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Home My WebLink About039-180-026\I'- 39-18-26 — MARVIN J. CHMELKA CHMELKA, Marvin J. 339-69B E/S Pierce Ave, 400'N Elk Ave, Chico 332-69E Permit#4167-83P(coynvert to patural gasSF) -1 -2 e/s Pierce.Ave. 40,@' no. of El 39-18-26 (swimming pool) Permit#1896-84B(reroof/SF) �jD�tC /'0;2 49c—q 039-180-026 99-2519 CHMELKA, MARVIN 10470 PIERCE ROAD, CHICO CONTR: BUTTE ROOFING RE ROOF ��.� J_T�_Dj� i� ,....��i �:,�;J , Y r � f C 1 OFFICE COPY r r 2 � Address ALL ILe��`r GAS Meter By�� Date ELECTRIC Meter By Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 4 APPLICATION SID PERMIT ASSESSOR PARCEL N'P'MBER --, -(o ZONING BUILDING PERMIT" OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS / O RAC'TOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee .$ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS .�f, PLUMBING PERMIT Fill Fee 10.00 n9 Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 -5 outlets 5.00 ",,r .� USE OF STRUCTURE SF 9 Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home S T7ETWF710-00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities ❑/ Installation❑ Other ❑ Describe work: / �1l�//f_-�l i��/.�'�rJ L_ _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST.(DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. 1 2/20sgff CONTRACTORS LICENSE LAW I declare under penalty of perjury p y p y (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business.20@50: and Professions Code and m license is in full force and effect. y 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 CONSTR ULTI-OUTLET 2.50 ea NON.RESID BRANCH clR7 ITs NEW CONSTR. (POWER APPARATUS & NON-RESID. %SINGLE OUTLET CIR. Ex. Occup(o OR FIXTURES .20 AL@30 FIXED AX OR ED A PP LNS Ex. OCCUp. OUTLETS (RESI.D.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 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. ❑ 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 Countyot 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 against said County in consequence of the granting of this permit. X Date Signature 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. I PARCEL PD NO I ISSUE 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. -' r. WNITE-O.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPAkTMENT OF PUBLIC WORKS • 7 County Center Drive - Orovilld, California 95965 - Telephone 916/534-4541 W.. i - APPLICATION AND PERMIT ERMIT NO/ ASSESSOR PARCEL BER ZONING 3f_ N BUILDING PERMIT OWNER TELEPHONE•S(�, �� FT. OL'`C, BUILDING V UATION OWNER'S MAILING ADDRESS ��po CON RAC TOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS N aCFEpety Al (7V PLUMBING PERMIT Fee Filin Fee 10.00 Filing -1149, Trap 2.00 Solar Water Heater 20.00 eldl e -o Water piping 5.00 LOT NO- SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 ,ov USE OF STRUCTURE SFX Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home S G W 10.00 e TYPE OF WORK New❑ Addition❑ Remodel❑ Utilities Installation❑ Other ❑ Describe work: f°[S�//E �,Y" Td r4rVAD.L. ps Lr��J Permit Fee $ 51 OD Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service e0v OR LESS 1000 AMP OR LESS 10.00 Main service EA. ADD -L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ( ACC. BLDGS. 2/20sgft 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 NEW CONSTR ULTI-OUTLT NON-RESID BRANCH CIRCEITS 2.50 ea NEW CONSTR. /POWER NON-RESID. (SINGLE OUTLET CIRAPPARATUS &'). 1 Ex. Occu FIXTURES 20@50C p( BAL030 FIXED APPLN S OR Ex. Occup. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT Filing 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. 14 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 Countyot 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, c ts, and enses which may in any way accrue against id County i cons ence of t e granting of this permit. Date JA, ��,� — Owner El Contractor ❑ Agent ❑ Sig�4 of Appli luired An OSHA permit is 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 $ JS'� Occup. GROUP I TYPE OF CONST. PARCEL PD No ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By PERMIT IRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date �Z�L Receipt No. WHITE-D.P.W., YELLOW-ASSFSSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT W -� �- ��/ �J /S96-g� COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 959E5 - Telephone 916/534-4541 APPLICATION AND PERMIT 4 ' 1 PERMIT NO. ASSESSOR PARCEL NUMBER sl ZONING I / BUILDING PERMIT OWNER TELEPHONE SQ. FT. OCC, BUILDING VALUATION OWNER'S MAILING ADDRESS CONTRACTOR'SNAME TELEPHONE - CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee Permit Fee $ 10.00 $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty Permit fee $ $ BUILDING ADDRESS PLUMBING PERMIT Filin Fee 10.00 9 Each Trap 2.00 Solar Water Heater 20.00 e Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE Building sewer 5.00 Mobile Home I S I G W 10-00e SF [ Duplex ❑ Mobi lehome ❑ Other SPECIFY TYPE OF WORK Permit Fee $ New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Contractor Describe work: '' % ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST.(DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. 1 2/20sgft 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 y� 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 NEW CONSTR U TI -OUTLET 2,50 ea NON-RESID BRANCH CIRC ITS NEW CONSTR / POWER APPARATUS W NON-RESID. %SINGLE OUTLET CIR. I Ex. Occup(OUTLETS OR FIXTURES SALA90 FIXED APPLNS. OR \ Ex. Occup. OUTLETS (RESID.) EA,/ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 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 Permit Fee $ Contractor for this reason MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE Heating I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. Cooling ❑ 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. Hood 3.00 Ventilation ❑ 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. 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. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ I also agree to save, indemnify and keep harmless the County of Butte against OCCUP. GROUP TYPE OF CONST. PARCEL PD HD ISSUE all liabilities, judgments, costs, and expenses which may in any way accrue I against said County in consequence of the granting of this permit. XDate t' This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do Signature of Applicant — Owner ❑ Contractor_ ❑ Agent ❑ work indicated above for which fees have been paid. An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. DIRECTOR OF PUBLIC By PERMIT EXPIRES Date WORKS Date Receipt No. i •`• , 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 ANDJPERMIT PERMIT NOr/ —d . ASSESSOR PAjiCEL iy�MBI-R� .J((�7ii��ov/ ZONIa1- I p ((//��// U BUILDING P E R M I T �/f� OWNER I""- 71 L ELE✓HONE S J SQ. FT. OCC. BUILDING VALUA ION 3 Z OO• VD OWNER'S AILING ADDRESS ox l G IV CONTRACT( 'SNAME TELEPHONE r56 s CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 6 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ 45,&D BUILDING ADDRESS S — 500 ` s � PLUMBING PERMIT Filing Fee 10.00 ° Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF d Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer5.00 Mobile Home S G W 10.00 e TYPE OF WORK New ❑ Addition ❑_ Remodel ❑ ,Ut' lit1es ❑ In tallation ❑ Other' Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. 2�t s2Sgft 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 NEW CONSTR. MULTI -CUTLET 2,50 ea NON.RESID BRANCH CIRCITS NEW CONSTF;L I POWER APPARATUS 6' NON-RESID. %SINGLE OUTLET CIR. Ex. OccuP Ts OR FIXTURES / 20®50a eAL®so FIXED PR Ex. OCCUp. OUTLETS (RESID IEA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑' The permit is for $100.00 (valuation) or less. ❑ 1 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. y� 1 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 FiIIng Fee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor 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 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 expe ses which may in any way accrue against id County in conseq a ce of the ranting of this permit. - Date G^ �F. Si atu a of Applic— Owner❑ Contractor F]Agent ❑ An OS A permit is r wired for excavations over 5'0" deep and demolition or construct- ion of structures over ssttorriie✓s in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ , 6o occUP. GROUP I TYPE OF CONST. PARCEL PD HD I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By v- / PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Da tp �, 11gAV / 2. Receipt No. i J WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT !f �.��.iF u;� ,+'•'r" `a.s�!ti..�s."'z,.J v. .x,:.�ik..•.,.QL,K..Li'i•�N';J�.n.:.l��ytq•f+�e::.�.J ,.s:....•.a'C+'�-�. •.., n.r. ,,,o.�•., o��;..-�.,�; —.. r• . . �-s ..��>,s- �r • , .r ' 039-180-026 99-2519 CHMELKA, BORVIN i 10470 PIERCE ROAD, CHICO CONTR: BUTTE ROOFING. _ RE ROOF „ .,�. �.-. ..._ �+_ .. .. . "� 9. • — � ��. .. • ,�v',• x ...: I" T' - r4 "• .. .... ...s..•1>: 1 x W xr M - • . � • k- !� 7Kf.:i 3 A -r � � .:Gv: iH •.• J � ' • 4 3 f / v 1 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, Caytorni 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT g4�,lg ASSESSOR PARCEL NUMBER_ / ZONING BUILDING PERMIT OWNER / TELEPHONE C SO. Fr- OCC. BUILDING VALUATION 1 _ OWNER'S MAULING ADDRESS pAJ. CaffMCTORI NAMEI TE NES CO TORS hIMUNG ADDRESS w C/ • C NSTRUCTION LENDER LENDER'S MAILING ADDR Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 2 0.0 0 Permit Fee $ 00 ARCHITECT OR ENGINEER HARING ADDRESS Plan Checking Fee $ BUILDINGADDRESS J Energy Plan Checking Fee $ $ PERMIT FEE S �D LAT NO:_.... ,.._.ii. I SU401IVISIONSNAY IEt--ti-..._.,,,.a,;»... -.n .�7t., .:._... ._.�. .y. ... PARCELAMAP ...r .. 46,1._ .. - P�UII�IBIf�G PERMIT Filirig'Fee 2b':00` USEOFSTRUCTURE SFC�' Duplex ❑ Mobilehome 11Other +r 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 ❑ Utilles ❑ Installation ❑ Other Describe Work: A6 f ?�r — 1e � ,frt �� ` v Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 Main Service 2�o.AoaLLEEss 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, e is in 11 and my licensforce and effect. License Class 61 Lic. No. 5(, 7 OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Lew for the following reason: ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ I am exempt under Sec. Business and Professions Code for this reason Main Service 200A To t000A 46.00so NEW CONST. DWELLING OCCUP. SO OR ADDNS. ( a Au C. BLDS. 3.50Fr. rwlw= ' MULTI.OUTLET 97.50 POWER APPARATUS a SINGLE OUTLET CIR. 20 ® 1.00 Ex. Occup. OUTLET OR FORURES aAL .so Ex. Occup. OUTLEEOTS R. D.DE'A5.00 TemPorary Service. 23.00 Mobile Home.Faal1,7tee= 20.00 Misc. Wiri , ng 23.00 PERMIT FEE S -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 l performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section ' 3700 of the Labor Code, for the performance of work for which this permitis issued. My workers' �pensation insurance carrier and policy number are: Carrier l I fo Policy Number A2 42YZ7'S 5 0 R (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, 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 forthw'th comply 'ith those provisions. X t� > Date a Signature o Applicant - ❑ Owner ❑ Contractor „Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT _ - Filing Fee.. ,20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE; Ov HAz. D FEES IMP I FLOOD I CDF PARCEL PO HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By Date PERMIT EXPIRES ONITE-D.D.S.-B.D. Dale rReceiptNo. :;' !% % CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT r COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, Ca lforr.�i 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT ��✓' Kz ASSESSOR PARCEL NUMB E� �J! U �j ZONING BUILDING PERMIT OWNER, 1 TELEPHONE SO. FT. OCC. BUILDING VALUATION .OWNERS MAILING ADDRESS c CCF7 TC JTELEP Zara NE CO TORS M41UNG ADDRESS ;5sl ONSTRUCT,ON LENDER Fireplace LENDER'S MaUNG ADDReSS, Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ,9P ARCHITECT OR ENGINEER MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS Energy Plan Checking Fee $ 1 $ PERMIT FEE $ f1D LAT NO. SUBDNISbNS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF 9( Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Udlites ❑ Installation ❑ Other jf� Describe Work: Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.00 Main Service 200AV OR OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is inII force and effect. �J Qq� License Class 9 Lic. No. S1Q / �Q( /C/ 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. 0 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. SO OR ADDNS. ( a ACC. BLDs. 3.5¢FT; LpµgESID. T. MULTI.OtmE. 97.50 POWER APPARATUS 8 SINGLE OUTLET CIS. 20 p 1.00 Ex. Occu OUTLET OR FIXTURES BAL @ .so Ex. Occup. OUUTTELETS FIESIp.OEq 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S 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 t 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' cppp��onsation insur nce carrier and policy number are: Carrier iUA41QV I h®• Policy Number / le—A — O(j- S$ (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, 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 forthw' h comply ith those provisions. X Dale Sign ure o App (cant - ❑ Owner ❑ Contractor Agent An OSHA permit is required for excavations over 60" deep and demolition or construction OR of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE S Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ /�% Op HOZ. D. FEES IMP I FLOOD I CDF PARCEL PD I 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 I 0%�j /�� PERMIT EXPIRES ON a r- Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT