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Home My WebLink About042-350-0070 42-35-7 CHARLES SKOW a 1212. Glenwood Drive,',Chico ' Contr. McGee & .Harris OFP, 3 8� Permit#816-85E,M(install;ele & mech),�. z 042=35=0-0071-�, T SKOW,-Ch`arle ' 99 0106 B ± fi 12 s - ". .. 12. Gleniaood Ave'° ' ieroof Chico r/S rra R6of Y ie z tR` 042-350-007 -03-2977=�: PINKERT, Jrn'I ' 1212 GLENWOOD AVE, CHIC # WALE . CONT: OWNER gri5_ REPLACE WINDOWS ' ti "t^' �' t 042-350 007 , ` B08 09401 << �i r iMISCELLANEOUS�' ;;:•`-Electric Panel, ELECTRICAL PANEL CHANGE OUT,_. 1212 GLENWOOD AVE, , ,i,iY xA ,,JOHNSON; DIANE &PINKERT, JIlVlr;.i: a - f i 1 M BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING PERMIT 24 HOUR INSPECTION (IVR): (530) 538-4365 OFFICE: (530) 538-7541 FAX#: (530) 538-2140 ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 1212 GLENWOOD AVE Owner: Permit No: B08-0940 APN: 042-350-007 JOHNSON, DIANE & PINKERT, Issued Date: 5/22/2008 By GLB Permit type: MISCELLANEOUS 1212 GLENWOOD AVE Subtype: Electric Panel CHICO, CA 95926 Expiration Date: 5/22/2009 Description: ELECTRICAL PANEL CHANGE Oi (530) 879-9673 Occupancy: Zoning: R1 Contractor Applicant: Square Footage: ABLE PLUMBING & ELECTRICAL ABLE PLUMBING & ELECTN Building Garage Remdl/Addn PO BOX 7907 PO BOX 7907 CHICO, CA 95927-7907 CHICO, CA 95927-7907 Other Porch/Patio Total (530) 899-9009 (530) 899-9009 FEE INFORMATION DBE Single Phase Service-Resid $59.00 Total Charged: $59.00 Fees Paid: $59.00 Balance Due: $0.00 Receipt No: B7423 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 ABLE PLUM & ELECTRIC 627760 / C36 C10 / 2/28/2009 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 HEREB AFFI UNDER PENALTY 0 PERJURY that I am licensed under provisions of Chapter 9 (co ancing Section 7000) of on 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) i n full for and effect. 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 X 5/22/2008 the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: CO factor's Signal a 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 WO KERS' COMPENSATION DECLARATION OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of the property, who builds or improves thereon, and who does I HEREBY IRM UNDER PENALTY OF PERJURY one of the fallowing declarations: the work himself or herself or through his or her own employees, provided that such improvements IH E AND WILL MAINTAIN 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.). ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED AVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractors License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the DELOS INSURANCEPolicy 5/1/2008 Carrier: Policy Number. �xp. Date: Contractors License Law.). (This section nee not a completed if the permit is or one unfired dollars ($100) or less. ❑ I AM EXEMPT under Section B. 8 P.C. for this reason: ❑I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shat employ any person in any manner so as to become subject to the Workers' Compensa ' cos of Califomia, and agree that if I should become subject to the workers' X 5/22/2008 comp. do provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owner's Signature Date pro cons. 5/22/2008 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 Signa fe Date WA NG: FAI RE SECURE RKERS' 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 A SHALL SU E AN EMPL ER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE njury, mcludin Bath, and property damage caused by, arising out of, or in any way connected with NDRED THO ND DOLLAR $100,000 , IN ADDITION TO THE COST OF COMPENSATION, ( ) the issue this permit. I hereby acknowledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use 0 ancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. C my enter t boned property for inspection purposes. I hereby certify that I am the rop owner or am orized to act on the property owners behalf. CONSTRUCTION LENDING AGENCY 5/22/2008 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of er Ittee [SI ] Print Date the performance of the work for which this permit is issued. (3097 civ. code) caner Contractor OR; E]Agent for Own Agent for Contractor FILE COPY Lender's Address City State ip BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION" OFFICE 4:(530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds PLEASE PRINT CLEARLY PERMIT NO. Otf BIN # "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 Nam First Name - Mailing Address wGp City State Zip 2� Phone ?-79-9( 73 � Fax E-mail PRO ECT LOCATION AN Property Address City 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: ange-f U lkrwh rl � Sq FT- Living Garage Open Cov ❑ Structure Built without Permits e/ ❑ Proposed Change of Occupancy (Note previous use): 4\ W\ For office use only: CONTRACTOR Name Name Address ilki Address w -� o State City Phone State , Fax Zip L7 Phone v Fax E-mail Lic. # -7 -7 6 a Class Q PRO ECT LOCATION AN Property Address City 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: ange-f U lkrwh rl � Sq FT- Living Garage Open Cov ❑ Structure Built without Permits e/ ❑ Proposed Change of Occupancy (Note previous use): 4\ W\ For office use only: ARCHITECT/ENGINEER Name C�iiv b v Address U City No State Zip Phone Phone Fax E-mail E-mail State License Number PRO ECT LOCATION AN Property Address City 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: ange-f U lkrwh rl � Sq FT- Living Garage Open Cov ❑ Structure Built without Permits e/ ❑ Proposed Change of Occupancy (Note previous use): 4\ W\ For office use only: APPLICANT INFORMATION Name C�iiv b v Address U City No � Stat Zip�S� vv// Phone / Z Fax E-mail PRO ECT LOCATION AN Property Address City 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: ange-f U lkrwh rl � Sq FT- Living Garage Open Cov ❑ Structure Built without Permits e/ ❑ Proposed Change of Occupancy (Note previous use): 4\ W\ For office use only: Zoning FloodZone SRA Yes No Occ. Type Const. �. k t 042-350-007 �Y,�03 2977. PINURT, JIM , s 1212,GLE1V�,�VOOD AV E, CHICO ! CONT. O WNER REPLACE WINDOWS f F. l •t; 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 (f,� l %3 4 ASSESSOR PARCEL NUMBER /'41`5 D0�,,) -.� ZONING BUILDINGPERMIT OWNER TELEPHONE - 1 SO. FT. OCC. BUILDING VALUATI N L' L- OWNERS MAIUNG ADDRESS / f F - iilk- CONTRACTOR'S NAME TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Fee $ 20.00 —Filing Permit Fee $ 2 . u ARCHITECT OR ENGINEERS MAIUNG ADDRESS Plan Checking Fee $ SUILDINGADDRESS f�'!j �`� , 1 1 iL'l.�r ��• /. f .L C. t tl 1 I � v Energy Plan Checking Fee $ $ l., r ,1 PERMIT FEE $ . LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑� Duplex ❑ Mobilehome ❑ Other SPECFY 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 ❑ Installation ❑ Other Of Describe Work: e P [Jy1 caws Py1j r re AJf [ M i ✓1C Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 800V 0R LESS Main Service zo..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. 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. 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 200. TO 46.00 NEW CONST. DWE8 ACOCCUP. WNG CCU OR ADDNS. ( C. BLD S. SO 3.50F7_ NON-REOSID T f MULTI IRCUITS T @7,50 POWER APPARATUS d SINGLE OUTLET CIR. EX. OCCU OUTLET OR FD(TURES 20 1'� BAL 50 FIXED APPLNS. OR Ex. Occup. otIrLETs RESID. EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring23.00 PERMIT FEE S 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 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.) 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 '✓ _ Date 9p 2 06 3 Si tura of Appll ant - ❑ Owner ❑ Contractor ❑ Agent 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 $ occ CONST. TYPE TOTAL FEE $ HA2. I D. FEES IMP I FLOOD I CDF AARdEL PD HD ISSUE This permit is hereby issued under of the Butte County Code and/or indica above for w ' h fee have / I By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date (Date _25 -Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT �,',, � .- +4r1 ., ...+..7,^� f,,...,.T.»-f'�'.-�.: Y.n a`le-._ , t..a>(w a•� ,..-�...� s r . • .... +{ +.w.. -. r.ti tom: !� a - 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 OWNER PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please n e this office when correction of work is completed. If you have any questions pertaining t is matter, or need additional explanation, please contact this office immedialely^ f'vl,) i /1%s /_ PN , 1/�f / i r_ // _ 1%74.1/ COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7,5_4 � RMIT NO. (Rev.12/96) APPLICATION AND PERMIT (L( T ASSESSOR PARCEL NUMBER P- ZONING BUILDING PERMIT OWNER ( ; y F 1 i� 1 J pN�'j/=-�• / Ems! SO. FT. OCC. BUILDING VALUAT N OWNERS MAILING AQQRESS �, 1 1-7 "C/— i CONTRACTOR'S NAME TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ 3S ' A ARCHITECT OR ENGINEER LICENSE NO. Filin Fee $ 20.00 Permit Fee $ z-00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS 11-12 b i olo c e-0 L. L.✓ Energy Plan Checking Fee $ $ Jfl PERMIT FEE $ z'u LOT NO. J SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SFDuplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump 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: re �l 101'1' .aos e4. n rc tl l (SLC Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI GI W1 920.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 600V 0'Main Service 20.AORLESS 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 1 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. 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 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.) 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. / 2 X /T� Date 2 V 0 J Si lure of Appll ant - ❑ Owner ❑ Contractor 11Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Main Service POA TO lOooA 46.00 NEW CONST. DWEWNG OCCUP. OR ADDNS. ( a ACC. Blas. SO 3.5¢FT; µp0 D. MULTI-DLITcu, @7,50 POWER APPARATUS a SINGLE OUTLET CR. � � Ex. OCCu OUTLET OR FDCrURES BAL SO Ex. Occup. o uTLEEDrsA RES o.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring23.00 PERMIT FEE $ MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE S Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ .0 HAZ. p. FEES IMP I FLOOD I COF PARCEL PD HD SSUE This permit is hereby issued under of the Butte County Code and/or indica above for w ' h fee have By i PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. D%ate Date Receipt No. 2 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT Dec 17 02 11:39a p.2 OWNER. BlUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit bas 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 I. d property improvement : YES NO O Q2.I HAVE tr HAVE NOT ❑ signed an application for a building permit for the proposed work I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: PHONE: CITY: CONTRACTOR'S 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: Nk'VIE: ADDRESS: CITY: PHONE: CONTRACTOR'S 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 SIGNED: � PROPERTYOWNER: /(' L_� v DATE: Jfi y NOTE: This Owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. OVER r - a Dec 17 02 11:37a - p.l Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself; you may protect yourself from possible Lability if that person applies for the proper permit in his or her name. ' - Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: 0 If you employ or otherwise engage any persons other than your immediate family. and the work (including materials 'and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 if you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insm*ance, disability insurance costs, and unemployment compensation contributions. 0 There may be financial risks for you if you do.not carry out these obligations, and These risks are especially serious with respect to worker's compensation insurance. 0 For more specific information about your obligations under Federal Law, contract the. Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law. contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "'ownerbuilder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Sina:MI , ) 'r Iviichadl C. Vieira, C.B.O. Manager, Building Inspection' NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. 1 s �. ... ..,di^T('I.'.S t�yn."s'�}ifti r.:'s; r��:. ,_:.. :;t..g; :�, .P i-ru • , -� -':xY..'''ri`.:L�`nfi}.iMf+.;T,.w-,;.':�'. .��.a.. _ �r: ,, 9 r4� �' -. ._�-.r�..� i - . � e . � . - 3� . y''� �-sem . - ,. z . , \ t ' i �• ., I . , t` 1 t . • t - S i - . � e . � . - 3� . y''� �-sem . - a COUNTY OF,BUTTE - DEPARTMENT'OF'DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive Oroville, California 95965 •Telephone (530) 538-7541, ,r PERMIT No. (Rev. 12/96) APPLICATION AND PERMIT Llj d ASSESSOR PAR DEL NUMBER �.O ZONING , BUILDING PERMIT OWNERTELEPHONE 1• !C �-- SO. FT. OCC. BUILDING VALUATION I�•.}.' �� O , - OWNERS MAILING ADDRESS CONTRACTORS, NAME .CA-��Lc.-�� I C TELEPHONE �4� �fi/o3 ^� lJ lJ 15(g) CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDERS MAILING ADDRESS Total Valuation $ 0 • ) ARCHITECT OR ENGINEER LICENSE NO. Filin Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO: SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF AL1 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 ❑ �_UilliAitiie�es ❑ Installation ❑ Other 13 Describe Work: - / C /I 2 ( j'1 C. (� , i1 S - lk:l�. tkiqPERMIT Gas piping stem 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 ON FEE $ U, - Y 5 i)i ELECTRICAL PERMIT Filing Fee 20.00 600V R LE Main Service .0.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. 7 - License Class [� •� 9 Lic. NO. to - 1 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. ❑ 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 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 4 x4 Policy Number 7 n - R (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shalln 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`rwthith comply wdh those provisions. r- + r. q X 1 f ) 4 .. ,�� Date • 1 '� I Signature of Applicant - ❑ Owner P/Contractor ❑ Agerit An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service TO /' 46.00 CCU000A WEE200A NEW CONST. DWELLING OCCUP. SG OR ADDNS. ( & ACC. BLDS. 3.5QFT. UTLET @7.50 NON-R6ID. 1=1110 a POWER SINGLEo �T CS . Ex, Occu an0 o 1.00 OUTLET OR FWMA6 FU(ED It' LNS. OR 5.00 Ex. Occup. ouTLErs REID. EA Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ . CONST TYPE V TOTAL FEE $ 9� d 0 HAZ. D. FEE IMP V FLOOD COF PARCEL Po HD ISSUE r✓- This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicate above for which fees have been paid. By Dat1e PERMIT EXPIRES ON I (Date) Receipt No. % ,s- --7 4U6 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT I COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION ` 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-754yy�� PER IT No. (Rev. 12/96) APPLICATION AND PERMIT `�9 �� ASSESSOR PARCEL NUMBER09' 35.0 — 00_ �,_ ZOylyG I BUILDING PERMIT OWNER ^ / - ►M1/ ^BMJ/ , l TEL SO. FT. OCC. BUILDING VALUATION 0 . OWNER'S MAID DRS �I� W , Lci 17 59ao CONTRACTORTELEPHONE ' ME 3�a_��n3 O j> • OT lJ lJ CONTRACTORS MAI�1�C7 (rJl /ODOR Af/ 6 `J CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS Total Valuation $ L4 44 0 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee , UO ARCHITECT OR ENGINEERS MAIUNG ADDRESS Plan Checking Fee $ BUILDING ADDRESS �- Energy Plan Checking Fee $ $ PERMIT FEE _ , v6 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT9 Filin Fee 20.00 USEOFSTRUCTURE SFX Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap V 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel /❑ Utilities ❑ Installation ❑ Otth�er� ❑ Describe Work: Gas piping system 1 - 5 outle 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ 56 �� ELECTRICAL PERMIT Fling Fee 20.00 RLESS Main Service zoOA OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in fLAf Ce 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. ❑ 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 hergby affirm under penalty of perjury one of the following declarations: I 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 ins4rance carrier and policy number are: Carrier 024E u110� Policy Number 85 Q 9 tan 14 0y) I (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 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' compensation laws of California, and agree that if I should become subject to the workers' compens provisions of section 3700 of the Labor Code, I shall ort ith cc y with tho a provisions. X Date '' \j '�� Signature of Applicant - ❑ Owner Contractor ❑ Agent An OSHA permit is required for excava ons over 60" deep and demolition or construction of structures over 3 stories in height. Main Service TO 46.00 W NEW CONST. DWELLING OCCUCUP. F°, SLOS. 3.50FT. OR a"� ( MULTI -OUTLET NDNREsID. @7.50 POWER APPARATus a SINGLE OUTLET FOTTU ES Q 1.00 Ex. Occup.OUTLET OR BAL p .so Ex. Occup. OUT,E�°�A R pOEp 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation t 7— PERMIT FEI: $ Mobile Home Installation Fee $ Energy Inspection Fee $ 3 yoVNB� HYPE TOTAL FEE $ 9a • d 6 HAZ. D FE P FLOOD I CDF PARCEL I PD HD SUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicate bove for which fees have been paid. By Date I I PERMIT EXPIRES ON —� 5-(:)w Q Date Receipt No. 4 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT S' 4. COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 4.,. 4 • : 7 COUNTY CENTER DRIVE - OROVILLE; CALIFORNIA 95965 - TELEPHONE (916) 538-7541 V PERMIT APPLICATION DATA SHEET OWNER: ASSESSOR PARCEL NUMBER: 2 iL Proposed Building se: Building Inspector: Date: )-/5 At time of permit application, I was a 6ised the following data must be submitted prior to permit processing and/or issuance: Date Received By 114. All items have been submitted -------------------------------------------------------------------------------------- 02. Plot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------ ❑ 3. Complete plans, 3/4 sets, signed by the preparer of plans. ----------------------------------------------------- ❑4. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. -------- ❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------ 116. Energy Design Compliance and supporting documentation. ---------------------------------------------------- ❑ 7. Statement of Intent for Non -Heated and A/C Buildings. ------------------------ --------------------------------- 0 8. Hazardous Material Form. ------------------------------------------------------------------------------------------ ❑9. Manufactured Home data and installation instructions including Tie Down Specifications ------------------- El10. Fees of $------------------------------------------------------------------------------------- ❑ 11. Impact fees as shown on the attached schedule. --------------------- ❑ 12. California Department of Forestry plan approval/fees.-------------- 1113. ------------- ❑13. Flood elevation certificate. --------------------------------------------- ❑ 14. Sanitation and plot plan approval Health Department. ❑ 15. City of Chico plumbing permit. -------------------------------------- ❑ 16. Plot plan and business license approval from the City of Biggs. --- ❑ 17. Planning approval for (A) Use: (B) Parking: ❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ❑ 1.9. Encroachment Permit for driveway (construction approval prior to occupancy). -- 0 20. Pre -inspection for required. Request to Building Inspector on 021. Contractor's license information. (Number, Name Style, Classification). ------------------------------------- 0 22. Workers' Compensation carrier and policy number. ----------------------------------------- ------------------ 023. Owner -Builder Verification (Given to owner ❑, Mailed to owner 0) - ----------------------------------=--- 024. Letter of signature authorization. -------------------------------------------------------------------------------- ❑25. Recorded copy of Agricultural Acknowledgment Statement. -------------------------------------------------- 026. Letter of intent on building use. ----------------------------------------------------------------------------------- ❑ 27. Manufactured Home utility clearance. --------------------------------------------------------------------------- ❑28. Existing violations and/or expired permits. ---------------------------------------------------------------------- ❑29. 13433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ .--------------- 030. -------------- ❑30. Other: ------- When you issue the permit, process as follows ❑ Mail to owner, KAail to contractor. (Date) ❑ Telephone and hold for pickup at office. deliver with inspector. c f ` i ,A., LflApplicant. Date: ' (� ' Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution Date: By: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By: 1. Index permit application for the above items numbered: ❑ Plan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Plans reviewed by: Date: Plans approved by: Date: Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: Yellow Copy - Department of Development Services, Building Division. (Rev. 12/96) COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7341 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER Oq 135.0 . OO 7 _ zO1)INy I BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION O OWNERS MAID ORES5�7a / %�.J. CONTRACTORTELEPHONE ' E �a N Q 0 , co CONTRACTORS 11r qD0 ` Y 6 X5 CONSTRUCTION LENDER Fire Iace LENDER'S MAILING ADDRESS Total Valuation S , ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee , 00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee S BUILDING ADDRESS �- Energy Plan Checking Fee $ PERMIT FEE S LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SFX Duplex O Mobilehome ❑ Other SPECIFY Each Trap V 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New O Addition O Remodel /O �U�tiilitiies ❑ Installation O Other ❑ Describe Work: l�-x-' fig t ...2 �Q �(A / ( S Gas piping system 1 - 5 out[ e 15.00 Buildingsewer 15.00 Mobile Home S G W 020.00 PERMIT FEE $ 56 ELECTRICAL PERMIT Fling Fee 20.00 Main Service 2"00' oA Tr, s. 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 ftfl fQrce and effect.POWER Q Lic. No. L08'6'8Q_7) License Class � OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ [,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. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hergby affirm under penalty of perjury one of the following declarations: I 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 permitis issued. My workers'compensaation ins4rance carrier and policy number are: Carrier �j-( I r�p� Policy Number '2'8 5 9 9 lAn I nOn I (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) O 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' compensation laws of California, and agree that if I should become subject to the workers' compen provisions of section 3700 of the Labor Code, I shall o with cc with tho provisions. ' X _Date �2 Signature of Applicant - O Owner Contractor ❑ Agent An OSHA permit is required for excava ons over 5'0" deep and demolition or construction of structures over 3 stories in height. Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUR SO OR AOONS. a ACC. BLDS. 3.5¢FT: MULTI.OUTLET @7.50 NONItW REOSID. T.BRANCH IRCUFTS APPARATUS 6 SINGLE OUTLET 20 EX. OCCU . OUTLET OR ES SAL @ I.00 .50 Ex. Occup. o� rs RESIO,DEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE : MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt S Mobile Home Installation Fee $ Energy Inspection Fee S Oc c_ TOTAL FEE $ 9 , d IO MP FLOOD COF PARc0. Po Ho uE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicate above for which fees have been paid. By Da'tle�nnn I I PERMIT EXPIRES ON '—/ 5 �W Date Receipt No. � WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT n s4o'w COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville/Ualifofi5ia 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER ' ZONING BUILDING PERMIT OWNER f TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS r CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS / Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS f ' r A PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF ❑ Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home JSJGJWJ 10.00 e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other ❑ Describe work: - — • •� , r • 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 NEW CONST. DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. 1 2 0sgft 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 m license is in full force and effect. y License No. ffl 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 NEW CONSTR MULTI -OUTLET 2.50 ea NO N•RESID BRANCH CIRC ITS NEW CONSTR. ( POWER APPARATUS &) NON -RES,D. SINGLE OUTLET CIR. I Ts OR FIXTURES Ex. Occu z P�o BAL@AL03030Q FIXED APP LNS. OR EX. OCCUp. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ i C, . Contractor MECHANICAL PERMIT FiIingFee 10.00 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. Heating Cooling Hood 3.00 Ventilation r. V 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. 1 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. X Date_ 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 $ TOTAL PERMIT FEE $ OCCUP. GROUP I TYPE of CONST. PARCEL PD HD 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. ' WHITE-D.P.W.• YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD-APPLIL'ANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, CIifc,rn t 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. _ LJ ASSESSOR PARCEL NUMBERZO — 1 ING _J BUILDING PERMIT OWNER, OWNER,,, /4✓ � 1. ELEPHONE SO. FT. OCC. BUILDING VALUATION OWNE 'S MAIyLI NG ADD ESS CO RAC�OR'S NAME T LEPHONE —' CONTR CT R'S MA16ING A15DIIESS ?�g & Fireplace CONSTRUCTION LENDER Jv 41 UNKNOWN Total Valuation is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER �d'r LICENSE NO. Plan Checking Fee .$ Penalty $ ARCHITECT O-R ENGINEER'S MAILING ADDRESS' Permit fee $ BUILDING ADDRESS � ZZEach PLUMBING PERMIT Filing Fee 10.00 IZ2 Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO. SUBDIVISION NAMEPA CEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF V Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home S G W 10.00 e TYPE OF WORK New❑ Additio Remodel❑ Utilities[] Installation❑ Other Describe work: e- 6&�� — P rmit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 10ov OR LESS 100 AMP OR LESS 10.00 G ✓ Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ( ACC. BLDGS: t 2h0sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): RJ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my licensq is in full force and effect. ,+-_ License No. ��JS % Classification /?Ex. ❑ 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 CONSTR U TI.OUTLECT 2,50 ea NON -RE SID BRANCH CIRITS) NEw CONSTPOWER APPARATUS &) NON.R RESID. (SINGLE OUTLET CIR. 200509 Ex. Occup(o TS OR FIXTURES / eAL030 FIXED APP LNS. OR D Occup. OUTLETS (RESID.) EA. 2.00 0 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 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. L1 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. Heating Cooling Hood 3.00 Ventilation ,� QCT 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. 1 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 County in consequence�of the granting of this permit. X Date :? Signature of Ap Icant — Owner ❑ Contractor � Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures7over 3 storiessiin height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP I TYPE OF CONST. PARCEL PD HD ssuE This permit is hereby issued under sions of the Butte County Code and/or work indic d above for which D ECTOR OF PUBLIC B PERMIT S the applicable provi- resolutions to do fees have been paid. WORKS 7 DateZ, X11 _ Receipt No. ✓ Zf ��EY WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT