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HomeMy WebLinkAbout040-240-021I� 40-24-21 _ 4 - 282 91B1 Howard 37,0 Servi'ss St,,ffDurHam reroof/sf) 9 _ ,r I 4 _ _ ,� _. .p7`y ^� ry '-iL+t,.•r.:i�-'rl.v�'+.ti .its "y-.. -d7+- ` 1 .. .'�.ily.lZ...rYl�l.�.�i. - ... ^� • � � :?I _y !° 1' . t� • _ +, f .. t� � .. 3 . • � � 1' �� i a `t S, ; }� }. • �,. • i '• ~� '• '' .� �. I • ;. • • \ • s•F.117.".'1�=F • f�.��..7:i,,.Y.�4a '_ '_C.'R. . 'r 1, ��i�T}sr-t�t.��{:,.t�.RlfA COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 -` APPLICATION AND PERMIT v ASSESSOR PARCEL NUMBER 40-24-21 ZO ING _ II BUILDING PERMIT OWNER Howard Horn TELEPHONE R 4 4-2--R177 $Q. FT. OCC. BUILDING VALUATION � OWNER'S MAILING ADDRESS CONTRACTOR'S NAME. Ownpr V TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $1.260.00 LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $22.00 ARCHITECT,OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty . $ BUILDING ADDRESS Permit fee $32.00 PLUMBING PERMIT Filing Fee 10.00 D Seryio—Ct Durkanm Each Trap 2.00 y 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 SFS] Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home Is G W 10.00e TYPE OF WORK New❑ Addition❑ Remodel❑ Utilities❑ Installation Ell ',Other® Describe work: RerOOf Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I am licensed under p ❑ provisions Of Cha t. 9, Div. 3 of the BUSInesS and Professions Code and my license is in full force and effect. License 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) ❑ orsa the owner, am exclusively contracting with licensed contract- 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.6: OR ADONS. ( ACC. BLDGS. , 2/20sgft NEW CONSTR. M ULTI.OUTLET NON" ESI BRANCH CIRC ITS 2,50 ea (POWER APPARATUS &) SINGLE OUTLET CIR. / Ex. Occup OUTLETS OR FIXTURES z0ea0t 1.20@50t FIXED APPLNS Ex. Occup. OUTLETS ((RESID.)REA.) 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 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. �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 FiIingFee 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 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. XI - ,I / / 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 $ occ CONST TYPE TOTAL FEE $ 32.00 ALSCHL HAZ CUA PARK I FED I PAR I PD HD Iss This permit is hereby issued under sions or the Butte County Code and/or work iD4icated above for which fees i DIR �T p OF PU9LIF, /� i By / PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date ` Receipt No. U 83302 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT j COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO./ ASSESSOR PARCEL NUMBER ZONING.. 40-24-21 _ 7- BUILDING PERMIT OWNER TELEPHONE Hownrd Hnrn 3-49-6884 S0. FT. OCC. BUILDING VALUATION 1260.70-- 1 OWNER'S MAILING ADDRESS 2370 Service St, T)iirhnm 95938 CONTRACTOR'S NAME Ownpr TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace 1$1.260.00 CONSTRUCTION LENDER UNKNOWN Total Valuation LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $ 22. ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee ,$ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit tee $ 32.00 PLUMBING PERMIT Filing Fee 10.00 2370 Sgrvio St Durham 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 SFE] Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W TYPE OF WORK New❑ Addition❑ Remodel❑ Utilities ❑ Installation❑ Other® Describe work: Reroof __10.02eEl� Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 1000V OR 0 AMP ORLESS10.00 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. icense No. Classification I 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 Main service EA. ADD•L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADONS. ACC. SLOGS. I 2/20sgft NEW NST ULTI.OUTLET NON•RESID BRANCH CIRC ITS 2.50 ea /POWER APPARATUS &) (POWOUTLET CIR. Ex. Occu po UTLETS OR FIXTURES 20@50t DAL®30 FIXED APLNS. Ex. Occup. OUT ETS P(RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 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 ,df Consent to Self -Insure. T11 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 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 s ' County in c sequence of the granting of this permit. X —" Date q/ Signature of App cant Owner ❑ Contractor E] Agent E]work4cated 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 $ occ CONST TYPE TOTAL FEE $ 32.00 HAZ I CUA I PARK I SCHL I FLD I PAR PD HD Iss This permit is hereby issued under sions of the Butte County Code and/or above for which fees ;IR OF PUJLJIWORKS Al Af BY PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. Al aJ uateIL4G Receipt No. XX 83302 WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT \OF PUBLIC WORKS - BUILDING DIVISION a 7 COUNTY CENTER DRIVE - OROVIGFORNIA 95965 - TELEPHONE: 916/538-7541 wt PERMIT APPLICATION DATA SHEET Permit No. OWNER Proposed Building Use Building Inspector Date At time of permit application, I was advised the following data must be submitted prior`to permit processing and/or issuance: DATE RECEIVED APPROVED —27. When fou issue the permit, process as follows: �wrer. Mail to contractor. Telephone and hold for pickup a office. Deliver w. /inspector. Other Applicant Date Z 1 Copy of Haz-Mat corm sent Health Dept. Fire Dept. air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date— ate The The following data must be submitted prior to permit issuance 1. Index permit for above items No. 2. Additional items required: By— By (Circle new item not checked above). Contractor, designer, owner, was advised of above required data by_phone---nail—counter by \" ..date Contractor, designer, owner, was advised of above required data by—phone —Mal l—counter by date Plans checked by Sets of plans on hold in Copy—DPW Date Plans approved by File cabinet AP folder Date All Items have been submitted . ..................................... _ 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ _ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . _ 4. Complete engineered plans and calcs, with wet signature on plans .. _ 5. Hazardous Material Form ..........................................-_- _ 6. Energy Design Compliance and supporting documentation ......... _ 7. Statement of Intent for Non -Heated and AC Buildings ........... _ 8. Engineered truss details and layout in duplicate (required prior to plan check)-' _ 9. Mobilehome installation data including manufacturer's installation instructions....................................................... _ 10. Fees of $ ........................ _ 11. Chico Urban Area fees paid ....................................... _ 12. Park fees paid .................................................... "�.. _ 13. School District fees paid .............. _ 14. Sanitation approval from Health Department - 15. City of Chico plumbing permit ..................................... _ 16. Plot plan and business license approval from City of (see City for other requirements) _ 17. Planning approval for (A) Use: (B) Parking: ...... _ 18. Improvements may be required. Contact Land Development Section DPW _ 19. Driveway permit (construction approval required prior to occupancy) _ 20. Pre -Inspection for required Pre-Inspec. request to Building Inspector (Date) -21. Contractor's license information (No., Name Style, Classifications ... -22. Certificate of Workmans Compensation Insurance .................. -23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... -24. Recorded copy of Agricultural Acknowledgment Statement ......... -25. Letter of signature authorization ................................... -26. —27. When fou issue the permit, process as follows: �wrer. Mail to contractor. Telephone and hold for pickup a office. Deliver w. /inspector. Other Applicant Date Z 1 Copy of Haz-Mat corm sent Health Dept. Fire Dept. air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date— ate The The following data must be submitted prior to permit issuance 1. Index permit for above items No. 2. Additional items required: By— By (Circle new item not checked above). Contractor, designer, owner, was advised of above required data by_phone---nail—counter by \" ..date Contractor, designer, owner, was advised of above required data by—phone —Mal l—counter by date Plans checked by Sets of plans on hold in Copy—DPW Date Plans approved by File cabinet AP folder Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR F; fEL NUMB _ (� �1�,/ ZONIN BUILDING PERMIT OWNER O mar 6 JELEPHONE (%O SO. FT. OCC. BUILDING VALUATION OWNER'S I LIN G A..." SS /. TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $ Z 6;0ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADORE Permit fee $15�1 PLUMBING PERMIT Filing Fee 10.00 3 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 G W 0.00e TYPE OF WORK New ❑ Addition ❑] jitLnRemodeI [:]Utilities ❑ InstallatInstallation[]Other] Describe work: . r o o -F Permit Fee $ Contractor. ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP 00V OR ORSLESS 10.00 Main service EA. ADD -t- too 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 Business and Professions Code and my license is in full force and effect. ,License No. CI"ossification 1, 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.a OR ADDNS. ACC. BLDGS. , /20sgft NEW CONSTR ULTI.OUTLET NON.RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS &) -SINGLE OUTLET CIR. Ex. OCCU OUTLETS OR FIXTURES P 209500 eAL930 FIXED APPLNS. OR Ex. Occup. OUTLETS IRESI D.1 EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 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. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice o 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 9 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 liabiliti�ee,ss judgments, costs, and expenses which may in any way accrue against "d'County in c sequence of the granting of this permit. X14&11. 4-1 -91 Sig azure f App 'can 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 $ occ CONST TYPE TOTAL FEE $ 3 Z• o �) HAZ I CUA [PARK I SCHL I FLI PAR PD Ho I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date Receipt No. WWTE-O.P.W.. YELLOW- ASS1.9Sn P. P,N NSPrCTOP. nnl n—Pna-4— -1T COUNTY OF BUTTE - DeaartMent of Public Works 7 County Center Dride, 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. • I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) ,i 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 igned : Property Owner / 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.