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HomeMy WebLinkAbout042-300-024A.P. 42-30-24 i YOUNG, M.C. 1738E `4 FAve IS 1768E 32 app . 1000•' west- of. Muir' y -3a >. V hico 1039-73Bl &: add porch) 42-30-24 ' Hwy 32, 4 miles past Muir Ave., Chico 4 Dale Long r NIS Hwy 32, app.1/10 mi.W;of Muir Ave. lot 5, Vista Del Monte, Chic y' Permit #3841-80P,E(uti ,MH) ELEC .GAS SUPPORT STRUCTURE COMPACTION TEST REQ. i 042-300-024 03-16A55rP HARRIS, DALE INAII[. ` 3588 HWY. 32, CHICO E3 Cont: WAGONER, DALE UPGRADE ELEC. SERVICE r ^ N 042-3001-0.24,..-,. "-03,1645 D ' HARRIS, ALE 3588 HWY. 32, CHICO Cont: WAGONER, DALE UPGRADE ELEC. SERVICE a OFFICE' COPY Address GAS Meter y Date-, ELECTRIC, By 7] Meter By Date kko f. I « 1 COUNTY OF BUTTE - DEPARTMENT OF'DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 , PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT 0> ASSESSOR SR6EL NUMBER 042-3U0-024 ZONING M-1 4,r' BUILDING PERMIT OWNER�,�.� HARRIS OA(41 TELEPHONE 343-7109 SO' Fr. OCC. BUILDING VALUATION . OWNERS MAIUNG ADDRESS :3588 HWY 32 CHICO, CA 95973 CONTRACTOR'S NAME DALE WAGONER TELEPHONE 343-4476 CONTRACTORS MAILING ADDRESS Y.O. BOX 7896 CHICO, CA 95973 CONSTRUCTION LENDER tee. LENDER'S MAIUNG ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENS E NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAIUNG ADDRESS Plan Checking Fee $ J dd °hwY 32 CHICO, CA 5973 Energy Plan Checking Fee $ F $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP (� PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE ` SF' O Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat um water heater 23.00 Water piping 15.00 �• Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities �Installation ❑ Other ❑ UPGRADE ELECTRICAL SERVICE ND Describe Work: I MISC. WIRING Gas piping system 1,- 5 outlets 15.00 Building sewer 15.00 s I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 R LE Main Service 2a 0A OR LE +• 23.00%3. 00SS LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed Linder 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. _ J Ste/ License Class C - in/ Lic. No. A � ��l ))) OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 1, 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. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. I ❑ 1 am exempt under Sec.l Business and Professions Code for this reason Main Service 200A TO I000A 46.00NEW CONST. DWELLING OCCUR s0 OR ADDNS. a ACC. Bins. 3.50F ; T. CUIT @7.50 NOWRESID. RANCHO CIRCUITS POWER APPARATUS a SINGLE OUTLET CIR. Ex. Occu OUTLET OR FD(TUREs &,L g 1:00 Ex. Occup. Dig R�D.O� 5.00 Temporary Service { 23.00 Mobile Home Facilities 20.00 Misc. Wiri ^I Z 23.00 23«0( FRE 11-AbeECTION PERMIT FEE $ 89.0U WORKERS' COMPENSATION DECLARATION I 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 MECHANICAL PERMIT Filing Fee 20.00. Heating Cooling 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.) {J 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 fo h I comply with those provisions. /� X /v2 � /(C Date !!0 ` 0 -3 _ Signature cf Applicant-- ❑ Owner M Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in.height. j Mobile Home Installation Fee $ Energy Inspection Fee $ Occ corer. TYPE TOTAL FEE $ 89.00 - HAZ. I D. FEES IMP I FLOOD CDF PARCEL I PD HD SSUE 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�/_ ha PERMIT EXPIRES ON Defe ReceiptNo. t1' 3'Ic� 1 MW • d 7,;2 WHITE-D.D.S.-B.D: � CANARY-AISSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 01,. 6 COUNTY OF BUTTE... BUILDING DIVISION' DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact. this office immediately. (Rev. 12/96) COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541�� APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 042-300-024 ZONING BUILDING PERMIT OWNER HARRIS DALE- TELEPHONE 1-34-3-7109 SO. FT. OCC. BUILDING VALUATION . OWNERS MAILING ADDRESS 3588 CONTRACTORS NAME DALE WAGONER TELEPHONE CONTRACTORS MAILING ADDRESS P-0 BOX 7896 CHICO,- CA 99973 CONSTRUCTION LENDER LENDERS MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Permit Fee $ Plan CheckingFee $ BUI GING ADDRESS 3 88 HWY 32 CH I CO CA 95973 Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF IN 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 ❑ Remodel ❑ Utilities M Installation ❑ Other ❑ Describe Work: UPGRADE ELECTRICAL SERVICE AND MISC. WIRING PtA- Gas piping stem 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI GI W1 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 600V 0 R LESS Main Service .A OR 1 23.00 3.00 LICENSED CONTRACTOR'S DECLARATION 1 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 (� + / V 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. ❑ 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 Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP, sD OR ADDNS. ( & ACC. BLDS.ONS3.5Q�: NNOONN-R SIDD. MULTI.OUTLET eG 7,50 POWER APPARATUS 8 SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES BAL Q I.50 Ex. Occu , ou Ds Aa,D )OE 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 1 23.00 23.0( PRE INSPECTION 1 123.00 23.0( PERMIT FEE $ $ 9 , QQ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE S 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.) H 1 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' 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 foith comply with those provisions. X Date � — s ' Q � Sign tura o Applicant - El Ow )31 Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in heig t. Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 89.00 HAz. o. FEES IMP FLOOD CDF PARCEL pp ND ISSUE This permit is hereby issued under the applicable provisions of thel Butte County Code and/or Resolutions to do work Indic ted above for which fees have been paid. B ^Date PERMIT EXPIRES ON eTe Receipt No. P •- WHITE-D.D.S.-B.D. CANARY -A SESSOR� PA)( -INSPECTOR GOD D -APPLICANT r=s COUNTY OF BUTTE BUILDING DIVISION .......................... r DEPARTMENT OF DEVELOPMENT SERVICES ,Y n. 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (5.30) 538-7541 CORRECTION NOTICE 15 _/"(, � - - J, R ' I PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact. this office immediately. MtV lVIUZ • COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: 0A& ASSESSOR PARCEL NUMBER OW " 3 `o — v 2 y Proposed Building Use: 1 r'tef o o G Ad • ���r Counter Technician: � Date: 6 3 c3 Items required in order to apply for a permit. All boxes MUST be checkedft marked NA in order to apply. ❑ L. Plot plans, 3 or 4 sets, signed�y the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the }ireparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! (0 5. Energy compliance design and supporting documentation in duplicate. ❑ 6. Manufactured homes: (A) Data sheets and installation instructions, (B) MarriaAe line information, (C) Floor Plan, (D) Tie down or foundation plans, all in duplicate. ❑ T. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The permit will be indexed and returned to the plan review line-up when required items are received. Date Received By ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................ ❑ 9. Plot plan and business license approval from the City of Biggs .................................... ❑ 10. Letter of intent for non-residential buildings......................................................:.. ❑ 11. Detached Accessory Building Form filled out by the owner ..................................... ❑ 12. Hazardous Material Form............................................................................... _ ❑• 13. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 14. Fees as shown on the attached Schedule of Fees Due Sheet ....................................... ❑ 15. Statement of Intent for Non -heated and A/C Buildings ............................................. ❑ 16. Sanitation and plot plan approval from the Environmental Health Department in ❑ 17. City of Chico Plumbing permit......................................................................... ❑ 18. California Department of Forestry plan approval ❑ paid. Sent. by: ...................... ❑ 19. Planning approval for (A) Use: (B)Parking: . (C) Parcel Check: ❑ 20. Contact Land Development about O Improvements, ❑ Drainage ............................... ❑ 21 Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). 1� 2 Pre -Inspection for p f G C ra t« S c-4 ✓r L -L required ................ ❑ 23. Contractor's license information. (Number, Name Style, Classification) ...................... ❑ 24. Worker's Compensation Carrier and Policy Number ..............:.............................. ❑ 25. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) ..................... ❑ 26. Letter of Signature authorization.................................................................... ❑ 27. Recorded copy of Agricultural Acknowledgment Statement .................................... ❑ 28. Manufactured home utility clearance................................................................ ❑ 29. Existing violations and/or expired permits.....................................................:... ❑ 30. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 31. Other: When issued Telephone 1A - and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: Date: & 611, 1. Index permit application for the above items numbered: 2. Additional items required Contractor, designer, owner, was advised cf the above data by Contractor, designer, owner, was adrvised of the above data by Plans reviewed by: t Date: Structural reviewed by: Date: Note transfer by: Date: ❑ phone, ❑ mail, ❑ counter, by ❑ phone, ❑ mail, ❑ counter, by _ Plans approved by: Structura['approved by: Yellow: Buildine Division Plan Check Letter _Date: _Date: Date:_ Date �. PRE -INSPECTION REPORT OWNER bf L Ir A04A (_) DATE: LOCATION: 3 egg /'rrc,,,,.��� Z AP. #• • 12'30c:> -02S CONTRACTOR: C LJL ZONING: � PRE.rKsPETION FOR:_ f 1 e (T_A L C /a- ( S- - A � 1 Ce— DATE TO INSPECTOPERMIT HISTORY:( ) NONE _(iYAS FOLLOWS: Building Deacrlption: CemmerciaWsar- Resid=tiaV# of Units: Currently Occupied Abandonc&Vacant Electric: Yes No, Condition of Electric Gas: BUILDING INSP=OR'S REPORT Electric currently On Off Natural_S� Propane None Currently On Off Obvious Problems: /* . Sanitation: Plumbing Working_ Well Working ��� Obvious SewmProblems _ � "0 Potable Water t ACTION RECOMMENDED: ISSUE: HOLD FORS ��� SL L✓iD���S/� Date Sketch buildings on reverse and indicate location on proper, �� � _+s r �� �� t u l PERMIT NUMBER - B 1039-73B r P i 3 E } PERMIT EXPIRES 'OWNER Dave Long CONTR: owner LOCATION (A.P. 42-30-24 j r n/s Hwy 32 app. 1000' west of Muir Ave.,Chico t eo,o�� r ° COUNTY OF BUTTE Department of Public Works . BUILDING INSf0ECTIO,N RECORD. Zoning Setback Forms Foundation Piers & Girders Fireplace Rgh. Plumbing Bond Beam Lath & Plaster Rein. Steel Gas.Piping & Test Found. Vents Framing Pimg. Topout Rough Elec. Wtr. Htr. Furnace Kitchen Vent Firewall Garage Vents Sanitation & Water ELECTRIC GAS BUILDING Temporary Temporary Cert. of Occup. Final Final Final DATE REMARKS OR CORRECTIONS _ /S — %y ��,�►i'/-�G .rest r COUNTY OF BUTTE —' YEPARTMENT OF PUBLIC WORKS D Y 7 7rourtty Genter Drive — O,roviIle, California 95965 aJ / Telephone! 534-4541 APPLICATION AND PERMIT dutnorize representatives of the county of butte to enter upon the above boned property for i spection purposes. 7 Date Signature o ermitee or Agent >> Receipt No. 2L White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -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 Date f—/ / 7 a Building Permit Expires Dat`�" 7r BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address t Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Permit Fee $ $ Building Address / - _ ° PLUMBING No. @ FEE PERMIT FILING FEE $2.00 e /, Each. Trap 1.50 / 1 cf Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. — O ^ pll — Zoning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .50 Fire Zone Fire Dept,, Sanitation Planning Building sewer 5.00 Plans Fees W. C. V1 R/W I Encroachment Lawn sprinkler system 2.00 NEW ❑ DI TION OTHER ❑ Permit Fee $ $ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 / a OL Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) U OF STRUCTURE Single Family Duplex ❑ Others ❑ Range, dryer or water heater 1.00 Oven, Cook -top or space heater 1.00 Light fixtures Receps., switches & fix outlets 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: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Misc. wiring License No. Classification © 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. 1:1 I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. ,171 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. @ I FEEPERMIT FILING FEE $3.00 Heating Cooling Ventilation 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 Pn5trurnentoIianor rDf a Motion $0.07/$1000 Evaluation $ TOTALY PERMIT FEE $ dutnorize representatives of the county of butte to enter upon the above boned property for i spection purposes. 7 Date Signature o ermitee or Agent >> Receipt No. 2L White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -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 Date f—/ / 7 a Building Permit Expires Dat`�" 7r rit { y�• . 1 ; ' , — _4 Cal I • • jdr i"v �'��' � •r Ar WIVE CPU NTY `, r BUILDING DEPARTMENT • �tJr APPROVED +y®TE:—All V4eriojs &. Workmanship Shall Be itt thiI het of plans and specifications MUST be F Accl5rdance ' with :FsKQ ized Good Practices MA � Scopt om the .job at all times and it is un!• wFul to of .!ja'ifv ' rescribed -for the Specified use in::tlI m3k4. ony changes or alterations on same witilioui Ur. :. rm Building Code Uniform r PlumbingCode . #rit ,parmisson from the Department of Public , =ate' Works,, County of Butte. `he National Electrical Code. r- s, (`` r rt4 `Ytc ts'� �s r { ix �''t r A. a`'f • �"14 , — _4 Cal I • • jdr i"v �'��' � •r Ar WIVE CPU NTY `, r BUILDING DEPARTMENT • �tJr APPROVED +y®TE:—All V4eriojs &. Workmanship Shall Be itt thiI het of plans and specifications MUST be F Accl5rdance ' with :FsKQ ized Good Practices MA � Scopt om the .job at all times and it is un!• wFul to of .!ja'ifv ' rescribed -for the Specified use in::tlI m3k4. ony changes or alterations on same witilioui Ur. :. rm Building Code Uniform r PlumbingCode . #rit ,parmisson from the Department of Public , =ate' Works,, County of Butte. `he National Electrical Code. r- s, (`` r CLAIMANT: _ ADDRESS: CITY & STATE: Chico, CA. 95926 IMPORTANT: August 11 1980 SEE INSTRUCTIONS DATE OF CLAIM: ' ON REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES eount* it OROVILLE, CALIFORNIA GENERAL CLAIM Jack McCumber Rt. 1, Box 480-S DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT Decided not to put in utilities for mobilehome. Owner: Dale' Long - Permit Appin. #3$4�$OP,E - AP 42-3 - Receipt #41265) Plumbing permit fee paid ----- $33.00 Retain filing fee ------------ 3.00 Amount of refund due -------------------$30.00 Electrical permit fee paid --- $25,50 e azn tiling fee ------------ Amount of refund due ------------------- JZ2.50 Total Permit Fees Refund due -----------$52.50 Land Development Fee Refund due -------- 25:00 TOTAL REFUND DUE -----------------------$77.50 $77.50 TOTAL $77.50 I, the undersigned, declare under penalty of perjury that the services or articles clai4haveperformed or delivered, and that this claim is true andelcorrrect as stated. Dated this ,;,,,.VS ........... day of ,,,, 19 at;,,,, Ca9 ature of laim ant I, the undersigned, hereby certify that, to the best of my knowledge, the services ora Iles specified above have been performed or de- livered and that there is a Budget Appropriation a or Specific Board Approval[] (d he one) for the same. 19h August 80 Oroville Datedthis .................................... day of ........g.................. 19....... at .............................. . Calif..................................................................................... Department Head or Authorized Deputy Dept. Exp. Code............................................ Code ..............................................:..PAYABLE FROM............................................................................................ FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY VENDOR I DEPT CODE & SUB. I PROD' SUB. OBJ. CLAIM NO. INVOICE NO. i INVOICE i DATE DISC. GROSS AMOUNT ENCUMB. SUB -DIST. i i � ( I COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT ASSESS R -PARCEL NUMBER `- ZONIN BUILDING PERMIT OWNER � y3 TELEPHONE 0 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING A ESS 1e4,*O wo S / G CONTRACTOR'S NAM TELEPHONE. CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER UNKNOWN Fireplace Total Valuation $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING WDRESS PLUMBING PERMIT Filing Fee 3.00 Each Trap 2.00 Repair drainage or vent piping 2.00 Water piping LOT NO. L S/U/�BDIVI��SIONnNAME - 4/J(Q U6 PARCEL MAP Each qas water heater or vent 2.00 Gas piping system 1 -5 outlets Ob USE OF STRUCTURE SF ❑ Duplex[] Mobilehome Other ' SPECIFY Building sewer Lawn sprinkler system 2.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities 0----' Installation ❑ Other ❑ Describe work' — Permit Fee $ 0 Contractor ELECTRICAL PERMIT Filing Fee 3.00 Main service i$$ AMP OROR LESS5.00 "00 Main service EA. ADD'L too AMP 2.50 NEW CONST. WELING OR ADDNS. (ACCLBLDGS. OCCUP,&� 20sgft 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 P/l, 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 CONSTR U TI.OUTLET 2.50 ea NON-RESID. BRANCH CIRCUITS) NEW CONSTR. ( POWER APPARATUS 9 NON-RESID, %SINGLE OUTLET CIR. / 50@0 OR FIXTURES aBAL@tOZ Ex. Occup(o XED A EOFIXED SOR Ex. Ccu p•(DUT LETTSS ((REREST, D.) EA.� 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 D Misc. Wiring 6.25 Permit Fee $ —� a 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 3.00 Heating Cooling Hood 2.00 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 cost, and penses which may in any way accrue all liabilities judgments*S_s.e against sai ou in the granting of this permit. Date �S�� Si ature of Applicant — Owner FJ Contractor ❑ Agent ® n OSHA permit is required for excavations over 5'0" deep and demolition Or Construct- ion of structures over 3ystoorries in height. Mobile Home Installation Fee $ Land Development Fee $ TOTAL PERMIT FEE $ OCcUP. GROUP I TYPE OF CONST. PARC L PD HD ssUE 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. �O�L� 6 � WHITE-D.P'.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT i Vy i NOTE:—All Materials & Workmanship Shall Be Ij fi Accordance with Recognized Good Practices and of a quality prescribed for the Specified use in the Uniform Building, Plumbing & Machanica! Codes and the National Electrical Code. Tv M9 Z 14 ff zip I?d,90?4 -T- I phi 14 INJ \e z AO G Ok �h NL00 -jep C c\e seo�,�r`�e tO 0 � e Xeo� :,,ie Nev�e 0 i\ 0 4e ez, ko, CPAC T j This set of pt*s.ond specific tions MUST be kept on the jo6li 4t all times and t is unlawful to make any chancds or alterations some without written permiss�o from the Dep!-nent of Public gn, 6 -2✓ � i�l, Inter-Depa 114 -ro v,, IAe!� f/l i ltif I a idum_ T FROM: SUBJECT: G2 �i i ! A -f' -'k 30 DATE: �l3J�GT�c-'Yy' 0 i Cao \- _ �� ��� C'i�)'4 ,•- i ®sr G CCS _� _ . - ". 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