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HomeMy WebLinkAbout066-010-016v - - --- --- -- -- - �CC HARRY MOLTER 66-01-16 6151 Woodpecker Drive, Magalia Contr; Illumination Ele Permit#2720-86P,E(power pole for well) 066=010 016 �" ` -PERMIT#95=4279. .TERRIERS,` thy? F ,.6f5V Woodpecker;Rd.ti, �Magalia = q Cont , Elvie .,Cobb Roof ing' IV Reroof/SF 1!61 IB0870097: 1-tN 066-010=016 NIISCELL_ANEOUS Electric Panel s REPLACE ELECTRICAL_M_ ASTHEAD ++ " 1`T� '6151 WOODPECKER°RD TERRIERE TIMOTHY J i+ t w t i ' ' I i A 1 ML�-m EP!! y.s r.:..�'�=it��C+l"i•. ' ter. -t= ;, �y�ec.4� •y� ��.;i�nr�,�, F'i-mss'' x .�+.Mr-Ks�..r•�-.�•;.y }r ;_ �)A 066-010:=016 E• PERMIT#9:5-1279 F•TERRIERE, Timothy' 6151.Wg6dpecker. Rd., Mag alia r :Cont'; Elvie'Cobb-Roof%ng Reroof SF. COUNTY OF BUTTE- DEPARTMENT OF REVELOPMENTSERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7 PERMIT No. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER'.) 066-'010,-016 ZONING FR5 BUI ING PERMIT OWNER TIh10THY TERRIERE TELEPHONE 873-0450 SO, FT, OCC. BUILDING VALUATION 22 C 60 1,320.00 OWNERS MAILING ADDRESS PO BOX 400 MAGALIA 95954 CONTRACTOR'S NAME ELVIE COB UG TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNIOYOWN Total Valuation Is Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ 33.00 ARCMRECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS HARING ADDRESS Penalty $ BUILDINGADDRESS 6151 WCODIPECKER RD PERMITFEE $ 530000 95954 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar or heat pump water heate• 23.00 USEOFSTRUCTURE SFYIa Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other' Describe Work: _ RF.ROOF W.1111WR Mobile Home I S I GI W 1 920.00 PERMITFEE 1 $ Contractor ELECTRICAL PERMIT Filing Fee 20:00 Main Service e00V OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 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, ��'CtlMdo the work, and the structure is not intended or offered for sale. ujo-1, 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 NEW CONST. DWELLING OCCUR \ SO. OR ADDNS. ( & ACC. BLDS. / 3.50 FT. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( b POWER APPARATUS ) SINGLE OUTLET CIR. Ex. Occup. (OUTLET OR FIXTURES) 20 Q I.00 6AL so Ex. Occup. (FIXED EBID.) EA ) 5.00 OUTLETS (R Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor 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 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 MECHANICAL PERMIT Filing 9 Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor 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.) M-11 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 provisions. Date / C� Signature of Applicant caner ❑Contractor ❑ 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 $ 53.00 HAZ. 1 0. FEES I IMP I FLOOD COF PARCEL PD HD I ISSUE 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. � p BY y'G' n 1 -41'L -Date 4o24_3 PERMITEXPIRESON // yel- (Date) ReceiptNo. 180209 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT J COUNTY OF BUTTE- DEPARTMENT OF Of-VELOPMENTSERVICES - BUILDING DIVI ON 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-754 PERMIT NO. APPLICATION AND PERMIT�� ASSESSOR PARCEL NUMBER X66-010-016 FRS ZONING BU!LPKG PERMIT OWNER TIMOTHY TERRIERE TELEPHONE 873-0450 SQ. FT. OCC. BUILDING VALUATION 22 @ 60 1,320.00 OWNERS MAILING ADDRESS PO BOX 400 MA ,ALIA 4 CONTRACTOR'S NAME TELEPHONE ELVIE COBB 'G CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ 33.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDINGADDRESS WOODPECKER6151 PERMITFEE $ 53,.00 A PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP Solar or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SFS Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ UGIities ❑ Installation ❑ Other )p Describe Work:—�RR(1f1F WOnp I 1C Mobile Home I S I GI W @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filina Fee 20:00 Main Service EOOV OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 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 DECLARATIONOUTLETS 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, o 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 NEW CONST. DWELLING OCCUR SO. OR ( 8 ACC. BUDS. ) 3.50 FT. CNS. NEW CONST. MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( 8 POWER APPARATUS ) SINGLE OUTLET CIR. Ex. Occup. (OUTLET OR FIXTURES) 20 @ I•50 SAL 0 .50 EX. Occup. (FIXAP LN .OR 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor WORKERS' COMPENSATION DECLARATION I 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 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 MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor 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.) fYTcertify that in the performance of the work for which this permit is issued, I shallTOTAL 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. X Date L7 "`/ Signature of Applicant - M-6wner ❑ Contractor ❑ 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 FEE $ 53.00 HAZ. D. FEES IMP FLOOD CDF PARCEL PD HD SSUE 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. , / By9. to (O 3 PERMITEXPIRESON .3 ITe _e (Date) Receipt No. 180209 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTYOF BUTTE - DEPARTMENTOF DEVE,W- PMENTSERVICES -BUILDING DIVISION 7COUNTYCENTERDRIVE - OROVILLE, CALIFORNIA95965 -TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER A. P Proposed Building Use Building Inspector Date At timeZ�� pplication, I was advised the following data must be submitted prior to permit processing Ad/or issuance: . items have been submitted. 2. Plot plans, 3/4 sets, signed by preparer of plans. 3. Complete plans, 3/4 sets, signed by preparer of plans. 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans. 5. Hazardous Material Form. 6. Energy Design Compliance and supporting documentation. 7. Statement of Intent for Non -Heated and A/C Buildings. 8. Engineered truss details and layout in duplicate (required prior to plan check). 9. Mobilehome data and manufacturer's installation instructions, 2 sets. 10. Fees of $ 11. Impact fees as shown on attached schedule. 12. California Department of Forestry plan approval/fees. 13. Flood elevation letter (100 year flood) by California Engineer. 14. Sanitation and plot plan approval Health Department. 15. City of Chico plumbing permit. 16. Plot plan and business license approval from City of Biggs/Gridley. 17. Planning approval for (A) Use: (B) Parking: 18. Contact Land Development about (A) Improvements (B) Drainage. 19. Driveway permit (construction approval required prior to occupancy). 20. Pre -inspection for required. 21. Contractor's license information. (No., Name Style, Classification). 22. Certificate of Workmans Compensation Insurance. 23. Owner -Builder Verification (Given to owner , Mail to owner �. 24. Recorded copy of Agricultural Acknowledgement Statement. 25. Letter of signature authorization. 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. 27. Letter of intent on building use. 28. Mobilehome utility clearance. 29. Documentation of legal access. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements. 31. Existing violations/expired permits. 32. Plan check list. 33. 34. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver with inspector. Other Applicant Date EXPIRATION OF APPLICATION Applications for which a permit has not been issued, will expire by limitation one year after date of application. In order to renew action on an application after expiration, a new application; plans and fees will be required. FEE REFUNDS Refunds can only be made upon writtten request by the person who paid the fee. The request must be made within one yearfrom . the date of fee payment on permits not issued, and one yearfrom the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan checking fees for work plan checked and other department costs are not refundable. Original - Applicant ...+-•+•ti...rv"".^••.�.v.... ,,, , �..: rr�.. �: t-.� n}•..,.jn,..�`.u'a,.�s.L "i�L ,. a 77L.c f .�i:. � rA^t' i '� +,.r-�••' •�+tii.w;..AF:'7�fTJ��r-,�ii'nY ' f!.'r"�+'�,C 7r�''Rv-::('-rr�.+.PY-.-.�1(�f1'tNr.�.-�Y)- COUNTYOF BUTTE - DEPARTMENT© ,-IJE /EWPM ENT SERVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVI LLE, CALIFORNIA 95965 -TELEPHONE (916) 538-754-1 PERMIT APPLICATION DATA SHE-Ef", OWNER t 4_./ A. P (4v flJ Proposed Building Use Building Inspector _, Date 1• At time of perru"rapplication, I was advised the following data must be submitted prior to permit processing a'nd/or issuance: DATE RECEIVED BY 1. All items have been submitted . ......................................... 2. Plot plans, 3/4 sets, signed by preparer of plans. ............ . 3. Complete plans, 3/4 sets, signed by prepareiI of plans . ...................... 4. Engineered plans and calcs, 3/4 sets, with Wet signature on plans . ............. 5. Hazardous Material Form. . 6. Energy Design Compliance and supporting' documentation . ................. . 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). . s 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........,.. . 10. Fees of $................................... } .... . 11. Impact fees as shown on attached schedule . .............................. 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer . ................. . { 14. Sanitation and plot plan approval Health Department . ............ 15. City of Chico plumbing permit . ......................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 'I. 17. Planning approval for (A) Use/' of (B) Parking: 18. Contact Land Development. about (A) Improvements (B) Drainage. ...... . t 19. Driveway permit (construction approval required prior to occupancy). . . 20. Pre -Inspection requ� Pre -inspection for required. . to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... ' 23. Owner -Builder Verification (Given to owner , Mail to owner . .......... . 24. Recorded copy of Agricultural Acknowledgement Statement. ........... `....... 25. Letter of signature authorization . ......................................... 26. Copyof recorded deed of parcel creation and 60 right of way to a public road. .... 27. Letter of intent on building use . ......................................... - 28. Mobilehome utility clearance. 29. Documentation of legal access . ....................................... . 30. Documentation of 50% subdivision developed or (A) Road improvements completed ' and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan check list . ...................................................... .............. 33. 34. / When you issue the permit, process as follows: _I Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver with inspector. Other Parcel Creation Acreage Applicant Date 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. 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 - Department of Public Works O/svd���� T Ole G(J�!/OFFfCEIC PY -, . Addresg GAS D ate _� Meter'By ELEC Dat Meter j COUNTY OF BUTTE - DEPARTMENT @F PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT - PERM IT NO. P/ :::r ASSESSOR PARCEL NUMBER (1,e- _ /-7 _ / ZONING BUILDING PERMIT OWNER `- r' TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILIN%ADDRESS s!/ tip �i✓r �/rf '� ? G , CONT -ACTOR'S NAMETE EPHONE -ALL 4 , � "�-;X� _0? z CONTRACTOR'S MAILING APDRE/ Fireplace CONSTRUCTION LENDER UNiKNOWN Total Valuation Is 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,. /S-„ Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping hVA I 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE i SF [_1Duplex ❑ Mobilehome❑ Other �7 ��{ f 1�1� SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 10.00 ea TYPE OF WORK New Addition[, Remodel❑ Utilities❑ Installation❑ Other ❑ Describe work: !i ��+ �c'•L•r f r! fi/Gflr f Permit Fee $ L) Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service e00V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADO'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check One): ElNON•RESID I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code �� ya,,n,�d my license is in full _force and effect. ,./,..� J (�' �^ / f,% 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) FlI, 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 OR AODNS. ACC. SLOGS. OCCUP.eI � yzQsgft NEW CONSTR. MULTI -OUTLET BRANCH CIRC ITS 2 -SO ea POWER APPARATUS e I SINGLE OUTLET CIR. - 3 , UJ / Ex. OCCUp\OUTLETS OR FIXTURES 0t pA 030 EX. OCCUp- OUTLETS ((RESID )FIXED APPLNS. REA.) 2.00 Temporary service 10.00 Mobile Home Filities ii 15.00 - Mi.s�. vjx-ing- �, r•J 15.00 , Permit Fee $ / Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (c'heck one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 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. 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 tp,save, indemnify and keep harmless the County of Butte against all liabilities!, judgments, costes, and expenses which may in any way accrue against`sai-d'County in copse uence of the granting of this permit. -t' i I ` r' X, "' —'�T ,,', 1 .f� Date i` l �-(7 Signature of AppS.icant – Owner ❑ Contractor t Agent ❑ OSHc umit is requiredexcavations over 5'0" deep and demolition or construct- An ru o Mobile Home Installation Fee $ Energy Inspection Fee $ _. TOTAL PERMIT FEE $ S, O 0 OCCUP. CONST.TYP! I IFLOODIPARCELI PD I ND I 1390 This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTO OIF PUBLIC By t PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date ,f i ''c. % Receipt No. f ', / - WNIT!-D.P.W., YELLOW -ASSESSOR FPINK-INSPECTOR• GOLDENROD APPLICANT ry V COUNTY OF BUTTE - DE'PARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville,_Califorfija 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. U' ASSESS -R ARCEL NUMBER ZONING BUILDING PERMIT OWNER TELEPHONE SQ, FT. OCC. BUILDING VALUA11ON OWNE'R'S MAILING ADDRRiS S` 6 64 Lf i CO GT OJi'S NAME TE PHONE `L J ' CONTRACTOR'S MAILING &PORES Fireplace CONS-rRtfCTION LENDER U K OWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER e LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS /C• G � Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping !!�� 5.00 , V Each qas water heater or vent 5.00 USE OF STRUCT E � SF ❑ Duplex ❑ Mobi lehome ❑ Other © 44/49 /D/ sPE I Fv Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00 ea TYPE OF WORK New Addition Remodel[:] Ut imee�❑ In Ilation❑ 0th ❑ Describe work:GIff Jaz?!: 4i/ Permit Fee $ 6 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 ^ ,f/0 Main service EA. ADD'L 100 AMP 2.50 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 Profession Code and my license is in full force and effect. License No. Classification >� ❑ 1, 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.N) yz2sgft OR ADDNS. ACC. BLDGS. / NEW CONSTR MULTI -OUTLET 2.50 ea.. NON-RESID BRANCH CIRCUITS POWER APPARATUS &I '� (SINGLE OUTLET CIR.. , Otom Ex. Occup(ouTLETs OR FIXTURES 2AL030 9ALoao Ex. OCcUp. OUTLETS (RESID )FIXED APPLNS.REAJ 2.00 Temporary service 10.00 Mobile Home F ilities 15.00 Irina M�&c-�---s�,/ . 15.00 Permit Fee S 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. ZKT 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 FiIirig Fee 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 County of Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree t save, indemnify and keep harmless the County of Butte against all liabilitie i dgments, cos ,and expenses which may in any way accrue aga' ou y in cons u nc `of he granting of this ermrit. C� %� Date `-� �`' C> Signature of Appcant - Owner ElContractorAgent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ _75 o v OCCUP. CONST.TYP! IFLOODIPARCELI PD HD ssu This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIFJLECTO PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS nate %"�� oover93 -sttoories Receipt No. L�/ac /S Q WHITE-D.P.W., YELLOW-ASSESS,ORPINK-INSPECTOR, GOLDENROD -APPLICANT OWNER r COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION / 7 COUNTY CENTER DRIVE - OROVI.LL&j7C•AL'IF�ORNIA 95965 - TELEPHONE: 916/,534-4541' PERMIT APPLICATION DATA SHEET Permit No. Proposed Building Use'- Permit se'Permit Fee Based Upon: Complete Contract Price /DPW Valuation Other (Explain) Building Inspector � //�/� / Date At time of permit application, I was advised the followin I data must be submitted prior to permit processing andJor issuance: DATE RECEIVED APPROVED 1. All items have been submitted. . . . . . . . . . . . 2.. Plot plans in duplicate./triplicate. . . . . . . . . . . 3. Complete plans in duplicate./triplicate. . . . . . ... 4. Complete engineered plans and calcs. . . . . . . ... 5. Plans with Energy Design Compliance Statement. 6. State Energy Forms No. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . 9. Letter of signature authorization. . . . . . . . . . . 10. Sanitation approval from Health Dept. . . 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 owner0, Mail to owner ❑ ) 15. Improvements may be required. . . . . . . . . . . . 16.,,Mobilehome Installation Data. . . . OfQ . /�. •P,re-Inspec. request to 1-1 4Pre-inspe'ction for �n 7x ,ice I `��7Aed ulred.�� 6 ", q Building Inspector 18. Recorded copy of Agricultural Acknowledgment Statement. 19. Other When you issue the permit, process as follows: Mail to owner.. Mail t�contractor. Telephone and hold for pickup at office. Deliver w./inspector. Other Appl•icant� chi L_, J� Z Date ,v v " t Copy of plans sent Health Dept., Fire Dept., OtherDate During the plan checking process, the following data must be submitted prior to permit issuance. (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: / i (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 COUNTY OF BUTTE - DEPARTMEA,_L--ri---3F PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT ASSESS R ARCELNUMBER ZONING BUILDING PERMIT OWNER TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWN R'S MAILING ADDRR S J� W CH v i CO CiTOJi*S NAME TE PHONE J GG LL ' CONTRACTOR'S MA LING DRES �/ Fireplace CONS RUCTI N LENDER U KF40WN Total Valuation $ 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 Permit fee $ PLUMBING PERMIT Filing Fee 10.00 � Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each pas water heater or vent 5.00 USE OF STRUC� / /,% SF ❑ DupDuplex[]Mobilehome❑ Other_T EGt/,/� � sPE IFV Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home J S I G I W 1 10.00 ea' TYPE OF WORK New Addition Remodel❑ Utilit�ie ❑ Ii.&Iallation❑ 0th ❑ Describe work:, j G,gLz� Permit Fee $115-1 0 Ci Contractor ELECTRICAL PERMIT Filing Fee 10.00 i Main service 6001 OR LESS 100 AMP OR LESS 10.00 r Main service EA. ADO'L 100 AMP 2.50 61614 TR C ORS LI CIE K SEL I declare under penalty of perjury (check o e : ❑ I am licensed under provisions Chapt. 9, Di the Business and Profession C de and m I nse IS In rc n ffect. License No. If t10 ❑ I, as the owner, or my employees with wages as their sol 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 a contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. / DWELLING OCCUP.. yj�S(]ft OR ..DNS. 1 ACC. BLDGS. I NEW CONSTF ULT' -OUTLET 2,50 ea NON.RESID BRANCH CIRC ITS rPOWER APPARATUS e . `SINGLE OUTLET CIR. Ex. Occu 20 a bot p OUTLETS OR FIXTURES eAL030 FIXED APPLNS. OR Ex. Occup. OUTLETS IRESID.I EA.) 2.00 fiporary service 10.00 Mobile Home F ilities 15.00 ss �v__iri Mi�; 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. JZ?"( 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 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. 1 also agree t save, indemnify and keep harmless the County of Butte against all liabilitie I dgments, cos and expenses which may in any way accrue aga ou yin cons u nc `of he granting of this ermit. j X Date "'y `� — Signature of Ap Icanr - Owner ❑ Conrrocror 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 $ TOTAL PERMIT FEE $ S. d occuP. CO.ST.TYPEJ IFLOODIPARCELI PD ND ISSUE + This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No.�� WNITE-O.P.W., TELLOW-ASeESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT