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HomeMy WebLinkAbout039-360-01939=36-19 1734-90P,E 'COCKRELL, Al & Debbie. '1239 Marian Ave, Chico A (elec 'sere &1 p bg/SO / 039-360-019 02-0853 TROTTER, JENNIFER 1239 MARIAN AVE., CHICO LAWN SPRINKLERS & ELEC. FOR TIMERS 0 n COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541_ E IT NO. (Rev. 12/96) APPLICATION AND PERMIT 0 5 z JJF§SSOJgCEL„[JIJA]@ER U1NIFER ZONING BUILDING PERMIT MIrm, TELEPHONE 99 9371 SO. FT. OCC. BUILDING VALUATION IT �MARIANSAVE. CHICO CA 95928 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS 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 1239 MARIAN AVE. CHICO CA 95928 Energy Plan Checking Fee $ $ PERMIT FEE $ IAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF [X 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 ❑ Utilities ❑ Installation ❑ Other KI Describe work: LSPRINKLERS AND ELECTRICAL FOR TIMERS Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00AWN LAWN SPRINKLERS 1 15.00 15.00 PERMIT FEE S 35.00 ELECTRICAL PERMIT Filing Fee 20.00 600VOR UE Main Service zo.A 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 in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law pr the following reason: I, as owner of the property, or my employees with wages astheir 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 CO. to construct the project. I am exempt under Sec. Business and Professions Code for this reason Main Service 200A To IooOA 46.00 NEW CONST. DWELLING OCCUR OR ADONS. ( & ACC. BLDS. SO 3.50FT. Ro,o MULTI.OUTLET 97.50 POWER APPARATUS d SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES SAL p .so Ex. Occup. DFIXED . Aa oEl 5.00 TemporaryService 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 43.00 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: I 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. [3I 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.) 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 forthwith comity with qDse pro is ns. o X D n to °'B gn u of Applic - Owner ❑ Contractors Agent An OS permit is re ired f r excavations over 60" deep and demolition or construction/ of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating Coolin Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ Gcc CONST. TYPE TOTAL FEE $ 78.00 FEES IMP I FLOOD CDF PARCEL PD 1 HD 1 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 ON �f ate Receipt No. 7_33 i5,3 WHITE-D.D.S.-B.D. CAN -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 APPLICATION AND PERMIT - 0 A; -CJ e�� SES.On PAA ER r S TO/BUILDING PERMIT OwNER COrrTRACTOns NAME COrrt RAC rOn; MAIUNO ADOnESS CJr4 TlUC TnON LENOER Lf.r,DEr+S MAJUNG ADDRESS ARC.nEcr OR ENGINEER ---- — AACHNECT OR ENGINEERS LUIUNO ADDRESS O..LJ�NG bDQ.@ESS k A-- . o LOT NO SUBDNTSIONSNAME USEOFSTRUCTURE SF If Duplex ❑ Mobilehome ❑ Other SPECIFY TYPE OF WORK New ❑ Addition,❑ Remodel ❑ Utilities ❑ Installation ❑ Other TELEPHONE UCENSE NO .li SO. FT. j OCC. BUILDING VALUATION .---- `— --�_� _._.._ i _Fireplace I _ Total Valuation b Filin Fee i i b 2; r -- Permit Fee _ b Plan Checking Fee b Energy Plan Checking Fee S $ V "PERAAIT FEE PA20 SRA • . SHERIFF AA 6VN'T RECEZVEb "RICO" Nu#JM 5�- 39e " TO a rvr =t fo comim PERMIT FEE I S PLUMBING PERMIT Each Trap j Solar or heat pump water heater Water piping _ Each gas water heater or vent Gas piping system 1 - 5 outlets I Building sewer Mobile Home I S G i W PERMIT FEE 1 S ELECTRICAL PERMIT eaov oR LEss Main Service ( zooA oR u¢ss Main Service ( 200A TO 1000A NEW CONST. DWELLING OCCUP. OR ADDNS. ( & ACC. BLDS. NEW CONSTMULTIOIITLET NON•RESID. ( BRANCH CIRCUITS / POWER APPARATUS 6 SINGLE OUTLET CIR Ex. Occup. ( OUTLET OR FOCTURES EX. OCCU FIXED APPLNs. OR Occup. ( OUTLETS (RES10.1 EA. Temporary Service Mobile Home Facilities Misc. Wirinq Filing Feei 20 C 7.00; 23.001 1 5.001 _ 15.0(Y' 15.001 15.001--- (920.00' 5.00@20.00' 35,0() Filing Fee 20.0 23.00 j 46.00: 1 3.5cFT CD?7.50: 20 ;� 100 ; j I 5.00' I 23.00 ' 20.00 I 23.00'431-0t) I i ' I PERMIT FEE I S f ( 5,�212 ►APrHANIrAI PFG6AIT I Filina Fee: 20 Heating CoolingI i Hood j 6.50 ; Ventilation I I r PERMIT FEE I S Mobile Home Installation Fee $ Energy Inspection Fee 5 Occcc CONST. 11 TOTAL FEE $ I NAZ. 10. FEES I IMP I FLOOD I COF I PARCEL I PO ; ^D . 5 This permit is hereby issued under the applicable provislc of the Butte County Code and/or Resolutions to do we indicated above for which fees have been paid. By Receipt No. PERMIT EXPIRES ON WHITE-O.O.S.-8.0. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT Date 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. personally plan to provide ajor labor and materials for construction of the proposed propertyim vement : YES the O 2. I HAVEV HAVE NOT E3 signed an application for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed construction: WE PHONE: CITY: CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of�s work, but I have hired the following supervise, and provide the major NAME: F-WITIT"T*91 PHONE: 'S LICENSE NO. I will provide some of the work have contracted (hired) the work indicated: NAME ADDRESS PHONE Coordinate, persons to provide OF WORK SIGNED: PROPERTYOWNE SOCIAL SECURITY N i R: DATE: NOTE: This Owner -Builder Verification is required by Section 198.31 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit OVER T I OWNER BUILDER INFORIN ATION I Dear Property Owner: 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 parry 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 you plan 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 S300 or more for the entire project, and such persons are not licensed as contractors or subcontractors. then you may be an employer. ♦ If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance 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 abouty our obligations under Federal Law, contract 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 1030 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 building permit will not be issued until the verification is returned. I4NM,1ige'4rC,iBuildi2ng �C6k, .B.O. Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code- OVER oda OVER 0-10`b''J"F% .. .p i Not �. a COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS. PERMIT NO. , 7 County Center Drive - Oroville, Cal,ifornia 95965 - Telephone: 916/538-7541 1»-y��(� Q� APPLICATION*AND PERMIT 11:2 � 7 ASSESSOR PARCEL N UMBER 39-36-019 ZONING ' SR -1 BUILDING PERMIT OWNER Al & Debbie Cockrell TELEPHONE 894-3260 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS P.O. Box 1417 Chico 95926 CONTRACTOR'S NAME Owner TF�LEPH NE 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 ,$' Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS I Penalty $ BUILDING ADDRESS Plermit fee $ PLUMBING PERMIT Filing Fee 10.00 1239 Marian Ave., Chico Each Trap 4 2.00 8.00 Solar -or heat pump water heater 20.00 LOT NO. Prt/60 SUBDIVISION NAME Stanley Park PARCEL MAP Water piping /y 1 5.00 5.00 trach qas water heater or vent 1 5.00 5.00 USE OF STRUCTURE ( rYl SF[] Duplex❑ Mobilehome❑ Other SPECIFY ; Gas piping system 1 - 5 outlets 1 5.00 5.00 Building sewer 5.00 Mobile Home SG W OOe FIE TYPE OF WORK t New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ ; Other ® Describe work: Electric Service Upgrade & Revised _ Plumbing ( Permit Fee $ 33.00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 8001 OR LESS 100 AMP OR LESS 1 10.00 1Q .00 Main service EA. ADD'L 100 AMP 1 2.50 2.50 CONTRACTORS LICENSE LAW { ( 1 de la under penalty of perjury (check one): I I am licensed under provisions of Chapt. 9, Div. 3 Of thq Business and Professions Cod_ and my license is in full force $nd effect. icense No.Classification ! T ?111E, 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 Ogalttrh OR ADDNS. ACC. SLOGS. �Va) X 2'h¢sgft 31.00 NEW CONSTR.ULT'-OUTLET NON-RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS &) (SINGLE OUTLET C'R. Ex. Occup( OUTLETS OR FIXTURES s20e50e AL030 FIXED APPLNS. OR EX. OCCUp. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Pre -Inspection 11 115.00115.00 Permit Fee $ 68.50 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 Consent 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 FiIingFee 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, judgments, costs, and expenses which may in any way accrue agains aid County in consequ ce of the granting of this permit. s a/ 5o Signature of Applicant - Owner Contractor Agent 1:1 An OSHA permit is required for excavations over 5'0" deep and demolition or construct- structures over 3 stogies in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $101.50 HAz CLIAPARK SCHL EE PAR PD Ho Is Th;s permit is nereby issued under sions of the Butte County Code and/or work indicate ove f r w1 idh fees 1 TO �%f sj LC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. -WORKS Date -/ I- pt No.S Ci �/ op LRe D.P.W., TELLOW-ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE 4 DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico —,,Phone: 891-2751 7 County Center Drive, Oroville — Ph3ne: 53�r-7�41 747 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE C 0 CY- �Z,�- L I- 1-73q -go. 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. N L) -T (,A �- i c 1A, c a I,, I g- ii t) i r -,u I s 14 JT 11 �' r- V, - -;0' -2 Date Inspector 04 COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorfal Way, Chico — Phone: 891-2751 7 County Center Drive. OTvi Ile — P�one: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICf 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. C rc - Date— Inspector COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, Ca�fornia,95965 - Telephone: 916/538-7541/23qt- 90 / J. APPLICATION AN6 PERMIT /--t , ASSESSOR PARCEL NUMBER 39-36-019 ZONING _ SR -1 BUILDING PERMIT ` OWNER Al & Debbie Cockrell TELEPHONE 894-3260 SQ. FT. OCC. BUILDING VALUATION ' OWNER'S MAILING ADDRESS P.O. Box 1417 Chico 95926 CONTRACTOR'S NAME Owner 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 ,$ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ ' PLUMBING PERMIT Filing Fee 10.00 1239 Marian Ave., Chico Each Trap 41 2.00 8.00 Solar or heat pump water heater 20.00 LOT NO. Prt/60 SUBDIVISION NAME Stanley Park PARCEL MAP Water piping 1 5.00 5,00 Each qas water heater or vent 1 5.00 5.00 USE OF STRUCTURE SF ® Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 1 5.00 5.00 Building sewer 5.00 Mobile Home I S I G JW I 10.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ® Describe work: Electric Service Upgrade & Revised _ Plumbing Permit Fee $ 33.00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP ORV OR LESS_j 10.00 10.00 Main service EA. ADD'L 100 AMP 1 2.50 2.50 CONTRACTORS LICENSE LAW 1 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 it full force and effect. /{A (cense No. li%®� .� Classification �, ,J 7' 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- ontract ors. ors.(Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OJ(2n&) OR ADDN5. ACC, BLDGS. X 2'/z¢sgft 31,00 NEW CONSTR. MULTI -OUTLET NON.RESID BRANCH CIRC ITS 2.50 ea (POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(20®g°e OUTLETS OR FIXTURES 201.@ 1.. FIXED APPLNS. OR Ex. Occup. OUTLETS (RE SID .) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. byirin g 15.00 Pre—Inspection 1 15.00 15.00 Permit Fee $ 68.50 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 Consent 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. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling g 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 n" aid County in consequ a of the granting of this permit. X Date ,5 O�/ Signature of Applicant - Owner Contractor Agent ❑ An OSHA permit is required forexcavations ov r S'0" deep and demolition or nstruct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 0 0 HAZ I CUA J;A�FLD PAR PD Ho I"sagai ThI permit is hereby issued under sions of the Butte County Code and/or work indicated bove f r w i h fees I O By. PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. " ORKS Date ��✓!9 — Receipt No. �� • WHITE-D.P.W., YELLOW -ASSESSOR, PINK•INSPECT R GOLDENROD -APPLICANT OWNER COUNTY OF BUTTE - DEPARTMENT ,OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, RL'IF6ROIA 95965 - TELEPHONE: 916/538-7541 i PERMIT APPLI6M U1, N,cUATA SHEET Permit No. Proposed Building Use Building Inspector CSS 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. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .......... 8. Engineered truss details and layout in duplicate (required prior to plan ched') 9. Mobilehome installation data including manufacturer's installation instructions .... 1 ................................................. . 10. Fees of$ ......................... 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13. School District fees paid .............. 14. Sanitation approval from T Health Department 15. City of Chico plumbing permit..... r.' ....................... 1► .... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 420. . Driveway permit (construction approval required prior to occupancy) cznh Pre -Inspection for �C��� required Pre-Inspec. requestBuilding Inspector (Date) Contractor's license information (No., Name Style, Classifications Certificate of Workmans Compensation Insurance .................. 1 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 26. 27. When ou issue the permit, process as follows: Mail to owner. Telephone and hold for pickup at Co office Other 1 Applicant Mail to contractor. _Deliver w/inspector. Copy of plans sent Health Dept., Fire Dept., Other Date Date �a `% The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. i 2. Additional items required: t Contractor, designer, owner, was advised of above required data by—phone---Mail Contractor, designer, owner, was advised of above required data by_phone_mail Plans checked by Date Plal s..approved by_ Sets of plans on hold in File cabinet AP•folder -fol-sn l�� '+-7- Copy—DPW unter by .date unter by date Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroviiler Ci�lifornia,95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR P R EL NUMBER _ O �-f -- 3k, /� .. ZONING s/?_ % BUILDING PERMIT OWNER 4L Cock��LL _ TELEPHONE 4�Sy-326 SO. FT. OCC. BUILDING VALUATION OW MAILING l 7�C r5'2 r « 6 ;7 CONTRACTOR'S NA/M. _ n TELEPHONE CONTRACTOR'S MAILING ADDRESS - Fireplace CONSTRUCTION LENDER VNKNOWN 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 ACDRESS Penalty BUILDING ADDRESS Permit fee c$ $ PLUMBING PERMIT iilingFee 10.00 %2 C7 11 -I&A Each Trap 2.00 $ Solar or heat pump water heater 20.00 40I NNp. SUBDIY ION NAME PARCEL MAP Water piping 5.00 -� Each pas water heater or vent J 5.00 USE OF STRUCTURE SF"V- Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 _ Building sewer 5.00 Mobile Home I S I G JW 1 10-00e TYPE OF WORK New ❑ . Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other Des rib^e work: L �e4 J � c -L s�! ��,,,a�.�J Permit Fee $ 3 Contractor ELECTRICAL PERMIT Filing Fee 10.00 -Main service 100 AMP V OR LESS 10.00 Main service EA. ADD -L too AMP 2.50 5 CONTRACTORS LICENSE LAW r 1 declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business - - and. Professions Code and ry license is In full force and effect. + License No. Classification Q -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. Businessland Professions Code for this reason NEW CONST. DWELLING OCCUP.6 OR ACDNS. ACC. BLDGS. Z +/z¢sgft �-a NEW NON.RESID CONSTR. BRANCH CIRCITS 2.50 ea TU /POWER APPARAUS e (SINGLE OUTLET CIR. / EX, OCCUp\OUTLETS OR FIXTURES BAL 30¢ ewLoso¢ FIXED APLN5. EX. OCCUp. OUTLETS PIRESID IKEA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 /fie J Permit Fee $ 6 g..S'� 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. 0 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 Ccde, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation Permit Fee E 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 Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature of Applicant — Owner Gntractor ❑ 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 HoWe Installation Fee $ Energy Inspection Fee $ OCC I CONSTTYPE 9 Z3 �✓ TOTAL FEE $ (�J HAz CUA PARK SCHL fLD PAR PO tD ISSUE 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 EXPIRES Date- the applicable provi- resolutions to do have been aid. p WORKS Date - Receipt No. COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 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 or 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 V City Phone Contractors 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 Contractors 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 Work Signed: Property Owner Social Security Number Date NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. PRE -INSPECTION kk OWNER : lUG� C oC 1C/liL - DATE LOCATION:_,.�CH/ c' o A.P. # 3 �- 3 6 - 0 ) `� CONTRACTOR: f l►- ZONING �S J PRE -INSPECTION FOR: CQ�Q-Al(, o f 10e-A-Yh DATE TO INSPECTOR PERMIT HISTORY: KNONE' AS FOLLOWS: TYPE OF OCCUPANCY �- 3 FIELD - INFORMATION BUILDING USAGE: {LE S TENNANT: OCCUPIED HAS ELECTRIC HAS GAS © HAS SANITATION FACILITIES ,,HEATED -COOLED � PERSON CONTACT, A Co�� E Lli OTHER COMMENTS: ACTION RECOMMENDED: ISSUE HOLD FOR OTHER: D i C> %Z-®�1� ..G9 Q� l .u�►. BY J . DATE F COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS r-i,t t 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, OroviIle — Phone: 538-7541 747 Elliott Road, Paradise —Phone: 872-6307. = CORRECTION N OT IC -.PERMIT NO. OWNER 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. _::.�r`<`. /c07 - .A. i� Date s 3� - (a Inspector '!'_'