Loading...
HomeMy WebLinkAbout061-550-048� r „ P. 'ZR Don Mann A (p 5 cyQ I - off e/s Ponderosa Way mi. no. of Feather Ridge Sub. �g_tP-7,57' A 061DIVISION', Permit 1498-72 (new single family) -SUMMARY FOR LAND DIVIS r , _� �'wJohn Danner T Shady Lane,, Orovill'e CERTIFICAT 0 COMPLIANCE - 12/20/78 ' + BOUNDARY LINE MODIFICATION:{,•'-. 061-550-048 PERMIT#98-2101 DANNER, John 240 Mann Ave., Berry Creek24 ry=r ` - Cont: George Roofing Reroof/SF r , 00+1 I5 1 s r � COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 ,PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ® f 0—or ! ZONING BUIL G PERMIT ` OWNER `� Danner John TELEPHONE 589-39054400 SO. FT. OCC. BUILDING VALUATION — OWNERS MAILING ADDRESS 240 Mann Ave...'Rerry Creek, CA 95916 CONTRACTOR'S NAME George Roofs533-6393 TELEPHONE CONTRACTORS MAILING ADDRESS 6810 Lincoln Blvd. Oroville, CA 95966 CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS ' Total Valuation $ 2640.00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee s54.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 240 iKann Ave. BerryCreek-,$ Energy Plan Checking Fee $ PERMIT FEE $ -.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF I Duplex ❑ 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 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation)b Other ❑ Describe Work: C OMP O S i t i O n Shingles _ Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.00 Main Service 1 AOR LE 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 full force and effect. License Cless C — 3 9 C-14 Lic. No. 452266 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 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. I 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 Legion -Insurance Co. n Policy Number WC 0 3 01 9 (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' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X OC Date Signatur plicant - ❑ dwrier actor NO Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service TO 46.00so CCU000A NEW CONST. DWELLING OCCUP. SO DWE200ALLING OR ADDNS. ( & ACC. BUDS. 3.50FT. NON-RESIDT MULTANCI CIIRCUTS @7.50 POWER APPARATUS 8 SINGLE OUTLET CIR.OUTLET OR FIXTURES 20 Q 1'00 Ex. Occup.I&Ap ,50 Ex. Occup.OUTLETS RESIOOEA 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 FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 74.00 HAZ. D. FEES IMP FLOOD COF PARCEL PD HD ISSU This permit is hereby issued under the applicable provisions of theButte County Code and/or Resolutions to do work' indicated above for which fees have been paid. By Date PERMIT EXPIRES O Da e Receipt No. WHITE-D.D.S.-B.D. CANARY- SSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT SUMMARY SHEET FOR LAND DIVISIONS COUNTY OF BUTTE E'U!LDiNG DEPT APPLICANT ADDRESS P.O. Box 11. Berry Creek. CA 95916 OWNER Same and Lucille Danner PROJECT DESCRIPTION BOUNDARY LINE MODIFICATION LOCATION 2 Parcels located on both sides of Mann Avenue. 200 ft.. north of Shadv Lane. Bloomer Mountain area. ASSESSOR'S PARCEL NUMBER(S) 61-55-23 & 24 ZONING U GENERAL PLAN A�. -Res i. PROJECT CONSISTENT? YES GENERAL PLAN CONFORMANCE REPORT May 26, 1993 LAND CONSERVATION ACT CONTRACTS? NO DATE APPLICATION RECEIVED July 2, 1993 AGENT/SURVEYOR/CIVIL ENGINEER Ron Graves & Associates ADDRESS P.O. Box 986. Oroville, CA 95965 DATE PLANNING DIRECTOR'S REPORT PREPARED ENVIRONMENTAL DETERMINATION AND DATE CATEGORICAL EXEMPTION - DATE FILED, NEGATIVE DECLARATION - DATE ADOPTED MIT.NEG.DECLARATION - DATE ADOPTED ENV.IMPACT REPORT - DATE CERTIFIED STATE CLEARINGHOUSE NO. DEVELOPMENT REVIEW COMMITTEE HEARING DATE APPEALED BOARD ACTION APPEAL HEARING DATE COMMENTS FOR PLANNING DIRECTOR'S REPORT ASSIGNED TO RECEIPT NUMBE LD 1005 (11/92) DIS �c t��1C;;rY05� '4. '-'" Land Development Sectior� 9MC'-4; _ CEPT-LFICA71-1, PFi r- issued to: Don Mann DEC 210 P. 0. Bax 11 Berry Creek, CA .95916 COUN i nz;;;.:•.�� r , This C.ertificate of Compliance is hereby issued by the County c.f Butte to certify that the land division which created the parcel of ' property identified below complies with the applicable provisions of the Subdivision Map Act and of Chapter 20 of the Butte Cour zy Code. 1. Property location: Bloomer Mountain area. 2. Assessor's Parcel `lumber: 62-53...21,, Description: ;11 *..hat cz%--ain property located in the County of Butte, State of California., more particularly described as follows: A portion of Section 30, 'Cov,iship 21 North, Range 5 East, F.D.B. & M., more partic- ularly described as folloc..s: Cor:r;::encioc, at the Northeast corner of the Southeast quarter of the Southeast quarter of said Section 30; thence South 89°20'07" Vest, aloe; the Northerly boundary line of the Southeast quarter of the Southeast quarter of said Section 30, a distance of 353.94 feet to the point of beginning for the parcel of land 'herein described; thence continuing along said Northerly boundary line,•South 89°20'07" West, 336.60 feet; thence South 5°27'37" West, 403.78 feet; thence South 35039'45" East, 359.12 feet to a point that bears South 2014'10" Uest from.the point of beginning; thence North 2014'. '10" East, 433.35 feet to the point of beginning. TOGETHER WITH a right of way for road and public utility purposes over a strip of land 30.0 feet in wdith, lying i,'esterly of and adjacent to the Westerly boundary line of the above described .parcel,of land. ALSO TOGETdER WITH a right of way for road and .public utility purposes over a strip of land 60.0 feet in width, lying 30.0 feet on each side of the following described centerline: Commencing at the Northeast corner of the Southwest quarter* of the Southeast quarter of said Section 30; thence South 1°21'30" [gest, 328.80 feet to the point of -beginning for the centerline herein described; thence North 88°10'53" East, 260.16 feet; thence South S0021'15" East, 335.79 feet; thence South 5°27'37" West, 52.33 feet; thence South 16037'35" East, 244.73 feet to the beginning of a 300.0 foot radius curve to the rioir_; thence along the arc of said curve, through a central angle,of 67°22'41", an arc distance of 352.79 feet; thence South 50°45'06" West, 503.39 feet; thence South 00°40'05" East, 577.84 feet; thence North 89°54'41" Nest, 1172.63 feet to a point in the centerline of Ponderosa flay and the end of said line. Issuan'ceoi this Certificate is . conditional upon the follovnn; conditions been im- posed 331lrsuant to the E ate County Code .napter 2C) -16E and Government Code, Section 66499.37 (b), to protect Ye public health and public safety. None. _ r R40 OF 0000$ E`iT County of Butte Subdivision V-iolation Co=, ittee em o: CCA C.I. rr, -No GO PERMIT NUMBER - B 1498-72 BPE5M - P E PERMIT EXPIRES 73 Don Mann OWNER owner CONTR: LOCATION (A.P. 62-07-70 off e/s Ponderosa Way -,L mi. north of Feather Ridge Sub. . �\�� p j .\�� � \ \ ?: , yw 2 : / & k \_ � .z�. � G�\�/nom �� � . . \ � ..��\\�� , y « % �� � � / \ � y \ �f z w.2 . \- 2� • � , � �� ... . , < \\ () (/ . . � d®� v . 2 . . - �: �` � . � §> « . � � � � � \\ \ƒ � � \ ƒ � � � � � ` { \ z . � 2` 2 � � � � . � / � � . � . : � :. � t . . . . .\ . �. �` • � � � . � f � � . t ) / & k \_ � .z�. � G�\�/nom �� � . . \ � ..��\\�� , y « % �� � � / \ � y \ �f z COUNTY OF BUTTE Department �orf�Public.Works BUILDING INSPECTION RECORD Zoninge 0141 -t- 7 -� Setback V Forms ,,�- Foundation ���� g % —7 Piers & Girders/tv Fireploce Rgh. Plumbing % Bond Beam Lath & Plaster Rein. Steel Gas Piping & Test Found. Vents Framing Q14,1_.Plmg. Topout Rough Elee: -:X-0 Wtr. Htr. Furnace Kitchen Vent Firewall ^ Garage Vents Sanitation & Water ELECTRIC / _ _ ,GAS BUILDING Temporary %�- '�_-r Temporary Cert. of,Occup. ' Final Final Final DATE REMARKS OR CORRECTIONS ce.7") 4,e�e -7--, n / � V I .f �. _ . moi" �'` ~ .:a.-. .._ _ �� r., �. A COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive , — Oroville, California 95965 Telephone: 533-1230, Ext. 259 /ZI' P g - 7 Z APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I X lJ �`,� Yhcl, 4 f Date go— ?� 17 Signatures of Permitee or Agent Receipt No. White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -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 F PUBLIC WORKS By Date J Building ermit Expires Date BUILDING Owner In, LVan e7-1 Q. FT. OCC. B111LDING VALUATION Mai I i ng Address 4—Fireplace Contractor 41 Total Valuation Mailing Address Permit Fee Plan Checking Fee&/or Penalty �r Permit Fee $ $ Building Address 6r PLUMBING No.1 @ I FEE PERMIT FILING FEE $2.00 Each Trap 1.50�S`® S'jcRepair drainage or vent piping 1.50 Water piping 1.50 —0 Water Each gas water heater or vent 1.50 A. P. No. _ / / V �7— 740 Zoning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .50 Fire Zone Fire Dept. Sanitation Planning Building sewer 5.00 Plans Fees W. C. R/W Encroachment Lawn sprinkler system 2.00 NEW ADDITION ❑ OTHER ❑ Permit Fee $23, 60.$ 46 ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (morethanl2) USE OF STRUCTURE Single Family Duplex ❑ Others ❑ Range, dryer or water heater 1.00 Oven, Cook -top or space heater 1.00 Light fixtures Receps., switches & fix outlets 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: A Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Misc. wiring License No.z7 *4 5& Classification C"3(0 ❑ i am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 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. ®I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. lecertify 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. I certifythat I have read this application and state that the above pp information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Permit Fee $ n51 umenta� onir graTion (� $0.07/$1000 Evaluation $ $ TOTAL PERMIT FEE $ dG r authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I X lJ �`,� Yhcl, 4 f Date go— ?� 17 Signatures of Permitee or Agent Receipt No. White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -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 F PUBLIC WORKS By Date J Building ermit Expires Date i COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS9 7 County Center Drive Oroville, California 95965 // /e� �e-� Telephone: 533-1230, Ext. 259 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date 2 Signature of Permitee or Agent Receipt No. 5;'�% White-D.P.W. — Pink -In pector — Goldenro -Assessor — Yellow -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 7—I 2-7i Building Permit Expires Date *—/.I• -7 :S BUILDING - OwnerSO. FT. OCC. BUILDING VALUATI N L -r— 4/ — Mai I ing Address 0-4,23 ZG Fireplace eo o o ��— Contractor r,� Total Valuation Mailing Address Permit Fee 2 2— Plan Checking Fee &/or Penalty Permit Fee $ Ahl, Building Address p4-4 nti i PLUMBING No. @ FEE PERMIT FILING FEE $2.00 11 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. 6-2— 0-7—;?.o Zoning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .50 Fire Zone Fire Dept. Sanitation Ianni g C9 Building sewer 5.00 Plans!/ ees W. G�/ R/W Encroachment Lawn sprinkler system 2.00 NEW 0� ADDITION ❑ OTHER ❑ Permit Fee $ $ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 3 � Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more&ffn 12) USE OF STRUCTURE Single Family Duplex ❑ Others ❑ Range, dryer or wate4'rieater 1.00 Ov Coop or space heater ,� 1.00 Light fixtures L Rea&., swiJbho's & fix o*f ets / CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the nameAir style of: HmTcT, Ex. Fan or F.A. Fure-Motor o 1.00 Z Evap. cooler, gar.. or49rW. 1.00 con i lone or heat pump Z s Water pump Misc. wiring License No. Classification i am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ G 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. ❑ I 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 3 i Heating Cooling Sy Ventilation i Permit Fee $ D $ � 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 Pn5trumentationt` oa om1On $0.07/$1000 Evaluation $ a, O TOTAL PERMIT FEE $ .� authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date 2 Signature of Permitee or Agent Receipt No. 5;'�% White-D.P.W. — Pink -In pector — Goldenro -Assessor — Yellow -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 7—I 2-7i Building Permit Expires Date *—/.I• -7 :S I GRANT DEED (Individual) For value received SHIRIM CAMW= GRANT .... . ......... to GARI FRY all that real property situate in the County of Huth state of California, described as follows: See Attached 0 a .............. f'elpm ro R rder' Use Only 2.4 ................ ig.72-.. C-/ Tali. ' To brfr me . ........ ..... ............ a SoInry Public 2A.E39 in and for said Counly and Slate, persnmily appeared ....................... Shirla Caldwell ..................................... L.)TTE .477-C.Lif .............................................. ................................................. ORdVI*L'L'TITLE. E -COMP i Cz ............................................. r . knownto me to be the ratnr �A ............. U& Fie 19 4 26 PH 19 scribed to c wilbi,"—t-ment. and �rknowlrdqed to me LMSE KLJk�[R 11, —cc.t,d I d' . ................... .. Notory tar . V P . u . blic IEE 74 AIV Commission expires . r. . ...... ...ch..7,.... ....19..... Appl. No . ........ 0, &-Q. �4 Return & Mail Tax State-nts to LEO iL 1Lk RM Gary Fr7 St. Him 665 Hiv oroville, Calif. 95965 Dated .......... STATE OF CALIFORNIA-sh ................. . . . ...... 3 r (;aldwell ................................County of ..Pq� ........... . .. .. ............. 0 a .............. f'elpm ro R rder' Use Only 2.4 ................ ig.72-.. C-/ Tali. ' To brfr me . ........ ..... ............ a SoInry Public 2A.E39 in and for said Counly and Slate, persnmily appeared ....................... Shirla Caldwell ..................................... L.)TTE .477-C.Lif .............................................. ................................................. ORdVI*L'L'TITLE. E -COMP i Cz ............................................. r . knownto me to be the ratnr �A ............. U& Fie 19 4 26 PH 19 scribed to c wilbi,"—t-ment. and �rknowlrdqed to me LMSE KLJk�[R 11, —cc.t,d I d' . ................... .. Notory tar . V P . u . blic IEE 74 AIV Commission expires . r. . ...... ...ch..7,.... ....19..... Appl. No . ........ ` - ' ' '- in the County of Butte. State -All that certain real Property situaof California, described as of t . he Southeast quarter of theshiv 21 NorthSoutheast quarter of of Ilest, along the Il.rihexly boundaryD.B. Z' I - thence south 890 20`07 - rter of said Sectionline oj i�e southeast quarter of the southeast qua.iuiin7, -for the wrcel. of land here- -94 feet to the point of be - Northerly boundary line,30t 358 ilong saidin described; thence, continuin,:,, 1,feet' thence South 50 2V 37" lelest,90 201 07" West 335.60south 8 _�th 85- 39.1 Zast, 359 12 feet to a Doint thatn oinning; thence Northbears south 20 14' loll Uest, rx n thee point of beginning - 20 141 loll Zast, 433.35 feet to th utility purposes.'my for road.and public.7om a right Of"over the Uesterly 30 feet. mublic utility purposes overTOG3.11 )"leet in width, lying Uesterly Of and ad�acent toa strin of land Y , line of -the above described Darcel of land - the Vesterly. boundary purposesfor road and public utilityALSO t in width, lyin,, 30 feet on edcoveV a strio of land 60 feefolloving described centerline:t quarter of the southW.Z'E,lCjgG at the 'Northeast corner of the southwes -lest, 328.80. said Section 30*1 thence South 10 211 30's 1east quarter of nning z -or the centcrline herein described:feet jo the Doint of be -i . 16 feet" thence South Boo 211 15"thence ilorth'800 101 53" ::asto 260 52.33 feet; thence. thence south 50 27, 3711 llest,Zast, 335.791cet, :,_,st, 244.73 feet to the be -inning of a 300-00 footsouth 160 371 35" a;c of �aid curve thrOU7,hradius curve to the rijht; thence along the ,-Ice of 352.79 feet; thence670 226 41", an arc distz 0511 ::ast,a central anzle pointsouth 500 451 06" llest,' 503.39577.84 feet; then 'I y and the end of said line.in the centerline -of ionderosa ..a '- - w ,061-550-048:' PERMIT#98-210V*'ry y ,DANNER , T`John a 240,Mann Ave`,., -Berry Creek l ' Cont:" George Roofing Reroof%SF COUNTY OF BUTTE -'DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION ' PERMIT NO. 7 County Center rDrive - Oroville, California 95965 -Telephone (916) 53877541 (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER J OWNER Danner, John ZONING BUILDtNVGPERMIT TELEPHONE 589-39054401 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 240 Mann Ave. Rprry Crppk, rA 5A1 A C mn 640- CONTRACTOR'S NAME Ge©>rAe KoofinA TELEPHONE 533-6393 CONTRACTORS MAILING ADDRESS 6810 Lincoln Blvd. Oroville, CA 95966 CONSTRUCTION LENDER - s LENDER'S MAILING ADDRESS Fireplace Total Valuation $ 2640.00 ARCHITECT OR ENGINEER w� LICENSE NO. Filing Fee $ 20.00 Permit "Fee s54.00 ARCHITECT OR ENGINEER'S MAILING ADDRESS Plan Checkir Fee $ BUILDING ADDRESS 240 Mann Ave. Berry'Creek, CA 95916 Energy Plan Checking Fee $ $ PERMIT FEE $74.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heeki.pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation20 Other ❑ Describe Work: Composition Shingles Gas piping system 1 - 5 outlets' 15.00 Building sewer 15.00 Mobile Home S I G 1 @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service eoov oR LES3 zooA 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.PO License Class C — 3 9 (,—J.4 Lic. No. 4 5 7. %. 6 6 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: ❑ 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 insurance carrier and policy number are: Carrier tLon Insuranne Co. Policy Number 4 G�-'� 7 3 U 1 (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' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X -Date _ /�/. �_ Signature of Applicant - ❑ Owner ❑-CoWector -❑ Agent�� An OSHA permit is required for excavation over ver 5'0" deep and demolition or construction, of structures over 3.stories in height. Main Service ( 200A To I000A 46.00 NEW CONST. DWELLING OCCUP. SO OR ADDNS. ( & ACC. BLDS. 3.5a Fr. NEWCONST- .=O ANCTI C�Cu. @7.50 ER APPA US a SINGLE OUTLET CIR. 20 @ I.00 Ex. Occup. OUTLET OR FUTURES SAL @ soNS OR Ex. Occup. ourELE s(RES D.) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 207001 Heating 14 Cooling Hood *' ,;V-056 Ventilation P PERMIT FEI: $ 0*_ -#J*,* Mobile Home Installation Fee $ Energy Inspection Fee $' occ CONST. TYPE TOTAL FEE $1Q HAZ. D. FEES IMP FLOOD CDF PARCEL PD HD leir ISSUE This permit is hereby issued under the applicable pro isions of the Butte County Code and/or Resolutions to fdo work/ indicated above for which fees have been paid. f / {�� By _ f / '� Date/%�i/�-1.l PERMIT EXPIRES ON' s//%slr v r iDe(e Receipt No. i�f�'a� %,�i�% WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT