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HomeMy WebLinkAbout063-240-039G3-24--39- AUL JOHNSON ;} w/s Doe Mill Rd. app. 5/8 mi."S. o Nicholas Rd., Forest Ranch i ermit 4W0 -80E lec s bwel .n i I e i a M CSI '� . �� � �� ;�� c; :,.:' ��;� 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 NUMBER a,1 11 rJ 'rj —<!:91— e_lo ZONING BUILDING PERMIT OWNER - --" U TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWN 'S MAILINQ, ADDRESS �. it/Cf-r •'S'9yZ CONTRACTOR'S NAME TELEPF;0NE CONT_ R_ACtT OR. 5 MAILING ADDRESS CONSTRUCTION LENDER UNKNOWN Fireplace Total Valuation $ LENDER'S MAILING ADDRESS , Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING A�i� j� �// �Zr ' J/rte/ S/ PLUMBING PERMIT FilinF g ee 3.00 '• /d//C-/��"�L Each Trap 2.00 Repair drainage or vent piping 2.00 _ Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 2.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF,Z-Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 2.00 TYPE OF WORK New❑ Addition❑ Remodel❑ Utilities❑ InstaliationC Other.0. Describe work: � J ------�-%' O/�, `������'� Permit Fee $ Contractor ,��_ ar ELECTRICAL PERMIT Filing Fee .3.00OR L' Main service 80000 AMP ORSLESS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELINGOR ADDNS. ( ACCL BLDGS.CCUP.&\ / 20 sq ft CONTRACTORS LICENSE LAW I declare under penaltyof perjury p 1 y (check one): ElI 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) ❑ 1 am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR MULTI.OUTLET NON•RESID BRANCH CIRC ITs 2,50 ea NEW CONSTR (ROWER APPARATUS & ) NON•RESID. SINGLE OUTLET CIR, s0@z5t Ex. Occup(o XTS OR FIXTURES gqL@10¢ FIXED APPLNS, OR Ex. Occup.(OUTLETS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 3.00 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. Heating Cooling Hood 2.00 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,c/onsequence of the granting of this permit. / X D%� =f �^'"''�-� Date /��/ /'1 G F]❑ ❑ / 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 $ Land Development Fee $ TOTAL PERMIT FEE $ Q OCCUP. GROUP I TYPE OF CONST. [-It/' 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 PUBLIC K-- a.�.✓/ By -* -� ,. A.^/l , PERMIT EXPIRES Date the applicable to do resolutions to do fees have been paid. WORKS f Date �"• - /� rf� Receipt No. �z��i�g WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS RMIT NO. 7 County Center Drive - Oroville, California 95965- Telephone 916/534-4541 APPLICATION -AND PERMIT A5S 5 A-�O RCE NU BER ZONING i BUILDING PERMIT OWNS TELEPHONE SQ. FT. OCC. BUILDING VALUATION O MAI LI ©KESS C 9� 9 IC-5NTRACTOR'S ^ NAME TELEPHONE CON O,jM A//LINGADDRESS - CONSTRUCTION LENDER UNKNOWN Fireplace Total Valuation $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER ' LICENSE NO. Plan Checking Fee' $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADORES Of S PLUMBING PERMIT Filing Fee 3.00 O Each Trap 2.00 Repair drainage or vent piping 2.00 NC Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 2.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF,�Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 2.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti�es ❑ Instal ion ❑ Othqcg Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee Main service 1 0ov OR LESS 100 AMP OR LESS 5.00 S/ V O Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELING OR AODNS. ( ACCL BLDGS.CCUP,&) 20 sq ft 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. 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 ULTI.OUTLET 2.50 ea NO N.RESID BRANCH CIRC ITS NEWCONSTR POWER APPARATUS & NON -RESID. (SINGLE OUTLET CIR, Ex. Occup(ouTLETs OR FIXTURES 50@25Q BAL@1o¢ FIXED APP LNS. OR Ex. OCCup.(OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 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 3.00 Heating Cooling Hood 2.00 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 said Count in c se uence of the granting of this per it. %� Date �4 _ Signature of Applicant — Owner E)Contractor ElAgentwork An OSHA permit is required for excavations over 5'0" deep and demolition or construct- f structures over 3 stori s i height. Mobile Home Installation Fee $ Land Development Fee $ TOTAL PERMIT FEE $ O OCCuP. GROUP I TYPE OF CONST. PARCEL PI HD I ISSUE e/ This permit is hereby issued under sions of the Butte County Code and/or indicated above for which DIRECTOR OF P- LIC BY, PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS DateED: �'� eipt No. rRe P. W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS — BUILDING DIVISION 7 Countv Center Drive — Oroville, Calijo�.nia 95965 — Telephone: 534-4541 PERMIT APPLICATION DATA SHEET OWNER Proposed Building Use Permit fee based upon: (explain) Buildina InsDector At time of permit application; I was advised the fo issuance: 1. 2. 3. 4. 5. 6. 7.- :88. . 9. 10. 11. 12. 627.1.3. 14. All items have been submitted. Contract Price ng data must be su Permit No. n �S A. P. --, DPW Valuation Date 77'x: >mitted prior to permit processing and/or DATE RECEIVED APPROVED Plot plans in duplicate/triplicate....`........................................................... Complete plans in duplicate/triplicate................................................. C7ti� Complete engineered,plans and calcs................................................... RE Plans with Energy Design Compliance Stateme State Energy Forms No. .................... Statement of Intent for Non-Heate AC Buildings ................... Feesof $.................................................. !� Letter of signature �hron........................................................... Sanitation approval Health Dept.... Planning approv or ............. Certificate orkmen's Compensation Insurance ........................ C-ontra ce e,-Wfor-mati,on (no., name style, classification) ............................... mprovements may be required. Contact Land Development Section of Dept. Public Works (see addressbelow)................................................................................................. P� 15. Pre -inspection for required. Pre-inspec. request to Idg.-inspector i 16. Other,l�&-2Fl> — wA5%Lr"E.r2- /��'17 3 OTWNTAINP�*—"W— i -� , W", 1/FIA When you issue the permit, process as follows: Mail to owner Mail to contractor. Telephone and hold for pick-up at office. Deliver w/inspection. ' Other Applicant 0 f� Date - F Copy of plans sent Health Dept., Fire Dept., Other Dater During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above atitime 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