HomeMy WebLinkAbout066-360-012BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
24 HOUR INSPECTION #: (530) 53877636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
1
PERMIT NO.
Il W' 12 S tr
DATE: s APN:
o
ZO I
NEAREST S SET:
TRACT/LOT#:
SITE ADDRESS: Al, . 2, 2 A C_
CITY, ZIP:
OWNER NAME:/
D eel! o�L71,290
PHONE:
STREET ADDRESS:FAX:
CITY, ZIP: Id
oE-MAIL:
APPLICANT NAME:
PHONE:
STREET ADDRESS:
FAX:
CITY, ZIP:
E-MAIL:
CONTRACTOR NAME:
PHONE -
a
STREET
STREET ADDRESS:
AX: -
CITY, ZIP: / �r
E-MAIL:
LICENSE NUMBER:
LICENSE TYPE:
ARCHITECT/ENGINEER NAME:
PHONE:
STREET ADDRESS:
FAX:
CITY, ZIP:
LICENSE NUMBER:
E-MAIL:
DESCRIPTION OR SCOPE OF WORK:
❑ Structure Built without permits
❑ Proposed Change of Occupancy (note previous use)
EXPIRA I OF APPLICATION
Applications for which a permit has not been issued will expire one year after the date of application. In order to renew
action on an a lication after ex iration, a new a lication, lans and fees will be re wired.
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must'be made prior to
the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan
checked and other department costs are not refundable.
For office use onl _
Notes: Sri c?-1�G`S.SI ble, <She��
It'd
Application Received by: To Date: & 1�,I),
Receipt number: Amount Received:
B. C. Building Permit 01-2304 pg 2