HomeMy WebLinkAbout040-140-046r
, I 101
I ,'
O
O
N
040-140-046 02-0505
DRULEY, Robert
1475 Durham Dayton Hwy, Durham
Cont: Arctic Air
Replace HVAC/SF
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMEN— SERVICES - BUILDINGD ;ION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538 4_ OPERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT C
ASSESSOR PARCEL NUMBER
ZONIN
-Lib IOWNER
g DING PERMIT
• a �v`�•• �J�:J�! T 1
,�Ip F<,L.EPH2ONE►��4
SO. FT. OCC. BUILDING VALUATION
OWNER /,jj AES
-CONTRA R'S E • TEI.Er ON i
a.-330
CONT R ILINOAmAie
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS -
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER LICENSE NU.—Filing
Fee
$ 20.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Permit Fee
$
Plan Checking Fee
$
BUILDINGADDRESS '
U
Energy Plan Checking Fee
$
$
PERMIT FEE
$
LOT NO. SUBDIVISIONS NAME PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
i Each Trap7.00
Solar or heat um water heater
23.00
SFX Duplex ❑ Mobilehome ❑ Other
Water piping
15.00
SPECIFY
Each gas water heater or vent
15.00
TYPE OF WORK
Gas piping system 1 - 5 outlets
15.00
New ❑ Addition ❑ Remodel [3 Utilities ❑ Installation ❑ Other ❑
Describe Work: 1` V Ac,
Building sewer
Mobile Home I S I G I W
15.00
@20.00
PERMIT FEE
S
ELECTRICAL PERMIT
Fling Fee 20.00
RLESS
"OVMain Service zo.A OR IESS
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. +++•••���
� �+ tri ,�
License Class 20 -C7 Lic. No. ` c `"11
OWNER -BUILDER DECLARATION
Main Service TO
46.00
NEW CONST. DWWELLING OCCUCUP.
E
OR ADDNS. ( d ACC. BMS.
SO
3.5¢FT.
T
N"�A6D. MULTI.O CIRCUITS
97,50
POWER APPARATUS
8 SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FIXTURES
20 @ 1.00
BAL o .50
Ex. Occup. FIXED
DT3 RESIo.GE.
5.00
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Temporary Service
23.00
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.
Mobile Home Facilities
20.00
Misc. Wiring
23.00
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
PERMIT FEE
S
MECHANICAL PERMIT
Fling Fee 20.00
Heating
I Ki!ap 5, pig
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
performance of the work for which this permit is issued.
Coolingr�'
Hood
6.50
Ventilation
0 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' com ensation insurance carne and policy number are:
Carrier L.tk;ryN 4 ry^ ram YYIuL- a �
PERMIT FEE
$
Mobile Home Installation Fee
$
Policy Number� 1(,s-e4I_�_Q
(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
Energy Inspection Fee $
cc
GGMT. TYPE
TOTAL FEE $ so, (5;:�)
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
HAZ. D. F ES
FLOOD
CDF
PARCEL
PD
HD
ISSUE
workers' compensation provisions of section 3700 of the Labor Code, I shall
This permit is hereby issued under the applicable provisions
forthwith comply with those provisions.
c
X Date,3 ' CJ ��i?i
of the Butte County Code and/or Resolutions to do work
indicate bove for which fees have been paid.
Signature of Applicant - ❑ Owner ❑ Contractor IrYAgent
An OSHA permit is required for excavations over 60" deep and demolition or construction'9
of structures over 3 stories in height.
By A/YL (/G/L� Date
PERMIT EXPIRES ON ��� �-3
De le
Receipt No. 'cv
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT