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HomeMy WebLinkAbout035-300-011Sunbeam Construction Co, y 2 Vern Ct., Lot 50, Crestwood Sub. #1, Oroville Permit 5372-77B,P,E,M (new SF) 35-30-11 " NEW OWNER / /J(p JOHN P. BUSH j%e4t001f*1i4 Contr: Sunbeam Const,. Jos Altos , PErmit #3918-79B(replace siding) 35-30-11 EW! OWNE YI_OHN PERMANN 2223 Verri Ct,Oroville - Permit#2952-82BJwood burning stove) SF Y 035:300-011 f , <.' '.04-3170 HURST, TERRI 2223'.VERN CT, OROVILLE Cont: OWNER RE-ROOF 1 5 • r t �� i CW2��YM�CD 'l 0'... * .s ;i BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP043170 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: 10/29/2004 APN: 035-300-011-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 2223 VERN CT ORO Date: Contractor. Map Index: Description: NEW ROOF MT. HVAC/NEW GAS WATER OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the HEATER/GAS PIPING 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 Owner: TERRI L. HURST AND CASEY E. HURST 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 2223 VERN CT: she is exempt therefrom and the basis for the alleged exemption. Any OROVILE CA . violation of Section 7031.5 by any applicant for a permit subjects the 95966 applicant to a civil penalty of not more than five hundred dollars ($500).): CELL # 519-2373 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, Applicant: TERRI L. HURST AND CASEY E.HURST 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.). Contractor: 131 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 License #: 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 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Architect: insurance carrier and policy number are: Engineer' Carrier: Policy #: fK I certify that in the performance of the work for which this permit is Total Square Ft: 0 S. F. issued, 1 shall not employ any person in any manner so as to Valuation' $0.00 ' become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' Census Code: compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 0 -IJ Date: /1-1— Applicant: 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. CONSTRUCTION LENDING AGENCY This permit -is here y issued under the applic bl provisions of the Biitte County CodR 2nrVo.r I hereby affirm that there is a construction lending agency for the Resolutio s to do ork indicated above fo hic fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Name: By: Date: —( Address: PERMIT EXPIRES ON: l� Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ 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 the duly authorized agent of the owner. 1 agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purpo /<C— Print Name: A, / 1 / Signature: Date: o ❑ Owner 13 Contractor Agent for Owner 0 Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPL ICA TION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER La ame First ame Address er-n Gc City ©roVrrlt'2_ Stye zip Phone A-773 l l Fax E-mail APP /CANT SIGNATURE XVV . &� // For office use only: CONTRACTOR Name Name tt-) z/ C r '— Address ' AOG- State City co (,tV' t Stata Zips -- Phone X33 J Fax E-mail Lic. 3S7 1 Class APP /CANT SIGNATURE XVV . &� // For office use only: ARCHITECT/ENGINEER Name (ceL a�e r" Address z/ C r '— City ► V State Zip Phone •— J C - Fax E-mail Planner State License Number APP /CANT SIGNATURE XVV . &� // For office use only: APPLICANT NAME Name (ceL a�e r" Address z/ C r '— City ► V Sta e Zig, 7 Phon7 •— J C - Fax E-mail Planner APP /CANT SIGNATURE XVV . &� // For office use only: Zoning Property Address Flood Zone Cross Atrhet SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. /- 3(1U BIN # LOCATION AP# Property Address C Cross Atrhet WORKER'S COMPENSATION Policy Number Carrier 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 Page 1 of 2 Description or Scope of Work: Sq. Footage 0 Structure 'Buil without Permits 0 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: _F' Amount:( . �S Bldg SRA Receipt #410, Sheriff c � 6 ` SMIP Other Date: / (� `�j Total REV 7-27-04 7Y PFsRMIT NO. 3918-79B S PERMIT EXPIRES 6/27/80 ' OWNER JOHN P. BUSH CONTR. Sunbeam Const i LOCATION (A.P. 35-30-11 ) 21-2-& Vern Ct., Oroville - f , t . k r, o - - n Temp. Power P /e— Called P &E Temp. Ele Serv. Cal .ed PG&E c /TemGas Sery. ed PG&E FINALED (Date) o (Signal ) Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES - - - - - - - - - - - - -•- - - - - Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping JdQ1316EHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping ■ DATE B REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING, BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall 'Siding To out Slab Roof Sheathing ~ Water Piping Piers Roofing ` Sewer Garage Fdn. Vents Fixtures Footings StemwaI l Garage Vents Insulation Water Htr. Heaters Slab Carport p Footings Prov. for physically handica ed Conformance of ex. esVitlftre Appliances Gas Piping &Test Temp. Gas Slab i±InaX Sanitation Patio REPLACE Final Footings Footing ELECTRICAL Masonry Walls Throat Rough Relnf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Wate-r Htr. Stucco Final Subpanels Mesh MECHANICAL Gird. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES - - - - - - - - - - - - -•- - - - - Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping JdQ1316EHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping ■ DATE B REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) \, COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovi Ile, California 95965 Telephone: 534;4541 APPLICATION AND PERMIT BUILDING Owner SO. FT. OCC. BUILDING VALUATION Mailing Cdress Telephone No. Contractor Mailing Address �`_ Fireplace Total Valuation Telephone No. _ Permit Fee � Building Address Plan Checking Fee&/or Penalty ,$ 00 Permit Fee PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 A. P. No. 2s--3 a -► p Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 F s Sanitation Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EOA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 ans ec'd Parcel A royal Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER M7 Permit Fee $ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 600V OR LESS Main service 100 AMP OR LESS 5.00 Single Family ❑ Duplex ❑ Mobil Home ❑ Others). Main service EA. ADD'L 100 AMP 2.50 Main service OVER 100 25.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 1.00 OR ADDNST %ACCLBL GS.CCUP. Y) 20sq ft CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name st le of: y 1 �L-t- V- J a i � CU ✓y `- ! T NEW RES ..CO BRANCH CIRCUITS) NON -REBID � BRANCH CIRCUITS) 2.50ea NEW CONSTR. (/POWER APPARATUS 9 NON-RESID. (SING LE OUTLET CIR. Ex. OCCUD{OUTLETS OR FIXTI1RES BAL@1 Ex. Occu p•�FIXED APPLNS. OR OUTLETS (RFIXED EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 �e� I License No.,ffi� 15 3 ZgO Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 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 Workmen's Compensation Laws of California. 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 County of Butte to enter upon the above-mentioned property for 'nspection purposes. Date ignature of Permitee or Agent Receipt No. --:?- White-D.P.W. - Yetlow-Assessor - Pink -Inspector - Goldenrod -Applicant Permit Fee $ MECHANICAL rt$:3 @ PERMIT FILING FEE .00 Heating Cooling Ventilation Hood 1 2.00 Permit Fee $ $ Land Development Fee $ TOTAL PERMIT FEE $ s 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. IRE T<R OF UBLIC WORKS Z,7-7 Date Building permit expires D to e � v 't. PE1'iMIT NO. 5372-77 B,P,E,M - , PERMIT EXPIRES OWNER Sunbeam Construction Co. CONTR. owner LOCATION 35-13-24 port. Lot 50, ern Ct., Crestwood #1, Oroville + y. r Y I I Temp. Power Pole Called PG&E Temp. Elec. ServZ��,?—Z-- Called PG&E Temp. Gas Serv. Called PG&E OB FINALED COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION REWORD. BUILDING IBUILDING (Cont'd) r PLUMBING Setback Firewall Soil PipingZ Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings 2 - L 1.- % Windows S, 3rd Floor Stemwall Sldin To out -7 Slab Roof Sheathin Water Pi In Piers Roofing Sewer Garage Fdn. Vents Fixtures Footin s Garage Vents Water Htr. StemwaI l Insulation Heaters Slab Z,3 Prov. for ph sically Appliances Carport handica ed xGas Piping &Test Conformance of e Footings structure — Temp. Gas Slab Final Sanitation Patio FIREPLACe Final Footings Footing ELECTRI Masonry Walls Throat Rough -� Reinf. Steel Final Fixtures Bond Beam FI RINKLERS Motors Framing — 3 ' kTest Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground lf/ Interior Lath Ventilation Permanent Door Closer . y 7,- Final Final MOBILEHOME UTILITIES ------------------ Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping MO§16EWOMEINSTALLATI N --------------Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS r G,. (NOTE: An entry must be made on this form each time you visit the job site.) THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH THE CURRENT REGULA- TIONS, CALI RNIA ADMINISTRATIVE CODE, TITLE 25, STATE OF, CALIFORNIA, IN THE BUILDING LOCATED AT: Street Lot Number Tract No. EXTERIOR WALLS�, Manufacturer 4k Thickness/Type R Value 14 CEILINGS Batts: Manufacturer Thickness R Valu,- Blown: alueBlown: Manufacturer Thickness � No. Bags % 7 Wt./Bag Sq. Ft. Covered R Value / FLOORS Manufacturer Thickness/Type R Value SLAB ON GRADE Manufacturer Thickness/Type R Value Width of Insulation _ ---------inches FOUNDATION WALLS R Value GENERAL TRACTOR LICENSE No. -%�� 0-n o BY TITLE —DATE INSULATI CTOR: AWKINS INSULATION CO., INC. LICENSE No. 215-925 BY TLE G DATE iI-,Z 3 ��� • COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 County Center Diive - Uroville, California 95965�%�_ Telephone: 53.4-4541 APPLICATION AND PERMIT auinurize representatives of the county of Butte to enter upon the above-mentioned property ,for �inspection purposes. Xtoa 0 D Signature of Permitee or Agent Receipt No. % / / ! -3 ' White-D.P.W. - Yello !$cesb,.eink- cA.4C&denrod-Applicant This permit is hereby issued under the applicable provisi 4 the Butte County Code and/or resolutions to do work in C, above for which fees have been paid. DIRECTOR OF P IC WORKS By tP /a -z-7- 77 Buileing permit expires Date /-- 7 i - 7 BUILDING Owner Sunbeam Construction Co. SQ. FT. OCC. BUILDING VALUATION Mailing Address 11190 Hooper Lane I efl Los Los Altos, CA. 94022 Tele Fir pl ce Contractor owner Total Valuation D Mailing Address Permit Fee 99, DO -8 pi Plan Checking Fee&/or Penalty Telephone No. Permit Fee $5940 BuildingAddressCt.,' Vern Oroville PLUMBING No. @ FEE PERMIT FILING FEE $3.00 3.00 Each Trap 5 1.50 7.50 Repair drainage or vent piping 1.50 Crestwood Unit #1, Lot 50 toning Verification -0-012 Water piping 1.50 1.50 Each gas water heater or vent 1.50 A. P. No. 35- - 4 port. q- Gas piping system 1 - 5 outlets 1.50 Each additional outlet 30 S Fire Dept. Fire Zone Use Permit Building sewer 1 5.00 5.00 EQA Parking Plans Parcel' Declaration rcel 60R/W improvementsLawn sprinkler system 2.00 d n e Parcel Approval Plans proval Permit Fee $ $ 17 00 NEW ADDITION ❑ UTILITIES E] OTHER El No. @ FEE PERMIT PERMIT FILING FEE $3:00 3.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD -1- 100 AMP 2.50 Single Family Duplex ❑ Mobil Home E] Others 1:1 60 Main service 1100EAMP oR LESS25.00 Main service EA. ADD -L 100 AMP 1.00 NEW CONST. I DWELLING O C OR ADDNS. %ACC.BLDGS. 20sgft NEW CONSTR. MULTI.OUTLET NON.RESID. ( BRANCH CIRCUITS) '2.50ea NEW CONST.R. (POWER APPARATUS & NON -REST D. SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: 3 C Ex. Occup(OUTLETS OR FIXTURES) BAL@1 Ex. Occu p• ( FIXED APPLNS. OR OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 O I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ IWO WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 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 Workmen's Compensation Laws of Cal ifornia. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 3.00 Heating Cooling Evap.3.00 Ventilation Hood 1 2.00 2.00 Permit Fee $ 8.00 $__7800 1 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 Land Development Fee 25.00 TOTAL PERMIT FEE $ auinurize representatives of the county of Butte to enter upon the above-mentioned property ,for �inspection purposes. Xtoa 0 D Signature of Permitee or Agent Receipt No. % / / ! -3 ' White-D.P.W. - Yello !$cesb,.eink- cA.4C&denrod-Applicant This permit is hereby issued under the applicable provisi 4 the Butte County Code and/or resolutions to do work in C, above for which fees have been paid. DIRECTOR OF P IC WORKS By tP /a -z-7- 77 Buileing permit expires Date /-- 7 i - 7 The Pllg."Setback shall be 5 ff., from the This set of plans and specMicclVons MUST be r side "property liie and 50' ff. from the kep+ on flee iob of all times crud it is tmlawful to rn,4n -6nv chances or CA Fllrr,+ic5ns on -centerline of the road,,pe. permitting a maxi I same without mum of a 2 ff. eave. O'Verhang,6u,t entirely wr;ffen permission from the bo-'parfmon+ of Public Woks. out of ally 60sern .7 ents. f� to o is d 2 F -41W, /,W,177Z74,,� 5 C.4 L IFOI?Iv/�4 < LJ? L . �n See Master Plan. on rile for building plans. - 53�a�� B.QTTE COUNTY BUILDING DEPARTYPNIr A-PPROVEU.. A. y I 1 -110 I -M/ ", it I 12 v Com. C v r -Fe- -'Z - 71,1,if, 6"," 0 0/?0 M L E9 BUT Tx: CO. v C4 Z ZF0I2,1114. .40 G. 9 r 16 -�..,K��„�,��:�..�:�a+v�'��':.i-x;��p..�...:er+,r4�Cae;o.v4r•�ls-irr � �*:.�-=.. s� •:rf?'�.f_ar�si°ate 'G�e .;k�,.�+}..�tkyv:. .�vk.•'._v�._ - �- John, Permann .. e • . -' •f �! �, ,p:erm_t #.2952-82�' 0 COUNTY OF BUTTE - DEPARTMENT, OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER,. 3.— _ _ + ZONING BUILDING PERMIT OWNER h TELEPHONE U - SQ. FT. OCC. BUILDING VALUATION OWNER' 'MAILING ADDRESS " U CONTRACTOR'S NAME T'ELEPH` NE t J0 EP_ CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER A UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER A'►1 P LICENSE No. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ , BUILDING ADDRESS PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF [P'Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New Q� Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe work: ( tl CN A bt f t %ok 1-% 1 . UC? O Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service OOOV OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. ( DWELLING OCCUP.81) OR ADDNS. ACC. BLDGS. / 20 sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ElNON 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 Rj 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) ❑ 1 am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR -OUTLET 2,50 ea NON -RE SID BRA CH CIRCUIT NEW -CONSTR POWER APPARATUS.6) 6 RESID. (SINGLE OUTLET CIR / EX. Occup(OUTLETS OR FIXTURES BAL�1 IXD APPLNS. OR Ex. Occup.(ouETLETs (RESID.I EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring +7L.50 Permit Fee $ Contractor MECHANICAL PERMIT FiIirig Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I 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. O 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. Heating Cooling Hood 3.00 Ventilation Permit Fee S 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 County of 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 against said Count ,j''n consequence of the granting of this permit. X Date 5 y arUre of Applicant — Owner Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP I TYPE OF CONST. PARCEL PD No I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which PIR kTOR OF PUBLIC By. \ ,/ .._ PERMIT EXPIRES Date, I l the applicable provi- resolutions to do fees have been paid. WORKS Date / F). �' t eQ J Receipt No. WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 • APPLICATION. ANQ PERMIT PERMIT N0. ASSESSOR PARCEL NUMBERZOMNG 3.!;-- —1 BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERISAILING AIDOFrts , rL 3U CONTRACTOR'S NAME LEP ONE CONTRACTOR'S MAILING ADDRESS Fireplace 00 CONSTRUCTION LENDER UNKNOWN Total Valuation Is 4 Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ - ^ ARCHITECT OR ENGINEER le LICENSE ND. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ ron BUILDING ADDRESS PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO. SUBDIVISION NAME 7PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New Addition❑ Remode Q Utilities ❑ Installation❑ Other ❑ Describe work: 1J Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. (DWELLING OCCUP.y) OR ADONS. ACC, BLDGS. 2�sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ElI 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 NEW,.CONS R. BRANCH CIRCTITS 2.50 ea NEw CONSTR. ( POWER APPARATUS D) NON-RESID. SINGLE OUTLET CIR. Ex. Occup OUTLETS OR FIXTURES BAL@1 IXED APPLNS, OR Ex. Occup.(OUT LETS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE I 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. Nf 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. Heating Cooling Hood 3.00 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 County of Butte to enter upon the above-mentioned property for inspection purposes. I 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 again s id Count 'n consequence of the granting of this permit. X Date gnature of Applicant — Owner Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structuress over3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCuP, GROUP I TYPE OF CONST. PARCEL PD Ho IssuE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which IR TOR F PUBLIC By ( PERMIT EXPIRES Dat the applicable provi- resolutions to do fees have been paid. WORKS Date -S, �_M Receipt No. /�/' WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD-APPLI CANT