HomeMy WebLinkAbout065-410-007�--
r
rt.
r �
r5:
r
x tiv
An.
.. .. ,:. .. .... .. ,. ..,. � .. ,.. :,. r ;;�!: a .. ,. .. ;.•. _;a� "h; <.. ,o -r �,5,-��..." y .tnq "rye„•
.y" t ;••'rk . e�.n? i.�4` r'+, v. >Xt: �,' S . -.5.: �';;,. • ,.,, . .A 3 t>' i:i' •�. �5 i� �,ix, , � i ,,:
:��y`.�!. • . a+,, �3; -�
3+^�F-°'E�S1'+�".�.+1DL Y'e'���. s,'.7 .`: � . ,.fit�f?�. ', • � ,�3 _ � _ _ � ��r�,e�i 1���� �Mi'� .. a .����m e.. _
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIJ NOr
' 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATIGN ANI" PERMIT I VAI
V
ASSESSOR PARCEL NUMBER
-- -
ZONING
BUILDING PERMIT
OWNER
T LEP oN
SO. FT. OCC. BUILDING VALUATION
OWNER'S MlItL %Dj.1 F}Cti55
CONTRACTOR'S NAME
CONTRACTOR'S MAILING A DRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation I $
Filing Fee.
$ 10.00
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 le
�p
Permit fee ,
$
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISIOJl NA�
(,/�—)
PARCEL MAP
Water piping
5.00
• Each qas water heater or vent
5.00
USE OF STRUCTUM -�
SF ❑ Duplex❑ Mobilehome❑ Other_e
T SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S G W
0.00 ea
TYPE OF WORK
New E5 Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work: as
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service eoov OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I de I re under penalty of perjury (Check.One):
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professiorrf and my license is in f force and effect.
License No. ` � Classification r
❑ 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.CONST. ( DWELLING OCCUP.ad +/zQsgft
OR ADDNS. ACC, BLDGS. /
NEW CONSTR. MULTI-OUTLETrNA 2,50 ea
NON-RESID BRANCH CIRC ITS
POWER APPARATUS e
(SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES 30AL020@BAL930
FIXED APPLNS. R
Ex. Occup. OUTLETS (RESIO )EA.I 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
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
FiIingFee 10.00
Heating
Cooling
Hood
3.00
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 sae in emnify and keep harmless the County of Butte against
all liabilities judg ent os and expenses which may in any way accrue
against saiTdun n equ nc o he granting of this permji/tom., (/
X Date (D ^G �D�
Signature of Applicant — Ownerl Contractor Agent ❑
An OSHA permit is required for excavations over S' " deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
TOTAL PERMIT FEE
OCCUP.
CONST.TYPEJ
F o DPA
EL
P
7177
This permit is hereby issued under
sions of the Butte County. Code and/or
work indicated above for which
DI CT F PUBLIC
BY
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
V
Date
Receipt No. �3 /
WHITE-D.P.W.. YELLOW-ASSE330R, PINK -INSPECTOR. GOLDENROD -APPLICANT
!;y � � r�. -T -"+-..lt+.:,'�s"�.y,.r•-.... �„.,:.T1�I,+h^"^�=Y+:.r�>C`��.,:'•..:�:..1.`�f,.:t:-^i��"` t....,:rrw+-T°w.r,i�.,:,.ir�7`tirs?`•;t'": " ��t`+`v}�" �� ..ti*,rltwr� R'r J '
3r �
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, "&C DFr0AA 95965 - TELEPHONE: 916/538-7541
PERMIT APPLICATION DATA SHEET
Permit No.
OWNER / y)'( A. P. No. Z�a 1:�' -
Proposed Building Use 64A,!�za� Building Inspector e$e - Date �yY�
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. . . . . . . . . . . .
i
2.
Plot plans in duplicate./triplicate, signed by preparer of plans. .
3.
Complete plans in duplicate./triplicate, signed by preparer of plans.
4.
Complete engineered plans and calcs, with wet signature on plans.
5.
Plans with Energy Design Compliance Statement. . . . . .
6.
School District "Fees Paid" Stamp on Floor Plan.
7
Statement of Intent for Non -Heated and AC Buildings.
8.
Fees of $ , . . , . , , ,
9.
�0.
Letter of signature authoriz inn .. . . . .
Sanitation approval from -�v Health Dept. .
/ 6--(a—�� rs
11.
Planning approval for (A) Use: (B) Parking: .
12,
Certificate of Workmen's Compensation Insurance. . . . . .
13.
Contractor's License Information (no., name style, classif.)
14:
Owner -Builder Verification (Given to owner❑, Mail to owner ❑ )
_15.
Improvements may be required. . . . . . . . . . . .
16.
Mobi lehome Installation Data. . . . . . . . . .
17. Pre
Pre-Inspec.
-Inspection for Required. Building Inspector
request to (Date)'
18.
Recorded copy of Agricultural Acknowledgment Statement.
19.
Driveway Permit.
20.
Plot plan approval from city of
21.
Engineered trusses in duplicate (required prior to plan check).
22.
When you issue the permit, process as follows: Mail to owner,
contractor.
Telephone and hold for pickup at office,
Deliver w/inspector.
Other n
Applicant
e-
Copy of plans sent Health Dept., Fire Dept., Other
s
Date
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--nail—counter
by date
Contractor,
designer, owner, was advised of above required data by —phone _maII—counter
by date
l. '
Plans
checked by Date Plans approved by
Date
Sets of plans on hold in File cabinet AP folder
Copy—DPW - 1
i
TOt
FROM:
SUBJECT:
i !
Building Department
Envi ronmenta 1
SANITATION CLEARANCE
OWNER LOCATION pp #
Plans approved for: Sewage Disposal g p Water Supply.
Hold final for: Water Supply
Final Clearance O.K. for:
Water Supply
Clearance
for
bedroom mobile home:
Other
Clearance
for
addition of_�
,G�/11r
Lis
"" .. DATE
A setback of 5 ft. rrom the
property lines and a setback
of 50ft. from the road
centerline shall be clear of
structures or equipment except
for a 2 ft. PA over .an.
/00
KEN BROWNI
11,55-0 : k y J,:; y
Magalia, CA. 96954
Fah. (916) 873-1215
NOTE, --M Materials & Workmanship Shall Be u:
Accordancd with Recognized Good Practices and
of a quaErt prescr.1 ed fo the Specified use in the
Uniform Building, Plumbing & Mechanical Codes and
+1aa tdationad Electricai Coe.
i
s
q7 9.3--
I
�
1 his sat p'km MW 10%
,, on the , '- at all tim s acid it is ueilava.ul f®
-! ami -.!-�nges or alter tions on some wmotd
-�I j ssiQWjMn th Deportment of PubG•
�n�ent�:R1owe.
l
sum
80
COUNTY
PARTM ..
"APP"ROVED
H,N- tnoPft-o
Ifs
L
e7-
17
te If e
1v 4,,oa--f e
&,v7ZAls
O
r7-
0 99
tr g
w
wmcouwy
DEPART. MEW,
'A P P . ROVFn-