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Home My WebLink About064-620-00964-62-09 `� i P92 -630E! rt 'NIEMEYER,,Iris 14326 Nimshew Rd, Magalia 4 �� 9 Z cont: Illumination El'ec / (elec ser.v/sf) - .064-620-009 OJ -2008 JNIEMEYER, 14326 NIMSHEW RD. MAGALIA CONT: GREENE & SONS ROOFING RE ROOF. 0 /'5-0 / T 064-620-009 01-2008 NIEMEYER, IRIS '14326 NIMSHEW RD. MAGALIA CONT: GREENE & SONS ROOFING RE ROOF COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-754 / �P�TN . (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER �TpWj.3�'NE12CM TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 1026 WINZEN RD., NAMIA9 CA 95954 CON//rRR7AACTO��R'S GREW y� GREW &SMONS ALJ 1i�17 TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS Total Valuation $ 4 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ Es.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUMAINGADDRESs 14325 i� RD. MAW Energy Plan Checking Fee $ $ PERMIT FEE $�� LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Feel 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: RE -MF W10W. Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home IS I GI W1 @20.00 PERMIT FEE t ELECTRICAL PERMIT Fling Feel 20.00 Main Service A 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.POWER License Class Lic. No. 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 fog workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. M, 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 ��1, fe Policy Number 12 / 9, Z 3 CJ (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 af4he 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. • -y X l' ,'-I!X ��. Date X %•�% D Signature of Applicant - ❑ Owner Contractor ❑ Agent An OSHA permit is required for excaations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service 46.00 WEE200A NG CCU000A NEW CONST. DWELLING OCCUP. SG OR ADONS. ( a ACC. BLDS. 3.5¢FT. NOµq°SID. MULTI.OUTLET 97,50 APPARATUS 8 SINGLE OUTLET CIR. Ex. Occup.20 OUTLET OR FIXTURES �L p ,50 EO A Ex. Occup..FIXREM.GE 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEi: $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $35.00 HA2, D. FEES IMP FLooD CDF I PARCEL PD HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated ali&e for which fees have been paid. f By Ilii t Date+ �`f i . EXPIRES ON Date l ReceiptNo. 3U811 =.()()PERMIT WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, Califorri'ia 95965 - Telephone (530) 538-7541 PERMIT o. (RE:v.12ORP APPLICATION AND PERMIT _ /�/�� ALIOESQonPARceLNueeeR _ ow"ERZONNO BUILDING PERMIT T Ne S OCC. BUI VALUATION owNots�AAUNo AODRESt_ F CONSTRUCTION LENDER - LENOER'S MAILING ADDRESS - ARCHITECT OR ENOIIEER ARCHITECT OR ENONEER'S MAILING ADDRESS BUILONOADORESs 1 / -f I1 LAT NO. I tLeWaKwswim USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other it Ofi"w NO. Total Valuation Is rlun res I Permit Fee I Plan Checking Fee I Energy Plan Checking Fee E S PERMIT FEE $ PLUMBING PERMIT Each Trap Solar or heat pump water heater Water piping TYPE OF WORK Each gas water heater or vent New ❑ Addition ❑ Remodel ❑ lilies ❑ in paw Oth Ga!21ping system 1 - ate Buildin 1 sewer Describe Work: Mobile Home S G W PERMIT FEE I ELECTRICAL PERMIT -'—•—• ------ Main Service 800V OR LESS 200A OR LESS Main Service SOAR TO IOWA NEW CONST. Dw Lwo OCCVP. NEW OR C6M a ACC. BLDS, NON•RESID. MULTFOUTLET POWFA APPAMTus A SINGLE OLrrLET CIR. Ex. Occup. OVTLET OR FIXTURES EX. OCCU FDTEO APPLNS. OR OUTLETS fSID. EA 1 Tem orar Service 1 Mobile Home Faciliti "PERMIT FEE PAID SRA -- SHERIFF OTHER AMOVNT RECEIVED c •QeCQVT NniMsei ;5�5 1 " TO BE PVT INTO COMPUTER PERMIT FEE I I MECHANICAL PERMIT Heatina 20.00 Fling Fee 20.00 7.00 23.00 ~ 00 15.00 15.00 15.00 0P20.00 Filin Fee 20.00 23.00 46.00 3.5Qi° @7.50 2F -Q 1.00 -eILO .SO 5.00 23.00 20.00 23.00 • 20.00 6.50 Ventilation PERMIT FEt I Mobile Home Installation Fee I Energy Inspection Fee I I occ WAIST. TYPE I TOTAL FEE Z i HA2. D. FEES IMP PL000 COf PARCEL PO 35 HD , SUE 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. By PERMIT EXPIRES ON Date .26 COUNTY OF BUTTE - DEPARTMENT OF -DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT N (Rev. 12/96) APPLICATION AND PERMIT of - a00W ASSESSOR PARCEL NUMBER 064-620-009 ZONING BUILDING PERMIT OWNER IRIS NIEMEYER .873- TELEPHONE S0. FT. OCC. BUILDING VALUATION 80 . OWNERS MAILING ADDRESS 14326NIMIJEW RM, MAGALTA, CA 9595 CONTRACTOR'S NAME GPJDM & SONS ROOFING TELEPHONE 1873-3940 CONTRACTORS MAILING ADDRESS P.O. F._ CA 95967 CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ 480 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.0 Permit Fee $ 15.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 14326 NIMSHM RD. MAGALIA Energy Plan Checking Fee $ $ PERMIT FEE $ 35.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF'❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping .15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: RE -ROOF W/OOMP. Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W Q2o.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 NOV OR LESS Main Service za.AORLESS 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 Class Lic. No. 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 Main Service YOGA TO 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADONS. ( a ACC. SMS. SO 3.5¢FT: T. NONNEW REOSID MULTI -OUT ,T @7,50 POWER APPARATUS 8 SWGI.E OUTLET CIR. Ex. Occu OUTLET OR FocruRRIR Yo ,.00 SAL @ .w Ex.'Occu Oflx�SRES OR 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 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. 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' ompensation insuranc carrier and policy number are: Carrier tDrnq_3- FR,t,,ti� MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FES S Policy Number -5 O (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 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 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 wp those provisions. 01 AL -0 X Date 1 Signature of App icant - ❑ Owner ontractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $35.00 FEES IMP I FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under of the Butte County Code and/or in ted e f r wh' h fees have B PERMIT EXPIRES ON14167 the applicable provisions Resolutions to do work been paid ' De e eta Receipt No. 33181% $35.00 WHITE-D.D.S.•B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 64-62-09.x'' _ 92-630E NI EMEYER, Iris 14326 Ninishew Rd, Magalia cont: Illumination Elec i�io� sexy/sf) :z . 64-62-09.x'' _ 92-630E NI EMEYER, Iris 14326 Ninishew Rd, Magalia cont: Illumination Elec i�io� sexy/sf) COUNTY OF BUTTE`,DEPARTMENT OF PUBLIC WORDS- » PERMIT NO. 7 County Center Drive - Orovllle, California 96965 - Telephone: 916/538.7541 t--' - APPLICATION SAND PERMIT DOE 0 NBER 64424)9 ZONING ARMH 3 BUILDING PERMIT OWNER IRIS NIEMEYER 9bli SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 14326 NIMSHEW ROAD MAGALIA CONTRACTOR'S NAME I%S MATION ELECTRIC & LIMP TELEPHONE 873-0122 CONTRACTOR'S MAILING ADDRESS 14590 CENTERVILLE ROAD MAGALIA 95926 Fireplace . CONSTRUCTION LENDER UNKNOWN Total Valuation$ Filing Fee $ 15,00 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 14326 NIMSHEW MAGALIA Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ® Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation Other ❑ Describe work: _E'.F,( MT– RVRVTCE TTP(;RADF, _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200AORLESS 18.50 18.5% Main service 200ATO1000A) 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 an my license is in full /�;prce and effect. License J0.6 �� Classification l /M ❑ 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) El 1, as the owner, am exclusively contracting with licensed cont ors. ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason _37.50 NEW CONST. / DWELLING OCCUP.&\ 3.54sq.ft. OR ADDNS. l ACC. BLDGS. I/ NEW CONSTR ULTI.OUTLET @ 5.00 NO N•R ESID BRANCH CIRC ITS POWER APPARATUS e (SINGLE OUTLET CIR. 20 76 Ex. Occup(OUTLETS OR FIXTURESFIXED APLNS Ex. DCCUp. OUTLETS P(RESID.)REA.) I .3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 PRRE INSP 0"• Permit Fee $ 68.50 — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ,KI 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. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating Cooling Hood 6.50 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, cc.00rsts, and expenses which may in any way accrue ag LFrst al ounty in consequence of the granting of this permit. J ( ? X ��, 1 �/� Date �Cl Signature of Applicant – oWner g pp ❑ Contractor Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- of structures over 3 stories`in hei ht. g Mobile Home Installation Fee S Energy Inspection Fee $ OCC CONST TYPE TOTAL FEE $ HAz DFEES IMP FLOOD CDF PARCEL PD HD IssuE This permit is hereby Issued under the applicable rovi- P Y PP P sions of the B to Count-ICode and/or resolutions to do / 4 a ve for which fees have been paid. work indir,11REC-f0R`CF ,ion PUBLIC WORKS11101oxReceipt PERMIT XPIRS Date -Date it/ -.:P.7 ' / I No. V WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDEHROD-APPLICAHT Q3 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 7 County Center Drive - Orovil'I'e,`C8110ornla 95965 - Telephone: 916/538.7541 APPLICATIQU AND PERMIT PERMIT NP. ASSESSOR PARCEL NUMB R 64-62-09 ZONING ARMH 3 BUILDING PERMIT OWNER IRIS NIEMEYER ��j�3E P1 SQ. FT. OCC. BUILDING VALUA ION OWNER'S MAILING ADDRESS 14326 NIMSHEtia ROAD MAGALIA CONTRACTOR'S NAME ILLUMINATION ELECTRIC & PUMP TELEPHONE 873-0122 CONTRACTOR'S MAILING ADDRESS 14590 CENTERVILLE ROAD MAGALIA 95926 Fireplace CONSTRUCTION LENDER ,UNKNOWN Total Valuation is LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 14326 NINSHEW LIA Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ® Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: ELECTRICSERVICEUPGRADE _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A OR LESS 18.50 18,90 Main service 200A TO 1000A) 37.50 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 Coe an c� my license is in full {y�rc'e/ and effect. License No. L' � Classification �/t/ FlI, 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 OCCUPM OR ADDNS. 1 ACC. BLDGS. / 3.64sq.ft. NEW CONSTR. ULTI.OUTLET NON•R ESID BRANCH CIRC ITS @ 5.00 POWER APPARATUS e (SINGLE OUTLET CIR. ) Ex. Occup(OUTLETS OR FIXTURES 20 76 FIXED Ex. Occup. OUTLETS P(RESID,)REA.) I 3.00 Temporary service 15.00 Mobile Home Facilities Misc. Wiring #5.0 15.00 PRE INSP Permit Fee $ 68.50 — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. 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. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating Cooling g Hood 6.50 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, c ts, and expenses which may in any way accrue ag �sai unty in co uence of the granting of this permit. �a Date �� % Z Signal re 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 $ occ CONST TYPE TOTAL FEE $ HAz OFEES IMP FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the cions of the B to C ode and/or Work Indl which fees �• O BLIC BY .. PERMIT EXPI • ES DateO applicable provi- resolutions to do have been paid. WORKS ate Receipt No. WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT l•1t�rtnyrysry 2��f'y�•' � .... .. ,;�...�,..-.T.. ...�� .�... �. -.: 't"9Cs ",-'7`Y:gFI:.*:f:+•Y"t-�c� �»,v :,.�;... -,,- w'�.�.,Kmv:!c.icR-r:•"+�.rY'4 S:�Y�'`sP`fj�if7..+�S7�F`v+n-.1.\4�,.�`,�l i" COUNTY OF BUTTE - DEP,ARTM.DI._ PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE-OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT°APPLItATION DATA SHEET, Permit No. ! ,....OWNER //1 /1 / vi M10 yea— A. P. No. �% Z Proposed Building Use ek-C r= S'eay 7C -r— x--41 4ui (ding Inspector Z S Date 3 � 5 2 At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 9. ,4Z20. 21. 22. 23. 24. 25. 26. 27. All items have been submitted . .................................... Plot plans in duplicate/triplicate, signed by preparer of plans........ Complete plans in duplicate/triplicate, signed by preparer. of plans . . Complete engineered plans'arid calcs, with wet signature on plans .. Hazardous Material Form .......................................... Energy Design Compliance and supporting documentation ......... Statement of Intent for Non -Heated and AC Buildings .............. Engineered truss details and layout in duplicate (required prior to plan check) Mobilehome installation data including manufacturer's installation instructions....................................................... Fees of $ Chico Urban Area fees paid ....................................... Parkfees paid .................................................... School District fees paid .............. Sanitation approval from Health Department City of Chico plumbing permit ..................................... Plot plan and business license approval from City of (see City for other requirements) Planning approval for (A) Use: (B) Parking: ...... Improvements may be required. Contact Land Development Section DPW Driveway permit (construction ap roval required prior to occupancy) Pre -Inspection for �/CC l�� I L requiredPre-Inspec. request to Building Inspector (Date) Contractor's license information (No., Name Style, Classifications ... Certificate of Workmans Compensation Insurance .................. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... Recorded copy of Agricultural Acknowledgment Statement ......... Letter of sianature authorization ............... . . . When you issue the permit, process as follows Telephone Other Mai I to owner. Mai I to contractor. and hold for pickup at office. Deliver w/inspector. Date 7_10191? Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By. The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by—phone ---mail—counter by ..date Contractor, designer, owner, was advised of above required data by—phone—mail '_counter by date Plans checked by Date Plans approved by \� Date Sets of plans on hold in File cabinet AP folder Copy—DPW f • f . n� COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. /"l 7 County Center Drive - Orovllle, CelifoPnla 95965 - Telephone: 916.`536-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBE t4 YO IN 6 Z ' 0 c ✓�� 3. OWNER BUILDING PERMIT / TELEPHONE /415 Ale ?- - �jZ J S0. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1'13 .9 AL., /�c( CONTRACTOR'S NAME LL t, /M1,-114 flow fz fen c- i°vryi� TELEPHONE _0 CONTRACTOR'S MAILING ADDRESS �� D 0 C VIPe A/,44Z,,,0 CIF 9 ZC Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 15.00 ARCHITECT OR ENGINEER Permit Fee S LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee --s BUILDING ADDRESS Penalty $ Permit fee $ %y 3Zto IVI s, PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF�uplex❑ Mobilehome❑ Other Building sewer 15.00 SPECIFY Mobile Home S G W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Permit Fee $ Describe work: 2�G��M( C- S en .;i3 GG c,/ A:5 Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600v OR LECs 200A OR LESS 1 8.50 CONTRACTORS LICENSE LAW Main service 20CATO 1000A) 37.50 I declare under penalty of perjury (check one): NEW CONST. DWELLING OCCUPM — OR ACDNS. ACC, BLDGS. I 3.64 sq.ft. �am licensed under provisions of Chapt. 9, Div. 3 of the Business NEW CONSTR. U TI.OUTLET NON.RESID BRANCH CIRCUITS @ 5.00 and Professions Code a d my license Is In full force and effect. ( POWER APPARATUS e ( SINGLE OUTLET CUR, License 'Jo. � Classification 0j6 Ex. Occup�OUTLETS OR FIXTURES 20 @5 76 ❑ I, as the owner, or my employees with wages as their sole com en- g p FIXED TS (REAPPLS, OR EX. Occup. OUTLETS IRESI D,) EA.) I 3,00 sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) Temporary service 15.00 ❑ I, as the owner, am exclusively contracting with licensed contract- Mobile Home Facilities 15.00 ors. (Sec. 7044) ❑ I Misc. Wiring 15.00 am exempt under Sec. Business and Professions Coded— for this reason -140 Permit Fee $ Z gh WORKMEN'S COMPENSATION INSURANCE Contractor I declare under penalty of perjury (check one): ❑ The is for MECHANICAL PERMIT Filing Fee 15.00 permit $100.00 (valuation) or less. Heating ox- 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. Cooling ❑ I shall not employ any person in any manner so as to become subject Hood to the W. C. laws of California. 6.50 Notice to Applicant: If after making this statement, should you become subject Ventilation to the W. C. provisions of the Labor Code, you must forthwith comply with such Permit Fee $ provisions or this permit shall be deemed revoked. Contractor I certify that I have read this application and state that the above information is correct. 1 agree to comply to all County Ordinances and State Laws relating Mobile Home Installation Fee S to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection Energy Inspection Fee $ purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against • occ CONST TYPE TOTAL FEE $ all liabilities, dgments, costs, and expenses which may in any way accrue HAz OFEES IMP agai aid C my in con uence o the granting Of this permit. FLOOD coF PARCEL PD HD ISSUE / ` Date "7 �" This permit is hereby issued under the applicable provi- Signarure F Applicant — Owner ❑ Contractor Agent ❑ sions of the Butte County Code and/or resolutions to do An OSHA permit is required for excavations over 5'0" deep and demolition or construct_ ion of structures over 3 storiesslin height. work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS Receipt No. I(;j By Date WHITE-D.P.W„ TELLOW-•--i--no PERMIT EXPIRES Date N.4.. =" '.s I PRE -INSPECTION ' OWNER: �/� !, f N/ - DATE yvq? LOCATION: / �%3 2_6: N1 A. P. CONTRACTOR :/LLrev ------------------------------------------------------------------------------------- ----------------------------------------------------------------------- 4 ri D N / L rG 7A/ G ZONING /dR�i y 3 PRE—INSPECTION FOR: 1/etyt' �U,nhGQ/ DATE TO INSPECTOR G� ---------------------------------------------------------------------=--------------- •r ------------------------------------------------------------------------------------ PERMIT HISTORY: NONE 1___j' AS FOLLOWS: TYPE OF OCCUPANCY 1 1 FIELD - INFORMATION BUILDING USAGE:e Ild of e, i TENNANT: /d O/Y�ie2 Pr► �,dL, OCCUPIED i HAS ELECTRIC 'HAS GAS E2HAS SANITATION FACILITIES ffHEATED-COOLED PERSON CONTACTED I/orige OTHER COMMENTS: Alew t., ACTYN RECOMMENDED: ISSUE [::] HOLD FOR, OTHER: BY DATE z u