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Home My WebLink About061-630-0210^ GEORGE ROBIS % -.CPO, 21 cF Z. I EJS Deer Meadow Rd, app 250' S Down -A Country.Lane, Bloomer Mountain Permit#3401-82E(temp power -.for -future, w lot development) y B07-0847 061-630-021 MISCELLANEOUS Ag Exempt AG BUILDING- 44X28 (1232) FARM E( ' DOUNACOUNTRE LANE HOLLINGWORTH, JOHN L ETAL JT i ai BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES AGRICULTURAL BUILDING EXEMPTION PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: DOUNACOUNTRE LANE Owner: Permit NO: B07-0847 APN: 061-630-021 HOLLINGWORTH, JOHN L ET Issued Date: 07/16/2007 By KCG Permit type: MISCELLANEOUS 20 CELENA CT Subtype: Ag Exempt OROVILLE, CA 95966 Expiration Date: 07/15/2008 Description: AG BUILDING- 44X28 (1232) FARM .(530) 589-4225 Occupancy: Zoning: U 00 Contractor Applicant: Square Footage: HOLLINGWORTH, JOHN L ETAL JT HOLLINGWORTH, JOHN L E Building Garage RemdUAddn 20 CELENA CT 20 CELENA CT OROVILLE, CA 95966 OROVILLE, CA 95966 Other Porch/Patio Total (530)589-4225 (530)589-4225 FEE INFORMATION DBEH Building Review Fee $75.70 DBOMSCF Ag Exemption Permit $109.98 Total Charged: $185.68 Fees Paid: $185.68 Balance Due: $0.00 Receipt No: B2732 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that 1 am exempt from the Contractor's License HOLLINGWORTH, JOHN L ETA OL:CRW_00402096 / / Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed 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 pursuant to the provisions of the Contractors License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects X 07/16/2007 the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: Contractors Signature Date I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE 19COMPENSATION, WILL DO THE WORK AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of the property, who builds or improves thereon, and who does WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: HAVE AND WILL the work himself or herself or through his or her own employees, provided that such improvements ❑I MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. ( improve for the purpose of sale.). I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and The Contractors License Law dows not apply to an owner of the property who builds or improves policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors License Law.). Carrier: Policy Number: Exp. Date: (This section nee not be completed if the permit is or one hundred dollars ($100) or esss.) ❑ 1 AM EXEMPT under Section B. & P.C. for this reason: 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 Workers' ` Compensation laws of California, and agree that if I should become subject to the workers' X 07/16/2007 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owner's Signature Date provisions. ` 07/16/2007 I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Signature U Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, injury, including of death, and property damage caused t is arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the /property owner or am authorized to act on the property owners behalf. (,Fivlwf;c � 07/16/2007 CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Permittee IGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) Owner ❑ Contractor OR. DAgent for Owner Agent for Contractor WAJ FILE COPY Lender's Address City State Zip BUTTE COUNTY 0��0 DEPARTMENT OF DEVELOPMENT SERVICES 0 o BUILDING PERMIT APPLICATION o 0 OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 e == �, o A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds c�U Nty "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name OLLrAlawOPWN Address First Name T0'1N -e 'qh-,Pj F Mailing Address a O Ce L ewq Cuvt/✓l city O&V I'L-L f Fax StateGN Zip g5- // Phone Jr� �^ y� Fax E-mail CONTRACTOR Name Address City State Zip Phone Fax E-mail Zip Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City1U V ALL f Address Zip 6 City Fax State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name &LLjw t T :F()# { &NI'11-5: Address -7t) CtLtrvI) CO L4/1- % City1U V ALL f StateC N Zip 6 Phone o? Fax E-mail APPLICANT SIGNATURE X PERMIT NO. ()tL� 61 O BIN # PROJECT LOCATION AP# 6te 1 & 3 0, Property Address City WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK. r' L�!Ice Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning Flood Zone SRA Yes INo Occ. Type Const. �e BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net/dds AGRICULTURAL BUILDING EXEMPTION STATEMENT Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated or packaged, nor shall it be a place used by the public. Buildings used for purposes other than described above or that are located in a flood hazard zone are not eligible for an agricultural exemption. Authorization of an agricultural exemption permit by the Department of Development Services does not preclude any requirements and/or review by the Butte County Public Works Department, Butte County Fire Department, Butte County Environmental Health, or any state and federal agencies. Initials AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. Initials l d AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a manufactured home, and 23 feet from a commercial/industrial buildings InitialsO 4 AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum 23 feet from a ---�� ``` residence and a manufactured home, and 40 feet from a commercial/industrial buildings Site Address: DOUNACOUNTRE LANE Permit No: B07-0847 APN: 061-630-021 Square Footage: Permit Type: MISCELLANEOUS Occupancy: Permit Subtype: Ag Exempt Zoning: U 00 Description: AG BUILDING- 44X28 (1232) FARM EQUIP Required Setbacks: Applicant: HOLLINGWORTH, JOHN L ETAL JT Front: 20' Side: 20' Rear: 20' 20 CELENA CT Type of Construction: OROVILLECA95966 (530) 589-4225 Type of Siding: T=111 Owner: HOLLINGWORTH, JOHN L ETAL JT Est. Const. Cost: $ 10,000.00 20 CELENA CT Roof Covering: Compostion OROVILLE, CA 95966 (530) 589-4225 Floor Type: Dirt I declare under penalty of perjury that the building will be used as stated above, and the proposed use conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Building Division and obtain the necessary permits, inspections and approvals to comply with the requirements in effect at that time and prior to occupancy. Signature of owner Date: 04/20/2007 FILE COPY Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property 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 you plan to do your own work, with the exception of various trades that you plan to subcontract, you should 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 $500 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 government 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 to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact 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 thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor 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 contacting the Contractors' State License Board's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. I PERSONALLY PL!!ANkTO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEMENT. kYE9OR NO) I k3HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: NAME ADDRESS, PHONE CITY CONTRACTORS LICENSE NO 4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: Ii0NJI� 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 Description: AG BUILDING- 44X28 (1232) Reference Number: B07-0847 Applicant Name: HOLLINGWORTH, JOHN L ETAL JT Owner's Name: HOLLINGWORTH, JOHN L ETAL JT AP # : 061-630-021 Signature of Property Owner: Date: y f W G/07 T 061- 00—oat - 000 'tee •Q � � si o� �< PLANNING DI ION - BUILDII" P FV`+� i a o Use: Date: Parking: scaP+ng: ----- Other. - Signature: � 1 1 Z y I T IV ao pec y C��T ill y'/•�LF 6j9 y5 X66 � 3v-�89- Raaf_ COUNTY OF BUTTE - DEPARTMENT., OF PUBLIC WORKS 7 County Center Drive - Oroville, Califc�Tnia 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. �'_a/-42 ASSESSO 'PARCEL NUMB .•. ZONING r BUILDING PERMIT OWN ITELEPHONE Gve-oll-Op-so SQ. FT. OCC. BUILDING VALUATION O ER'S M I G ADDRESS P CONTRACT R'S NAME r� (Vl TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. - Plan Checking Fee $ Penalty $ ' ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILD' G AD SS � s.PLUMBING ' PERMIT Filing Fee .10.00 13 1A _ r L4JV- Each Trap 2.00 Solar Water Heater 20.00 , Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5,00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF ❑ Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home S I G I W 10.00 e TYPE OF WORK New ❑ Addition ❑ Remodel Utilities Installation Other ❑ Describe work: `%—i�iyr�� 0t-� vy— t -e Permit Fee $ Contractor ELECTRICAL'PERMIT Filing Fee 10.00 Main service 600v OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST DWELLING OR ADDNS. ( ACC. BLDGS.CCUP.&) 21/22sq It 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. 'Classification .1, 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 ULT' -OUTLET 2,50 ea NON-RESID, BRANCH CIRC ITS NEW CONSTR (POWER APPARATUS &) NON-RESID• SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR-, FIXTURES aA ®a°o FIXED APPLNS, OR Ex. QCCUp. OUTLETS (RESID.) EA. 2.00 Temporary service 10.00 0, Mobile Home Facilities 15.00 Misc. Wiring 15.00 jD 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. ❑ 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 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. 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 aid County ' consequence of the granting of this permit. `rX—!6 ^ � , Date Signature of Applicant — Owner J& Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP, GROUP I TYPE of CONST. PARCEL PD I HD ISSUE This permit is hereby issued under sions of the Butte County Code.and/or work indicated above for which DIRECTOR OF PU LIC By PERMIT EXPIRES Date�_� the applicable provi- resolutions to do fees have been paid. WORKS 01 Date any --Q-0 _-- Receipt No. 7i ZZ k WHITE -D. r. W•, YELLOW -ASSESSOR, SINK -INSPECTOR, GOLDENROD -APPLICANT' rt L COUNTY OF BUTTE - DEPARTMENT OF,PUB..IC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/534-4541 PERMIT APPLICATION DATA SHEET Permit No. o OWNERL.0�6'� A. P. No. 1J �" D 9 Proposed Building Use = Permit Fee Based Upon: Complete Contract Price DPW Valuation y� Ot eP (Explain) I — Building Inspector Date�� " Il' At time of permit application, I was advised the following data must be submitted prior to permit processing and/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. Contractor's License Information (no., name style, classilf.) 14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ ) 15. Improvements may be required. . . . . . . . . . . . "16s Mobilehome Installatigp Data. . ... . • • • • 7. Pre -inspection for M; J-I'�K�' Q Re uired.•Pre-Inspec. request tol p q Building Inspector 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 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 Mail Other By Date Plans checked by Date Plans approved by Date Other: Copy—DPW b ' 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 material' for construction of the proposed property improvement (yes or no) �S 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 provide the proposed struct ion : Adcyfess City P one Contractors License No. 4.(I plan to provide portions of this work, but I have hired the following erson to coordinate, supervise, and provide the major work: Address Phone City Contractors License No. 5. I w' 1 provide some of the work but I have contracted (hired) the following pe ons to provide the work indicated: N e Address Phone Type of Work Signed: Property Owner Social Security number U Date 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. • y� • i1 A r � �. r. i "tom Y/• r;. • � t COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 • APPLICATION AND PERMIT ASS F_550 PARCEL NUMB 1., ._ ZONING �V BUILDING PERMIT OWN TELEPHONE SQ. FT. OCC. BUILDING VALUATION' t ------ I '------- O' E R' S M I G ADDRESS ' - - CONTRACT R'S NAME a cAj� TELEPHONE _ — - --- --- ----- - Fireplace _ CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER UNKNOWN Total Valuation --' Fling Fee �$ _ 1_00 - LENDER'S MAILING ADDRESS _ Permit Fee Plan Checking Fee' $ _ $ ARCHITECT OR ENGINEER LICENSE NO. Penalty --- -- --- Permit fee I $ $ ARCHITECT OR ENGINEER'S MAILING ADDRESS BUILD/IG AO -SS �'7^ - 2Rd PLUMBING PERMIT FI IIni�Fee �—.. 10.00-� Each Trap 1 -- Co 1 " r - -- -- --- Solar',later Heater -2=00 20.00 - Water piping --- --- - -- - b.w _ —_ LOT NO. SUBDI V1510 NAME �S PARCEL MAP . Each Qas water heater or vent- Gas piping system 1 - 5 outlets 5.00 TURE US:Wth SF ❑ Duplex El Mob - _ SPECIFY —^ sewer 5.00 _Buiiding _ Mabi le Home S -G 'Al! _ 10.00 e —_- -- TYPE OF WORK New❑ Addition[] Remodel Utilities Installation , Other L] Primit Fee $ I Contractor—__-- Describework: FiV &LQ ELECTRICAL PERIMIT FilingFee1 10.00 \\� ,�•� �y� ``}. `�.� 600V OP LESS i`.4a!n service 100 AMP OR LESS — `rte !�� V�AJ 1� \) .'_.- _ Main Service EA. ADD -L_ 100 AMP NEW CONST. r DWELLING OCCUF°. Ii)- �1--- OR ADONS. t ACC. BLDGS. 12/?C'111t1. :E -C ONST R. N ULTI.OUTLZT t:G:.;.RE 51D_`BR=NCH C:RCVIrc� 2.00 ea" . - CONTRACTORS LICENSE LAIN' 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. • 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 _]2.50 NEWC0NST. POWER AFPARAT N•7NRESID•R_(51NG LE OUTLET CIR. I Ex. FIXEED --- Ex. Occup(o XDTs OR FIXTURES IB,,L;=� APPlh15. OR Ex. C)ccup. C:UT LETS (RESID.) EAJ Teri;?crary service ) -� 2.00 10.09 _ 1! /t7�� Mobile Home Facilities 15_GO �� ^;isc. 'Wiring 15.CIC1 for sale. (Sec. 7044) EJ 1, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044)--�-- ❑ 1 am exempt under Sec. , Business and Professions Code Permit Fee $ -� for this reason --_ Contractor _ h1cCHANICAL PERMIT ---- FiiingFee — 10.00 l WORKMEN'S COMPENSATION INSURANCE Heating 1 declare under penalty of perjury (check one): ` — ❑ The permit is for $100.00 (valuation) or less. Cooling — Hood 3.00 -- - '-- ❑ 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. ------ -• Ventilation 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. 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 I_av,& relating to building construction, and hereby authorize representatives of tile Countyot Butte to enter upon the above-mentioned property for inspection purposes_ Mobile Home Installation Fee- $ ---`- -'----- TOTAL PERMIT FEE I also agree to save, indemnify and keep harmless the County of e.utte against all liabilities, judgments, costs, and expenses which may .in any way accrue OCCUP. GROUP TYPE ae =ovsi. PAF.0 L j ��—�— D "SUE against said County ' consequence of the granting of this permit. `� ��6 7 X_, Date—_ Signature of Applicant — Owner JK Contractor ❑ Agent 10wurk I I _ This permit is hereby issued Lander the applica le prori- signs of the Bute Co!�.nty Code and/or reso!utiorts to do indicated above for which tees have' been paid. An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures overstories in height. — DIRECTOR OF PUBLIC WORKS By--.____.------ Date—. /33 Receipt No. —1_Z_L/k -- PE R1411T EXP#RES Date WHIT-D.P.W.• YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT F_