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HomeMy WebLinkAbout040-240-039I 39 40-24-39 ` _.- -LEONARD GOLDKIND-- -- ,r( MORSE, Lois. J. 5048B 2365 Seevis Dr,Chico Permit#2412-87B(reroof/SF) 0-24-39 040-240-039 -0692 229 Serviss. S.t...:, Durham , DENNHARDT, RANDAL CONTR:_.Pacific_Metal Awniig Co., 54.21 84th E Sacramento +` 2365 SERVISS ST. DURH CONT: K B CONSTRUCT (alum. siding) RE ROOF F -B08-0875 yj�' `039-540-004 ,MISCELLANEOUS. ,HVAC Chang_e Out HVAC CHANGE OUT�iy� k;?I- ;'�' -- - -- i _ 9478 DILLON. CT "' ' `' 0 t ," e. , - t, t WILKINSON TIMOTHY R,�11 ' + ' i I _ p I 39 40-24-39 ` _.- -LEONARD GOLDKIND-- -- ,r( MORSE, Lois. J. 5048B 2365 Seevis Dr,Chico Permit#2412-87B(reroof/SF) 0-24-39 040-240-039 -0692 229 Serviss. S.t...:, Durham , DENNHARDT, RANDAL CONTR:_.Pacific_Metal Awniig Co., 54.21 84th E Sacramento +` 2365 SERVISS ST. DURH CONT: K B CONSTRUCT (alum. siding) RE ROOF F -B08-0875 yj�' `039-540-004 ,MISCELLANEOUS. ,HVAC Chang_e Out HVAC CHANGE OUT�iy� k;?I- ;'�' -- - -- i _ 9478 DILLON. CT "' ' `' 0 t ," e. , - t, t WILKINSON TIMOTHY R,�11 ' + ' i I _ p 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 PROJECT INFORMATION Site Address: 9478 DILLON CT Owner: Permit No: B08-0875 APN: 039-540-004 WILKINSON TIMOTHY R, Issued Date: 05/13/2008 BY TMP Permit type: MISCELLANEOUS 9478 DILLON CT ' Subtype: HVAC Change Out DURHAM, CA 95938 Expiration Date: 05/13/2009 Description: HVAC CHANGE OUT (530) 894-2006 Occupancy: Zoning: Contractor Applicant: Square Footage: GALLAGHER'S HEATING & AIR GALLAGHER'S HEATING &. Building Garage Remdl/Addn PO BOX 35 PO BOX 35 LOS MOLINOS, CA 96055 LOS MOLINOS, CA 96055 (530) 384-2444 (530) 384-2444 Other Porch/Patio Total FEE INFORMATION DBM Heat Pump (Package Unit) $59.00 Total Charged: $59.00 Fees Paid: $59.00 Balance Due: $0.00 Receipt No: B7328 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License GALLAGHER'S HEATING & AIF 777334 / C20 C38 / 04/30/2008 Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, , also requires the applicant for such permit to file a signed statement that he or she is licensed I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing with Secti n 7000) of Division 3 of the Business and Professions Code, and my license pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) is' II force and ffe of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects 05/13/2008 the applicant to a civil penalty of not more than five hundred dollars [$500); Please check one of the following: c6itractoes So nilt re Date ❑ 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 (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: HAVE AND WILL MAINTAIN the work himself or herself or through his or her own employees, provided that such improvements ❑I A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). IIlZHAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code: of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the State Fund 713-0013855 05/01/2008 Carrier: Policy Number: Exp. Date: -7 Contractors License Law.). (This section need not be competed if the permit is or on' n5 unfired dollars ($100) or less. ❑ I AM EXEMPT under Section B. & P.C. for this reason: ❑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 Workers' Compensation Laws of California, and agree that if I should become subject to the workers' X 05/13/2008 mpensation provisio of Section 3700 of the Labor Code, I shall forthwith comply with those Owner's Signature Date pr isions. X ✓ 05/13/2008 I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Si R re Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, injury, including death, and property damage caused by, arising out of, or in any way connected with DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to en r t above mentioned property for inspection purposes. I hereby certify that I am the o rty ow o thori ed to act on he props wner behalf. CONSTRUCTION LENDING AGENCY 05/13/2008 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for a Of I ee [SIGN] nt Date the performance of the work for which this permit is issued. (3097 civ. code) Owner 1:1 Contractor OR. Agent for Owner Agent for Contractor FILE COPY Lender's Address City State 771 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES PERMIT BUILDING PERMIT APPLICATION" NO. OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds BIN # PLEASE PRINT CLEARLY "When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. OWNER INFORMATION Last Name First Name 0 Mailing Address z C Ser \r t Sc, City State C Zip Phone 5 V 1 Fax E-mail CONTRACTOR Name l a G S4-4\141� G Address Pa J� City I is mD 11 State CA Zi Phone "% Fax E-mail Lic. # -7-7 7 3 3 Class C 3a APPLICANT INFORMATION ARCHITECT/ENGINEER Name City 1 O Address Zip06ft City Fax State Zip Phone Fax E mail State License Number APPLICANT INFORMATION Name 'S Address To C 3 G; City 1 O state C Zip06ft Phone 5 L+ ?IJLHA Fax E-mail PROJECT LOCATION API Property Address 3ro City —7 �X- t rJ WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than licensed contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK. 1 Yvs�` /-) i ne C Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning Flood Zone SRA I Yes I No Occ. Type Const. ,. '"""'�"�'..�'irSrK.r.- .w., ..-. «. w" S-`C..s ,..'s—-:rf�-•.'+.7(> .: ..., _$ �. vr�-F....�✓.yt�.!"--f.^-sr� .- _.�.......t,��--a„-r �c--�^'.� � .. �w+-.+*�...w.-� : „s, r - �. 040-240-039 01-0692 DENNHARDT,RANDAL 2365 SERVISS ST. DURHAM CONT: K B CONSTRUCTION RE ROOF s h (Rev. 12/96) COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - SbILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 APPLICATION AND PERMIT ('_. PERMIT NO. ASSESSORPARCEL,�J� MBERR ��� ry _ � !` ' Ir. O, ZONING i BUILDING PERMIT OWNS)- p / I ! L�� TELEPHONE SO. FT. OCC. BUILDING VALUATION - OWNER'S1 MAILING ADDRESS- _ • �' (o •:) �� �.I_ "L' t..! �J � �. • .I � rr(ILT�t�:',lgf , ,� r, U CONTRACTOR'S NAME' TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ .• O (i CSU ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Pian Checking Fee $ BUILDINGADDRESS rs Energy Plan Checking Fee $ I, �_r. LZ l"n PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF 51/ 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 ❑ nRemodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: Ili ' .n k7,': i g l /` � Gas piping system 1 - 5 outlets 15.00 Buildingsewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 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. ■ r'� License Class t', Lic. No. �� / L tea 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. ❑ 1, 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 200, TO tOooA 46.00 NEW CONST. DWELLNJG OCCUP. OR ADDNS. ( a ACC. Bins. SO 3.5¢FT; NEW CONST. NON-RESID. MULTI.OUTLEr 97,50 POWER APPARATUS a SINGLE OUTL: cIR. • Occup. OUTLET OR FDRURES BA200 ® 1.00 Ex. Occup. ou�T TS AP=.) E 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 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 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.) 0-1 certify that in the performance of the work for which this permit is issued, I shall employ any person in any manner so as to become subject to workers'IMP 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 . Date 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. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEP $ Mobile Home Installation Fee $ Energy Inspection Fee $ CO TYPE TOTAL FEE $not VofthPeI3.tt.S FLOOD CDF PARCEL PD HD ISSUEcompensation 4, rmit ihereby issued under the applicable provisions County Code and/or Resolutions to do work indicated above for which fees have been paid. -� { 7 By Date i PERMIT EXPIRES ON (Da to) Receipt No. �� WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT ■V W COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION V 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 P MIT NO. (Rev. APPLICATION AND PERMIT C, �� 9 ASSESSORPARC UM — y1 ' o — yU 3q ZONIN _3 BUILDING PERMIT OWNS /j /� TELEPHONE SO. FT. OCC. BUILDING VALUATION V ' . OWN LI ��.Y-`'ter - 3 CONTRACTO 'S E 6. TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ OO . t)0 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS al ^ �� l -J( lil"�/ /.�/��' Energy Plan Checking Fee $ C�-X3'1'1 ZlydL$ PERMIT FEE $ 14q.M LAT NO. SUBDNISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF,9'e Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 - Solar or heat um 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: — AADq eQ nsg Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 RLE Main Service ".A 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 i full force and effect. „,_ `2 License Class Lic. NO. .'-)-/' J�)�C.�/ OWNER -BUILDER DECL A ION 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. ❑ 1, 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 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.) tr—icertify 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 rthwith comply ttith those provisions. XLj _ Date Signs ure of ApMicant - ❑ Owner Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demZtion or 4onstruction of structures over 3 stories in height. Main Service 200A To I000A 46.00 NEW CONST, DW UNG OCCUP. SO OR ADDNS. ( 8 ACC. BLAS. 3.50FT. NEW CONST. MULTI.OUTLET NON-RESID. @7.50 POWER APPARATUS 8 SINOIE OUTLET CIR. OUTLET OR FIXTURES 20 @ I'0° Ex. Occup. BAL @ ,50 Ex. Occup. ountDrs ao °PEAL 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirin 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FET= $ Mobile Home Installation Fee I $ Energy Inspection Fee $ a!_c� TYPE TOTAL FEE $ r 00 Ift HAZ. D IMP FLOOD COF pAILC0. ro HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicat above for which fees have been paid. By Date —Z PERMIT EXPIRES ON^Z'�Z Date Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 61 � w-tGAq( COUNTY OF BUTTE - DEPARTMENT OF PUBLICtWORKS ` :-7 County Centigr. Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND -PERMIT PERMt�f N0. 1 �/7 ASSESSOR PARCEL NU To -J( ZONIN 3 BUILDING PERMIT Ow7OWN R v TELE HONE SQ. FT. OCC. BUILDING VALUATION OWN .5 MAILING ADDRESS - p // CONTRACTOR'S NAME I 111?06in TELEPHONE 895-8 3 CONTRACTOR'S MAILING ADDRESS 0 '21Fireplace CONSTRUCTION LENDER - UNKNOWN Total Valuation $ ` Flling'Fee $ 1Q,QQ :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 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 gas 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 10.00 ea TYPE OF WORK New❑ Addition Remodel❑ Utilities❑ Installation❑ Other❑ Describe work: I�t_' �D GCS IY\.f1 _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service e01V 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): Q�am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license i? in full force and effect. License No. 7 �� 7 L�L— Classification G 3 % ❑ 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.& '/z¢sgft OR ADONS. ACG. BLDGS. / NEW CONSTR. MULTI -OUTLET 2,50 ea NON-RESID BRANCH CIRC ITS /POWER APPARATU56� SINGLE OUTLET CIR. EX. Occup(OUTLETS OR FIXTURES 5AL&30 DAL030 FIXED APLNS. Ex. OCCUp. OUTLETS (RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare underenalt p y of perjury y (check one): ❑ The permit is for $100.00 (valuation) or less. &4,,,rhave 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 FiIi Fee 10.00 � Heating Cooling Hood 3.00 Ventilation Permit Fee ; Contractor 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 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 cgonsequence of the granting of this permit. X Date 7,�3_ k Signature o(r pplicont — Owner Q�Controctor ❑ Agent ❑ An OSHA p rmit 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.TYPE I IFLOODIPARCELF15 I 1113_1ISSUE This permit is hereby issued under sions of the Butte Count Code and/or work indicated above for which DIRECTO,# OF PUBLIC c By- PERMIT EXPIRE Date the applicable provi- resolutions to do fees have been paid. WORKS ate I Receipt No. WHITE-O.P.W.. YELLOW-ASSESSa11, PINK -INSPECT.'- GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 -Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT N0. ASS "SOR PARCEL NU To 3 Z IN �j BUILDING PERMIT OWN R TELEPHONE SQ. FT. OCC. BUILDING V UATION OWNER'S MAILING ADDRESS _ p CONTRA CTOR'S NAME in TELEPHONE 89 5--,g,3 CONTRACTOR'S MAILING ADDRESS 0gA,5--Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ 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 Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 -- / USE OF STRUCTURE SF Iii' Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home I S I G JW 10.00 ea. TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP ORV OR LESS10.00 Main,service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): Q--li-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. t/ S N/ 7. _Classification F] 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.s ,/z¢sgft A New CONSrR( MULTI - OUTLET N.ON.RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS &) SINGLE OUTLET CIR. Ex. Occu o 20050e Occup(OUTLETS OR FIXTURES eAL@30 Ex. Occup. our ETS P(RESID )REA.) 1 2.00 Temporary service 10.00 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 Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ - Contractor 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 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 againstfB 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 %—%3 SS Z_is Signature o pplicant — 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 $ UP. CONST.TYPE FLOOD PARCEL I_PD NO 133U permit is hereby issued under the applicable provi- ns of the Butte Count Code and/or resolutions to do rk indicated above for which fees have been paid. ` DIRECTO F PUBLIC WORKS D PERMIT EXPIRE Dae Receipt No. S WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT C-