HomeMy WebLinkAbout040-221-01340-221-1
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COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLIC-ATION,AND PERMIT
#%SSESSOR PARCEL NUMBER
.. L; -- .2 - ... /�
ZONING
,.
BUILDING PERMIT
OWNER
TELEPHONE
SQ. FT. OCC, BUILDING VALUATION
OWNER'S MAILING ADDRESS
! f r,'7 4-.
CONTRACTOR'S NAME
I�) .li
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
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
r
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
1 1
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 Q Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S G W
10.00 ea
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work: +UL 1 �-» .- •. _
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V 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):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the BUslnesS
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
oa ADDNST L DWEACCLLIN GOCCUP &)S.
yxQsgft
NEW CONSTR. MULTI -OUTLET ,�•- 2.5Oea
NON-RESID BRANCH CIRC ITS -+-si•
POWER APPARATUS 61
SINGLE OUTLET CIR.
209501
Ex. Occup(OUTLETS OR FIXTURES BALe 30
FIXED APPLNS. OR
Ex. Occup. OUTLETS (RESID.) EA.) 2.00 2,
Temporary service 10.00
Mobile Home Facilities
15.00
Misc. Wiring15.00 - •�,
n
'�• u
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.
0 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 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 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.
Signature of Applicant — Owner `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 $
TOTAL PERMIT FEE $
OCCUP.
CONST.TYP!
FLOOD
PARCEL
PD
ND
seuE'
/
This permit is hereby issued under the applicable 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 �' r
Receipt No. r
WNIT!-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
} 7 County Center Drive, Orovi Ile — Phone: 538-7541
747 Elliott Road, Paradise — Phone: 872-6307
y. CORRECTION NOTICE
OWNER i PERMIT NO.
A routine Inspection indicates that the following violations of County. Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
s
r
Inspector. Date
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 538-7541
747 Elliott Road, Paradise— Phone: 872-6307
CORRECTION NOTICE
R
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
Inspector_ Date / C�/ 1>
COUNTY OF BUTTE -DEPARTMENT OF PUBLIC WORKS PER IT 0��
7 County Center Drive - Oroville, Califo7nia 95965 - Telephone 916/534-454
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
D— a aL 9— 13
zoG
r I
BUILDING PERMIT
OWNER ,
Com• (��
T LEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNER AI G ADD]RESS _—rp
T
CONTRACTORS NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
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
J
Permit fee
$
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 S I G W
10.00ea
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Inttallation❑ Other ❑
Describe work: IUev.► �(e-41, 4_1 <Ieeu.4_�e _
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
—��
V OR
Main service 100 AMP ORSLESS
10.00 Q.00
Main service EA. ADD'L 100 AMP
2.50 aid
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
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-
ontract-
ors.
ors.(Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUP.ty ,
OR ADDN5. ACC. BLDGS. 2/zQsgft
NEW TLET
NONRESID, BRANCH CIRCUITS) 2.50ea
POWER APPARATUS &)
SINGLE OUTLET CIR.
Ex.Occu Occup(200509
p\OUTLETS OR FIXTURES BALI 300
FIXED APPLNS. OR
Ex. Occup. OUTLETS (RESID.) EA.) 2.00 ®®
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. byirin g 15.00 p
Permit Fee $
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 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.
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Cooling
g
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 agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, cost and expenses which may in any way accrue
st said County in consequ ce of the gr ting of this permit.
- e �- _\ ��l�f
�� ,,Cl —l�`�•c�
Signature of Applicant — %ner Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
�`(,
TOTAL PERMIT FEE r✓
occu P,
CONST.TYPEJ
I
JFLOOOJPARCELJ
PD
1 ND 1
Issu
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTO F PUBLIC
By
PERM EXPIRES Date_
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date/.
�� O
�over
Receipt No. l�J�%�7
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
�r
COUNTY OF BUTTE - DEPARTMENT OE--PUB?L1IC WORKS - BUILDIN61DIVISION
7 COUNTY CENTER DRIVE - OROVILLE• GA•LIRORNIA 95965 - TELEPHONE: 9. 6/534-4541
PERMIT APPLICATION DATA SHEET
1 1
Permit No. I
OWNER � ��ekCu ��., l -f«... � +�..� A. P. No. y� " a a l — / 7
Proposed Building Use S T=/ �-,e,--,.. -g CG.��
Permit Fee Based Upon: Complete Contract Price DPW Valuation
Other (Explain)
Building Inspector �� Date- /0/6�S-G
At time of permit application, I was advised the following data must be submitted prior to permit processing
and/or Issuance: DATE RECEIVED APPROVED
1. All items have been submitted. . . . . . . . . . . .
2., Plot plans in duplicate/triplicate. . . . . . . . . . .
3. Complete plans in duplicate/triplicate. . . . . . . . .
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. . . . . . . . . . . .
•
Mobilehome Installation Data. . , , , ,
• 6 �y Pre -Inspection for �r'ec�. Se.�. C_l.r.quired, Building Inspector Pre-Inspec. request to �" (Date)
18. Recorded copy of Agricultural Acknowledgment Statement.
19. Other
When you issue the permit, process as follows: Mail to owner. Mail to contractor.
Telephone and hold for pickup at office. Deliver w/inspector.
Other
A p p I i c'ti��
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:
(For required items not checked above at time of application, circle item.)
1. Index permit for above Items No.
2. Additional items required:
(Contractor, Designer, Owner) was advised of above required data by Telephone Mail Other
By Date
Plans checked by Date
Plans approved by Date
Other:
Copy—DPW
COUNTY OF BUTTE - Department of Public Works
7 County Center Drive, Oroville, CA 95965 Phone: 916-534-4541
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An 'owner -builder" building permit has been applied for iny our 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
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 1
Address City
Phone Contractors License o.
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 Owne
Social Security Number
\
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.
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95+965 - Telephone 916/534-4541
APPLICATION AND PERMIT
ASSESSOR EL PARCNUMBER
O -- `,� ,
zo ` I
BUILDING PERMIT
OWNER +
TffLEPHONE
SO, FT. OCC.1 BUILDING VALUATION
OWNER -5 MAILQ4G ADDRESS
CONTRACTORS NAME
TELEPHONE
,
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee
$ 10.00
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
$
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2,00
m
Solar or heat pump water heater
20.00
LOT NO.SUBDIVISION
NAME
PARCEL MAP
I
Water piping
5.00
Each gas water heater or vent
5,00
U F STRUCTURE
SF Duplex❑ Mobileh ❑ Oth
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G I W
10.00ea
VPE.� ORKNew ❑ Additio ,modtil ies ❑ Installation❑J Other ❑
work:, _
Permit Fee
$Describe
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 80001 OR 0 AMP ORLESS10.00
49, 0 7
}
CONTRACTORS LICENSE LAW /
I declare u of perjury (check one):
( ,
E:1I Ic, Sed n provisions of Chapt. 9, Div. 3 of the Business
an rofe si ode and my license Is In full force and effect.
License No Classification
I , as the own, r my employees with wages as their S(�le COmpen-
sation, will do b work,and the structure is not intended or offered
for sale. (Sec. 7 ) I
❑ I, as the owner, am exclusively contracting with licenstid contract -
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
Main service EA. ADO'L 100 AMP
2.50
NEW CONST. DWELLING OCCUPM
OR ADDNB. ACC. SLOGS. f 2'/z¢sgft
NEW CONST R. ULTI.OUTLET
NON•R ESID BRANCH CIRC ITS 2.50 ea
POWER APPARATUS &)
SINGLE OUTLET CIR.
Ex. Occu 20®50C
P(OUTLETS OR FIXTURES BALM 30
Ex. Occup.FIXED APPLNS. OR
OUTLETS (REBID.) EA.) 2,00 ' t; Cj
Temporary service
—
10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00 Lil.
,
Permlt Fee $ `tz
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.
Contractor
MECHANICAL PERMIT
Filing Fee 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. 1 agree to comply to all County Ordinances and 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, cost ,and expenses which may in any way accrue
Stsaid County in consequ ce of the gr ting of this permit.
- e (1,� VI&O
Signature of Applicant — ner Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structuresover
r 3l stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
TOTAL PERMIT FEE $ sero
occuP.
CONST.TYPe
I
FLOoo
PARCEL
PD
1 No
I ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF PUBLIC
By
PERMIT EXPIRES Date
the applicable provi-
-resolutions to do
fees have been paid.
WORKS
Date
Receipt No. 6 7' --3—<
/
WHITE-O.P.W.. YELLOW-AS3E7lOR. PINK -INS •1R. GOLDENROD -APPLICANT