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Important Message*)
Time: �' C� Date: 1 8 Da
For:
From:
Telephone: A23-- — 3519(7
❑ Telephoned
❑ Wants to see you
❑ Returned your call
❑ Was here to see you
Message:
Taken by:
Post -it° 7679-4 OM 1993
A Please call
❑ Will call again
❑ URGENT
I
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PER IT NO.
(Rev. 12/96) APPLICATIONANDi�ERMIT
ASSESSOR PARCEL NUMBER
055-330-014
ZONING
RMH
BUILDING PERMIT
OWNER
CHRISTINE COLLICOTT
TELEPHONE
SO, FT, OCC. BUILDING VALUATION
. OWNER'S MAILING ADDREES
14726 WOOD DR., MAG4LIA
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
—Filing Fee $ 20.00
Permit Fee $
ARCHRECT OR ENGINEER -3 MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS
14726 WOOD DRIVE MAGALIA
Energy Plan Checking Fee $
$
PERMIT FEE $
LOT NO.
SU5DN610N'S 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 as water heater or vent 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: SERVICE CHANGE
Gas piping system 1 - 5 outlets 15.00
Building sewer 15.00
Mobile Home I S I G W @20.00
PERMIT FEE S
ELECTRICAL PERMIT Fling Fee 20.00
EOOV oR LESS 2) ,
Main Service 2ooA OR LESS 23.00 .. ; . O
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:
1AI, 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 constrL.ct 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.
❑ 1 have ane 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
Policy Number
(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 with those prov' ions.
X Date 10 -2_g- — o _
Sigeof Applr t - ❑Owner ❑Contractor ❑AgentB
Anperm t is required for excavations over 5'0" deep and demolition or construction
ofes o'er3 stories in height.
Main Service To +000A 46.00so
NEW CONST. ow
W EwNo uP. occ 3.52F°.
O ADO S.. (
MUAiT�i ou�rler
NDN-RESID. @7.50
PowER APPARArus
8 SINGLE OurtEr CIR.
Ex. Occup. OUTLET OR FIXTURESj 20 @'•50
eAl p .so
Ex. Occup. otmEEDTs RESID.) 5.00
Tem orar Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
_ _ a — ii s -p 2 -- t 1 O n 2 3. 0'
PERMIT FEE
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEt $
Mobile Home Installation Fee $
Energy Inspection Fee $
Dcc
CONST. TYPE
TOTAL FEE $
HAZ.
D. FEES IMP
I FLOOD
CDF
PARCEL
PO
HD
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte unty Code and/or Resolutions to do work
Indic d a v to whit fees have been paid.
Y ate //— �20
PERMIT EXPIRES ON 7�al
1 14 1 Pate
Receipt No. 308857
WHITE-D.D.S.-B.'D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
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- COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDINION.
If 7 County Center Drive • Oroville, California 95965 • Telephone (530) 53j8-741 PER T NO.
(P,ev.12/96) APPLICATION AND PERMIT - _a'
ASSESSORPARCELNUhim
T�
v
ZONING -
BUILDING PERMIT
01MNE"/I ZI,C/ TELEPHONE
�
SO. FT. OCC. BUILDING VALUATION
OWNERs M
MAILING ADOM9 p !U� 7f3-uf�-
1/)X
/ O IC
CON PACTOR'S MAE TELEPHONE
CON RACTORs WLLING ADORESs
CONSTRUCTION LENDER
LENDERS LwuNG ADORERS
Fireplace
Total Valuation E
ARCHRECTORENGINEER UCEN6ENO.
Filing Fee b
20.00
ARCHITECT OR ENOINEERs MAILING ADDRESS
Permit Fee b
Plan Checking Fee $
OULDNOADDRESS J//V L/,?—/UEV
Energy Plan Checking Fee E
$
PERMIT FEE _
LOT NO. SUBDIMIDHSume PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
Each Tre
7.00
USEOFSTRUCTURE
Solar or hent pump water heater
23.00
SF ❑ Duplex ❑ Mobilehome�(Mer
Water piping
15.00
sPECFY
Each as water heater or vent
15.00
TYPE OF WORK
Gas piping system 1 - 5 outlets
15.00
New ❑ Addition ❑ Remodel ❑ UtiGdesInstallation ❑ Other 13Buildin
sewer
15.00
Mobile Home S G W
@20.00
Describe Work: -
y6i�Ul Lp e �%�I� L�
PERMIT FEE S
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service °zo°OVwOR, 9s,
23.00 346
Mein Service 200A TO IOWA
46.00
NEW CONST. owFUNo OCCUP.
OR ADONS. i ACC. BIDS.
3.5¢so
NtW ONS . MULTI-0UTLET
NON•RESID.
@7.50
POWER APPARATUS
6 SINGLE OUTLET CMR.
Ex. Occup. OUTLET OR FvmEs
20 ® 1.00
BAL @ .50
EX. OCCU nD AP ENIS ORR.w 5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
— I5-PeT/O /L&W
IA�1)
PERMIT FEE _6
MECHANICAL PERMIT
11
Fling Fee 20.00
*PERMIT FEE PAID $
Heating
SRA $
Cooling
S
SHERIFF $
Hood
6.so
Ventilation
OTHER. $
$
PERMIT FEt $
Mobile Home Installation Fee is
$
Energy Inspection Fee $
N
o`c CONST. TYPE TOT FEE $
AMOUNT RECEIVED $ �p
NAz D. FEES tMM FLOOD COF
PAR PO Nn ISSUE
This permit is hereby issued under the applicable provisions
�QQQ
�
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
*RECEIPT NUMBER UU�
* TO BE PUT INTO COMPUTER
By Date
PERMIT EXPIRES ON
ro
FACSIMILE
COVER SHEET
Dater
To: _0a1Z 7:)14 i! P1 UlS/Dlt-)
From:
Subject: /'
Number of pages (including this cover sheet):
Telephone Number of Receiving Telecopier:
If you do not receive all of the pages, please call (530) 538-7541 as soon as possible.
Special Instructions:
❑ Review and respond accordingly:
❑ For your information only.
Sincerely,
CONFIDENTIALITY NOTE: The information contained in this facsimile is confidential and may also contain
privileged information. The information is intended only for the use of the individual or entity to whom it is addressed.
If you are not the intended recipient, you are hereby notified that any use, dissemination, distribution, of copying of this
communications is strictly prohibited. If you have received this facsimile, in error, please notify us immediately by
telephone, and return toe original to us. Thank you.
A
PRE -INSPECTION REPORT
DATE: /,Q -//( -(fZ)
LOCATION:
CONTRACTOR: U (_-) .
PRE-INSPETIONFOR: D O 11 A-10
TO
Building Description:
Commercial/Usage:
Residential/# of Units:
Currently Occupied
AbandonedNacant
Electric:
PERMIT
ZONING-
( ) AS FOLLOWS:
BUILDING INSPECT'OR'S REPORT
Yes No Electric currently On Off
Condition of Electric
Gas:
Natural Propane None Currently On Off
Obvious Problems:
Sanitation:
Plumbing Working
Well Working Potable Water
Obvious SewageProblems • .
Comments:
ACTION RECOMMENDED: ISSUE: HOLD FOR
Inspector.
Date
Sketch buildings on reverse and indicate location on p"roperty.
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