HomeMy WebLinkAbout040-214-008�f0TH. �%7 40-214.-8
,ILIZABENDERSON
2015 Goodspeed St., Durham
Contr: Tri County Elect, Durham
Permit #5388-77E(ele ser ch & instil
circuit for dryer) SF
040-214-008• PERMIT#94-1618
BULTEMA, JOHN C.
9385 GOODSPEED ST., OROVILLE
REROOF/SF 'F J i-
►.
040-214-008 ,,PERMIT#94-1618
BnTEMA JOHN C.
»' x 9385'GOODSPEED ST.; OROVILLE
REROOF/SF .
—i5-�s
E,
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t
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 ` 16, Z/
ASSESSOR PARCEL NUMBER _
040-214—MR
ZONING
P3
BUILDING PERMIT
OWNER
JOHN C BUL
TELEPHONE
891-5050
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
PO BOX 502 DMAM, 959113 -
15 0
00
CONTRACTOR'S NAME WMIR
VIYI`I limit
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee $
20,00
Permit Fee $
23.00
ARCHITECT OR ENGINEER
,L..tCENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS 9385 COODSPEUsi) ST
PERMIT FEE $
43.00
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
LOT NO.
SUBDIVISION'SNAME
PARCEL MAP
Each gas water heater or vent
15.00
USE OF STRUCTURE
SF Q Duplex O Mobilehome ❑ Other
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 O
Describe Work: REROOF W W11"
PERMIT FEE $
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service ( "OR LESS )
200A OR LESS
23.00
Main Service ( 200A TO IOOOA )
46.00
NEW CONST. DWELLING OCCUP.
OR ADONIS. ( a ACC. OLDS. )
so,
3.50 FT.
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
Code and my license is in full force and effect.
cense No. Classification
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)
❑ I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
❑ I am exempt under Sec. Business and Professions Code
forthis reason
NEW CONST. MULTI -OUTLET
-NON-RESID. ( BRANCH CIRCUITS )
@7.50
( POWER APPARATUS )
6 SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES )BA
20 @ 1.00
Professions
Ex. Occup.FIXED APPWS. OR
( OUTLETS IRESID.) EA. )
5.00
Temporary Service
23.00
Mobile Home Facilities
20,00
Misc. Wiring
23.00
WORKER'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ This permit is for $100.00 (valuation) or less.
O 1 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.
A 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.
I 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.
GV J
X (: (, j J'�[f �' [Q�l7! / / Date /
Sigpature of Applicant - ❑ Owner CI Contractor ❑Agent
//
Alt 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 S
ocC
CONST. TYPE
TOTAL FEE $
4
HAZ.
1 D. FEES
I IMP
I FLOOD
I CDF
PARCEL PD
HD ISSU
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.
/
By Date G/3 d
a C
PERMIT EXPIRES ON �/ J
Dere)
166$35
Receipt No.
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
F
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-754�Y-
PERMIT NO.
APPLICATION AND PERMIT `9
ASSESSOR PARCEL NUMBER
ZONING
BUILDING PERMIT rly 1;
OWNER JOHN C. BULTEMA
TELEPHONE
891-5050
SO, FT, OCC. BUILDING VAI UATIO
OWNER'S MAILING ADDRESS
PO BOX 509 DUR, 99QIR 7
AM
G
15 6 900.00
CONTRACTOR'S NAME
OWNER
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
LENDER'S MAILING ADDRESS
Filing Fee $
20.00
Permit Fee $
23.00
ARCHITECT OR ENGINEER
LICENSE No.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS 9385 GOODSPEED ST
PERMIT FEE $
43.00
_
�� Dee r ka 1Z
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15,00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Each gas water heater or vent
15.00
USE OF STRUCTURE
SF g( Duplex O Mobilehome ❑ Other
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 O Utilities O Installation O Other O
Describe Work: REROOF W COMP
PERMIT FEE $
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service I 000V OR LESS )
2OOA OR LESS
23.00
Main Service ( 200A TO 1000A )
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( & ACC. BLOS. )
s0,
3.50 FT,
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one)
O 1 am a licensed under provisions of Chapter 9, Division 3 of the Business and
P P
Professions Code and my license is in full force and effect.
�cense No. Classification
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)
❑ I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
O 1 am exempt under Sec. , Business and Professions Code
forthis reason
NEW CONST. MULTI -OUTLET
NON-RESIo. ( BRANCH CIRCUITS )
@7.50
( POWER APPARATUS )
6 SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES )
20 @ 1.00
BAL. .50
Ex. Occup.FIXED APPWS. OR
( OUTLETS IRESID.1 EA. )
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
WORKER'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
O This permit is for $100.00 (valuation) or less.
O 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
rtificate 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 S
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.
I 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
n c nsequence of the granting of this permit. Date
e of Applicant - O Owner O Contractor ❑Agent
VA 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 $
occcoNsr.
rrPE
TOTAL FEE A
HAZ.
I D. FEES
IMP
FLOOD
I CDF
PARCEL PO
HD
Issu
This permit is hereby issued under the applicable provisions
of the tte Cou ty Code and/or Resolutions to do work
Indic e b v. f ;which fees have been paid.
ey �� Date � �3 t
C
✓
PERMIT EXPIRES ON 3&.;
Receipt No. 166835
WHITE-D.D.S.-B.O. 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
APPLICATION AND PERMIT
PERMIT NO.
ASSESSORPARCELNUMSER D/L��.o
ZONING /
BUILDING PERMIT
OWNER
SQ, Fr, CC. BUILDING VALUATION
oWNER'SM
CONTRAOIr
TELEPHONE
CONTRACCCTTTO WS MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Fling Fee $
20.00
Permit Fee $
O
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRE G r — �5 -,7,_
O
PERMIT FEE $
PLUMBING PERMIT
Fling Fee 20.00
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15,00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Each gas water heater or vent
15.00
USE OF STRUCTURE
SF Duplex O Mobilehome O Other
SPECIFY
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G I W
@20.00
TYPE OF WORK
New El Addition Addition O Remodel O Utilities O Installation Other ❑
.,0'
Describe Work: C�
PERMIT FEE $
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service ( 600vORLEW )
200A OR LESS
23.00
Main Service ( 200A TO 1000A )
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( & ACC. BLDS. )
gO,
3.SC FT.
NEW CONST. MULTI -OUTLET
-NON-RESID. ( BRANCH CIRCUITS )
@7.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one)
O 1 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
❑ 1, 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)
❑ I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
O I am exempt under Sec. Business and Professions Code
for this reason
( POW ER APPATUS )
8 SINGLE OUTLARET CIR.
Ex. Occup. ( OUTLET OR FIXTURES )
B 20 @ 1.00
Ex. Occu FIXED APPLNS. OR
p' ( OUTLETS (RESID.) EA. )
5.00
Temporary Service
23.00
Mobile Home Facilities
20,00
Misc. Wiring
23.00
WORKER'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ This permit is for $100.00 (valuation) or less.
O 1 have placed on file with the County of Butte Dept. of Development Services,
Building Division a Certificate of Workmen's Compensation Insurance or a
Certificate of Consent to Self -insure.
❑ 1 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.
I 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.
X Date
Signature of Applicant - O Owner O Contractor O Agent
An OSHA permit is required for excavations over 5"0" deep and demolition or
construction of structures over 3 stories in height.
11
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. rrK
TOTAL FEE $
HAZ-
D. FEES
IMP
I FLOOD
I CDF
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 above for which fees have been paid.
BY Date
PERMIT EXPIRES ON
(Date)
ER.ce.-3�
S. -6.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY Ok'"BUTTE - Department of Public Works
7 County Center Drive, Oroville, CA 95965
OWNER-BUILDERVERIFICATION
Attention Property Owner:
Phone: 916-538-7541
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) Lsigned 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
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.
COUNTYOF BUTTE - DEPARTMEIVTOF DEVELOPMENT SERVICES -BUILDING DIVISION
7 COUNTYCENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE (916) 538-7541
PERMIT APPLICATION DATA SHEET
OWNER A. P. No. 0 4146 - a/,/ - 0
Proposed Building Use Building Inspector Date !.-"
At time of perm( pp1)cation, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED BY
`� 1, b b 'tt d
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
All items have een su in e ........................................ .
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 (required prior to plan check). ....
Mobilehome data and manufacturer's installation instructions, 2 sets. ...........
Feesof $ ...... :...................................
Impact fees as shown on attached schedule . ............................. .
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 from City of Biggs/Gridley. .............
Planning approval for (A) Use: (B) Parking:
Contact Land Development about (A) Improvements (B) Drainage. .......... .
Drivewa ermit (construction app q roval re uired prior to occupanc )
J p y Fre Inspection request
Pre -inspection for required. . to Building Inspector (Date)
Contractor's license information. (No., Name Style, Classification) . ..............
Certificate of Workmans Compensation Insurance . ......................... .
Owner -Builder Verification (Given to owner , Mail to owner _). .......... .
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 . ......................................
Plan check list . .....................................................
When you issue the permit, process as follows: Mail to owner. Mail to contractor.
Telephone and hold for pickup at office. Deliver with inspector.
Other
Parcel Creation �. GJDate 6 9
Acreage Applicant
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 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 _ 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 AP folder
Copy - Department of Public Works
ow/s
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORDS -, I r� • J j�
7 County Center Drive r— UrCville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
•-,..r.wc�n..uvw .i u— wunry vi OULLU U erlter UPUn the
above mentioned property for inspection purposes.
t
X Date �
Signature of Permitee or Agent
Receipt No.
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.
DIRECTOR OF PUBLIC WORKS
By r Date ' r
Building permit expires Date
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Fireplace
,-
Contractor / f i�� ��� /r�r �i�r'ie-
Total Valuation
Mailing Address f.° i /
•,
Permit Fee
Plan Checking Fee&/or Penalty
/
el
Tephone No.
Permit Fee $
Building Address
PLUMBING No.1 @ I FEE
PERMIT FILING FEE J$3.00
-1 ( rl ', %% o7/ `i: S/.
Each Trap 1.50
'
Repair drainage or vent piping 1.50
,`�
/ h / . — r �•�.../ e/� �ii��.� ,--s
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No. fr �/ _ n '�
J
Zoning & Planning
I
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
Fees
W.C:
Sanitation
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parkn g
PlaBldg.
Declare ion
Parcel Map
60' R/W
Improvements
Lawn sprinkler system 2.00
Plans•Rec'd �
'Parcel Approval
Plans Approval
Permit Fee $
$
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER 0
ELECTRICAL No.1 @ FEE
PERMIT FILING FEE J$3.00
,
Main service i00o AMP OR1 OR LESS5.00 ; ,;; r
r /
• r� �'�
Main service EA. ADD'L 100 AMP 2.50
Single Family ❑ Duplex ❑ Mobil Home ❑ Others ❑
Main service OVER 600V
100 AMP OR LESS 25.00
Main service EA. ADO'L 100 AMP 1.00
NEW CONST. DWELING
OR ADDNS. ( ACCLBLDGS.CCUP. &) 20sgft
NEW CONSTR. MULTI -OUTLET
NON-RESID. ( BRANCH CIRCUITS) 2.50ea
NEW CONSTR. (POWER APPARATUS &)
NON RES,D. l SINGLE OUTLET CIR.
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:
Ex. Occup(OUTLETS OR FIXTURES) BAL@1¢
Ex. ccu FIXED APP LNS. OR
O p'(OUTLETS (RESID.) EA) 2.00 / /1,•J
Temporary service 10,00
t
Mobile Home Facilities 15.00
License No. r 1 J JMisc.
Classifications ' i �
Wiring 6.25
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
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.
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.
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
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
TOTAL PERMIT FEE
$ 7
•-,..r.wc�n..uvw .i u— wunry vi OULLU U erlter UPUn the
above mentioned property for inspection purposes.
t
X Date �
Signature of Permitee or Agent
Receipt No.
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.
DIRECTOR OF PUBLIC WORKS
By r Date ' r
Building permit expires Date
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive ,— Urtville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
..._.._ ...r, �,..,�,.,... r..� .,,c -�.� y — Dull. LG .Ill.l UPOII lne
above-mentioned property for inspection purposes.
X Date
Signatue/of (P�ermi e r ent
Receipt No. l r(� / 27:
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.
DIRECTOR OF)PUBLIC WORKS
BY�
�ingermit expiresDate
BUILDING
Owner 114, Al
SQ. FT. OCC. BUILDING VALUATION
Mai I i ng Address
Telephone No.
Fireplace
�
Contractor .. C �j'
Total Valuation
Mailing Address n �� ��
,C
Permit Fee
Plan Checking Fee&/or Penalty
N
Tele hone �j
=
Permit Fee
Building Address
PLUMBING No.1 @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
Repair drainage or vent piping 1.50
r�
Water piping 1.50
Each gas water heater or vent 1.50
A. P. �—q% '� Zoning &Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
es
3artttattt3n
FireDept.
FireZone Use Permit
Building sewer 5.00
EQA
Parkin
Parc
Declaration
I Parcel Map
60' R/W
I Improvements
Lawn sprinkler system 2.00
Bid,, PlumsRvc'd
Parcel Approval
Plans Approval
Permit Fee
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
G £
Main service 100 AMP OROR LESS5.00 ,
C ,
Main service EA. ADD'L 100 AMP 2.50
Single amily Duplex ❑ Mobil Home ❑ Others ❑
Main service R 600V
100EAMP OR LESS 25.00
Main service EA. ADD'L 100 AMP 1.00
NEW OR ADDNST ( ACCLBLDGS.LING OCCUP. &) 20sgft
NEW CONMULTI.OUTLET
NO N.RESI DST.R. ( BRANCH CIRCUITS) 2.50ea
NEW CONSTR. POWER APPARATUS &)
NON.RESI D. (SINGLE OUTLET CIR.
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 f'
,
Ex. Occup(OUTLETS OR FIXTURES) BAL@ a
Ex. Occup.(OUTLETS (RESID )KEA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No.2 Z 5/^.��!-iMisc.
Classification �-'�/ O
Wiring 6.25
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Feed
WORKMEN'S COMPENSATION INSURANCE
I am aware of the provisions of Section 3700 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.
o.�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.1 @ FEE
PERMIT FILING FEE $3.00Heating
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
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TOTAL PERMIT FEE
s
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above-mentioned property for inspection purposes.
X Date
Signatue/of (P�ermi e r ent
Receipt No. l r(� / 27:
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.
DIRECTOR OF)PUBLIC WORKS
BY�
�ingermit expiresDate