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HomeMy WebLinkAbout042-590-035#4�VNDEL�S JOE HAS SW/S Cussick Ave, 1400'NW Shasta Y Ave, Chico Permit#6020-80P (c12v17t80 nat. A gas/SF) FINP,LEI _ COUNTY OF BUTTE,- DEP.AR-,T,MENT OF PUBLIC WORKS' >< PERMIT NO. -.-.• , • 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND `PERMIT (` ASSESSOR PARCEL NUMBER Z42-- 77 ZONING BUILDING,PERMIT OWNER �-T ��� / 'TEtLEPHONNEa/ SO. FT. OCC. BUILDING VALUATION OWNERR'''s�M•''AILING ADDRESS ,/r /,r w, moi/ L CONTRACTr--'.___.�__._�__.--,---. AMP 2.50 CONTRACT 1 :CUP.ni� 20 sq ft f CONSTRUCT + c' ❑ s LENDER'S DOR EA. 2.00 $ 10.00 • C s ARCHITEC 7.50 ❑ ARCHITEC $ I declare s BUILDING IIT Filing Fee 10.00 3.00 2.00 l` li ng 5.00 LOT NO. :nt 5.00 $ provision Ilets S F ©' D I 5.00 $ 15-, ,r3ra New ❑ I Describe) ,MIT Filing Fee 10.00 moi/ L _SS 5.00 AMP 2.50 l� :CUP.ni� 20 sq ft I declare I -T2.50 ea ITS kTUS bl r CIR, i ❑ )(TURES_ BAL@j00 DOR EA. 2.00 ® 10.00 C 15.00 ❑ 7.50 ❑ $ MIT Fi ling Fee 10.00 I declare I 3.00 NotlCe to to the WJ $ provision I certify ie $ I s correct to buildit Butte to i _ I also a . g • •- PARCEL PD ND ISSUE all liabil I against s Id under the applicable provi- X ' and/or resolutions to do Signci a of Applicant — OWner_Contractor 1-1— _'ode r which fees have been paid. p•. AnOSHA ermit is required for excavations over 5'0" dee and demolition or construct- p DIRECTOR -OF PUBLIC WORKS of structures over 39 stories In height. l ���%� � •^� B ' Y � - ^----- Date Receipt No. WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT PERMIT EXPIRES' Date r o , yr _ - � l w . , hof`,, � � .� ' .�.—;^i .. ..r• �;, ��, r r,..�.. ....�._s� ,' .y P � c'h'i" ' �'� y 4. ;•.. 4 fo / COUNTY OF BUTTE - DE-PART161ENT OF PUBLIC WORKSPERMIT N 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 O -�@ APPLICATION AND PERMIT All ASSESSOR PARCEL NUMBER s �� Z NING — BUILDING PE OWNIER TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNERMAILING ADD 55 D / r✓ iC CONTRACTOR'S NAME TELEPHONE CONTRACTO MAILING ADDRESS „ Fireplace CONSTRUCTION LENDER "IOL/1--c UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS , Permit Fee $ ARCHITECT OR E'ENGGII NNEER /✓ LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUJ.L ING ADDRESS PERMIT PLUMBING P Filin Fee 10.00 9 Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 0 �� � USE OF STRUCTURE SF PE Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New❑ Additio5noRemodeiEl UtilitiesInstallation[:] Other Describe work: �� Permit Fee $ l ' p Contractor G� ELECTRICAL PERMIT Filing Fee 10.00 Main service 100v OR LESS1005.00 1AMP OR LESS Main service EA. AOD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.DI) OR ADDNS. ACC. BLDGS. 2d sq ft 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. icense No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec: 7044) ❑ 1, 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 -OU LET 2,50 ea NON-RESID BRANCH CIRC TS NEw NON.CONSTR ESID. R ( POWER APPARATUS SINGLE OUTLET CIR. 6i 1 Ex. Occup OUTLETS OR FIXTURES a �@1 IXED APPLN5. OR Ex. Occup.�OUTLETS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declarpunder penalty of perjury (check one): The permit is for $100.00 (valuation) or less. E] 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 penult Fee S Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said Coun n consequen of the granting of this permit. �( E/ �� �` /�— Date Sign ure of Applicant — Owner 9CContractor ❑ 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 PO I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTO F PUBLIC By PE T EXPIRE Date the applicable provi- resolutions to do fees have been paid. WORKS Date 12 Receipt No. WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT