Loading...
HomeMy WebLinkAbout047-260-18647-26=186 John Ferrell O 9 I S/S Keefer Rd.,app.200'E.of Here - t, ford Dr. ; •Chico:AC Permitl#3890-81P(inst.solar water ' z< - - heating 'sys/SF)` i R , } r h+ . i 1 COUNTY OF BUTTE - DEPARTM'ENT OF PUBLIC WORKS PER IT NO 7 County Center Drive - Oi'6viIIe, California 95965 - Telephone 916/534-4 1 U— APPLICATION AND PERMIT ASSESSOR /PARCEL N MBER p ZONING BUILDING PERMIT OWNER TELEP o E SQ. FT. OCC. BUILDING VALUATION OWN AILING ADD SS 07 CONTRACTO 'SNAME ELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace VCO STRUCTION LENDER ®��' NK UNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ . ARCHITECT OR ENGINEER .6' LICENSE NO. Plan Checking Fee $ Penalty $ RCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESY ,l / PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO. SUBDIVISION NAMEPARCEL MAP - Each pas Water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 •� Z1 c0 TYPE OF WORK New ❑ Addition ❑ Rem�o�del ❑ Utilities ❑ Installatiori❑ Other Describe work: 3� /` SD�G�P tat%di��� ,r Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP 001 OR ORSLESS 5.00 T- Main service EA- ADD'L 100 AMP 2,50 NEW CONST. (DWELLING OCCUP.N) OR ADDNS. \ ACC. BLDGS. / 22 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 m license is in full force and effect. y 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 CONSTR I.OUTLET 2.5Oea NON.RESID BRANCH CIRC ITS NEW NON -CONSTR. RESID. (POWER SINGLE OUTLET CIR. POWER APPARATUS 8) @25a Ex. Occup OUTLETS OR FIXTURES SAL@1 FIXED APPLNS. 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 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. 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. 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 consequ c f the granting of this permit. X Date �-/ j� �� Sigg. o licant - Owner E 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. JPARCIELJ PD ND 159UE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which I ECTOR OF PUBLIC By. %!l PERMIT e/� the applicable provi- ^/ resolutions to do fees have been paid. WORKS Date 1✓—f Receipt No.J2yve,6 . R WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT 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 QC. 7/�- Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance. (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone By Plans checked by Date Plans approved by Date Other: Copy—DPW -Mail Date Other ,af •3 � COUNTY OF BUTTE - DEPARTMENT OFe,PUBLIC WORKS - BUILDING'DIVISION . .• s r 7 COUNTY CENTER DRIVE ,�OROVI LLE, CALIFORNIA 95965 - TELEPHONE': 916/534=459.1r PERMIT APPLICATION DATA SHEET Permit No. OWNER A. P. No.--/ Proposed Building Use Permit Fee Based Upon: Complete Contract Price ._---''"DPW Valuation Other (E p In) Building Inspector v, G�G�/ Date At time of permit application, I was advised'th_ foil wing data must be submitted prior to permit processing sand/or,issuance: DATE RECEIVED APPROVED 1. All items have been submitted.. . 2. Plot plans in duplicate./triplicate. . . . . 3. Complete plans in duplicate./triplicate. 4. Complete engineered plans and calcs. 5. Plans with Energy Design Compliance Statement. . . . . . 6. State Energy Forms No. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . 9. Letter of signature authorization. . . . . . . . . . . . 10. Sanitation approval from Health Dept. . . 11. Planning approval for (A) Use: (B) Parking: . 12. Certificate of Workmen's Compensation Insurance. . . . . . 13..–Co'ntractor's License Information (no., name style, classif.) / � 14. (% Owner -Builder Verification (Given to owner [a—, ail to owner ❑ ),/�-r.� Y/ &, 15. Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . - .- •Pre-Inspec. 17. request to Pre -Inspection for ,Required- Building Inspector -(Date) 18. Other 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 QC. 7/�- Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance. (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone By Plans checked by Date Plans approved by Date Other: Copy—DPW -Mail Date Other COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA. 95965 Phone: 916 -534. -4541 - 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 in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your build- ing 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) \.+ 2. I (have/have not) hGIle- signed an application for a building permit for the proposed work. 3. I have contracted with the following per§on•(firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, su ervise, and rovide the ma'or work:. Name �(GSCc>L. UNC //V Address 4!J= &AJ3 Z. City Phone SQ,� — 9265 Contractors License No. �� I </ / !' G 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 S igned : Property Owner Social Security nurkber Date 0<z.+ I mo. 1 G it 1. 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 permitted to issue the permit.