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Home My WebLink About039-460-016" BARKSDAIE, John D- 4609B v 4499E p of (new, single family) / f . " ------- -- '-� r`p COUNTY OF BUTTE - DEPARTMENT,OF PUBLIC WORKS 7 County Center,Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT .PERMIT NO o� r r C ASSESSOR -PA R EL NU7Q ZONING. BUILDING ,PERMIT OWNER I foorr-S S /� - TEL PF14NE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILIN ADDRESS ,� -J 1, 1r 10 X7 CONTRACTOR'S NE^COT LEP''O^; 1 / CONTRA OR'S'MAI.LING ADDRESS V " r / Fireplace CONSTRUCTION L'EN'DER /` UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ G �/ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS R Penalty $ BUILDING ADDRESS rr f)n - r o Permit fee $ PLUMBING PERMIT Filing Fee 10.00 i Each Trap 2.00 )U Ah A Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MA Water piping 5,00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF CS( Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home Is G W 0.00ea TYPE OF WORK New ❑ Addition ❑ Remodel F1 Utilities J� Ins allati n Other % Describe work:/? r� fit%/ Q� r 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 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. '— % i `� Classification '' rl ❑FIXED 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 OCC UP.y , OR ADONS. ACC. SLOGS. �z¢sgft NEW CONSTR MULTI -OUTLET '2,50 ea NO N.R ESID .BRANCH CIRCUITS) POWER APPARATUS IN) (SINGLE OUTLET CIR. Ex. Occup OUTLETS OR FIXTURES eA 0 0 APPLNS. R Ex. OCCUp- OUTLETS ((RESID )EA.) 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. �Yirin 15.00 9 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): * ❑ The permit is for $100.00 (valuation) or less. a,,rf'liave 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 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 against said.County in consequence of the granting of this permit. X `r r / �r� - 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 $ Energy Inspection Fee $ TOTAL PERMIT FEE $ tllI OCCUP, CONST.TTP! SCHOOL FLOOD PARCEL PD I HD I ISSUE This permit is hereby issued under sions of the Butte County Code and/or efor which work indf-dited abovgE-6 DIRiOF PU By 1 .r. PERMIT EXPIRES Date //) the applicable provi- resolutions to do fees have been paid. ICWORKS /^l Receipt No. v WHITE-D.P.W.. YELLOW-A3e[SSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. / 3 E,;v 74yV ASSESSr9 AR E NU7 `•/( -` / ZONIN BUILDING PERMIT i ow R ►^ h TELEPHJ,NE SQ. FT. OCC. BUILDING VALUATION OWN E 'S AIL' ADDRE S ho n / CON ACTOR'S NA E _ O E O CON R C OR'S M LIN AD WES r n Fireplace C NSTRUCTION r_ ER • UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee$ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 'T _ V,Permit In fee ; PLUMBING PERMIT Filing Fee 10.00 Each Trap 2,00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAMEPARCEL MA Water piping 5,00 Each qas water heater or vent 5,00 USE OF STRUCTURE SF �Z Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00 ea TYPE OF WORK New ❑ Addition ❑ emodel ❑ t Iitiesyrrs allat on❑dOther % Describe work: ro 9 k)..C`J Q �l� 7 Penult Fee $ Contractor. ELECTRICAL PERMIT Filing Fee 10.00 Main service 10000 AMP -OR V OR SLESS 10.00 Main service EA. ADD'L 100 AMP 2,50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check one): ElNON-RESID I am licensed under provisions of Chapt. 9, Div. 3 of the BU$IneS$ and Professions Code and my license is in full force and effect. License No. �� 92D�— Classification ❑FIXED 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.SI , OR ADONS. ACC, BLDGS. �, /2(tsgft NEW CONSTR. U '.OUTLET . BRANCH CIRCUITS) 2.50 ea (POWER APPARATUS a) (SINGLE OUTLET CIR, Ex. Occup(OUTLETS OR FIXTURES eAL030 20 30 APLNS Ex. OCCup. OUTLETS PIRESID,IREA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00Misc. Wiring 15.00 9 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. na--I-Rave 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 Filing Fee 10.00 Heating Cooling 9 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. also agree to save, indemnify and keep harmless the County of Butte against all li I lef s 'ud ments- osts, and expenses which may in any way accrue aga'st not eq ce of granting of this permit. ` Date d �� Signot a of Applicant - ner Contractor ❑ Agent An 0 HA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures Over 3 tories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ 0CCUP. CONST.TYPC I ISCHOOLIFLOODIPARCrI.1 PD I ND Is uE This permit is hereby issued under sions of the Butte County Code and/or work i ca d above for which D OF PU Y 1 EXPIRES Date the applicable provi- resolutions to do fee have been paid. I ORKS D to Receipt No. WNITE-O.P.W., YELLOW-ASe ESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT '�J�'"m��Y�'=i!r•.,.,%`�,. . t�.1'1'•?�`�}'�i"��N ?'+i"�"`S.y..�5"�+"�,l'►�"d��`}.'�t'..ary1'ti.'.e'-.rsZM� nit:�,•:�+-�SI':�,6i-'�iAe�i•"%L�!"t^'Jittd�2.,,�..IrYutdrly+^"^..� ,f4+R"3.etr--..� _ .rr �. 9-46-0-016 91-3834 OLSEN, FRANCES CONTR: MCDONALD ELEC 2459 DURHAM DAYTON HWY, DURHAM UNDRGRND ELEC/SF OFFICE COPY Address y5�• Dtn21 (M bAyr�d GAS, MeterBy Date ELECTRIC Meter By /�.`.11.Q�-,n Date 10-3a -41 ane I COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS P RMIT N0. 7 County Center Drlve - Orovllle, Callfornle 95985 - Telephone. 918.'538.7541 APPLICATION ANaPERMIT A33ESSOR PARCEL NUMBER 39-46-16BUILDING ZONING PERMIT OWNER FrAne.l." 01 • TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS2459 tt DDaytanAa, Durbas 95938 CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS 146 R. Itlitte St., willmm Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 15.00 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 15.00 9 Each Trap 1 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 SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S G W @ 15.00 TYPE OF WORK New ❑ Addition LJ Remodel ❑ Utilities ® InstallationE Other ❑ Describe work: D•U•U.D• Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 1 18.50 200A OR LESS Main service 20CATO 10o0A) 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑NON-RESID• 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.SINGLE 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 CONST. DWELLING OCCUP.&\ 3.64 sq.ft. OR ADDN5. ACC. BLDGS. II NEW CONSTR ULTI.OUTLET @ 5.00 BRANCH CIRCUITS) POWER APPARATUS e\ OUTLET CIR. I Ex. OCcup(OUTLETS OR FIXTURES 20 76d FIXED IPPINS. Ex. Occup. OUTLETS ((RESID OR3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 1 • Permit Fee $4 — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. i ❑ 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 Filing Fee 15.00 Heating Cooling g LHood 6.50 J 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. q X ' '��, r.�n �'} rt- ' -Date l l Signature of Applicant — Myner Contractor ElAgentElI 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$48• SO I HAz 1 DFEES IMP I FLOOD I CDF PARCEL I PD HD Issu This permit is hereby issued under the applicable provi- sions of the -Butte County Code and/or resolutions to do A n work Indic ted aboye�lfwhich fets,have been paid. DIRECTgR�OF P BL WORKS By i ,,¢n 0 ,I`T�.f �__A'11ii/ Y Date �1�1 PERMIT,EXPIRES Date `.Tr,14 i - Receipt No. 100990 WWTE-O.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT !v COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS P MIT N0. 7 County Center Drive - Oroville, California 95965 - Telephone: 916,'538.7541 APPI-reAtION AND PERMIT ASSESSOR PARCEL NUMB R 39-46-16 ZONING BUILDING PERMIT OWNERTELEPHONE SO. FT. OCC. BUILDING VALUATION / l OWNER'S MAILING ADDRESS 2459 Dqrham Dayton Hwy, Durham 959-18 CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS 146 S_ Rjittp St-, Willowq ' 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 Permit fee $ 9459 Durham 112yton Hwy, I)iirhnm PLUMBING PERMIT Filing Fee 15.00 Each Trap 1 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 TX Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home I S I G JW 1 @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities ® Installation ❑ Other ❑ Describe work: D. U. U. D. Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A DOR LESS 1 18.50 18.50 Main service 20GATO1000A) 37.50 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 ❑ 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.&\ OR ADDNS. ( ACC. BLDGS. / 3.6Q sq.ft. NEW CON5TFLMULTI-OUTLET NON-RESID, BRANCH CIRC ITS @ 5.00 POWER APPARATUS a, (SINGLE OUTLET cIR. Ex. Occup(OUTLETS OR FIXTURES 20 76 Ex. Occup.'ou LETS ((RE51D.)REA.) I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring g 1 15.00 15.00 Permit Fee $ 48.50 — 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 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 Cooling g 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 s 'd County in consequence o the granting of this permit. q X ��'��, /) Date �G �� / l Signature of Applicant — OwnerW Contractor E]Agent ❑ An OSHA permit is raquirad 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 $ OCC CONST TYPE E TOTAL FE $ 48.50 HAz I DFEES I IMP I FLOOD I CDF PARCEL I PD HD ISSU This permit is hereby issued under the sions oft utte County Code and/or work i is ed abo f r whicWfes DIRE ' F P BRKS BY PER IT PIRES Date applicable provi- resolutions to do ave been paid. Dat I,. Q Receipt No. 100990 WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT - 1 y{+rw r � _ ,s. __. ., .,, ....{-.t,..t.-i..w..fr+-��•h+�Lfs�:'�'+WF.,�A1'"`�"./.n,�,-w�,'�.+s.*-c-.-.,.".y�"5... ��..;,�*�.3y'."t•V`r'�' ..-..�ti-••='t...t'i.... z •.. r.. y COUNTY OF BUTTE - DEPARTMENT N'OF PUBLIC WORKS -.BUILDING DIVISION 7 COUNTY CENTER DRIVE - 61710J,11LLF�ALvFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET Permit No. / OWNER A. P o. Proposed Building Use L? 6-1614j�2 Building Inspector 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 Glans and calcs, with wet signature on plans .. 5. Hazardous Material Form ................ ........................... 6. Energy Design Compliance and supportir g documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ " y 11. Chico Urban Area fees paid ....................................... 12. Park fees paid 13• School District fees paid .............. 14. Sanitation approval from Health Department *- 15. City of Chico plumbing permit .........% 16. Plot plan and business license approval from City of (see City for other requirements) ris 17. Planning approval for (A) Use: (B) Parking: ..... 18. -Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec.request to s...,. ' ' Building Inspector, (Date) �ontractor's license information (No., Name Style, Classification) ... 22.• Certificate of Workmans Compensation Insurance .....:............. .` 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 4 . Recorded copy of Agricultural Acknowledgment Statement ......... Letter of signature authorization .................................. 426. w... 27. When you issue the permit, process as follows: Mail to owner. Mail contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other Appl, can �4Date ,,2,� � 0 .1a r p sent Health De t. Fire Dept. Air Pollution Date C�ipy !s n Health Dept. Fire Dept. Other Date By 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 reouired: Contractor, designer, owner, was advised of above required data by_phone---jnaiI—counter by ..date Contractor, designer, owner, was advised of above required data by —phone _maII—counter by date Plans checked by Sets of plans on hold in Copy—DPW Date " Plans approved by File cabinet AP folder Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Orovill,e. Califgrnia 95965 - Telephone: 916 '538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER FK Zt�tic/S O&-5CG 6,/ TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S M ILING ADORES ol it -1,Q n C NTACTAME � � - V TELEPHONE ONTRACTOR'S MAILING 0.0DRE55 S (Jt%?" ��. l�/1 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 Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SU 001 VISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF� Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home I S I G 1W 1 15.00 TYPE OF WORK New ❑ Addition L✓ Remodel❑ UtilitiesInstallation F_!, Other ❑ Describe work: Z Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A OR LESS 18.50 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 jJ 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-Misc. ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason Main service 20GATO t000A) 37.50 NEW CONST.OR ADONS. l / ACC. BLDGS. DWELLING OCCUP.&) 3.6dsQ.ft. NEW CONSTSL 7MULT I.OUT LET @ 5 00 NON.RESID•. BRANCH 'JT FU ITS /POWER APPARATUS & (SINGLE OUT LET'CIR. Ex. Occup( OR FIXTURES J 20 76d MA FIXED APPLNS. OR Ex. Occup. OUTLETS (RESIO.) EA.) I 3.00 Temporary service 1 15.00 Mobile Home Facilities 15.00 Ho g 15.00 Permit Fee $ — 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. to the W. C. laws of California. NoMI shall not employ any person in any manner so as to become subject ice 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 Cooling 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 ounty in consequencee grantin of his permit. V. X �yi a e �4 �% /j Signature of Applicant — Own6W, 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 $ Energy Inspection Fee $ OCC CONST TYPE TOTAL FEE $ HAz 1 0FEES I IMP I FLOOD I C= PO HD HD ISSUE This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By DatePERMIT EXPIRES Date Receipt No. -MITE-O.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT