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Home My WebLink About040-180-093COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7.County Center Drive • Oroville, Mlifornt'a 95965 • Telephone (530) 538,7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT 0-. �?`; J ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS t� C • . . L1.a 2S ado • Z.as': . 1 CA 1 i�=...�..+ CONTRACTOR'S NAME " L C A '.."4) TELEPHONE CONTRACTORS MAILING ADDRESS 011: IAY$ 11A 01.1 CiA CONSTRUCTION LENDER Fireplace 1 1 C43. (;a LENDER'S MAILING ADDRESS Total Valuation $ ^9 !%)0 6,J ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 43. ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS Energy Plan Checking Fee $ $ PERMIT FEE S LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Feel 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: S .+.r 5'l�i-!-.:�.� "SIS .r _ Ta Si. ' .i' Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service ?DDA 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. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License 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. ❑ 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 Main Service PGOA TO 1000A 46.00 NEW CONST. DWELLMxi OCCUP. OR ADDNS. ( a ACC. BLDS. SO 3.50F.. CONST No ESID, MULTI.OUTLET @7.50 POWER APPARATUS a SINGLE OunET CIR. EX. Occup. ourET OR FIXTURES 20 .00 BAL ®1. 0 Ex. Occup. ou�nEDTS Aa1D.) E 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 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. ❑ 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' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEk $ Policy Number (The above sections need not be completed if the permit Is for work of a valuation of one hundred dollars ($100) or less.) ❑� I certify that In the performance of the work for which this permit is Issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X I . _ Date 1 '_ r r Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ __ L. C:J HAz. D. FEES IMP I FLOOD I CDF PARCEL 1 PD HD ISSUE' This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By r% �� PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date Date Receipt No. - 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, Cahfornia+ 95965 • Telephone (530) 538-7541 PERMIT NO. �-�L (Rev. 12/96) APPLICATION AND PERMIT 01-2686 ASSESSOR PARCEL NUMBER 040-180-093 ZONING BUILDING PERMIT OWNER ALLAN t= TELEPHONE 343-9293 SO. FT. OCC. BUILDING VALUATION . OWNERS MAILING ADDRESS 9495 CUMMINGS RD. DURHAM CA 95938 CONTRACTOR'S NAME WOOD HEAT & SPA TELEPHONE CONTRACTORS MAILING ADDRESS SKYWAY, PARADISE CA 959 9 CONSTRUCTION LENDER LENDER'S AWUNG ADDRESS Fireplace Itype A1,843.00 Total Valuation $ 1, 64J. UU ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 43.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS CUMMINGS -RD-, DITRHAM CA 959119 $ Energy Plan Checking Fee9495 $ PERMIT FEE $ 63.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: WOOD STOVE FIRE PLACE INSERT Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home IS I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 aOOV OR LE Main Service 200.OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors license Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, VIII do the work, and the structure is not intended or offered for sale. la' 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 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. ❑ 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' compensation insurance carrier and policy number are: Carrier Main Service 200A TO 1000A 46.00 NEW CONST. DWELING OCCUP, 3.5QSo ACC.BILDSS. O ADDNS.CONST. ( M NpN.RE51D. @7.50 POWER APPARATUS 6 SINGLE OLm.ET CIR. 20 @ 1.00 Ex. Occup, OUTLET OR FIXTURES I3AL @ ,,o50 Ex. Occup. OurLeDrB Ao R.5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Policy Number (Tjae above sections need not be completed if the permit Is for work of a valuation ®//d one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the pon provisions of section 3700 of the Labor Code, I shall workers' tmp17yw:iftth fo Mwith those provisions. X Date 0 • Z. Z — �_ Sign ture of Applicant - Cr Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 63.00 HAz. D. FEES IMP FLOOD COF PARCEL PD HD ISSUE This permit is hereby Issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated Ove for w ich f es have been paid. �� / - - Date 10-22-2001 B PERMIT EXPIRES ON 10-22-2002 to Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT