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HomeMy WebLinkAbout043-260-021`43-26-21 121.7-91E SLOCOMB, Eugene 1522 Bidwell Dr, Chico Cont: Wally's Electric (elec upgrade/sf) 043-260-021 99-2385 SLOCOMB, EUGENE R. . 1522 BI-DWELL DR.. CHICO REROOF/SF •.ls y • r f, t •+•s� d ; - a . _ i 043-260-021 t 99-2385 SLOCOMB, EIIGENE R. 1522 BIDWELL DR, CHICO REROOF/SF i �_411111111. (Rev.12/96) COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541,1, PERMIT NO. APPLICATION AND PERMIT -7 1-itSESSORPARCELNUMBER / i' ZONING BUILDING PERMIT OWNERal[ 0K t" NG - o c,00" ki TELEPHONE ... P5;S �o1 S SQ. FT. OCC. BUILDING VALUATION 3 U . OWNERS MAIUNG ADDRESS / �? ' ; wt< /04 Chico eSf t 5- L) CONTRACTOR'S NAME TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDERS MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ S ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESC1 / �� fir, � e Energy Plan Checking Fee $ $ t PERMIT FEE S LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF f Duplex ❑ Mobilehome ❑ Other SPECIFYWater Each Trap 7.00 Solar or heat pump water heater 23.00 piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition 0, Remodel ❑ Utilities ❑ Installation ❑ Other Describe Work: I?LH ct /op a a /I" jk r4,,,v <" 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 Fling Fee 20.00 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 in full force and effect.POWER 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: q 1, as owner of the property, or my employees with wages as their sole compensation, wi)l 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 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUR s0 OR ADONS. & ACC. BLDS. 3.50FT. =RESIDTMULT ' I.OUTLET @7,50 AP= U b SINGLE OUTLET CSR. j 20 .00 EX. OCCu OUTLET OR FDITURES BAL I. 0 Ex. Occup. O RL.ID.° 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 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 Y' of one hundred dollars ($100) or less.) C 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 pro isions. �i �/ X 1 J0, `'7.0►"';4ate /O "J -f " �f Signature o pplicant - 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 $ ` HAZ. I D. FEES IMP I FLOOD CDF PARCEL PD HD ISSUE 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. / O �y �� By ! / Date PERMIT EXPIRES ON 14/ �� / 0 0 / Bfs ReceiptNo. .Z% 94 5 WHITE-D.D.S.-B.O. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 71 County Center Drive • Oroville, Calyorn.ia-A95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT ZL ? 3 kS ASSESSOR PARCEL NUMBER _/J_ ` O ' ZONING 1/ BUILDING PERMIT OWNER a eNC S/®Goy, T LEPHON'E!` 55=0/S SO. FT. OCC. BUILDING VALUATION O OWNER'S MAILING ADDRESS i9d Ch c. ,err iso CONTRACTOR'S NAME TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS Total Valuation $ ARCHITECT OR ENGINEERLICENSE N. Filing Fee $ 20.00 Permit Fee $ ,S ARCHITECT OR ENGINEERMAILING ADDRESS S Plan Checking Fee $ BUILDING ADDRE 1T•?6V.�'n Pi G � -L� Energy Plan Checking Fee $ I L PERMIT FEE $ LOT NO. SUBDIVISION'S NAME PARCEL MAP � PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ Other SPECIFY I 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 ❑ Installation ❑ Other L� Describe Work: /� �n��C Kid -d I - ��. Sed Gas piping stem 1 - 5 outlets 1 5.00 Building sewer 15.00 Mobile Home I S I G W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 OOOV OR LESS Main Service PGOA 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.POWER 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: Y1, 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' 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 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( d ACC. BLDSFIC. SO 3.5ttFT. ,Ipµq�,p T.MULTI.OUTLET @7.50 APPARATUS 6 SINGLE OUTLET CIR. Ex. OCCU OUTLET OR FIXTURES BA0 50 O I'.00 L Ex. Occup. oFlxuTLEE°TSA R pOEA. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 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' 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 isions. forthwith comply with tho7X—?,dW;4ftt. X 0 �� Signature &VApplicant -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 $ HAZ. D. FEES IMP fL000 CDF PARCEL PO HD ISSUE 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. cG By Date © / PERMIT EXPIRE ON 11V100 ete Receipt No. .;Z.7� (; WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT OWNER -BUILDER ,VERIFICATION Attention Property Owner: An "owner -builder" building permit has 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. 1. I personally plan to provide the major labor and materials for construction of the proposed property im rovement : YES .. NO O 2. I HAVE, HAVE NOT signed an application for a building permit for the proposed work. 3. I have contracted with the 'following person. (firm) to.provi.the, proposed construction: NAME: �. ADDRESS: CITY:_ PRONE: 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: ' . NAME: 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:. SOCIAL SECURITY NUMBER: DATE: 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. OWNER BUILDER INFORMATION I Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of propetty 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 liability 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 yod plata to do',your own woik, with tiie exception of various trades that you plan tdsubcontracf you 'shouts be aware of the following information for your benefit and protection: ' ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including `materials and other costs) is 5300 or more for the entire.project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. ♦ 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 insurance, disability insurance costs, and unemployment compensation contributions. ♦ 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. ♦ 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 "owner builder" 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. rely, Mic el C. Vi ira, C.B.O. Ma ger, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the Calljornia Health and Safety Code. .��� .'' ,3`..+•.,.��`•.*��i'�'�'+j`,..iry•t1p `S.•�'Q.. .�,��. ,�},;,,. . ,� .� •� a....s..• -Se wr..a•m^'� i-••R^�;�tttilh/f�r�V*t.e•+.+r. �l.�f�s: �i'�'54�...r - v I F43-26-21 1 1217-91E Eugene ell Dr, Chico ont: Wally's Electric (elec upgrade/sf) • S OFFICE COPY Q� Address M�L�` B' + ELECTRIC Meter BY Dq COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovllle, California 95965 -Telephone: 916/538.7541 ` .. .•� APPLICATION AND PERMIT t'qk PERMIT NO. .111 z1,? --W ASSE S R I= MOMBIR 43-260-021 ZONING R-1 BUILDING PERMIT WNER Eugene R. Slocomb 'TELEPHONE .SQ. FT, OCC.i BUILDING VALUATION OWNER'S MAILING ADDRESS 1522 Udwell Dr., Chico 95926 CONTRACTOR'S NAME __794 Wally's Electric LEPHONE 93-4742 CONTRACTOR'S MAILING ADDRESS 1086 Vallombroaa Ave., Chico 95926 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 tee $ PLUMBING PERMIT Filing Fee 10.00 1522 Bidwell Dr., CHico Each Trap 2.00 V Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other Upgrade Service SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W ° 10.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities g Installation❑ Other ❑ Describe work: Upgrade Electrical Service to 200 A01PS r ,' �� ,• Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 _ L an service 100v OR LESS Mi 100 AMP OR LESS . 1 1000 10.0000 Main service EA. ADD'L 100 AMP 1 2.50 2.50 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. Y ";,_4_ Classification.: ' / 0 ❑ I, as the owner, or my employees with wages as their sole =compen- sation, will do the work,and the structure is not intended ooffered r 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 1 � NEW CONST. At 'DWELLING OCCUP.ai OR AODNS. ( ACC, BLDGS. / hQsgft NEW CONSTR. MUL TI.OUTLET2.50 NON•RESID BRANCH CIRCU ITS ea POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES eot A 0530 Ex. Occup. OUTLETS ED PR RESID )EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 1 15.00 15.00 pre -Inspection _ 1 15.001 15.00 _ Permit Fee $ 52.50 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. ® 1 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 g Hood 3.00 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 againstAz all liabilities, ,judgments, costs, and expenses which may in any way accrue against said ounty in consequen, a of the granting of this permit. X' Z e / / Date Z71 -M Z "/- q1 S gnature of Applicant - OwnerContractor E]Agent El /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 $ rH CONST TYPE TOTAL FEE $52.50 E Z. can PARK scHL FLD PAR Po j HD. ISSUE This permit is hereby issued unaer the applicable provi- sions of the Butte County.Code and/or resolutions to do work indicated above for which fees have been paid. — DIEC ,OR OF PURI IC WORKS By e - {uI /7(_Datee q-75 PER IT EXPIRES D to / —• S / Receipt No. 88709 WHITE-D.P.W., YELLOW-ASBE350R, PINK -INSPECTOR. GOLDENROD -APPLICANT 1 COUNTY OF BUTTE s]]i DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 r 7 County Center Drive, Oroville — Phone: 538-7541 3 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office When correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. MIFAN-M E J I Date Inspector _��0 //_ 4524 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT AA ASSESSOR PARCEL NUMBER 43-260-021 ZONING R-1 BUILDING PERMIT OWNER Eugene R. Slocomb TELEP-HONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1522 Bidwell Dr., Chico 95926 CONTRACTOR'S NAME Wally's Electric TELEPHONE 893-4242 CONTRACTOR'S MAILING ADDRESS 1086 Vallombrosa Ave. Chico 95926 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee Energy Plan Checking Fee E$ $ A ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 1522 Bidwell Dr., CHico Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME 77[PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other Upgrade Service SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities El Installation[--] Other ❑ Describe work: Upgrade Electrical Service to 200 AMPS Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 1 OR Main service 100 AMP ORSLESS 1 10.00 10.00 Main service EA. ADD'L 100 AMP 1 2.50 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): r—y IYX�I 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./,9,9 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 oR ADDNSCONST DWEACCLING DGSCCUP.8d) y2¢sgft NEW CONSTR ULTI.OUTLET NON-RESID BRANCH CIRC ITS 2,50 ea POWER APPARATUS e (SINGLE OUTLET CIR. Ex. OCCUp(OUTLETS OR FIXTURES 20050t e AL930 FIXED Ex. OCCUp. OUTLETS (RESID )REA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 9 1 1 15.00 15.00 Pre—Inspection 11 115.00 15.00 Permit Fee $ 52.50 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 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. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling g Hood 3.00 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 Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also ree to save, indemnify and keep harmless the County of Butte against all I' lilies, 'udgments, costs, and expenses which may in any way accrue agai said �Uu�nin con equ of the granting of this permit. Date // Z Ignature of Applicant — O er Controctor ❑ Agent El 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 $ occ CONST TYPE TOTAL FEE $ 52.50 HAz. CLIA- PARK SCHL FLD cDF PAR Po I Ho. ISSUE. This permit is hereby issued unser the applicable provi- sions of the Butte County. Code and/or resolutions to do work indicated above for which fees have been paid. D) C ' R OF P IC WORKS OO BY Date PER IT EXPIRES 61te eceipt No. Ak7nA NITE-O.r.W.. YELLOW-ASSE350R, PINK -INSPECTOR, GOLDENROD -APPLICANT F Ma COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET Permit No. OWNER �" A. P. No. -4 3-2G_ZI Proposed Building Use � Building Inspector Date 112419 At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuanc DATE RECEIVED APPROVED 1. All items have been submitted. 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer of plans .. 4. Complete engineered plans and calcs, with wet signature on plans . . 5. Hazardous Material Form ......................................... . 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13. School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-lnspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ....... 25. Letter of signature authorization ..... . d6. j 27. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other Applicant Date 1 Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: F Contractor, designer, owner, was advised of above required data by—phone—mail—counter by .date Contractor, designer, owner, was advised of above required data by—phone _mail—counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW a - `� COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovllle, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO.. ASSESSOR PARCEL NUMBER o'A -- 2 -Co c) -" O Z\ ZONING t2-- ` BUILDING PERMIT OWNERTELLPHONE 4& aeniffs� - S0. FT. OCC. BUILDING VALUATION OWN '9 KfAILING ADDRESS Z / � C-0�9 a CONTR ACTOR•5 NAME // 's C /L J%z1'c TELEPHONE �CONTRA OR'S MAILING ADDRESS 1) ?'1 Fireplace CONSTRUCTION LENDER UNKNOWN _ Total Valuation is LENDER'S MAILING ADDRESS - Filing Fee _ $ 0.00 Permit Fee $ ARCHITECT OR cN _,INEEP. LICENSE NO. Plan Che --king Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS Permit fee ; PLUMBING PERMIT Filing Fee 10.00 Trap 2,00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Water piping _ 5.00 Each pas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other )PQ y -Q 'P <E�e!(Qlt^`P, SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home - S G W 0.00ea TYPE OF WORK New❑ Addition❑ Remodel❑ Utilities InstallationOther❑ Describe work: D fCA P_ P—Ve _ �1(LQ Permlt.Fee $ i Contractor " ELECTRICAL PERMIT Filing Fee 10.00 V OR L Main service 1000 AMP ORSLESS 10.00 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. '� J70O Classification. e— /!� � ❑ 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 Main service EA. ADD•L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.y OR ACDNS. ACC. BLDGS. , vtsgft NON.RESIDCONSTR BRANCH CIRCUITS 2.50 ea POWER APPARATUS S SINGLE OUTLET CIR. EX. Occup(OUTLETS OR FIXTURES 209306 5ALO 30 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) 2.00 ' Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wirt 15.00 -00 e90 Permit Fee $ 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. Ili I shall not employ any person in any manner so as to become subject tom' 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. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling 9 Hood 3.00 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 a ree to save, indemnify and keep harmless the County of Butte against all liabi ties, judgments, costs, and expenses which may in any way accrue again t aid ounty in, co uence of the granting of this permit. X ?6 Date �SL�<7/ Si nature of Applicant - wner ❑ Contractor R Agent ❑ n OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 33 stories in height. Mobile Home Installation Fee. $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ HA2. cuA• PARK SCHL FLD cDF PAR PD I HD. IssuE This permit is hereby issued under the applicable provi- sions or the Butte County -Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date c56 Receipt No. ZZ2 WHITE-D.P.W.. YELLOW-ASSE330R. PINK -INSPECTOR. GOLOENROO-APPLICANT PRE -INSPECTION OWNER: LOCATION : L52 7h11 C n CONTRACTOR: A PRE -INSPECTION FOR: .j DATE 2 C( A.P. _ aL4 ZONING R_ -j DATE TO INSPECTOR J4 PERMIT HISTORY: NONE AS FOLLOWS: `--- --_ -__ .TYPE OF OCCUPANCY'S FIELD - INFORMATION BUILDING USAGE: TENNANT : A , M OCCUPIED f HAS ELECTRIC `IAS GAS �n HAS SANITATION -FACILITIES [—t HEATED -COOLED PERSON CONTACT.( OTHER COMMENTS : ACTION RECOMMENDED: ISSUE Q HOLD FOR d OTHER: