HomeMy WebLinkAbout043-730-005Gary Pederson 'KENNICOTT CONST. CO. 1068-69.B26 Ranchita Way, Chico
contr: Tom Hall, Chico 218-70P 1044-69EPermit#5052- 78B P ,E,Mq2I4additiio nA 26 Ranchita. Way (LOT Chic(new single family)B tt4� . / -FContir: David Brandt 044s--7sPErmit#3111-87E(relocate di washer/SF)PEDERSON, GaryRanchita, Chicocontr: Ely Roofing|
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043-73-0-005
92-3783B
" PEDERSON, Gary
26 Ranchita, Chico
contra Ely Roofing.
reroof/sf
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COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
�,•: 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
r PERMIT NO.
C
ASSESSOR PARCEL NUMBER ' ..-
ZONING
BUILDING PERMIT
OWNER
TELEPHONE
J—
- S0. FT. OCC.1 BUILDING VALUATION
OWNER'S MAILING ADDRESS
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
0. J C'r
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
Filing Fee
$ 1 d • JJ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ JU .
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS _
r
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
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
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home I S I GW
10.00ea
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other ❑
Describe work: r� `' -. I,1 t r_.
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 6101 OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
DI am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Codef and my license is in full force and effect.
+,J/ .��i.j --..
License 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)
❑ 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 CONST. / DWELLING OCCUP.y 2/,zQsgft
OR ACDNS. (ACC. BLDGS.
NEW CONSTR. MULTI—OUTLET
NON.RESID BRANCH CC ITS 2.50 ea
RARTUS
POWER APPAI6
(SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES 20@50t
eALO 30
FIXED APLNS
EX. OCCup. OUTLETS P(RESID.)REA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring
9 15.00
Permit Fee $
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
FiIingFee 10.00
Heating
Cooling
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 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 $
Energy Inspection Fee $
TOTAL PERMIT FEE $
OcCUP,
CONST.TYPC
I FLOOD
PARCEL
P11
I No
I 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 1
Receipt No.
WHITE-o.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBERt
3--7 _0a5
Z'NING
�-
BUILDING PERMIT
OWNER
Gary Pederson
TELEPHONE
345-1234
SO. FT. OCC. BUILDING VALUATION
2 400 1440
OWNER'S MAILING ADDRESS
26 Ranchita Way Chico CA 95926
CONTRACTOR'5NAME
Elv Roofing Inc
TELEPHONE
343-7663
CONTRACTOR'S MAIL NG ADDRESS
P 0 Box 704 Chico CA 95927
Fireplace
CONSTRUCTION LENDER
UNKNOTr
1C
Total Valuation $
Filing Fee
$ 15.00 34mmx
LENDER'S MAILING ADDRESS
Permit Fee
$30.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
26 Ran chita Way - Chico
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
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
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 [I Installation[] Other j]
Describe work: roofing overlay -24 sqs - 20 yr COMI
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 8001 OR LESS
100 AMP OR LESS
10.00
Main service EA, ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
1 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. 607386 Classification C-.39
❑ 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 ACDNSCONST. DWEACCLLIN GS CCUP.N) 1/20sq ft
/
NEW CONSTR.U TI.OUTLET
NON.RESID BRANCH CIRCUITS) 2.50 ea
/POWER APPARATUS &)
(SINGLE OUTLET CIR,
20050Q
Ex. Occup OUTLETS OR FIXTURES eAL93'0
Ex. OCCUp. OUTLETS (RESFIXED ID.)REA.1 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $
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
FiIingFee 10:00
Heating
Cooling
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.
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 con q ence of the granting of this permit.
+ 10-12-92
X Date
Signatu4,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 $
Energy Inspection Fee $
TOTAL PERMIT FEE $ 45.00
OCCUP.
CONST.TYPFJ
I
IFLOODIPARCEL
PD
NO
59UE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
IRE OF PUBLIC
By l2l2r
PERM( EX IBES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Receipt No. 17-6 2- ID
WNITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT
a ,
.PERMIT NO.
PERMIT EXPIRES
Gary Pederson
OWNER
;CONTR. Tom Hall, Chico
LOCATION (A.P. 42-36-5 )
t
26 Ranchita Way, Chico
'
I,
a
i
R •
• a
{a
}tyT`
}
Temp. Powe�Pole
Called PG&E
Temp. Elz Serv.
Called PG&E
TempGas Serv.
Called PG&E
FI ALED
(Dat
(Signature)
.f
1
5052-78B,P,E,M-
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
' - BUILDING INSPECTION_REC_ORD
.JtU�%,U rinai auo aneis
Mesh MECHANICAL Gird. Fault Prot.
Scratch Heating Service
Brown Cooling Temp. Pole ,
Finish Ducts Underground -
ilnterior Lath Ventilation Permanent
Door Closer Final 4 '2- Final i
MOBILEHOME UTILITIES ------------- ---- Elec- dervice Elec. Pedestal
Water Piping Sewer Gas Piping
E OME INS ALLATI N - - - - - - . - - - - - • • Support Elec. Continuity
'3
Water Piping Drainage Gas Piping
DATE REMARKS 0 CORRECTIONS
Rim
/o
16 �1 ��-
_ ,:=
,Gc�4;�4� r GLr-e� �y -� •
each time you visit the job si e.) +
BUILDING-
BUILDING (Cont'd)
PLUMBING
Setback -
o—
Firewall
Soil Piping
Forms 2 2
Parapets
1 st F loor
Main Bldg.
Restroom Finish
2nd Floor
Footings !2-2,2—,-'9
Windows
3rd Floor
Stemwall
-2 7-7 9
Siding
To out
-� $
Slab
Roof Sheathing
Water Piping
Piers
Roofing
Sewer
'
Garage
Fdn. Vents .-
Fixtures
w'
Footings
Stemwall
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Carport
Footings
Prov. for phsically
handicapped .
Conformance of ex.
structure
Appliances
Gas Piping
Temp. Gas
&Test O —2
Slab
Final /2
Sanitation
Patio
FIREPLACE
Final
Footings
Footina
ELECTRICAL
Masonry Walls
Throat
Rou h
Reinf. Steel
Final
Fixtures
)
Bond Beam
FIRE PRINKLERS
Motors
Framinq % ,67z.L-
- Test
Water Htr.
,-
.JtU�%,U rinai auo aneis
Mesh MECHANICAL Gird. Fault Prot.
Scratch Heating Service
Brown Cooling Temp. Pole ,
Finish Ducts Underground -
ilnterior Lath Ventilation Permanent
Door Closer Final 4 '2- Final i
MOBILEHOME UTILITIES ------------- ---- Elec- dervice Elec. Pedestal
Water Piping Sewer Gas Piping
E OME INS ALLATI N - - - - - - . - - - - - • • Support Elec. Continuity
'3
Water Piping Drainage Gas Piping
DATE REMARKS 0 CORRECTIONS
Rim
/o
16 �1 ��-
_ ,:=
,Gc�4;�4� r GLr-e� �y -� •
each time you visit the job si e.) +
COUNTY OF BUTTE - bE'PAIRTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965
.� Telwhrone: 634-4541
APPLICATION AND PERMIT M
t1U111U11Le [upluJCllto CS UI Ule I,UUIIty 6Ulre tU enter upun the
above-mentioned p rtv for insoectio utAes.
X Date
$ignoture of Perm* a or Agent
Receipt No.
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -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
B ding permit expires Date
III
BUILDING 3F III
Owner
a
SO. FT. OCC.
BUILDING VALUATION
�
Mailing Address
Telephone No.
Contractor1-0c =114415pt&mow/ dke i
Mailing Address
replace
Total Valuation
Telephone No.
Permit Fee �.
Building Address
Plan Checking Fee&/or Penalty
Permit Fee s ,b,
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
Ch//A_
k C,6
Repair drainage or vent piping 1.50
A. P. No.
Zoning &Planning
Water piping 1.50
Each gas water heater or vent 1.50
F s
Sa ' Fire Dept.
Fire Zone
Use Permit
Gas piping system 1 - 5 outlets 1.50 ?>
EOA
Parking Parcel
Plans Declaration
parcel Ma 60' R/W
P
improve is
P
Each additional outlet .30
Building sewer 5.00
Bldg. ans Recd
Parcel p rovaI
Plaho Approval
Lawn sprinkler system 2.00
NEW ❑ ADDITION UTILITIES ❑ OTHER ❑
permit Fee $ na co
$
l/t7osol �%
ELECTRICAL No. @ FEE
b
PERMIT FILING FEE $3.00 ,DC7
Main service 100 AMP OR11V OR LESS5.00
Single Family 10 Duplex ❑ Mobil Home ❑ Others ❑
Main service EA. ADD'L 100 AMP 2.50
Main service OVER 25.00
100 AMPP OR LESS O
y
Main service// EA. ADD'L 100 AMP 1.00
ORNEW CONST. \ AC B CUP. &) 20sgft
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:
pEEQ. C_ws_eh, <--cww QVC \ kIt, t -k
NEW CONSTR MULTI -OUTLET
NON-RESID, BRANCH CIRCUITS) 12.50ea,
NEW CONSTR. (POWER APPARATUS .&,
NON-RESID. `SINGLE OUTLET CIR.
250
Ex. OCCUD(OUTLETS OR FIXTIIRES 6 L 11
FIXED APPLNSOREx. OccuP•(OUTLETS
(RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No.�+SdgO6 Q
Classification
Misc. Wiring 6.25
I am exempt from the Contractors License Laws of the State of California.
Permit Fee $ t)
is t
WORKMEN'S COMPENSATION INSURANCE
I 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 have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
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. @ FEE
PERMIT FILING FEE $3.00 , 4>0
Heating/t u Lab
ACAj
Cooling �a
Ventilation
Hood 2.00
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
Land Development Fee
$
TOTAL PERMIT FEE
$
t1U111U11Le [upluJCllto CS UI Ule I,UUIIty 6Ulre tU enter upun the
above-mentioned p rtv for insoectio utAes.
X Date
$ignoture of Perm* a or Agent
Receipt No.
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -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
B ding permit expires Date
III
COUNTY OF BUTTE -,DEPARTMENT OF PUBLIC VORKS
` 7 County Center Drive - Oroville,.Califotnia.95965 - Telephone: 916/53817541-
APPLICATION AND -PERMIT
PERMIT NO.
ASSESSOR PARCE[NUMBER
) -
ZONING
BUILDING PERMIT
OWNER
TE/L%EPHONE
SO, FT. OCC. BUILDING VALUATION
OWNER'S WAILING ADDRESS
hy/wry
l
COON{TTR`AC'TOR'S-NAME '
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCT ON 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
$ .
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
� ��� ����
`' h ����
Each Trap
2.00
i
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
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home I S I G I W
O,OOea
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Uti lit'es ❑ Installation ❑ yOther El
Describe work: �Pf���� r ��«���—
_ - ! d
�1� t
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
-
Main service eoov OR LESS
100 AMP OR LESS
10,00
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
El 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
❑ 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 CONST. (DWELLING OCCUP..) yzQsgft
OR ADDNS. ACC. BLDGS.
NEW CONSTR.MULTI-OUT LET 2,50 ea
NON•RESID BRANCH CIRCUITS)
/POWER APPARATUS IN)
(SINGLE OUTLET CIR. 1
Ex. OCcup(OUTLETS OR FIXTURES SAL@30
9ALaso
Ex. Occup. OUTLETS FIXED P(RESID )REA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $
Contractor
WORKMEN'S COMPENSATION INSURANCE
1 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 10.00
Heating
Cooling
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.
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 jsaid County in consequen�c/e of the granting of this permit
X !���� -1 /f y�� / ter"� 7� Date 5 �lG� ��
/ O ❑ C ❑ g entT
Signature of Applicant — wner ontractor A '
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories
n7 height.
Mobile Home Installation Fee
$
Energy Inspection Fee $
TOTAL PERMIT FEE $
oc CUP,
I CONST.TYPE
FLOOD
PARCEL
PD
I NO
I ISSUE
This permit is hereby issued under the applicable provi-
sions of the Butte County. Code and/or resolutions to do
work indicated above for which fees have been aid.
%1 p
DIRECTOR O.F�PUBLIC WORKS!
B I',� .-,Jft�/,�I-,lAf � Date
y+, �+ q111 -1,
PERMIT EXPIRES Date
�s �
-i
Receipt No./
WHITE-O.P.W„ YELLOW-ASet:,SOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
kid� - . .�
Z7- 4dvr yolcvrO
14 40,
/✓1
0
COUNTY OF BUTTE .
DEPARTMEAT OF PUBLIC WORKS
196 Memorial Way, Chico —Phone: 891-2751
f 7 County Center Drive, Oroville - Pho�.e: 538-7541
`s '
747 Elliott Road, Paradise — Phone: 872-6307
CORRECTION NOTICE
�'Pco ,Pr so✓l -311-1- 9 7.
'NER PERMIT NO.
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.
i.r r+r.cr�nds ?md"
J-�� />Y✓/yI 1 �% T b � vrn tee%/ ��,�� i1L�
e.
? In, S.P 6m_&c.1 ewc, of k/4eC
X30 S i7 ft /n (Vo r rfc f e/k/ I'S
Date 12 - 3b-q� Inspector . 01
Bill h®R`Q'�1101'T,N/I/E99AW
FOR
A.M.
DATE TIME' P.M. -
M
PHONE
AREACODE - NUMBER ' :EXTENSION
a'iupp✓//Z,.%Y�'.To� �^k �`3i�`C `3�2 / �
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Y7ELEPHDNEDZJ„�
e
mill
PLEASE CALL��yk
�Wt
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GAME SEE
AGAIN '
�
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4's
TO YOU ,
>WILLSGALL u y
�
¢�
�RETURNEDLYDURCALL���
a
SPECIAL'�ATTENTIDN�'
�s�'�,�.
■m
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO. ,
ASSESSOR PARCEL, NUMBER•
�),
'ZONING /
BUILDING PERMIT
Ow ER
TELEPHONE
SQ. FT. OCC. BUILDING
VALUATION
OW,4ER'S VAILANG ADDRESS
,
C(_JOA T 'S AME
r
TELEPHONE
CONT ACT RV 4'S M&J41NG ADDRESS
�ylt
Fireplace
ONSTRUCT ON 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 fee
$
PLUMBING PERMIT
Filing Fee 10.00
/
fP !
Each Trap
1 2.00
Solar or heat pump water heater
20.00
Water piping
5.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF ❑ Duplex[]Mobilehome❑ Other SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S G W
10.00 ea
TYPE OF WORK
New ❑ Addition ❑ Remodel Utili 'es ❑ Installation❑ Other ❑
Describe work: -� J
��LLLL
Permit Fee
$
Contractor
ELECTRICAL PERMIT
FiIin Fee 10.00
9
Main service 600V OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD -L 100 AMP
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 Businessf
and Professions Code and my license is in full force and effect.
License 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)
❑ 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 CONST*( DWELLING OCCUP.EdI/Z¢sgft
OR ADDNS. ACC. BLDGS. I
NEW CONSTR. ULT).OUTLET
NON-RESID BRANCH CIRC ITS
2,50 ea
POWER APPARATUS 6\
(SINGLE OUTLET CIR. /
Ex. Occup(OUTLETS OR FIXTURES
20®50t
5AL0 —0
FIXED APPLNS. OR
EX. Occup. OUTLETS (RESID.) EA.
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00
Permit Fee
$
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 10.00
Heating
Cooling
Hood
3.00
Ventilation
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 Cou in copse rice of the granting of this permit.
X Date
Signa? re of Applicant Owner ❑ Contractor ❑ Agen
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 $
TOTAL PERMIT FEE $
occuP.
CONST.T77
I
IFLOODIPARCEL.1
PD
I ND
ISSUE
This permit is hereby issued under
sions of the Butte County. Code and/or
work indicated abo for which
DI OR F PUBLIC
f
By
PE MIT EXPIRES Date
the applicable provi-
resolutions to do'
fees have been paid
WORKS /
Receipt No. �� d
WHITE-O.P.W-. TELLOW-ASSE330R, PINK -INS ECTOR. GOLDENROD -APPLICANT
a
.t
COUNTY OF BUTTE -,Department of Public Works
7 County Centef Drive, Oroville, CA 95965
OWNER -BUILDER VERIFICATION
Attention Property Owner:
Phone: 916-538-7541
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 improvement (yes or no) We) �.
2. I (have/have not)
for the proposed work.
signed an application for a building permit
3. I have contracted with the following person (firm) to provide the proposed
construction: p
Name he, V e /J td. d
Address city
Phone 3y3 -?33% Contractors License No. g6,?y2
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 Contractors 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:
Property Owner �2Gov�—
Social Security Numbe
Date J'ea -1 /S /9y Z;
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and
19832 of the California Health and Safety Code.
This verification must be completed and returned to our office before we are per-
mitted to issue the permit.