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HomeMy WebLinkAbout040-170-131AP 40-17-1-91/-S/ h,y ,..Bertha;: s/sande Reed, " .�j O D` /77 3 1 •Lane 400' e of Cummino � Rd, , Durham r J -P ermit-#-241p E ute, 1H) �-��-�-a13-AP17- k B3 R MEYER --400_ ::o f h e� i�ngs =Rd: ,=Dur " F. contr: Ancel Ballard, Paradise ' Permit# •366-75B,P,E,M(new SF) •' R :040-1:7=p-131•. � � �, ,.. -WOOD, MIKE r&','VAL$RIE 93=1675'jBEMt ' �J�! - 1971., REED 'LN; DURH 1 "�V� - - ADDITION/SF 040=170 `131 WOOD; VALERIE""'OS-3039. 1971 REED L1V, .D URHAM ', , Cont: OWNER ELEC C/O' ' I , BUILDING DIVISION COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE — OROVILLE, CALIFORNIA 95965 — TELEPHONE: (916) 538-7541 AGRICULTURAL BUILDING EXEMPTION PERMIT 1?.F,RMIT NO Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place used by the public. ASSESSOR PARCEL NO. ZONING 040 — -70-131 - OWNER1 PHONE NO. ' _V.%,LS M. l,W ooO dv,& V2101L4 6 t... WOOD E 916) bq b—?611 OWNER'S ADDRESS (R-71 Qe,-o L *jC -0.-W-,, CA Ci S615 2 LOCATION OF BUILDING T 19.11 RfrO 1�►.rF .`.LLQ.Nse+, Ci+r 45Fi38 USE OF BUILDING '' r+la-PJ moi" o�F 3Ai+J , 5.6 e I Acke- 12 -- SIZE OF STRUCTURE A X -.L+--' t"� /� SO. FT. TYPE OF CONSTRUCTION: WOOD FRAME STEEL CONCRETE OTHER (Specify) TYPE OF ROOF COVERING FLOOR TYPE �CS�I/DIING &+ -L¢tr' I 11 ESTIMATED COST OF CONSTRUCTION $ 11 <v t' I - AG Buildings shall comply with the building front, side, and rear yard requirements of the applicable County Ordinances as follows -1 r �5 �� l0 FRONT SIDES REAR AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a mobilehome, and 23 feet from a commercial building. AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a mobilehome, and 40 feet from a commercial building. AG Buildings must comply with Flood Zone requirements. Finish floor elevation must be at or above elevation 159: 56 USGS Datum. I declare under penalty of perjury that the building will be used as stated above and the purposed use confirms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Building Division and obtain any necessary permits, inspections, and approvals to comply with the requirements in effect at that time and before occupancy. Date 134 Signature of Owner Permit Fee - $60.00 The above described AG Building is exoqpatom a building permit. r�✓ � q / FL PARC P. ROOF G S U Receipt No. -C Manager Building Division By % Date .� White - DPW, Yellow - Assessor, Pink - B. I., Goldenrod - Applicant COUNTY OF BUTTE - DEPARTMENTOF.DEVELOPMENTSERVICES -BUILDING DIVISION ` 7 COUNTY CENTER DRIVE - OROVILL-E, CALIFORNIA95965 -TELEPHONE (916) 538-7541 PERMIT.APPOCATION DATASHEET OWNER �/d �. G1 U ob t' A. P. No. %O % 3/ Proposed Building Use A (dam, e'w- Building Inspector Date At time of per it application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED By 1, All items have been submitted . ........................................ 2. Plot plans, 3/4 sets, signed by preparer of plans . .......................... 3_ Complete plans, 3/4 sets, signed by preparer of plans . ...................... .4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5.. Hazardous Material Form . ............................................. 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). ... . 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $ .......................................... 11. Impact fees as shown on attached schedule . .............................. 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval Health Department . 15. City of Chico plumbing permit . ......................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: 18. Contact Land Development about (A) Improvements (B) Drainage. ........... 19. Driveway permit (construction approval required prior to occupancy). Fre-!ns sa o; reqs 20. Pre -inspection for. required. . to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner ) ............ 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on building use . ......................................... 28. Mobilehome utility clearance . .......................................... 29. Documentation of legal access . ..................... :.................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ....................................... 32. Plaeck ist. 33.f-100 e_e .......5�) ��l .....j1� ) .......... . 8 9� 34. �-� When youi e er it pr Gess as follows: _� wrier. Mail to contractor. e.Jtpl�� 179✓ �3 LAd hold for pickup at office. Deliver with inspector. Other Parcel Creation Acreage Applicant 'Nr!.", _U Date ��� 3�`r3 Copy of Haz-Mat form sent Health Dept. Fire Dept. `-Air Pollution Date Copy of plans sent Healthbept. 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 required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by `'a Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet 4 AP folder Copy - Department of Public Works j COUNTY OF BUTTE -`DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA 95965 PHONE: 916-538-7541 JAMES & VALERIE WOOD 1971 REED LANE DURHAM CA 95938 DEAR MR. & MRS. WOOD: With reference to the above subject: Attached is: Application for permit Building Plans Engr. Calcs Owner -Builder Verification Form OTHER DATE 8-26-93 RE: AGRICULTURAL BUILDING EXEMPTION PERMIT APPLICATION A.P. # 040-170-131 Mobilehome Utilities Installation Sheet Mobilehome Installation Information Sheet Typical Plan Sheet List of Codes Enforced We need the following information: Permit application signed and completed where indicated with all copies returned. Fees of $ payable to Butte County Treasurer. Certificate of Workmen's Compensation Insurance or check exemption statement. Contractor's License Law information or check exemption statement. Complete plans in including plot plans. Plot plans in Structural details in Complete plans and talcs in by registered engineer or -:architect. Energy design including Street and drainage improvement plan approval from Land Development Section sets_of.plans in accordance with.the changes -marked in red. Sanitation approval from Butte County Health Department at: 1469 Humboldt Road, Chico 7 County Center Dr., Oroville Skyway' & Elliott -Rd. ,-Paradise (DPW). Planning approval from Butte County Planning Department, 7 County Center Drive, Oroville, for Completed Owner -Builder Verification form. Recorded copy of deed showing Recorded-copy.of.-agricultural-acknowledgement statement. XXX OTHER PROPERTY SHOWN FINISH FLOOR EI BE DETERMINED BY RCE WITH A FIELD REFERENCE ESTABLISHED AND SUBMITTED TO -US FOR APPROVAL.PRIOR TO CONSTRUCTION AND PERMIT ISSUANCE. Should you have any questions concerning the above, please contact SCOTT RUTHERFORD of this office. Yours very truly, William Cheff Director of Public Works ..J.F. Glander JFG/aj August 30, 1993 Butte County Department of Public Works 7 County Center Drive RE: Flood Plain Elevation Oroville, California 95965 James Wood Building Permit APN: 40-17-131 A cross section taken from the F.E.M.A. Flood Plain Map, through the Wood property indicates the elevation of the 100 year flood plain to be 159.50 feet (U.S.G.S. Datum). There is a U.S.G.S. Datum bench mark, a P.K. nail in the base of a 6" (six inch) Round Gate Post 15'+ Southwest of the Southwest corner of the proposed building pad, elevation 159.98. A finish floor elevation protect-l.i.f.e..„and property. Expires 12-31-96 083093.1tr at or above 159.50 will be adequate to A. C. 1Br`uhn$ . R.C.E. 10531 FEMA FLOOD PROGRAM ! Residential Garages, Residential Storage Buildings, Agricultural Buildings and Residential Crawlspaces Buildings located in designated flood areas generally must have the lowest floor elevated at or above the 100 year flood elevation.' "Lowest Floor" means the lowest floor of the lowest enclosed area (including basement). An unfinished or flood resistant enclosure, usable solely for - parking of vehicles, building access or storage in an area other than a base- ment area is not considered a'buildings lowest floor; provided that such enclo- sure is not built so as to'render the structure in violation of the applicable non -elevation design requirements. If the floor is not elevated and the structure is exempt from the "lowest - floor requirement," (see above), then the following must be done: (a) building designed and anchored'to prevent floatation, collapse or lateral movement. (b) building is constructed with materials resistant to flood damage. (c) building constructed by methods and practices that minimize flood damage. (d) electric, heating, ventilation, plumbing and air conditioning equipment and other service facilities shall be designed and/or located so as to prevent water from entering or accumul- ating with the components during conditions of flooding. Note: We will normally accept the following as compliance with the above conditions: 1) Building is anchored to concrete stemwall system with conventional anchor bolts. - 2) Building plate on top of stemwall to be at or above the 100 year flood elevation,. (Plate height less than 24" above grade or engi- neered design required.) N 3) Electrical, heating, ventilation, plumbing and AC equipment and facil- ities located above;the plate, (100 year flood elevation). 4) At least 2'openings in exterior walls, located on opposite or adjacent walls with a total net area of not less than 1 sq. .inch for every sq. ft. of enclosed area. 5) The bottom of 'the openings shall be no higher than 1 foot' above grade. 6) The openings may be screened or covered with other devices that will permit automatic entry and exit of flood water. 7) Lowest Floor Declaration form signed by property owner. On residential buildings where the "lowest floor" is elevated at or above the 100 year flood elevation, the crawlspace must comply with items 3, 4, 5 and 6 above. J: F. Glander October 13, 1989 Chief Building Inspector Butte Countv De:oartment of Public Wor'ko Lowest Floor Declaration I declare that the proposed construction of the. A01 under Building Permit Ap cation. - 3 at tR ( A.P. will be used as indicated so it will not be -considered a buildings "lowest floor."# I am aware that the floor level is below the 100 year, flood elevation and will advise prospective buyers of this condition. Property Owner �t-(t e. W60J. Address Phone No. i f (p Dat - Z *"Lowest Floor" means the lowest floor of the lowest enclosed area (includ— ing basement). An unfinished or flood resistant enclosure, usable soley for parking of vehicles, building access or storage in an area other than a basement area is not considered a buildings lowest floor; provided that such enclosure is not built so as to render the structure in violation of the applicable non—elevation design requirements. 1 II0 j`•' COUNTY OF BUTTE - 6EPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oros ille, California 95965 - Telephone: 916.538-7541 APPLICATION AND PERMIT LIlJ 1 ASSESSOR PARCEL NUMBER 040-170-131 ZONING A-10 BUILDING PERMIT OWNER Mike & Valerie Wood TELEPHONE 893-8520 S0. FT. OCC. BUILDING VALUATION 698 R 37,692.00 OWNER'S MAILING ADDRESS 1971 Reed Lane Durham 95938 Est. 800.00 CONTRACTOR'S NAME Owner TELEPHONE ' CONTRACTOR'S MAILING ADDRESS Fireplace I A 1,500.00 CONSTRUCTION LENDER UNKNOWN Total Valuation $ 39,992.00 Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ 307.50 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 153.75 Energy Plan Checking Fee $ 20.00 ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit tee $ 496.25 PLUMBING PERMIT Filing Fee 15.00 1971 Rppd LanL-, Durham Each Trap 5.00 /5-_00 Solar or heat pump water heater 20.00 LOT NO.,SUBDIVISION NAME 7Each PARCEL MAP Water piping 7.00 7. O'er qas water heater or vent 7.00 USE OF STRUCTURE SF F� Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 o-> Mobile Home S I G I W @ 15.00 TYPE OF WORK New ❑ Addition L_J Remodel❑ Utilities ❑ Installation El Other ❑ Describe work: Add New Family Room, Master Bedroom, _ Add Bay Window in Existing Bedroom and Relocate Permit Fee $ p Contractor ELECTRICAL PERMIT Filing Fee 15.00 Cl osetr. � Main service 600V OR LESS 18.50 200A OR LESS Main service 20CA TO 1000A1 37.50 CONTRACTORS LICENSE LAW 1 declare under penalty of perjury (check one): El am licensed under provisions of Chapt. 9, Div. 3 of the BuSIneSSPOWER and Professions Code and my license is in full force and effect. License No. Classification as the owner, or my employees with wages as their sole compen- X -( sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) EJI, 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.& 3.66sq.ft. OR ADDNS. ACC. BLDGS. 24.45 NEW CONSTR.ULTI.OUTLET @ 5 00 NON•RESID BRANCH CIRC ITS ifAPPARATUS &) OUTLET cIR. Ex. Occup(OUTLETS OR FIXTURES 20 760 FIXED APP LNS. OR Ex. Occup. OUTLETS IRESIO.I EA.) 3.00 Temporary service 15.00 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. 1 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. MECHANICAL PERMIT Filing Fee 15.00 Heating Duct E t. 1 6.00 6.00 Cooling Hood 6.50 Ventilation Permit Fee $ 21.00 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 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 consseequence of the granting of this permit. Date (0-41-9s Sign re of Applicant - Owner JE 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 $ 40.00 OCC CONST TYPE TOTAL FEE FEES IMP -' FLOOD DF I PARCEL ---� P HD ISSUE This permit is hereby issued under the applicab a 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 Date PERMIT EXPIRES Date Receipt No. 143184 WNITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance s oJ eed L V \ Owner (�a J"� Location Plan Approved for: Sewage Disposal Water Supply: Public Clearance for bedroom mobile home. Other - Hold final for: Final clearance O.K. for: NOTE J, En ironmental Health Specialist 8/92 0 F.H. USE ONLY AP# Private Well Date t TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Location APS Plan Approved for: Sewage Disposal Water SLI Public Private Well r Clearance for bedroom mobile home. Other Hold final Final clearance O.K. for: NOTE jEnvinmental Health pecialist 8/92 Date F.H. USE ONLY v 1'1l)()f Tl:i AlI:1dli'd 11 Sall to B.D. --c Owner Location APS Plan Approved for: Sewage Disposal Water SLI Public Private Well r Clearance for bedroom mobile home. Other Hold final Final clearance O.K. for: NOTE jEnvinmental Health pecialist 8/92 Date •• "`�t�('tr''1-.�4d1y.�. ,.r-,:.. •�'Y' "hr'.-T}•y .,. �•• i, •n r�w'''�+1:-f{`.�t:rrN�.ti�..}••,nfi.•�,•..�r•+. .. dam. • COUNTYOF BUTTE - DEPARTMENTQFpEEVELOPMENTSERVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET Oya-i7a- i3� OWNEReke A. P. No. Proposed Building Use ,j%r%Di�`�fl Building Inspector 70 Date i3 At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY All it ms have been submitted.'........................................ Plot plans, 3/4 sets, signed by preparer of plans . ........................ /2— Complete plans, 3/4 sets, signed by preparer of plans. 11�L 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans. . 5. Hazardous Material Form . ............................................. 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). ... . 31CalMobilehom.e date and manufacturer'sstallationn��instr4�t{Rns, 2 set Fees of $' �a �ttl4D !K%/Q.' .(.�(51:d1V_./ =11 `[BQ�- ............. . ifornia Impact fees -as -shown on attached schedule. Department of Forestry plan approval/fees. ................. Flood elevation letter (100 year floo . by California Engineer . ................. . Sanitation and plot plan approval 4G0 Health Department . ............ 15. of Chico plumbing permit . ....................... 16. P14 plan and business license approval from City of Biggs/Gdley. 17. Planning approval for (A) Use: (B) Parking: ......... 18. Contact Land Ddvelopment.about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). .. 20. Pre -inspection for P`ea"sPeC�°"'�4"— required- . . to euiIding Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. t 22. Certificate of Workmans Compensation Insurance. ......... * . ............ . 23. Owner -Builder Verification (Given to owner , Mail to owner ) ............ 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ........:............................... ' !' 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. ..... 27. Letter of intent on building use . ......................................... 28. Mobilehome utility clearance . .......................................... 29. Documentation of legal access . ..................... :.................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Pim chert lit. 33. T/ooc�' •Dec���f�a:✓ 34.- we When 6u issue the_permit rocess as follows: Mail to owner. Mail to contractor. Telephone Y9.3'o and hold for pickup at 01A�9 office. Deliver with inspector. Other Parcel Creation j Acreage Applicap Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to r uance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advi ed above requ'irI%4 datWthine j _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by%! ; _ mail counter by _ Date Plans checked by Date Plans approved by Date 2 OR Sets of plans on h9l w / �// File cabinet AP folder Copy - Department of Public Works 7ZiT I COUNTY OF BUTTE - Department of Public Works,.t 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 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 Secur"tyNuber 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. FLOOD PLAIN DECLARATION I declare the actual value of the proposedp constructs n//work under build= ing permit application at / ? �e&FhA) 0,9r114y1 A. P. # bqQ -/70-/3/ for AivA,,/Qv� does not equal or exceed the definition of "Substantial Improvement."* I am aware the building site is in a flood -plain .area, even though I am not required to comply with the flood plain management criteria. PROPERTY OWNER ,6k ADDRESS C-1), / / WeedlA) eO /yA-U PHONE NO. 8 9 3 - B51-1 b DATE *Substantial improvement is'defined as follows: Any repair, reconstruc— tion, or improvement of a structure, the cost of which equals or exceeds 50% of the market value of the structure either, (a) before the improvement or repair is started, or (b) if the structure has been damaged, and is being restored, before the damage occurred. NOTE: Documentation may be required to substantiate costs. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC 'NORKS Fe 7 County Center Drive - Oroville. California 95965 - Telephone: 916.538-7541 10 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER i /70 -/3/ ZON. -/I) BUILDING PERMIT OWNER / eY%E. Do �'iG )040/ TELEPHONE � �-sv0 SO.FT. OCC. BUILDING VALUATION OWNER'S MA LIADESS go (D CONTRACTOR' NAME wive TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuati n $ 3 Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ ,30'7..50 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ �.�L3 . 7.51 Energy Plan Checking Fee $ 2 0. Cu> ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS l 9 `7 l ee Permit fee $ Al 9 6. j7, PLUMBING PERMIT FiIingFee 15.00 Each p 5.00 Solar or he mp water heater 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or ve 7.00 USE OF STRUCTURE SF�Z Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S G TW @ 15.00 A , TYPE OF WORK 1 New r_; Addition ilk Remodel',F_, Utilities ❑ Installation E] Ot/jyer ❑ Describe work: Axv4- C, h, -e, M, 17 1 ND A r3 it D iN g I`S%" �,t,t Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 �S - Main service 600V OR LESS 200A OR LESS 18.50 Main service 20CATO 1000A> 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 l_J 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. 1 ACG. BLDGS. II 3.6Qsq.ft. 2 yS` r NEW CONSTR. ULTI.OUTLET NON.RESID BRANCH CIRCUITS) @ 5.00 POWER APPARATUS e) SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 @ 76d FIXED Ex. Occup. OUTLETS (RESID.)REA.1 I 3.00 Temporary service 15.00 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. ❑ 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. MECHANICAL PERMIT FiIingFee 15.00 Heating 6.00 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 waya crue against said County in consequence of the granting of this permit. X Date 5J Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ 11 permit is required for excavations over 5'0" deep and demolition or construct. An OSHA a ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST TYPE TOTAL FEE $ 70 HAz DFEES IMP FL OD FDF PARCEL P HD ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date /�3 -7 Receipt No. -7 D WHITE-O.P.W.. YELLOW-A33E33OR. PINK -INSPECTOR. GOLDENROD -APPLICANT L.l.'ll1V 1 Z .jr ou 1 1 L' LL.CL�L[ jP' ,lV 1 vl uL. v L.uvri-u;.t7 1 .7L' M V 11.x..7 , zu 1 L la" Ll V 1 7 County Center Drive, Oroville CA 95965 Phone: 916-538-7541 RE: Building Permit Application #93-1675 DATE: Angus 91'. 1991 A.P. # 040-170-131 With reference to the above subject: FlAttached is: Application for permit Mobilehone Utilities Installation Sheet Building Plans _ Iobilehcme Installation Information Sheet Engineered Calculations Typical Plan Sheet Owner -Builder Verification Fm List of Codes Enforced We need the following information prior to permit processing and/or issuance Permit application signed and completed where indicated with all copies returned. Plot plans, 3/4 sets, signed by preparer of plans. Complete plans, 3/4 sets, signed by preparer of plans. Engineered plans and calcs, 3/4 sets, with wet signature on plans. Hazardous Material Form Energy Design Compliance and supporting documentation. Statement of Intent for Non -Heated and A/C Buildings. Engineered truss details and layout in duplicate. Mobilehane data and manufacturer's installation instructions, 2 sets. Fees of $ , payable to Butte County Treasurer. Impact fees paid. California Department of Forestry plan approval/fees. Flood elevation letter (100 year flood) by California Engineer. Sanitation and plot plan approval Health Department. City of Chico plumbing permit. Plot plan and business license approval fran City of Biggs/Gridley. Planning approval for Land Development (a) Improvements (b) Drainage. Driveway permit (approval of construction required prior to occupancy). Contractor's license information (No. Name Style, Class) or exemption statement. Certificate of Workmans Compensation Insurance. Owner -Builder Verification Form. Recorded copy of Agricultural Acknowledgement Statement. Letter of signature authorization. Copy of recorded deed of parcel creation and 60' right of way to a public road. Letter of intent on building use. Mobilehome utility clearance. Documentation of legal access. Documentation of 50% subdivision developed or (a) Road improvements completed and (b) Parcel meets zoning area and frontage requirements. Existing violations/expired permits resolved. Plan check list data and revisions. sets of plans in accordance with changes marked in red. 0 Other: School Fees are due. Should you have any questions concerning the above, please contact Bart League of this office., between 3:00 and 5:00 pm weekdays. Yours v , DP:ahb David Purvis Manager, Building Inspection BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 - OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY" APPLICANT NAME OWNER Name Address Last Name City irst Name /I V Address Zip t City Fax State C/V i Zip .75"7� Phone <�3 , ?�-20 Fax E-mail APPLICANT NAME CONTRACTOR Name Address �J ' City N State Zip Phone Zip Fax E-mail Fax l.ic. # Class State License Number APPLICANT NAME ARCHITECT/ENGINEER Name City Address N City Fax State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT NAME Name Address City State Zip Phone Fax E-mail AP LICANT SIGNAT RE X JL4� For office use only: Zoning Property Address (� Flood Zone I SRA Policy Number No Occ. Type Const. Subdivision Name Map Book Page7_07 Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:WORMSMILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 PERMIT NO. BIN # LOCATION ) AN /-70— / 1 Property Address (� Cross Street C't'w �N WORKER'S COMPENSATION Policy Number Carrier F / If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name dre Description or Scope of Work: �-e-- AWry f /l JOD AMA< -0 1.11 c f Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: Amount: Bldg G� SRA 2 Receipt( #: ((`�� Sheriff L1 / SMIP • ��`� DatOther Date: � I V Total REV 6-16-04 SUBMITTAL REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit: INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. Residential, New, Remodels, Additions, and Accessory Structures: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPER! OR 3 Sets Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation. (Note: Not required for additions to mobile ormodular homes.) ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Detached Accessory Building Form, filled out by the property owner (if required). ❑ 8. Sanitation and site plan approval from the Environmental Health Department. ❑ 9. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer. Mobile, Manufactured, or Modular Homes: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ 4. 2 Floor plans. ❑ 5. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation and site plan approval from the Environmental Health Department. ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). Commercial, New, Additions and Remodels: ❑ 1.. 4 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations, with code analysis. ❑ 3.. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation (if required). ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Statement of Intent for Non -heated and A/C (if required). ❑ 8. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer. ❑ 9. Letter of intent. ❑ 10. Hazardous Material Form. ❑ 11. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530) 538-7541. OVER FOR BUILDING PERMIT APPLICATION KAFORMSMILDING F0RMS161dgApp1SubRgmts.doc Page 2 of 2 REV 6-16-04 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP053039 LICENSED CONTRACTORS 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 Issued Date: 11/10/2005 APN: 040-170-131-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 1971 REED LN DUR Date: Contractor. Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: change elec service, 200 amp Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: WOOD VALERIE L to its issuance, also requires the applicant for such permit to file a 1971 REED LN signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section DURHAM, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95938-9628 she is exempt therefrom -and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of'not more than five hundred dollars ($500).): 1p I, as owner of the property, or my employees with wages as their 9 sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: WOOD VALERIE L Code: The Contractors' State License Law does not apply to an pp owner of property who builds or improves thereon, and who does 1971 REED LN such work himself or herself or through his or her own employees, DURHAM, CA provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one 95938-9628 year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044• Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: . and who contracts for such projects with a contractovN licensed pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 f he Business and rofe io s Code Date. Owner. WORKERS' COMPENSATION DECLARATION License #: I 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 Architect: is issued. ❑ I have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: V/ Carder: Total Square Ft: 0 S. F. Policy #: Valuation: $0.0.0 I certify that in the performance of the work for which this permit is Census Code: '\ issued. 1 shall not employ any person in any manner so as to `. become subject to the 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 comply with those provisions. l r^ Date: D ox - Applicant: Applicant: Lk WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one I hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit i ereby issueg u he a p icbble provisions of the BiMe County Coda ?nrVor I hereby affirm that there is a construction lending agency for the Resolution to do work i scat aboveJr whi fees have been paid. /�' performance of the work for which this permit is issued (Sec 3097 Civ.) /�—/v e— Name: By: /Date: /� Address: PERMIT RE N: �/ —6 Address: ( 7 Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application• that the above information is correct, and that I am the owner or a duly authorized a ent of th o ner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance o any official for or do mento Bu to County. I hereby authorize repres nt ives of Butte Co myLenter pon the above mentioned property for inspection purpos . Print Name: ��r �t' C. C� \ Signature: Date: �y S Owner 0 Contractor EJAgent for Owner 0 Agent for Contractor PERMIT NO. P E M MH UTIL. PERMIT NO. 9410-74P E PERMIT EXPIRES w 90 7- -OWNER RPrtha MPVPr CONTR. LOCATION (A.P. 40-17-1.21 ) 6 i• .' s/side Reed Lane, 400' e/ Cummings Rd. Durham �f '. tJ Uj . S d • :L f Temp. Power Pole Called PG&E .gyp. EIec. Serv. Called PG&E r 2 7 Imp Gas Serv. Called PG&E JOB FINALED� ' '(Date) (Signal re) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. Stemwall Slab Prov. for physically handicapped Heaters Appliances Carport Footings Conformance of ex. structure Gas Piping & Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Masonry Walls I ThroatRou h Reinf. Steel I Final Fixtures Stucco Mesh Scratch Brown Finish Interior Lath Door Closer DATE FIRE SPRINKLERS Test Final MECHANICAL Heating Cooling Ducts Ventilation Final REMARKS OR CORRECTIONS Water Htr. Subpanels Grd. Fault Prot. Service Temp. Pole Underground. Permanent Final COUNTY OF BUTTE — DEPARTMENT OF PUBLIC 0 S ✓ 7 County Center Drive - Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMITS ff/4*7 �D BUILDI G OwnerSQ. — E FT. OCC. BUILDING VALUATION Mailing Address '76— Tel Tele hone �g Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ $ Building Address PLUMBING No. @ I FEE PERMIT FILING FEE $2.00 �® / /J�/ S Each Trap 1.50 V Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. A I�i �n g Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fe W. . SAY Fire Dept. Fire Zone s Use Permit Building sewer 5. 00 EQA I Parking Plans Parcel Parcel Ma Declarat' n P 60' R/W Im rovements P Lawn sprinkler system 2.00 PRecd &, or rova ` Plan rovaI Permit Fee $ c $ t3C NEW ❑ ADDITION ❑ UTILITIES OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 3" 00 Main service incl. 1 meter OQ 5, O Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Single Family ❑ Duplex ❑ Mobil Home Others ❑ Range, Cook -top or Oven 1.00 .4-d > / Water Heater or Space Heater 1.00 202 Light fixtures ba1%10 Receps., switches & fix outlets CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 00 Temp. Power Pole 5.00 License No. Classification Misc. wiring I am exempt from the Contractors License Laws of the State of California. Permit Fee $ T od $ Q( WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. K 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 the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 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 TOTAL PERMIT FEE $ O( authorize representatives of the County of Butte to enter upon the This permit is hereby issued under the applicable provisions of above-mentioned property for inspection purposes. the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. x" X Date - - % DIRECTOR OF 7PLIC WORKS Signature of itee or Agen B 7�� / r� y Date Receipt No. ,, o_ White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant ding permit expires Date..............7...-�. `....... FILE NO. BUTTE COUNTY (For Action 1, 2, 3) Public Works Dept. (For Information✓) Director Dep. Dir, Sec. Rd. & Br. Mtce. Shop Equip. & Yards Ref. Disp. Bldgs. & Grds. Bldg. Insp. Admin. D & C/Traffic Const. Rd. Des. Br. Des. Sur. & Loc. Mapping Drng./Permits Sub. Checking Right of Way 4;k. -L4 A .;PERMIT NO. nft= 366-75'B$P'E.M P E M ,'�MH UTIL. d,PERMIT NO. PERMIT EXPIRES -Bertha Meyer 1c t ONTR. Ancel Ball1ard, Paradise LOCATION (A.P. 40-17-121&123 4001, off e/s Cummings Rd., Durham Q( o CJD SAN ql fifi o Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. G, -2 Called PG&E 7&ZX? /JOB I/ FINALED (Date) (Signature) r r' ` • r S r r' ` COUNTY OF BUTTE — DEPART,MFNT OF PUBLIC WO `7 County Center Drive — Oroville, California 95965 Tel epho ie:,534x1541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. x /!J'q Date Signature of Permiiteeeeo�Agent Receipt No. � Z White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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. (RECTOR F PUBLIC WORKS By DateZ'— L__ Building permit expires Date ............................................ BUILDING Owner nM SO. FT. OCC. BUILDING VALUATION OU Mailing Address Telephone No. Fireplace Q O Contractor Total Valuation 7 Z Q Mai I i ng Address CPermit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ s Q Building Address'* 4^ S $' PLUMBING No. @ FEE PERMIT FILING FEE 900 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 IOV~ Each gas vtyeter heater or vent 1.50 , A. P. No. z of8 Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fe Vere' Ski tion Fire Dept. Fire Zone :1V15— Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W Improv prove ents Lawn sprinkler system 2.00 Bldg. Pla R c'd Parcel Approval Plans Approval Permit Fee $ NEW 2r ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 .00 Main service incl. 1 meter Additional meters, each 1.00 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Sub -panel (12 or less) (mor 12) 01 RaLgeCook-top or Oven 1.00 Q Water Heater or Space Heater 1.00 Light fixturesbal dio Q 7c ., swi & fix/ ets 010 CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: f'Jr q_ -e-- ��/�r� HoodL5-3f-Fancrl�Furn.Motor 2 1.00 Q Evap. cooler, gar. d' r 1.00 Q o Air conditioner or heat pu I,— Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. 26 127 Classification_ / Misc. wiring ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. NI have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. ❑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 the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Q Heating0 Cooling I; Q Ventilation Hood 2.00 �, Q Permit Fee $ $�3 (3( 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 TOTAL PERMIT FEE CO S authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. x /!J'q Date Signature of Permiiteeeeo�Agent Receipt No. � Z White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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. (RECTOR F PUBLIC WORKS By DateZ'— L__ Building permit expires Date ............................................