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Home My WebLink About040-170-0944 40-17-94 LYLE OLSON 9479 Cummings Rd, Durham t (Special Inspection #10-86) --------------------- 40-1-7-94—- Permit#853-86B (plbg & stove inst)SF tlY(0' 0404170=094 ''c ;PERMIT#94 ;2612. w KOHL" JAN,., 947.9. 4UMMINGS RD`.. , DURHAM - k w... CONT :'; ELY, ROOF ING- REROOF/SF' . ki i }i I O 19 �"� . COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBERZONING BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS CONTRACTOR'SNAME J c. / A.1 <, TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER ..Nle nQ. UNKNOWN Total Valuation $ j /,rJ�k-1. 0J FilingFee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER '1", ^•R"' 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 ,> Each Trap 2.00 r +i't" 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 ❑ Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 10.00ea TYPE OF WORK" New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Installation ❑ Other ❑ Describe work: C!.., 4•. c t �.I r�. r I •.1_. ,�.f:, ,. r Permit Fee $ 5; e>,3 Contractor ELECTRICAL PERMIT Filing Fee 10.00 S• Main service 100V 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 Bushes$ and Professions Code and my 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. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.� , New CONSTR.( A 1 h¢sgft MULTI -OUTLET NON.RESID BRANCH CIRC ITS 2.50 ea /POWER APPARATUS e (SINGLE OUTLET CIR. Ex.Occup(OUTLETSOR FIXTURES SAL@3t eALeo Ex. Occup. OUED P OUTLETS (RESID )REAJ 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. OI 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 Filing 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 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 f Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit isrequired 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 $, •5 U OCCu P, CONST.T1'PC I JFLOOOJPARCELJ PD NO I ISSUE, Y This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which 1 DIRECTOR OF PUBLIC BY L1 '>?'LfrY PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS j Date _J/ r`' Receipt No. WNITE-D.P.W., YELLOW-AS8ES90R, PINK -INSPECTOR, GOLDENROD -APPLICANT r J COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT - PERMIT N0. ASSESSOR PARCEL NUMBER - _ ZONING BUILDING PERMIT OWNER TELEPHONE ya -7071 SO. FT. OCC. BUILDING VALUATION OWNER'S M"YLING ADDRESS i CONTRACTOR'S NAME LJ TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace Ae Op. o0 CONSTRUCTION LENDER UNKNOWN Total Valuation $ � voce. O L1J 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 t Gtr✓ti Permit tee ; 7. SQ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 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 ❑ Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home Is I GJW1 10.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other ❑ Describe work: 21W. b l & Spex-7M/tlt A .S-itnve ivvQL #arty Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 S Z LJ �O Main service eoov OR LESS 100 AMP OR LESS 10.00 Main service EA. ADO'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ 1 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.& , New AMULTI-OUTLET h¢sgft CONSTFL NON.RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS &) SINGLE OUTLET CIR. c Ex. Ocu zALO p OUTLETS OR FIXTURES aL030 FIXED PR Ex. Occup. OUTLETS IRESID )EA.7 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring g 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. j)( I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: It 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 Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also ag'r'ee to save, indemnify and keep harmless the County of Butte againstOccup. all li ti' ies, judgments, costs, and expenses which may in any way accrue agai said Co^ in quence of the granting of this permit. 45) ure of Applicant — Owner, Contractor ❑ Agent ❑ YnOSHA permit is required for excavations over 5'I)" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $, CONST*TYPIJ I JF1 .o PARCEL Pq ND IV This permit is hereby issued under sions of the Butte County Code and/or work indicated above for hich DI TOR O UBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS /Date J Receipt No. 5�� S /} WI/ITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENTF PUBLIC WORKS - BUILDING DIVISION .,_ 7 COUNTY CENTER'DRIVE - OROVILL�`,'CGhtll-ORNIA 95965 - TELEPHONE: 916/534-4541-_. PERMIT APPLICATION DATA SHEET OWNER 1,V1 -f Proposed Building Use Permit No.. A. P. No. 'Yb — l 7—QG/ Permit Fee Based Upon: Complete Contract Price DPW Valuation Other (Explain) Building Inspector Date ha 5"t -- At time of permit application, I was advised the following data must be submitted prior to permit processing andJor ssuance: DATE RECEIVED APPROVED 1. All items. have been submitted. . . . . . . . . . . . 2.., Plot plans in duplicate/triplicate. . . . . . . . . . . 3. Complete plans in duplicate/tri.plicate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . .5. Plans with Energy Design Compliance Statement. . . . 6. CUSD "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 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 17. Pre -Inspection for Required. Building Inspector (Dote) 18. Recorded coy of Agricultural Acknowledgment Statement. . . 19. Other __Dr�veway permit (const, approval required prior to occupancy) When ou issue the permit, process as follows: Mail to owner. Mail to contractor. Telephoneand hold for pickup atQn►co office. Deliver w/inspector. Other Applica_atll y/i /,�� (��rsa'� Date Copy of plans sent Health Dept., Fire Dept., Other -,Date During the plan checking process, the following data must be submitted prior to, -permit issuance: .r (For required items not checked above at time of application, Trcle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required d/tayTelephone Mail Other By _ Date Plans checked'by Date Plans approved by Date Other: Copy—DPW I.- , , i .......... fte county LAND OF NATURAL W E A L T H AND BEAUTY DEPARTMENT OF PUBLIC WORKS WILLIAM (Bill) CHEFF, Director 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 Telephone: (916) 534-4541 RONALD D. McELROY April 7, 1986 Deputy Director Lyle Olson RE: SI 10-86 9479 Cummings Rd. A.P. #40-17-94 Durham, CA 95938 Dear Mr. Olson: With reference" to the above subject and your request for inspection of the garage and shop building the garage conversion to family room on your property at the above address, the inspection was made on April 4, 1986. The following items must be done or resolved: A) Garage -shop building 1) Provide a gas shut-offvalve at the gas water heater . 2) Provide a full sized T & P relief valve drain line to the ex- terior of the building terminating between 6" and 24" above grade. 3) Cover the exposed wiring beneath the electrical sub -panel.., B) Garage conversion to family room 1) The brick wall' shield behind the wood stove must have a 1" ventilated air space. 2) The existing wood burning stove must be relocated to bea minimum of 12" from the finish wall surface, protected by the 4" brick wall and (".ventilated air space. 3) The wood burning stove must have a hearth extension of at least 16" in front and 8" to the sides of the opening of the firebox. It is now in order for your to obtain a permit to do the above corrective work and request an inspection and approval. Should you have any questions concerning this matter, please contact this office. JFG:aam cc: Building Inspector - Chico Assessor Yours very. truly•,- William•Cheff Director of -Public Works J.F. Glander Chief Building'Inspector ❑ Complaint -Date Ef Other' Date BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS SPECIAL INSPECTION REPORT ZONING Owner: Address: IL(7 Q CV-" a s i?J.- Tenant: Building Location: S arc Type of Inspection requested: A.P. # �-0 - ( 'L Date of Inspection L(," Inspector 1. Housing / / 2. Financing / / 3. Change of Occupancy to 4. Work W/O Permit / / Other (specify) J Present use of building: 4 rl' -—,6 ��— A. Sanitation (Housing) \ 1. Water closet: 2. Lavatory: 3. Bathtub or shower: 4. Kitchen sink: 5. Hot and cold water to fixtures:' .� Heating facilities: 6v<7«( 7. Natural light and ventilation: 8. Room and space requirements: 9. Bedroom windowor door for second exit: 10. Infestation of insects, vermin, or rodents: 11. Connection to sewage disposal: 12. Connection to water supply: 13. Rubbish and garbage facilities: 14. Stairs:(Rise, Run, headroom, 1HR, Tolerances,Handrails) 15. Comments: B. Structural 1. Piers and footings: 2. Floor construction: 3. Wall construction: 4. Ceiling and roof construction: 5. Fireplaces: 6. Comments: C. Electrical 1. Service and ground: 2. Receptacles: 3. Fusing 4. Comments: Go -.�_✓ �-�•,2 a,- S �� ..Q ,-� �,.�. ,� �e _ s & ,� a / ,vim l �—� _ ��I_~IL7 Z—) .17 �- D. Plumbing ` 1. Fixtures connected and vented: �, Gas water heater: � j �o �/ -f T -r /� �.�L S1 i, 2 3 Gas heating vents: 4. Comments: E. F. Other 1. Maintenance and repair: 2. Fire hazards: 3. Safety hazards: 4. Weather protection: 5. Underfloor and attic ventilation: 6. Energy: 7. Comments: Commercial Buildings 1. Roof covering: 2. Distance to property lines: 3. Physically handicapped: _ 4. Restroom floors and walls: 5. Exits: 6. Improvements: 7. Zoning: 8. Comments: G. Field Problems or Violations 1. Problem or violation (give complete description): 2. What action taken (give complete description): 3. What action recommended: A. Information only - file. B. Hold for ten days, then write letter. 7-7 C. Write letter. / /.D. Other: COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 �Y. Telephone:. 534-45,.4'.1 "- APPLICATION FOR SPECIAL INSPECTION Owner L-.0 k✓� l;K,,1m, A4 a A.P. No. 4n, -/; � 9,L ! �j n l Mailing Address 7 y J 9 IJ IM M v, n /�,,� %Gs ✓ 46 i.n Telephone No. ��".�%� - %r� % i C Applicant 'Do V,,1 F` Telephone No `. Mail in=g�"Address' � �a d'`✓��" C^ �.� c'�`�=`.r� � '� 1 �Y Building Location C �r � )l'i Inn 4 int, j' �� r o_ •.r B I hereby request a special inspection of the following building:. 1 1. Dwelling (if only a portion, specify) 2. Apartment House (if only a portion, specify)' 1 3. Commercial (specify present occupancy) t / 4. Other (specify) , l')GV4.1 0 �,��i9V��✓off ✓t)�/� P t„ i I am requesting a special inspection for -;the purpose 1. Moving the building. 2. Financing (specify agency) Case No. 3. Change of occupancy to / V / 4. Other(specify)C n o . F �OtM � �l G h C"(Q o x I hereby certify that 'I�will"obtain the necessary permits and make any necessary corrections,; alterations, or,repairs required by the County of Butte, as a result of this inspection, to comply with building and housing code requirements. I also certify that prior to the use or occupancy of this building, I will complete the above required corrections, alterations, or repairs`,�r, if the building is presently occupied, I will complete the above required corrections, alterations, or repairs within thirty (30) days. t w I certify that I have read this application and state the above information is correct andkereby authorize representatives of,,the County of Butte to enter upon the above-mentioned property for inspection purposes. Date Sip'ature`of Owner y � Fee paid $ ^l*.C�(7) Receipt No. 1st -DPW - 2nd -Inspector - 3rd -Applicant :, .. 1 1 V .. _T} __ _ .. - _` - — _` - _. .. .. _ _ .. _ _. _. - � � r . tl I �- _ _ _ _ _. �• � ---- - — - - -- - - — v- � ': ,�, � _ _ � a {� . _ i+_ _.. __ - .. t - _. - - - _ _ .. - i� +r - j� /� %�� C w ---�7R}Y S.'`Y«�!'F: +_ • '' #dam •v «,.� . .. .. _ ;..fes • J��•..r,r• ^'ya."cPr"+'-r�+„"t"''v i Z � f,•" f 't '.:K;�'+!'�'ir�A'rd.'s �^ � Z � •r.""e �%� •� _ _ Ali. r"'• �- �° r� 040.170-094 PERMIT#94-2612' KOHL, JAN'°`: •:" 94.79 4UMMINGS RD ; ' DURHAM CONT: ,ELY ROOFING"'r"J REROW SF H • . A t 1 � ' t COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541PERMIT NO. APPLICATION AND PERMIT /� y _ �C� 2 -,z. ASSESSOR PARCEL NUMBERO D 917-1 ZONING ; BUILDING PERMIT OWNER� A / TELEPHONESQ, � FT, OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS6tj / R CONTRACTOR' Aloe !/ Q TELEPHONE � A CONTRACTOR'S MAI G ADDRESS 1�/ Fireplace CONSTRUCTION LENDER NKNO UWN Total Valuation $ lr6 O LENDER'S MAILING ADDRESS Filing Fee $ 20,00 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 $ - pp PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 LOT NO. SUBDIVISION'SNAME PARCEL MAP Water piping 15,00 Each gas water heater or vent 15.00 �) USE OF STRUCTURE SFfIrV Duplex ❑ Mobilehome El Other V1SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G I W @20.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other `� / /J Describe Work: f - o `i�,�%154 PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( BOOV OR LESS ) 200A OR LESS 23.00 Main Service( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( a ACC. BLDS. ) S 3.5E FT0,, CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) ❑ I am a licensed under provisions of Chapter 9, Division 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 compensation, will do the work, and the structure is not intended or offered for sale. (Sec 7044) 1, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) C3 am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET -NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POW ER APPARATUS ) d SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 @ 1.00 BAL. @ .50 FIXED APPLNS. OR Ex. Occu p' OUTLETS IRESID.1 EA. ) ( 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a kkCertificate'of Consent to Self -insure. I shall not employ any person in any manner so as to become subject to the Worker's ♦♦l Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 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. 1 agree to comply to all Butte County Ordinances and California 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. C-1 X ' P -_+Q ti . a Date � `�� "1 Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories,in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ ov HAZ- I D. FEES IMP I FLOOD I CDF I PARCEL PD HD ISSUE This permit is hereby issued under the -C of the Butte unty Code and/or Resolutions indicated ab. for which feebehave been I f By I ► / PERMIT EXPIRES ON lDetel applicable provisions to do work paid. Date q Receipt No. 1(17 �lQ WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT —� ASSESSOR PARCEL NUMBER ®,— fE///-y I_U .— ® ZONING ILDING PERMIT OWNER 9 / TELF�PHONE SQ. FT, OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS., r J1 CONTRACTOR' 7 d® TELEPHONE 3 - CON CTO R'SMAl G ADDRESS Z 1 /• Q Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ lS` LENDER'S MAILING ADDRESS Filing Fee $ 20,00 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 $ pO PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Water piping 15.00 Each gas water heater or vent 15.00 USE OF STRUCTURE SFC Duplex EI ❑ Other \� V��///��SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ,57 Describe Work: �- po� PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( 800V OR LESS 200A OR LESS 23.00 Main Service I 200A TO IOOOA 46.00 NEW CONST. DWELLING OCCUP. 8 OR ADONS. I ACC. OLDS. / S 3.50 ST'. CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) ❑ I am a licensed under provisions of Chapter 9, Division 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 compensation, will do the �work, and the structure is not intended or offered for sale. (Sec 7044) 1, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. MULTI -OUTLET NON.RESID. ( BRANCH CIRCUITS @7.50 IPOW ER APPARATUS ' 8 SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) B 20 @ 1.00 AL. 50 Ex. Occu FIXED APPLNS. OR Occup. ( OUTLETS (RESID.) EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a ertificate of Consent to Self -insure. shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the 'Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 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. 1 agree to comply to all Butte County Ordinances and California 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 ofthispermit. X �o�� C, Date Signature of Applicant - El Owner ❑ Contractor ❑ Agent I An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $� ®a _ -�-- HAZ• I D. FEES IMP I FLOOD I CDF f PARCEL I PD I HD I ISSUE This permit is hereby issued under the applicable of the B unty Code and/or Resolutions indica d abov for which fe have been BY PERMIT EXPIRES ON lDatel provisions to do work paid. Date Receipt No. WHITE-D.D.S.-B.D. CANARY -ASS SSOR PIN -INSPECTOR GOLDENROD -APPLICANT