Loading...
HomeMy WebLinkAbout039-180-04639-18-46 3369-W ,E,M DALTON, Dave 3743 Rodgers Ave, Chico cont: Artic Aire ' �l (hvac/sf) 3 I 39-18-N qCo FDAVID DALTON Rodgers Avenue, -Chico. =y �',`r: Dick Trent Uit#133-88E(electrical ser ch & misc ng/SF) 089--19-0- - -- � � � __ �� 1vL � � I 3369-91P,E,M 39-18-46 DALTON, Dave .3743 Rodgers Ave, Chico cont: Artic Aire (hvac/sf) fjj OFFICE Copy Address :YAG IE GAS Meter By E Date ELECTRIC Meter By Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovlller California 95965 - Telephone: 916/538.7541 APPLICATION AND PERMIT ERRMMIITT NO. (� / ASSESSOR PARCEL NUMBER 039-180-046 ZONING BUILDING PERMIT OWNER DAVE DALTON TELEPHONE S0. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 3742 RODGERS AVE. WOO CA 95928 CONTRACTOR'S NAMETELEPHONE RT AIC AIRE CONTRACTOR'S MAILING ADDRESS 2838 MY 32 M1100 CA 95926 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 15.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS ) Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS 3743 RODGERS AVE CHICO CA 95928 Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF F1 Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New ❑ Addition ERemodel Utilities[ ] InstallationC Other E:1Permit Describe work: NSTALL H& A/C Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200AORLESS 18.50 Main service 200A TO IOOOA) 37.50 CONTRACTORS LICENSE LAW I de la 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 .d0.- �/ � 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 CONST. ( DWELLING OCCUP.e\ OR ADDNS. 1 ACC. BLDGS. / 3.6dsq.ft. NEW CONSTR.ULT'-OUTLET NON.RESID BRANCH CIRC ITS @ 5.00 POWER APPARATUS 6 (SINGLE OUTLET CIR. Ex. OCCup(OUTLETS OR FIXTURES 20 75q Ex. Occup. OUTLETS P(RESID.)FIXED APLNS.REAJ 1 3.00 •00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ • — 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. Contractor MECHANICAL PERMIT FiIingFee 15.00 Heating 9.00 Cooling • Hood 6.50 Ventilation Permit Fee $ 33.00 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 sad County in consequence of the granting of this permit. ���.�: _.� � Date -��� 1� Signature of Applicant – Owner g pp ❑ 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 S Ener Inspection Fee $ Energy P occ CONST TYPE TOTAL FEES 71'00 HAz I DFEES IMP FLOOD CDF PARCEL PD HD ISS_ This permit is hereby issued under the P Y� sions sions of,t4 Butte County Code and work,indi ted dv for whic if DIR OF PU L By P EXPIRES Date applicable provi- PP P r resolutions to do have been paid. ORKS Date 9/19/9 Receipt NO. 100595 WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT ��"(rti+�''��"+i�''*-"-1'r=�1.;; 1.ri .•c:;'_ r. �.�:n�.-'.-7'i"t�'r`xyz'a"f`"�,+'•-,,,�' COUNTY OF BUTTE ; DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 ` 7 County Center Drive, Orovi I lb— phone: 538=7541 y 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOT -ICE Y '• 4. 'k -,A (-:c 0 j 336 V OWN�EF PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. tis— INSTNcry "fine_ 1AJA I[cdAd A•t"f Ic 70 N � � _ lnl5j�il S/in 6k//, l iL-r r,)./T 4 1 Date I o - 15, C1 I Inspector /_) ,L-4� COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS --PERMIT NO. 7 County Center Drive - Orovllle, California 95965 - Telephone: 916/538.7541 APPLICATION"AND,'PERMIT / A59ESSOR P RC NUMBER 039 -180-046 ZONING, - `" BUILDING PERMIT OWNER DAVE DALTON TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 3742 RODGERS AVE. CHICO CA 95928 CONTRACTOR'S NAME A TELEPHONE CONTRACTOR'S MAILING ADDRESS 2838 HWY 32, CHICO, CA 95926 Fireplace CONSTRUCTION LENDER NONE UNKNOWN Total Valuation is Filing Fee $ 15,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER NONE LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 3743 RODGERS AVE., CHIC0, CA ()5q28 Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ® Duplex❑ Mobilehome❑ Other SPECI FY Gas piping system 1 - 5 outlets 5.00 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK Iy� New ❑ Addition [:1Remodel [:]Utilities U Installation❑ Other ❑ Describe work: INSTALL HTG & A/C Permit Fee $ 20.00 Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 200A OR LESS 18.50 Main service 200A TO 1000A, 37.50 CONTRACTORS LICENSE LAW I declunder 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. ,23 �f'911 Classification El 1, 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 CONST. 9 ( DWELLING OCCUP. OR ADDNS. 1 ACC. BLDGS. I 3.60 sq.ft. NEW CONSTR. ULTI.OUT LET NON•RESID BRANCH CIRC ITS @ 5.00 POWER APPARATUS ( a ) SINGLE OUTLET C. Ex. Occup(OUTLETS OR FIXTURES AO 76q RL 4F;J EX. Occup. OUTLETS (RESID, IR PA I 3.00 3,00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. 6Virin 9 15.00 Permit Fee $ 18.00 — 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. Contractor MECHANICAL PERMIT FiIirgFee 1 15.00 Heating 9.00 Cooling 9.00 Hood 6.50 Ventilation perm it Fee Contractor $ 33.00 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 County in consequence of the granting of this permit. X L�%✓�Date ���—�1� Signature of Applicant — Owner �/ ❑ Contractor I� 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 S Energy Inspection Fee $ OCC CONST TYPE TOTAL FEE $ 71.00 HAz DFEES IMP FLOOD CDF PARCEL PD HD ISS j This permit is hereby issued under the sions of Butte County Code and wor 'ndi atedWaf DIRORKS ey PPIRES Date applicable provi- 4r resolutions to do have been paid. Date V19/91 91 9 19 92 Receipt NO. 100895 WNITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville. California 95965 - Telephone: 916.'538-7541 APPLICkTI0'1 AND PERMIT ASSESSORPARCEE'L NUMBER i� — V0_ � D ZONING BUILDING PERMIT OW R i0rk TELEPHONE SO. FT. OCC. BUILDING VALUATION OW E 4 MAILING 5S ODR _r CO TRACTOR'S N E PW '� �re-1 TELEPHONE CO N&A�OR'SM WING A DRESS ^ © ��[] &, 8- Fireplace I CO TRUCTION LENDIER V1 r - UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 15.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 1 Energy Plan Checking Fee Is ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ 9UILDING ADDRE:S ^ \ /�/ �� r Permit fee 1 $ PLUMBING PERMIT j Filing Feel 15.00 Each T rao Solar or heat pump water heater i 5.001 1 20.001 I .....T N :. j SUBDIVISION NAME PARCEL MAP Water piping i 7.00 Each Qas water heater or vent 1 7.00 USE OF STRUCTURE SFDuplex i� Mobi lehome ❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.001 S p I Building sewer 15.001 Mobile Home SIG 4y @ 15.00 TYPE OF WORK New❑ Addition j_ Remodel❑ Utiliti s Installation[ Other❑ Describe work: n f I Permit Fee $ ,�0.0 Contractor ELECTRICAL PERMIT Filing Fee 15.00 OOR LES (Main service 200A OR LESS 1 18.50 i Main service 20GATO1000AI I 37.501 CONTRACTORS LICENSE LAW ! 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 F; 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 CONST. / OWEL:ING OCCUP. OR aNS. ACC. SLOGS.y) 3.5dsa.rt.j ' .•'l NEINCONST!. "UL iO TL= `JON•PESID. SRANC,i CIPC' ITS j j@ 5.001 PC— R AGA AR ATVS h �ZINGLE ouTL=- _:R. ) / EX, Occup\OUTLETS OR =IAT'JPES I 20(2)75a �A �� I Ex. OCCUp. F7 S D A �REl�EA.) I 3.001 3, Gtr Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wirin g I 15.00 Permit Fee $ O — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): The permit is for 5100.00 (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. Contractor MECHANICAL PERMIT I Filing Fee 15.00 Heating j I Cooling g9.oen Hood 6.50 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 Si nature of Applicant — r—+ Contractor IJ r' Agent ❑ Owner 9I An OSHA -on of structures over r 3 storiesoineheigvfattions over 5'0" deep and demolition or construct. Mobile Home Installation Fee S Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ I riA[ I 0 FEES IMP j FLOOD I COF I PARCEL 1 PO HO ISSUE j This permit is hereby issued under sions of the Butte County Code and/or work Indicated above for which fees DIRECTOR OF PUBLIC By _ _ PERMIT E'<PIRES the applicable provi- resolutions to do have been paid. WORKS Date i 52'C� C Receipt No. U J ate .`.MIrC•O. P,w„ TCL�OW-ASeC770 R. Pi4„-�M9PCC TOR, .ni nlwPnO•APPLiCAwr r ,_. �.1�.,�,•�.,,�I iy��' �'l1,iF�4'�::�tii' 4+.rx.sir•`,"s�.x,,,#i'�/a.!-r•r\.r'.�rwr .�"•.,r-•,.�..;,.rr,,�-LK"t:,. :,+�,.^��w'•....•�-..:-,.. '-�.,.-.i.+�•'�-:--�..+�...' •r� 'R. OFFICE COPY ty 1, Address GAS 4. Meter By Date ELECTRIC',/ ' Meter By. Date (Ld J COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - OrovilleCalifornia 95965 - Telephone: 916/538-7541 • APPLICATION AND PERMIT 1 ✓ //d11 i��lll ASS ESSOR /1E1 fU ER z_ 6) —�� NI ' BUILDING PERMIT OWNER t+ 1 E), I 1 �' ✓ fT,FLEP.WONE t✓ tea' �i Q. FT. OCC. BUILDING VALUATION OWNER'S MAIL {ING ADS /DRESS (� LI J CO TRACTOR'S NAMTE,I�EPHONE CONTRACTOR'S MAILING ADDRESS II { Fireplace CONSTRUCTION LENDER J UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ S BUILDING ADORES I t ' � 7 Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 L C a 1 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF Q Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W O,OOea TYPE OF WORK z New ❑ Addition ❑ Remodel ❑ _Utilities Installation❑ Other Describe work: r _ * � Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 1000 AMP ORV OR LESS10.00 1 Main service EA, ADD'L 100 AMP 2.50 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 E] 1, 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 � or—sale. (Sec. 7044) ,- 21 1, 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 CONST. ( DWELLING OCCUP.EI) ,�2¢SQft OR ADDNS. \ ACC. BLDGS. NEW CONSTR. U TI.OUTLET 2.50 ea No N.RESID .BRANCH CIRC ITS (POWER APPARATUS eI SINGLE OUTLET CIR. 20@Ex. OCcup(OUTLETS OR FIXTURES SALO 30 AL0 FIXED PR Ex. Occup. OUTLETS (RESID )EAJ 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. ❑ 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. t0'I shall not employ any person in any manner so as to become subject to the W. C. laws of California. • I Notice to Applicant: If after making this statement,. should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply'with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation penult 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. Signature of Applicant — Owner❑ Contractor ❑ Agent r ❑ 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 $ Energy Inspection Fee $ TOTAL PERMIT FEE $ occu P, CONST.TrP! ISCHOOLIFLOOOIPAReELI P11 1 NO ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which IRECTOR+OF PUBLIC ? Iry Bye 4��1/���L-�" PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date �!/✓Niv �� / �` ✓r�/ Receipt No. li i/ p WHIT[-D.P. W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 y�— 7 County Center Drive, OroviIle — Phone: 538-7541 747 Elliott Road, Paradise — Phone: 872-6307 - - CORRECTION NOTICE X33- OWNER PERMIT NO. A routine inspection Indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. o [ e 1'e Inspector` in—' Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS �- 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. , ASS ES SOCEU ER• 0^ Z `Q ZONI n^ V -BUILDING PERMIT Da U ( a l P " O VVV SQ. FT. OCC. BUILDING VALUATION OWNER'S MAI L1[JG A�RESS � q33 O A cog A l c l NAM �tN,,11 C07ACTOR�ma-_� AILING ADDRESS L9Sq,5 3 G G IF 7 I Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ ///���y�1 BUILDING ADDRESS ^ /To a_d•1� / o��, f�7/(/" ` Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 �L e Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF 4 Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00ea TYPE OF WORK New ❑ Addition [:1Remodel ❑ „Utilitieso Installation[]Othe i Describe work-,-e7A&��? - I Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 1100V OR LESS10010.00 AMP OR LESS Main service EA. ADO'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): El 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 F] 1, as the owner, or my employees with wages as their sole compen- satign, will do the work,and the structure is not intended or offered Jor'sale. (Sec. 7044) E10001, 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 CONST. / DWELLING OCCUP.al yzltsgft OR ACDNS. \ ACC. BLDGS. NEW CONSTR. MULTI -OUTLET 2,50 ea NON-RESID BRANCH CIRCUITS) POWER APPARATUS 6 (SINGLE OUTLET CIR. Ex. Occup OUTLETS OR FIXTURES 200030 Ex. OCCUp. OUTLETS P(RESID )FIXED APLN5. REA.7 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00. ,5 - Permit Fee $ Contractor 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 nsent to Self -Insure. 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 Filirig Fee 10.00 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 judgm c sts, and expenses which may in any way accrue ag 'n sail' unty n c s nce of the granting of this pe mit. X <` Date I �� Signature of App I nt - Owner ❑ Contractor ❑ Agent I An OSHA permit 's required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ c l OCCUP. CONST.TYPEJ SCHOOL FLOOD PARCEL I P11 1 HD 1 ISSUE This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work icated 7ve for which fees have been paid. TOROF PUBLIC WORK BY ���—Date)����]��y�'� PERMIT EXPIRES Date / •/�/V Receipt No. WHIT[-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF 'PUBLIC WORKS - BUILDING DIVISION ' q 95965 - TELEPHONE: 916/538-7541 7 COUNTY CENTER DRIVE - OROVILL)»�,GG{W -�,FQRNIA / PERMIT APPLICATION DATA SHEET Permit No. L/ OWNER �-�V T`�U A. P. No. �/ ��' 7 Proposed Building Use r ��%Cai Building Inspector Sfl. Date/' At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted. . . . . . . . . . . . — 2. Plot plans in duplicate/triplicate, signed by preparer of plans. _ 3. Complete plans in duplicate/triplicate, signed by preparer of plans. 4. Complete engineered plans and calcs, with wet signature on plans. 5. Plans with Energy Design Compliance Statement. . . . . . 6. School District ''Fees Paid" Stamp on Floor Plan. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . 9. Letter of signature authorization. . . . . . . . 10. Sanitation approval from r _ Health -Dept. . . 11. Planning approval for (A) Use: (B) Parking: . 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) _14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ ) 15. Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . . . . Pre-Inspec.request to (Date) 17. Pre -Inspection for__ __. _. _ Required. Building Inspector Recorded copy of Agricultural Acknowledgment Statement. Driveway Permit. Plot plan approval from city -of_ When you issue the permit, process as follows: Mail to owner; Mail to contractor - I, --Telephone S Q� ���� and hold for pickup k )office, Deliver w/inspector. Other _ Applicant fl " k V/r,, Date of plans sent Health Dept.; Fire Dept., Other Date The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone---ritail—counter by date Contractor, designer, owner, was advised c9 above required data by_phone_mail=counter by date Plans checked by Copy–DPW Date Plans approved by Sets of plans on hold in File cabinet AP folder Date