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Home My WebLink About066-170-02566-17-25 WARD A. CARLSON, .505 Andover Dr.; Lot 154, P•P•#3;Mag: Permit 1829-73B,EI ` 9 -2 -99 - (garage -2 -99 -(garage & temp Powe pole A. FT 66-17-25 WARD A. CARL_ SON 505 Andover Dr.,'Lot 154, P.P.C.C.#3'.. Permit 2071=73B,P,E,M (new single family) 066-170-025- 0373325 LYNCH, GREG. & VALERIE',' 13748 ANDOVER; M;LlAexs Cont: MCCLELANDREPLACE HVAC pl 066-170-025L7 04-0130 LYNCH, GREG 13748 OVER CT, SMAGALIA :Cont: GALLAGHERS NEW HVAC SPLIT 1 ' t 1 ' _ r w • I 1 LAS TNAME FIRST CONTRACTOR ' STREET NO STREET NAME ' W • USE -TYPE REMARKS.. B� MI VALUATION EFLOOD, FEES PAID RECEIPT FEES 2 RECEIPT 2 FEES 3. RECEIPT 3. IRECEIPT4", FEES 4 Comments: PPLIED 'SUED LED County of Butte Oroville, California GENERAL CLAIM CLAIMANT: McClelland Air Conditioning, Inc. ADDRESS: 690 Thunderbolt Street CITY & STATE: Chico, CA 95973 nATF t7F CI AIM- 05/04/04 SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM DESCRIBE FULLY TO AVOID DELAY AMOUNT Refund Claim - See attached calculation sheet APN:. 066-170-025 Permit INIo.: 03-3325 PAID RETAINED, REFUND Development Services $ 50.00 $ 45.00 $ 5.00 SRA $ - $ - $ - Sheriff $ - $ - $ - Other: $ - $ - $ - TOTAL $ 50.00 $ 45.00 $ 5.00 ............................................... ............. ............................................... ............. ............................................... :.:. o...... :..... ..:.:.:.:. . O. ' .............................................................................. ................................................ "AIMO".*-:::::::::::::::::B-UD'4ET:: ............... ............... ............... .............. ............................. .............................. :Att6t t.: .............. ............... ":ALVi0i31iiT :' ............... Development Services 440-001 4210500 $ 5.00 SRA 0100 4617240 $ Sheriff 280 1011811 $ - Other $ - TOTAL 1 _7$ 5.00 $ 5.00 I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is true and correct as stated. Dated this day of , 2004, at -Calif. `� a Signature of Claimant I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or delivered and that there is a Budget Appropriation or Specific Board Approval (Check ole he same. Dated thisday of 2004, at, Oroville Cao X ll lel Yl�l Y aw Department Head or Authorized Deputy Dept. SEE Exp. Code BREAKDOWN Code PAYABLE FROM FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY DEPT & SUB PROJ SUB. OBJ CLAIM NO. INV NO. INV. DATE ENCUMB. GROSS AMT. DISPLAY REVENUE STATUS A _n r_n zno 7-1 ZI-) A� FUND 0010 ICOUNTY GENERAL FUND YEAR 04 BUDGET UN 440001 DEVELOPMENT SERVICES PERIOD ACCOUNT 4210500 CONSTRUCTIN PERMITS TRANS CODE d2l PROD/TASK TRANS DATE 05/26/04 PROD/TASK_ACCTjl DATE ENTERED 05/26/04 CASH ACCOUNT 101001 TREASURY CASH DUE DATE 05/26/04 VENDOR 1278 IMCCLELLAND AIR CONDITIONI INVOICE DATE 05/26/04 RECEIVABLE ACCT DISCOUNT AMT 0.00 DISBURSE FUND 1505 CO WARRANTS CLRNG F 1505 CHECK NUMBER ENCUMBRANCE__ 0 CHECK DATE 05/26/04 J E NUMBER PARTIAL/FINAL INVOICE/RECEIPT`066-170-025 1099, N AMOUNT 5.00 CLEARED SALES/USE TAX 0.00 —0.00 VOID DESCRIPTION 5/4 RFND CONTROL NO R1 ENTERED BY- kathleen BANK CODE WARRANT NO NOTES N CLICK 'OK' TO CONTINU@D 1=JoJJ OK Return - 1lotes... _"Object - Exit REFUND CALCULATION SHEET CLAIMANT. McClelland Air Conditioning, Inc. ADDRESS: 690 Thunderbolt Street CITY & STATE: Chico, CA . 95973 DATE OF CLAIM: 03/16/04 APN: 066-170-025 - RECEIPT INFORMATION NUMBER: 390712 DATE: 10/27/2003 ISSUED TO: McClelland Air Conditioning CHECK #: AMOUNT: $50.00 PERMIT #: 03-332`'5 Yes No Yes No Yes _ No PRIOR REFUNDS: X FEES VERIFIED X REFUND BREAKDOWN BLDG SRA SHERIFF , >> DETAIL PAID RETAIN REFUND 440-001 0100 280 4210500 4617240 1011811' BLDG FILING FEES Building 20.00 20.00 Plumbing Electric Mechanical PLAN CHECK Plan Check Ener INSPECTION; Ener SRA -BLDG Building $46 PERMIT FEES Building Plumbing Electric "Mechanical 30.00 30.00 30.00 :::.::.::.:.:.:.:.:.:.: .:.:.:.:.:.:.::: ::::::::::::::: ........................................ OTHER BLDG ". s. Overcharge REFUND PROCESS FEE 25.00 -25.00:::::::::::: ............................ BUILDING TOTAL 50.00 45.00 5.00 5.00:::::.'.*.*.'..*..*..*.'.'.*.*..*.*.'.'..'.'..*.*.*.'. ........... :::: .......................... ............ :: SRA - FIRE SRA -FIRE Fire $43 .............. .............. ............. SHERIFF - $360 SHERIFF Sheriff ' OTHER NON=BLDG r. , OTHER $ 50.00 $ 45.00 $ 5.00 $- 0 S.UU BLDG SRA SHERIFF 440-001 0100 280 4210500 4617240 1011811 CHECK: $5.00 DIFFERENCE: (Should be blank) APPROVAL Date Reviewed 004 Michael Vieira Building Manager �i/�� Development Services 04 Tuesday, May , Zoom E .., BUILDING DIVISION Ver: 1.0 Counter ToniaFund Person 10 (Bldg Permits) " SRA Fees (Fire) $0.00 Payment Date 10/27/2003 I SHR Fees (Sheriff) $0.00 r Permit Number 03-3325 I SMIP Receipt Number 1390712 I Copies/Document Sales + $0.00 Check Number or Cash CUA (Chico Urban Area) $0.00 Parcel Number 066-170-025 I TUA (Therm. Urban Area) $0.00 I .. Applicant Lynch, Greg & Valerie Water Tender Btln F= 1 $0.00 West Chico Fire Station $0.00- Received From McClelland Air Conditioning M . Witness Fees $0.00 Recorders Fees (N.O.C) $54 $0.00 Total Received $50.00..., I Thermalito Drainage $0.00 Total Fees To Collect J ).001 I Oroville Area Traffic F---- $0.00 NSF (Non Sufficient Funds) $0.00 Notice of Violation $0.00 J NCSP Trails System $0.00 NCSP Roads/Bridges $0.00 NCSP Storm Drainage $0.00 - NCSP Fire Station r $0.00 . NCSP Parks + $0.00 Value Type $0.00 I • Butte County Department of Development Services Building Division 7 County Center Drive Oroville, CA 95965 (530) 538-7541 BUTTE COUNTY MAR 1 12004 DEVELOPMENT SERVICES REFUND REQUEST APPLICATION REFUND POLICY - Butte County Code 3-41(t) 1. Refunds can only be made upon written request by the person who paid the fees, whose name is on the receipt issued for the fees paid. Any refund checks will be made payable to the name on the receipt. 2. The request must be made within two years from the date of fee payments on permits not issued, and two years from the date of permit issuance for permits issued - if no construction work has been done. 3. Filing fees and plan check fees for work plans checked are not refundable. 4. Fees paid to other County Departments are not covered by this claim. INSTRUCTIONS: Submit this application to Development Services for determination of refundable fees. A claim will be generated for any fees to be refunded and sent to the address below for signature (by the person whose name is on the receipt) and return to Develo ment Services for payment processing. CLAIMANT'S NAME:l_;t j, -j n -, -Q�L _ MAILING ADDRESS: d - L 0-6 a PHONE: ASSESSOR'S PARCEL NO.: biQ u - 4 [Please use one claim form per permit.] BLDG PERMIT NO.: Receipt No. 1 Receipt No. 2 Receipt No. 3 RECEIPTNO.:'*$O4� RECEIPT DATE: - ---- ______ ______ RECEIPT AMOUNT: �b REASON FOR REFUND REQUEST:b`. �f(pCp-►�O"av6 - PT - Check those fees which you wish to have considered for refund: OBuilding Permit Fees OSheriff Fees OSRA Fees (CDF Fire Planning) Other (specify): ns for cancelled permits will be disposed of within 10 working days upon submission of a r Request for Refund. If you want the plans, you may ick them up prior to that time. Siifnature L/ K:/Forms/Refund A 'cation 082203 Date ♦ ' 'COUNTY OF fTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-754 SPE ,F NO. (Rev.12/96) APPLICATION ANIS PERMIT �,, % > -- � � = ASSESSOR PARCEL NUMBER o 2ONINO BUILDING PERMIT OWNER i.. 4`r / � i..i✓av,= �Z: r-4 �.+L',-- ��) NE � Q SO. FT. OCC. BUILDING VALUATION OWNER'S- MAILING ADDRESS co RACTOR'S NAME _Lat, L A -A t,1 �� TE HONE TM i c, CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAIUNG ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Flin Fee $ 20.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Permit Fee $ ' Plan Checkin Fee $ BUILDING ADDRESS Energy Plan Checking Fee $ ii 13��-I �,� ;`j j ir' i% r� /! '1 /!f� $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP (•�1 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 E3 Remodel ❑ Utilities Installation ❑ Other 0/1" Describe Work:13C..�t 14 Vi�-,L Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service aoov oR UM zo.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, ( g ) and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION 1 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 200A TO 1000A 46.00 NEW CONST. DWEwNo OCCUP. s0 OR ADDNs. 6 Acc, gLps• 3.5QFT; Nt:W GU Io.. @7:50 NON °O MULTI -OUTLET PSO APPARATUS a SINGLE OvrLET CIR. Ex. Occup. OUTLET OR FIXTURES B 0 1. 0 Ex. Occu . oune°s"REESI6.o� 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. ❑ 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 worlds' compensati n insurance carrier and policy number are: Carrier L Policy Number --I f (The above sections need not be completed it the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 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' cc m ensafi n laws of California, and agree that if I should become subject to theHAZ wor ars' compensation provisions of section 3700 of the Labor Code, I shall fo with comp) 4ith those provisions. • X� Date / - v-7-0 2 'ignA ure of Ap - ❑ Owner ❑ Contractor 4-9gent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height, MECHANICAL PERMIT Fling Fee 20.00 Heating j , JJ Cooling Hood 6.50 Ventilation PERMIT FEI: $ Mobile Home Installation Fee $ Energy Energy Inspection Fee $ specCONST Occ TYPE TOTAL FEE $ D. FEES IMP FLOOD coF PARCEL Po HD [ISSUE This permit is hereby Issued under the applicable provisions of the Butte County Code and/or Resolutidhs to do work Indicated ove for whic fees have been paid. r �� f a._ 77 . k„ ey} i Date . { c v.. i r:'1, 0_01t, .EXPIRE ON �U. L. Y. -.0 ' • in.im i t / �y Receipt No. v WHITE-D.D.S.-R.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT 04-0130 ASSESSOR PARCEL NUMBER 066-170-025 1 ZONING BUILDING PERMIT OWNER ]LYNCH MM TELEPHONE 873-5010 SO, FT, OCC. BUILDING VALUATION . OWNER'S MAILING ADDRESS 13748 ANDOVER MAGATIA 99994 CONTRACTOR'S NAME GALLAG1384-9444 TELEPHONE CONTRACTORS MAILING ADDRESS LOS MOLINDS CA - CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 13748 ANDOVER D7. MAHALIA 95954 Energy Plan Checking Fee $ $ PERMIT FEE 3 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing 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: 494HVAGT TAT' rS*Sq M 9 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.00 vOR Main Service 200A 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 nd effect. �� 33 License Class C ZO E LIC. NO. 'OWNER -BUILDER DECLARATION 1 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 200A TO 1000A 46.00 NEW CONST. DWEWNG OCCUP. OR ADDNS. ( 6 ACC. S. SO 3.5¢x. NON-RESID. MULTI.OUTLET 97,50 POWER APPARATUS 8 SINGLE OUTLET CIR. Ex, Occup. OUTLET OR FIXTURES BAS @ 1.50 Ex. Occup. DvtLEEOTs Ao .D� 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S 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 nsurajce carrier and policy number are: Carrier 6;S. 4 Un d Policy Number _( -% Z Z'3 5 10- 3 (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 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. X %, Date _ z b_ Signature of Applicant - ❑ Owner ontractor ❑ Agent An OSHA permit is required for excav ins over 5'0" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating 15.0 15.0 Cooling 20 0121 Hood 6.50 Ventilation PERMIT FEE $ 55.00 Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 55.00 HAZ _ D FEES --- IMP --- FLOOD =1 ------ CDF PARCEL --- PD HD _ -- — ISSUE This permit is hereby issued under the applicable provisions of the Butte CountyCode and/or Resolutions to do work indicated a ve for whic a have been paid. By Date PERMIT EXPIRES ON GDete Receipt No. � , 64PMI-AW, WHITE-D.D.S.-B.D. CANARY -ASSESSOR PIN IN PEC OR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-75A -, PERMI FM R12/96) APPLICATION AND PERMIT o�'��Aill ZONING BUILDING PERMIT TELEPHONE. So. FT. OCC. BUILDING VALUATION r. ^ NE aa CCNrw+=0 'W +E , I I , I r A- 2 Q .,) a CONSTRUCTLONLENDER LENDERS MLING ADDRESS LICENSE ND. ARCNIfErT OR ENGINEER ARCHITECT OR ENGNEER'S MAILING ADDRESS /� Q ��//�� (�/y BUI DNG ADDRESS / r7,4 4j _ n ,o Y 11 •�- " 1 `a - LOT NO. I SUBDNISIDNS NAME USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPMFY TYPE OF WORK New ❑ Addition ❑ Remodel ❑ U666es E3 installation E3Other13Describe Work: nt?%u tl Ur4 ✓ 4em PERMIT FEE PAID SRA SHERIFF OTHER $ 1-O $ $ $ C � AMOUNT RECEIVED $ DATE "VED Total Valuation Is Erin Fee $ 20.00 Permit Fee $ Plan Checking Fee $ Energy Plan Checking Fee $ $ PERMIT FEE $ PLUMBING PERMIT Feng Feel 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Moble Home IS G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT IFilingFee 20.00 UK Main Service 20 AOA LESS 23.00 Main Service ( -- To I- � 46.00 h Ex. Occup. ( OVTLET OR FKMES ) I I SAL @ .50 1 1 Temporary Service 23.00 Moble Home Facilities 20.00 Wsc. Wiring _ 23.00 PERMIT FEE I $ M Fee 20.00 00 �� • �o 6.50 PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ crD CONST. TYPE TOTAL FEE $ HAZ. I L). FEES I LMP I FLOOD I CDf I PARCEL I PD I HD 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. By Date COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-i�� NO. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 406(,0 O v ZONING BUILDING PERMIT OWNERAIC T€LEPNONE53io UC.'� SO FT. OCC. BUILDING VALUATION . OWNER'S MAILING ADDRESS r CONTRACTOR' NAME C_ LM �� TELEPHONE l (� CO RACTOWS MAILING ADDRESS CONSTRUCTION LENDER [Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME 1E1 MAP PLUMBING PERMIT Filing 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 [3 Remodel ❑ Utilities ❑ Installation ❑ Other � Describe Work: � � 141ilJko I Gas piping stem 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G W 920.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 o.OR LESS Main Service "OVA 200AA OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter comencMULTI.OET 9 min with Section 7000 of Division 3 of the Business and Professions Code, ( g ) ons and my license is in full force and effect.P 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: IQ 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 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( 8 ACC. BLD S. SO 3.50FT. NEW CONST. NON•RESID. UTL @7.50 OWER APPARATUS 6 SINGLE OUILEr CIR. Ex. OCCU ounEroR FIXTURES Bn� p' 0 LNS Ex. Occup. ouT1EEDTS R.,6.) FRA 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. ❑ 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 5-'A,L Policy Number `-I (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 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' com sation laws of California, and agree that f I should become subject to the wor s' compensation provisions of section 3700 of the Labor Code, I shall fo 4ith comp) th those provisions. X Date LQ _?i1-0 _1919nVure- of App' a --D Owner ❑ Contractor g An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating Q Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ HAZ. D. FEES IMP FLOOD COF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicate ove for whi fees have been paid. By Date PERMIT EXPIR ON I ate Receipt No. _' WHITE-D.D.S.-B.D. CANAR -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT c o,reCoZ�� - - pa ob �S C�c1z (Led . w�✓yrvl' S �`�" `'b 6req 04 _ Zly r - PERMIT NUMBER - B 2071-73B,P,E,M P E rt� PERMIT EXPIRES tOWNER Ward A. Carlson CONTR: owner �n LOCATION (A.P. 66-17-25 505 Andover Dr., Lot 154, P'.P'.C..C.#3)Magalia a zy Y . f COUNTY OF BUTTE Z, �z fa-n-� I 1-7 FC I d 4� 1413 /q C '� `j 71*' '� :� F Department ofPublic. Works x BUILDING INSPECTIONE RECORD Zoning Setback / `J.3 `� 33 1 /J /gl Forms 7 Foundation Piers & Girders Fireplace '� c Rgh. Plumbing ��. c� �// Bond Beam 7—hl-J) 9� Lath & Plaster Rein. Steel Gas Piping & Test Found. Vents Framing f0� lt'z/�� Plmg. Topout JQ� �" Rough Elec. Wtr. Htr. T— Furnace Kitchen Vent Firewall r- Garage Vents Sanitation & Water cf ELECTRIC GAS BUILDING Temporar 7 .7, Temporary Cert. of 0 u c Final — Final !'�-'d '� `7 Final _ 6% v_�� DATE REMARKS OR CORRECTIONS Z, �z fa-n-� I 1-7 FC I d 4� 1413 /q C '� `j 71*' '� :� F COUNTY OF BUTTE - DEPARTMENT OF PUBLIC 7 County Center Dr0e — Croville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT WORK•o� Jv: _7� authorize representativesof the C unty of Butte to enter upon the above-mentioned property for ins tion purposes. X% ate Signature of Permitee or A ant Receipt No. ! D 7 / • White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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. DIRECTOR PUBLIC WORKS BY Date—!� Building permit expires Date BUILDING Owner -SQ. FT. OCC. BUILDING VALUATION 9e Mailing Address/ Telephone No. e -el< G 71 Fireplace O ® d Contractor &%/,Qre.--- Total Valuation` p e) Mailing Address $¢6j�� Permit Fee ; OD Plan Checking Fee&/or Penalty Telephone No. Permit Fee $ Building Address PLUMBING No. @ FEE PERMIT FILING FEE $2.00 �i®a 14p_ Q Each Trap 1.50 7 Repair drainage or vent piping 1.50 Water piping 1.50 �JV Each gas water heater or vent 1.50 A. P. No. ^— 4 2 5 Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fees Sanit tion FireDept. I FireZone Use Permit Building sewer 5.00 EQA Parking Plans Parcel I Declaration Parce Ma P 60' R/W ImprovementsLawn sprinkler system 2.00 Bldg. Plans Rec'd V Parcel Approval Plan pprovol Permit Fee $ $ y-,$1 NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ I FEE PERMIT FILING FEE 3.00 Oa Main service incl. 1 meter l ey Additional meters each 1.00 Sub -panel (12 or res s) (more & on 12) 71 V Single Family Duplex ❑ Mobil Home ❑ Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Spac Heater 1.00 40 Light fixtures bai a10 Bp Refcrp,, swi c es & fi outlets 2b.025 CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Hood, Ex. FanorF.A. Furn. Motor ! 1.00 pG Evap. cooler, gar. Tsp. or BW. 1.00 p?� Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring I am exempt from the Contractors License Laws of the State of California. Permit Fee $ aA -F $ SAW WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Compensation Insurance. �I certify that in the performance of the work for which this permit is issued'l, shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE r $3.00 00 Heating OB Cooling Ventilation Hood 2.00 00 Permit Fee $ $ 1,3let) 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 TOTAL PERMIT FEE $ / 32 authorize representativesof the C unty of Butte to enter upon the above-mentioned property for ins tion purposes. X% ate Signature of Permitee or A ant Receipt No. ! D 7 / • White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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. DIRECTOR PUBLIC WORKS BY Date—!� Building permit expires Date x i i PERMIT NUMBER - B 1829-73B9E P q E r 6 PERMIT EXPIRES .OWNER Ward A. Carlson f d CONTR: owner o' LOCATION (A.P. 66-17-25 505 Andover Dr., Lot 15ZP.P.C.#3, Mag. 7-2 x a 1 ' 3 Ca 7 S COUNTY OF BUTTE-_. Departmerif of Public -Works BUILDING INSPECTION RECORD Zoning Setback 4-7-22 _ ' Forms / F�vO✓�� Foundation a Piers &Girders Fireplace Rgh. Plumbing Bond Beam Lath & Plaster Rein. Steel Gas Piping & Test Found. Vents Framing %i�� = /' Plmg. Topout Rough Elec. Wtr. Htr. Furnace Kitchen Vent Firewall Garage Vents Sanitation & Water ELECTRIC GAS BUILDING Temporary Temporary Cert. of Occup. p�/ Final 7-2'x%3 i Final Final DATE REMARKS OR CORRECTIONS 3 Ca 7 S ,f COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for in ection purposes. X �� ate - ,2 Signoture of Permitee or Agent `� Receipt No. /lU��--), r White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant '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. DIRECTOR OF PUBLIC•WORK�S^ BY Date' '��7� J Building permit expires Date ..._. BUILDING Owner 1 SO. FT. OCC. BUILDING VALUATION Mailing Address elephone No. Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. _ Permit Fee $ $ a Building Address So C //,�q -PLUMBING No. @ FEE •PERMIT FILING FEE $2.00 / l1,2 P,? > ach Trap ' 1.50 epair drainage or vent piping . 1.50 Water piping 1.50 Each gas water heater or'vent 1.50 A. P. N — l — p� Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fees W. C. Sanitation FireDept- FireZone, Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W Improvements P Lawn sprinkler system 2.00 Bldg. Plans Recd ParcelAsal Plans val Permit Fee $ $ NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Single Family ❑ Duplex ❑ Mobil Home ❑ Others ❑ Range, Cook -top or Oven 1.00 / Water Heater or Space Heater 1.00 Light fixtures alZo(�Z5 Receps., switches & fix outlets bo CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of. the State of California Business & Professions Code under the'name' style of: Hood, Ex. FanorF.A. Furn. Motor 1.00 • Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring r- WI am exempt from the Contractors License Laws of the State of California. Permit Fee $ $goo WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. . -I certify that in the performance of the work for which this ermit is issued I shall not employ •any person in any manner so as to become subject 'to the Workmen's Compensation Laws of California. • • MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 1 2.00 Permit Fee $ $ 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 TOTAL PERMIT FEE $ �d authorize representatives of the County of Butte to enter upon the above-mentioned property for in ection purposes. X �� ate - ,2 Signoture of Permitee or Agent `� Receipt No. /lU��--), r White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant '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. DIRECTOR OF PUBLIC•WORK�S^ BY Date' '��7� J Building permit expires Date ..._.