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Home My WebLink About042-040-004A -nom . ....: �• a.. .ID ^i±'�.L'.r`s'tT,Y i, �":i+:a ,:-vi;r�.�„��r.��:.'KS�xa,••�av�r�..r,-.��•�7rv; .••;•r..-=s.:�--3'r„$.-,.`•,a•�.�-�r,,��.��,.,,�s�,��;5.•��- ,,:. -' 042-040-004 BURLEIGH99-0883 Ther730 Henshaw, Chicon Contr: McClullean HVAC & gas & misc. Wiring • l OFFICE OPY Ad GAS { Meter By Date ELECTRIC Meter By Date { • .....,,- .... _ :,v. ,ww �- �-••n.r .:-._.,--. ... .,r; .4'r :"rr:,•F"-*Te�7F'44i /ON COUNTYOFBUTTE- DEPARTMENXile'Callif8mia EVELOPMENT SERVICES -BUILDING DIVI 7 County Center Drive - Oro 95965 - Telephone (916) 538-7P5, l P IT NO. (Rev. 12/96) 0 APPLICATION AND PERMIT foel- ASSESSOR PARCEL NUMBER O� .6qO vO ZONING BUILDl GPERMIT OWNER J10- qL` CO / 7 SO. FT. OCC. BUILDING VALUATION OWNERtPL1ji'S MAIU$ CONTRACTOR'S NAME+ TELEPHONE CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filin Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 30 Energy Plan Checking Fee $ PERMIT FEE $ LOTNO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF IBA 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 y, New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installationy,l Other ❑ Describe Work: (�A I 1 Z-�G b-' v (-, 1 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 OR LE9 Main Service . 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.PSINGL 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. p. 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 To 46.00so VIEL200A CCU000A NEW CONST. DWELLING OCCUP. SO OR ADONS. ( 8 ACC. S.3.50FT. NEW CONST. MULTI.OUTLET NON-RESIO. 1 97.50 OWERE AOUTLET C PPARATUsIR. 8 Zu EX. Occup. OUTLET OR FIXTURES BA % Ex. Occup. Gur�°rs RESIp,OEp 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring / 23.00 Z , PERMIT FEE $ rj MECHANICAL PERMIT Filing Fee 20.00 Heating V0 CoolingS.6V Hood 6.50 Ventilation PERMIT FEE $ 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.) 1, 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. _I 1 X ' ; -_ �.JI.,i, Date y0/ Signatureof Applicant OOwner—{] Contractor ❑ Ag 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 $ OCCON9T. Q TYPE TOTAL FEE $ n� HAZ. F Es IMP FLooO CDF PARCEL PD HD ISS s 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. 7 },�,�; '�'�' �U 9 By �_ Date PERMIT EXPIRES ON 7 ��- �2600 Date Receipt No. y 7/1;19. IOU WHITE-D.D.S.-B.D. CANA -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES - 7 County Center Drive - Orovilfe, California 95 *& ; - Iephone (Rev. 12'/96) APPLICATION AND PERMIT BUILDING DIVI N (916) 538-75 PERMIT NO. ASSESSOR PARCEL NUMBER 041c� —6 LV _ Qo •� ZONING BUILD G PERMIT OWNER ♦ TELEPpo 100&JA 'nOWNER'S MAID E S • r SO. FT, OCC. BUILDING VALUATION CONTRACTOR'S Q TELEPHONE . CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. —Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 30 Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDNISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap7.00 Solar or heat um water heater 23.00 Water piping 15.00 Each as water heater or vent 1.5.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation Other ❑ Describe Work: Ocu c* aeaz Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S GW @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service zoos oa '.ss 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. 31< 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 200A To I000A 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( & ACC. BLDS. so. 3.50FT. NEW CONST. MULTI -OUTLET NON-RESID. ANC c c @7.50 PO.ER APPARATUS 8 SINGLE OVTLET CIR. Ex. Occup. OUTLET OR FIXTURES BAi @ I.50 Ex. Occup. ouiLzTS REESID.OEa 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring23.0023 4n PERMIT FEE $ 4 417) 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.) X 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 _� DateW Si ature of Applicant - '15� O Contractor ❑ Age An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating,(f(� 5- 00 Coolin , dV Hood 6.50 Ventilation PERMIT FEE $ S ob Mobile Home Installation Fee $ Energy Inspection Fee $ Occ �, TOTAL FEE $ CONST.&1E HAZ. IMP FLOOD 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 Indic ed above for which fees have been paid. By JSPL/ Date J-/--� PERMIT EXPIRES ON '4 -30 'aQ_ 0A00 to Receipt No . Gu WHITE-D.D.S.-B. D. CA A -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT