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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-