issued under the applicable provisions of th utte unty Code and/or Resolutions to do work indic to ab v r whi fees have been p i 27 n By to (7L J PERMIT EXPIRES ON Dete FReceipt No. �� WHITE-D.D.S.-B. D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541MIT (Rev.12/96) APPLICATm AND PERMIT .> - ASSESSOR PARCEL NUMBER/7 �D /7 ZONING ,. BUILDINGPERMIT ELECTRICAL PERMIT OWNE SO. FT. OCC. BUILDING VALUATION Main Service 200A TO 1000A 46.00 .OWN 5 I AgQRES z"ZUU DWELLINGOCCUP. 3 5¢SO. OR ADDNS. 8 ACC. BIDS. CO NTRACTO NEW CONS ./ NON-AESIn. 1 TELEPHONE @7.50 CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDERS MAILING ADDRESS Total Valuation Is ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS • Energy Plan Checking Fee $ $ PERMIT FEE S LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY 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 ❑ �jemgd�l ❑ Uh �� „Instal * Other C� // /J moi' I Gas piping systern 1 - 5 outlets 15.00 sewer 15.00 Mobile Mobile Home I S G I W I I I @20.00 .PERMIT FEE PAID SRA SHERIFF OTHER AMOUNT RECEIVED $ DATE RECEIVED �)2,7165' RECEIPT # %40 EX. OCCU . OUTLET OR FIXTURES PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.00 Main Service 2o0AORLESS 23.00TJ� Main Service 200A TO 1000A 46.00 NEW CONST. DWELLINGOCCUP. 3 5¢SO. OR ADDNS. 8 ACC. BIDS. FT. NEW CONS ./ NON-AESIn. 1 oM uLTI•OUTLET ) @7.50 EX. OCCU . OUTLET OR FIXTURES BZ @ .SO FDCED APPLNS. OR Ex. Occup. OUTLETS ESID. EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $WA MECHANICAL PERMIT Fling Fee 20.00 Heatino 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $' 4 � HAZ p. FEES 77 FLOOD CDF I PARCEL PD HDL 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 16W 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 03-oxo13 PERMIT NO. BP040655 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: 03/09/2004 APN: 035-215-012-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 1932 ROSE ST ORO . Date: Contractor. Map Index: Description: RE -ROOF HOUSE (12 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: WHITE DALE ETAL to its issuance;,:. also requires the applicant for such permit to file a W.HITE..HARRIETTA signed statement that'he or she is licensed, pursuant to the provisions of, thetontractor's StaW-License Law (Chapter 9 commencing witWSection .• " ' 1270 FEATHER AVE 7000).of Division 3 okhe'Business and Professions Code) or that he or'.•::. OROVILLE, CA 95965-4215 she,isexempt therefrom -and the basis for the alleged, exemption. Any. violation -of -. Section: 7031.5 by any applicant for a.permit:sbI5ib&ts the " applicant4o. a, civil:psnally 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 Pess. ,. ... ..:......androf .... apply. to an ...-_..,:... Code: ' The_Contractors''Stafe License. Law does not applysion � pp I cant WHITE DALE ETAL .., 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.). s,.•9wner .ofy,.the,.property,..am, exclusively:,„contracting ,w¢Fj, licensed contractors to: construct. the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does notapply to an gwrier of property who builds or improves thereon, Contractor: and who contracts,for-such projects with a contrac0r(s) licensed pursuant to the Contractors' State License Law.). D I am Exempt under Article 3 of e.Busine nd PrqfessjjDnFde Date / - U Owne 1 License #: �' WORKERS.'.COMPENSATION, DECLARATION. I hereby„affimt:under penalty of perjury one of the following declarations:- 1 ❑ ,. 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. •D 1. have and will maintain "workers' compensation insurance, as Architect: Engineer' 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. Total Square Ft: 0 S. F. _ Policy#: Valuation: $0.00 I certify that -in :the, perfoance of the. work for which.this permit is rm Census Code: 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 - to the workers' compensation provisions of Section.3700 of the Labor Code, I shall forthwith comply wit7th se provisions. ' , Date: WARNING- Faiiure to: secure workers' compensation -coverage ,is unlawful,, and-.shall'subject 4an 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 ThisF.. it 1c h reb i u du e he applicable -provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resol do t do d f r w ich fee have been paid 6 /ice performance of the work for which this permit is issued (Sec 3097 Civ.) D Name: By: Dat ' O Address: PERMIT EXPIRES ON: Dat l7 I hereby cehify:that the use of,this facility shall comply.wfth Sections .25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, a handling and use of hazardous materials. 13. Notification in'accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. 7 ❑ Allached'are copies, of the required E.P.A. notification forms. I hereby certify that .1 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 a official form or ument f Butte Co nty.� I hereby authorize represen tives of Butte C un y to enter uup�on9 the above mentioned property for inspectionrpos l Print Name:1� G�/�/ / "/� Signature: e Date:, Owner: ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor s. BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION M (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE M (530) 538-7541 FAM (530)538-2140 WEBSITE: www.buttecounty.net}dds PERMIT NO. BP040655 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: 03/09/2004 APN: 035=215-012-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 1932 ROSE ST ORO - Date: Contractor: Map Index: r • • _ -. _ . _., .. �,<_.... ., ,.- .. a.. , ... Description: RE -ROOF HOUSE (12 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: WHITE DALE ETAL -' �1. to its issuance, -.also requires the applicant for such permit to file,a yS ..... `iii; • i signed statement tfiat he or she is licensed. pursuant to the provisions of: ..� _, �, tWHITE..HARRIETTA ' FEATHER IT 6ntractor's 5t6te•License Law (Chapter 9 commencing with"Section " 1270 AVE 7000)•of Division 3 6f4fie'Business and Professions Code) or that Fie. or OROVILLE, CA 95965-4215 { sh& isItempt therefrom -and the bas{s.fo.j the alleged,. exemption. Any ;. __; :, a: ; ,, .,• I i violation.o6:Section 7031.5 by any applicant for a'perrndautijects the a licant.to a, civil, '_n'aIiy, of not more than five hundred dollars 500. ; . , '» .r .'"•�W "� �' ~�' '4""�Y� 1, -as owne ,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 Id 6d&. 'The:. Corifraotors''StateLicense"Law`does"nof'apply'to,an " -Applicant:,"WHITE`DALE-,ETAL-`"`'•"'-'-a_ --. -" • owner_of.property who builds or improves. thereon, and who does such work him_ self or, herself or through his or her own employees, provided that such'impiovemerifs 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.). O as,-owner„of the„grope•rty,,.arp�exclusively,,Rcontracting,,with.� licensed contractors to: construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: and ,who contracts,for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 o Vhe-Businepryand Profess' ns de Dater /`- U Owne [� Q /� ` • License.#. t ..., ' WORKERS'. COMPENSATION DECLARATION. I hereby,affirtm,under penaltyof perjury one of the following declarations:r'. ❑ '•,•1„have Lan d,will. maintain a certificate of consent to self -insure for „„�.-,k„.•., 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. , "❑ t'haJe and - .will maintain workers"'compensation {nsurance;'as . "••- Engineer: 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. Total Square Ft: 0 S. F. - Policy Valuation: Valuation: $0.00 _ . ,....ce o -w"o' ,.,,, itis 'A" I certify that•in,the)performance of the work for which this permit is Census Code: issued, I. shall, not, employ any person in any. manner. so. as. to become subject Jo- the 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 forthwithcomply with th se provisions. -—lJ•./l./ _.. . } Date: -W Appllca WARNING: .Failure to secure workers' compensation coverage ,is unlawful and shall'subject'an employer to criminal penalfies'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 pe it is h re b i u d u e the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resol do t do a d f r w ch,fee, have beer. paid. ` performance of the work for which this permit is issued (Sec 3097 Civ.) O� s Name: g��J{ By: Dat • 1, D 1 Address: PERMIT EXPIRES ON: Dat j hereby ceitifythai the Use bf this facility shall comply witfi Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. { f ❑ . 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 forms. I hereby certify that 1 have read this application, that the above informationJis 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 a official form 4f Butte Co nty.� I hereby ' �or/iument authorise repie%sentives/o�flButte C un y to enter u�p�on9 the above mCentioned property for inspection rpos Signature: t Date,`.{;_ .Owner: EI Contractor: ❑ Agent for Owner LI Agent for Contractor ;' 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 r6 L W DATE: _ APN: V ZONING: OWNER'S LAST NAME: 60111 TZE OWNER'S FIRST NAME: PHONE: STREET A DRESS: T U FAX: CI 0��_ E-MAIL: SITE ADDRESS: CITY, ZIP: NEAREST CROSS TREET: % \ f/—tel TRACTILOT t APPLICANT NAME: PHONE: STREET ADDRESS: FAX CITY, ZIP: E-MAIL: CONTRACTOR NAME: PHONE: STREET ADDRESS: FAX CITY, ZIP: E-MAIL: LICENSE NUMBER: LICENSE TYPE: ARCHITECT/ENGINEER NAME: PHONE: STREET ADDRESS: FAX: CITY, ZIP: LICENSE NUMBER: E-MAIL: DESCRIPTION OR SCOPE OF WORK: d S ❑ Structure Built without permits ❑ Proposed Change of Occupancy (note previous use) EXPIRATION OF APPLICATION Applications 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: 3�q� Amount Received: q ) D Master application 34-04 O.B.- I 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. I HAVE HAVE NOT ❑ signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: CITY: PHONE: 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: 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 WORT{ NOTE: This Owner-Builder-Verifuation is required by Section 19831 and 19832 of the California Health and Safety Coda This verification must be completed and returned to our office before we are permitted to issue the permit: OVER r OWNER BUILDER INFORMATION Dear Property Owner: O.B.- I 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 record on such a permit Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself you may protect yourself from possible liability if that person applies for the proper permit in his or her name. . Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply, If youplan 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 $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 asian employer and you are subject to seveial obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability msurance 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, conhact 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 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 reverse side of this form so that we can confirm that you are aware of these matters. The budding permit will not be issued until the verification is returned. r4eir.cz?z ' Mi ,C.B.O. dinInspection NOTE' This Owxer Builderinfomwdon is required by Section 19930 of the California Health and Safety Code OVER JDATE: PERMIT: ASSESSOR PARCEL OWNER'S NAME: y -- FEES- (Amount and Purpose): 9p BALANCE OF FEES: ADDITIONAL FEES: $ REVISED PLAN CHECK: $ SHERIFF FEE: $ Lit BALANCE Off' 1 � SSI' - -:;,�- (Check one) (Check one) ' orf-rT-D7\TTTMRF.R,i: COUNTY CITY OF BIGGS RESIDENTIAL COMMERCIAL s SRA $ COPIES $ URBAN AREA FEES $ CSA 87 (North Chico Spec.) $ WATER TENDER FEE $ BATTALION # THERM DRAINAGE FEE $ OTHER $ OTHER $ VALUATION - IF BALANCE OF FEES OR ADDITIONAL FEES: TOTAL VALUATION: $ ADDITIONAL VAL: $ (Check one) (Check one) ' orf-rT-D7\TTTMRF.R,i: COUNTY CITY OF BIGGS RESIDENTIAL COMMERCIAL s 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.netldds 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 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Date: Contractor: 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 to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of 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 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 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 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.). ❑ I am Exempt under Article 3 of the Business and Professions Code Date: Owner: WORKERS' COMPENSATION DECLARATION I 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. ❑ 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: Policy #: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the 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. Date: Applica WARNING: Failure to secure workers' compensation 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. PERMIT NO. BP042489 Issued Date: 08/25/2004 APN: 035-215-012-000 Site Address: 1932 ROSE ST ORO Map Index: Description: misc. electrical Owner: WHITE DALE ETAL WHITE HARRIETTA 1270 FEATHER AVE OROVILLE, CA 95965-4215 Applicant: WHITE DALE ETAL Contractor: License #: Architect: Engineer: Total Square Ft: 0 S. F. Valuation: $0.00 Census Code: V,,--4-46&6 RsAmmll IQ9.g8' 'CONSTRUCTION LENDING AGENCY This permit is ereoy issued uno I hereby affirm that there is a construction lending agency for the Resolutionsl3ildo work indicated performance of the work for which this permit is issued (Sec 3097 Civ.) By: Address: aid. �,r �V been paid. n�ro• ❑ I 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. ❑ 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 forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or a 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 ubstanc o ny official form o d ument of B tte Cou • . I h reby authorize repres ntatives of Butt �,CLPunty to enter upon the above mentioned property for inspect s Print Name: / Signat Date: Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor �y �t ,. r _ ... _ .i r ...�t: r.:...,.., .s t- ,• .-yam E035-2 2 03-2613ItIETTA�� ST, OROVILLE P SERVIC t1 I Address e ELECTRIC Meter By Date4� COUNTY OF BUTTE'- DEPARTMENT OF DEVELOPMENT SERVICES'- BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530).538-7541 PERMIT N&�, (Rev. 12/96) APPLICATION AND PERMIT�I ASSESSOR PARCEL NUMBER i1��e � Seil't ZONING BUILDING PERMIT OWNER TJPTTV PARRTG'MA TELEPHONE SO. FT. OCC. , BUILDING VALUATION .OWNER'S MAIUNGADDRESS_✓..._•W—V. 11')'70 r. Tr= AIM olamm x r rA � Cn q CONTRACTOR'S NAME . --V ��--� 4'- ----- INER TELEPHONE CONTRACTOR'S 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 1 A�7 CF' C'T` Ldf'6T7TT T 1♦ Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 1 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other B'ry 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 ❑ i Describe Work: �r/O. 700 AMP T;T F("T" T(- C�x U`Irrr "DA*TF'TI Gas piping system 1 - 5 outlets 15.00 Building sewer's 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE $ CK TO Tq�PTlr Platt r-ARi7 t?Tyf1 m ELECTRICAL PERMIT Filing Fee 20.00 Main Service ZDDA OR LESS 23.00 y � f%n LICENSED CONTRACTOR'S DECLARATION 1 ' 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: ❑ 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 ProfessionsCodefor this reason • 4.00 Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADONS. ( a ACC. BLDS. SO 3.50FT: NON -R MULTI - SID OUTLET CIRCUITS 1 @7,50 APPARATUS 8 SINGLE OUfIEf CIR. Ex. Occu OUTLET OR FOTTURES sA� p':� DoLXED APPLNS. OR Ex. Occup. mFTs RESID. EA S.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ GZ WORKERS' COMPENSATION DECLARATION 4_ 1 I 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. i ❑ 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 20.00 Heating Cooling Hood 6.50 Ventilation 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.) ' 4• !0 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 �JffoAhwith comply�wi h those provisions"% �� /� ---- �% �X "�/I' /;,�/.� ' 4 •; (�/��Date - 0�=� Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over )stories in hei ht. Mobile Home Installation Fee ,A.• Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ �,.� HAZ. D. FEES IMP FLOOD CDF PARCEL PD HD ISS This permit is hereby issued under the applicable provisions of thVButte unty Code and/or Resolutions to do work indicated ab6ve for whi fees have been paid! �12 7/0 By _r P I Date PERMIT EXPIRES ON (\ ✓ '(Date) Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT +`