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HomeMy WebLinkAbout068-140-05468 -/4 - Greg Williams 4494 Olive Hwy, Oroville Permit # 479- OB,E M(additbn & remodel/SF) e-�*d 6 /a- /,rf 068-14=0'=054 93172435 B WILLIAMS, GREG 4494 OLIVE HWY, OROVILLE� CONTR: FOUR COUNTIES REROOF/SF 068-140-054 BP040733 WILLIAMS, GREGORY & RHONDA 4494 OLIVE HWY, OROVILLE CONT: PAUL'S ELECTRIC ELE SER CHANGE 068-140-054 04-1507 WILLIAMS, GREGORY 4494 OLIVE HWY, OROVILL(INALED Cont: ALVIS HEAT & A/C INSTALLNEWHVAC � 44 i BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.netWds JERMIT NO. P041507 LICENSED CONTRACTORS 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 Issued Date: 05/25/2004 APN' 068-140-054-000 ' the Business and Professions Code, and my license is in full force and effect. 2 �� License Class: License Number: Site Address: 4494 OLIVE HWY ORO Date: Contractor: 01S J)A Map Index: Description: INSTALL NEW HVAC OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 t Business and Professions Code: Any city or county which requires a WILLIAMS GREGORY S & RHONDA Z JT permit to construct, alter, improve, demolish, or repair any structure, prior Owner: to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of OLIVE HWY the Contractor's State License Law (Chapter 9 commencing with Section 4494 7000) of Division 3 of the Business and Professions Code) or that he or OROVILLE, CA she is exempt therefrom and the basis for the alleged exemption. Any 95966 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 1, 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 (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does . Applicant: WILLIAMS GREGORY S & RHONDA Z JT such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: ALVIS HEATING & AIR CONDITIONING INC ❑ I am Exempt under Article 3 of the Business and Professions Code Date: Owner: PO BOX 5127 OROVILLE, CA 95966-5127 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 530-534-8491 ❑ I 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 License #: 779257 is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the for this is issued. My workers' compensation work which permit Architect: insurance carrier and policy number are: / Engineer: �►�b�tOLt�.��� Carrier: e—r Policy #: ,A I //,,� y O I 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 Total Square Ft' 0 S.F., become subject to the workers' compensation laws of California, Valuation: $0.00 and agree that if I should become subject to the workers' Census Code: compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those provisions. Date: ,.�� ... Applicant:nzuo WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. c ) CONSTRUCTION LENDING AGENCY CONSTRUCTION This emit she by is i d r e ppl" . b1 pr visions of the Bufta County and/0 I hereby, affirm that there is a construction lending agency for the s to wo in oor i f s ve a aid. performance of the work for which this permit is issued (Sec 3097 Civ.) Name: By: 1 Date: tJ PERMIT EXPIRES ON: Date Address: ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of ButteCounty to enter upon the above mentioned property for inspection purposes. ut'1 -4tle Print Name: W -e1 O) 0 1 S. Signature: Date: ❑ Owner Contractor 0 Agent for Owner ❑ Agent for Contractor F -I-- COUNTY OF BUTTE BUILDING DIVISION 4 DEPARTMENT OF DEVELOPMENT SERVICES zK 411 Main Street * Chico, CA - (530) 891-2751 7 County Center Drive • Oroville, CA - (530) 538-7541 4 CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed If you have any questions pertaining to this'matter, or need additional explanation, Please contact this office immediately. o Date REV 1 Inspector P, BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.netWds PERMIT NO. BP041507 LICENSED CONTRACTORS 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 Issued Date: 05/25/2004 APN' 068-140-054-000 ' the Business and Professions Code, and my license is in full force and effect.. 2 - )q /—I License Class: License Number: Site Address: 4494 OLIVE HWY ORO Date: PJ Contractor: V Is • oti. kl. (} Map Index: Description: INSTALL NEW HVAC OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: WILLIAMS GREGORY S & RHONDA Z JT to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 4494 OLIVE HWY 7000) of Division 3 of the Business and Professions Code) or that he or OROVILLE, CA she is exempt therefrom and the basis for the alleged exemption. Any 95966 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 1, 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 (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: WILLIAMS GREGORY S & RHONDA Z JT such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: ALVIS HEATING & AIR CONDITIONING INC D 1 am Exempt under Article 3 of the Business and Professions Code Date: Owner: PO BOX 5127 OROVILLE, CA 95966-5127 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: 530-534-8491 ❑ 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 License #: 779257 is issued. xI have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Architect: insurance carrier and policy number are: Engineer: II Carrier: ht�lS Policy ❑ I certify that in the performance of the work for which this permit is Total Square Ft' 0 S. F. issued. I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, Valuation: $0.00 and agree that if I should become subject to the workers' Census Code: compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those provisions. Date: Applicant:��/i.l WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This rmit s he by is d r ie +ppl' bl pr visions of the Butte County Coda enrUo I hereby affirm that there is a construction lending agency for the s to wo i o for i f s ve '8e aid. performance of the work for which this permit is issued (Sec 3097 Civ.) D Name: By: Date: PERMIT EXPIRES ON: Date Address: ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. 1 Print Name:IA. 1A 61) 1'4) 0 ` Signature: Date: E S" 0 r� 13 Owner �K Contractor D Agent for Owner 13 Agent for Contractor T�o BUTTE COUNTY / DEPARTMENT OF DEVELOPMENT SERVICES 0 o BUILDING PERMIT APPLICATION 0 o AND SUBMITTAL REQUIREMENTS 0 24 HOUR INSPECTION#: OROVELLE: (530) 538-7636 • CHICO: (530) 891-2834 c�UN'�yOFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION OWNER Name W t( -Lt wl S Address �-q 4 dL t, 0 \�E City 0-"2,V I LL L State C Zip 1 9 - Phone Fax E-mail APPLICANT NAME ICrONTRACTOR Name 6vc, 14 Address !� S�7 \ &C -i lfiL t4C2 2 �ccf CityOno Vt (.(--� State G� Zlpc! Phone ��34�� cl Fax E-mail Lic. #CIa si—s,-2 APPLICANT NAME ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT NAME Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X For office use only: Zoning Flood Zone SRA Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: UVtK ruts sU13Ml i TAL REQUIREMENTS K:\FORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc m'i PERMIT NO. I �, BP BIN # LOCATION AP# 067� / O Property Addres Cross Street WORKER'S COMPENSATION Policy Number Lo V- P V Carrier If hiring anyone other than license contractors, a certific a of worker's compensation must be shown at the time ofpermit issuance. LENDING AGENCY Name Address O pl,zr Sc pe of Wor Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION 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 application after expiration, a new application, plans and fee will be 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. jj*"QR#d b Amount:�15 Bldg I I Y� Page 1 of 2 Receipt #: / _r71 SRA Sheriff SMIP Total REV 430-04 s SUBMITTAL REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply fora permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. Residential, New, Remodels, Additions, and Accessory Structures: ❑ 1. 3 Site Plans, signed by the preparer.._ NO GRAPH PAPER! ❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPER! ❑ 3. 3 Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed calculations.. . ❑ 4. 2 Engineered truss details and layouts (if required) (NO FAXES!). ' I ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. 2 Energy compliance design and supporting documentation: (Note: Not required for additions to mobile or modular homes.), ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 8. , Detached Accessory Building Fohri, filled out by the property owner (if required). ❑ 9. Sanitation and site plan approval from the Environmental Health Department. ❑ 10. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be `stamped and wet -signed by the engine'er. Mobile, Manufactured, or Modular Homes: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ 4. 2 Floor plans..' ❑ 5. 2 Engineered -Tie Downs or Foundation`plans. ❑ 6. Sanitation and site plan approval from the Environmental Health Department. ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). Commercial, New, Additions and Remodels: ❑ 1. 4 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations, with code analysis. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation (if required). ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Statement of Intent for Non -heated and A/C (if required). ❑ 8. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed d by the engineer. ❑ 9. Letter of intent. ❑ 10. Haza`rdou`s Material Form. "N ❑ 11. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530) 538-7541. ' I OVER FOR BUILDING PERMHtAPPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 4-30-04 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538=7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.netWds PERMIT NO. BP040733 LICENSED CONTRACTORS 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 Issued Date: 03/18/2004 APN: 068-140-054-000 the Business and Professions Code, and my license is in full force and effect. —7 7 License Class: " (� Number. Z" license / Site Address: 4494 OLIVE HWY ORO Date: Contractor Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: ELE SER CHANGE Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: WILLIAMS GREGORY S & RHONDA Z JT to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 4494 OLIVE HWY 7000) of Division 3 of the Business and Professions Code) or that he or OROVILLE, CA she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the 95966 applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 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 (Sec. 7044, Business and Professions ` Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: WILLIAMS GREGORY S & RHONDA'Z JT such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: PAUL'S ELECTRIC Cl I am Exempt under Article 3 of the Business and Professions Code 625 MISSION OLIVE RD Date: owner: OROVILLE, OROVILLECA 95966 , 530-5894100E, 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 License #: 376492 Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of Architect: the work for which this permit is issued. My workers' compensation insurance Engineer: carrier and policy number are: Carrier. Total Square Ft: 0 S.F. Policy #: 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 Valuation: $0.00 become subject to the workers' compensation laws of California, Census Code: 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: �n a, Appli WARNING: Failure to secure w ers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY i hereby -affirm ,hat -there i; a const:uction•e;ding Zgenoyfprthe performance of the work for which this permit is issued (Sec 3097 Civ.) This nn is re y 'sdedn r th of the Butte County Code and r Re s t do o ave been paid. /) Name: *Asions By: ' te: L///•��� PERMIT EXPIRES ON: ZZZ Address: to ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owpthe duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge itis unlawful to alter the sub lance of ny official form or document of Butte County. I hereby authorize r tatives of Butte County to enter upon the above mentioned property for inspectio purpose . Print ` S 64"iF14,�lr,Z Name: i�LLL— Signature. t Date: ❑ Owner 8 Contractor ❑ Agent for Owner 0 Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BPO`107 DATE: APN: ' ZONING: OWNER'S LA PT NAME: 1 N f OWNER'S FIRST NA E• 1-3 PHONE: STREET ADDRESS: FAX: CITY. ZIP: E-MAIL: SITE ADDRESS: y `� CITY, ZIP: NEAREST CROSS STREET: TRACT/LOT It. APPLICANT NAME: PHONE: STREET ADDRESS: FAX: CITY, ZIP: E-MAIL: CONTRACTOR NAME: PHONE: STREET ADDRESS: FAX, CITY, ZIP: E-MAIL: LICENSE NUMBER: LICENSE TYPE: ARCHITECT/ENGINEER NAME: PHONE: STREET ADDRESS: FAX: CITY. ZIP: LICENSE NUMBER: E-MAIL: DESCRIPTIO,IN OR SCOPE OF ORK: ❑ Structure Built without permits ❑ Proposed Change of Occupancy (note previous use) EXPIRATION 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 application after expiration, a new application, plans and fees will be required. 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 only: Notes: Application Received by: Date: Receipt number: 3 Amount Receive lJ Ila -CO Master application 3-4-04 fP�Y �.� ����i�,;�N�("r�...n., t�H�L�'r'R •.-�..,.. ,rr�'� .<-,..dW' .. `sY�.'"5..:�,t ,,� _�..+w...-�•Ltir`thinti.•.+r+i r�r-..�r'r ..-:,Z,jT�:..-r^.fir .. y ,. - �...,� ., < COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: l /LJ (J(QlfilY A ASSESSOR PARCEL NUMBER 1"Og-' o , nS Proposed Building Use-, -X-,<-V, )(I -( "X/L • Counter Technician:V, -Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order toT y. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in du licate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ❑ 14. Hazardous Material Form ❑ 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. ❑ 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ......... ❑ 20. Erosion Control Plan Required........................................................................ ❑ 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 22. City of Chico Plumbing permit........................................................................ ❑ 23. California Department of Forestry plan approval ❑ paid. Sent by: ............. ❑ 24. Planning approval (A) Use: (B)Parking: (C) Parcel Check: ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... ❑ 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Publi/Works Dept ........................... @,1'28. Pre Inspection for - -�& Q0 0�h 4 n_ lig � • required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... ❑ 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ 32. Letter of Signature authorization......................................:............................. ❑ 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 34. Manufactured home utility clearance............................................................... ❑ '35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction......................................................................................... ❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ❑ 39. Other: When issued Telephone���� and hold for pickup. I have been infor i6d of the bpve items and requirements for obtaining a building permit. Applicant: Date: 3-- ((o 1. Index per application for the,.- as numbered: Plan Check Letter 2. Additional items required Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Contractor, designer,'owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Plans reviewed by: Date: Plans approved by: Structural reviewed by: Date: Structural approved by: Note transfer by: Date: Yellow: Building Division Date: Date: Date Date: PRE-INSPECTI ON REPORT OWNER: DATE: O LOCATION: A.P. #�DO ���(.t X� C{ q CONTRACTOR ��. C-�'ZONING: REASON FOR PRE -17 CTI N DATE TO INSPECTOR: V ERMIT HISTORY ( ) NONE ( EE ATTACHED BUILDING INSPECTOR'S REPORT Building Description:. . Commercial/Usage: Residential # of Units: Currently Occupied ( es ( ) No Abandoned/Vacant: Electric: Electric Currently ( ( ) Off Condition of Electric Gas: Currently (') On ( ) Off Condition Sanitation: Plumbing Working (,..Kes ( ) No Obvious Sewage Problems ( ) Yes (, ACTION RECOAN[ENDED: ISSUE ( ) Yes Hold for permits or verify: Mobile home # of Units: Ins ector• • Date ��_ �j� P WETCH RT]TTMM S ON REVERSE AND INDICATE LOCATION ON PROPERTY: BUTTE COUNTY Al DEPARTMENT OF DEVELOPMENT SERVICES,, BUILDING PERMIT APPLICATION 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. 13P0q07 DATE: APN: ZONING: OWNER'S LAPT NAME: OWNER'S FIRST NA E' PHONE STREET ADDRESS: FAX CITY, ZIP: E-MAIL: SITE ADDRESS: CITY, ZIP: .NEAREST CROSS STREET: TRACT/LOT M APPLICANT NAME: PHONE: STREET ADDRESS: FAX CITY, ZIP: E-MAIL: CONTRACTOR NAME: \ PHONE: STREET ADDRESS: FAX CITY, ZIP: E-MAIL: LICENSE NUMBER: LICENSE TYPE: ARCH ITECTIENGINEER NAME: PHONE: STREET ADDRESS: FAX CITY, ZIP: LICENSE NUMBER: E-MAIL: DESCRIPTIO/,N OR SCOPE OF ORK: ❑ Structure Built without permits ❑ Proposed Change of Occupancy (note previous use) EXPIRATION 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 application after expiration, a new application, plans and fees will be required. 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 only: Notes: Application Received by: Date: Nt Receipt number: 315Amount Recei IND, Master application 3.4-04 Imo• COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 F ^'_ CORRECTION NOTICE pS� OWNER PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, p,l_e ase -contact this office immediately. 2T L>4 / T T/ -71O (4 T 1s . dr: - i' S n // 17 Ff Date tnspecto� r, REV 10/92 i w 154 Greg Williams 4494 Olive Hwy, Oroville Permit #3479- OB E M(additdon &';'"�, �r y remodel/SF) Tii�f G /.t a /D 93-243 B Y 068-14-0-054 WILLIAMS, GREG 4494 OLIVE HWY, OROVILLE CONTR: FOUR COUNTIES REROOF/SF. of l� • i'. � � r .. r y 068-14- 0 U54 WILLIAMS G 93-2435 B 4494 pLIVEHWY CONTR: ORO OUR VILLE REROOF/SCOUNTIES • 1Ii f i� / COUNTY OF BUTTE - DEPARTMENT OF QEVELOPMENT SERVICES - BUILDING DIVISION County Center Drive - Oroville, California -95965 - Telephone (916) 538-7541 E,RryIT.NO. APPLICATION AND PERMIT`"--� ASSESSOR PARCEL NUMBER 06.8-140-`054 ZONING w BUILDING PERMIT �i eg Williams TELEPHONE SQ. FT. OCC. BUILDING VALUATION ftV Rt&wa�r Oroville CA 95968 4MM6Or °9 • e , • • 00 Re mo ERt g 2'00 ,FpNTRACT27oMties Rpofing �pany ` DN1416 �• 1 TR merd% t Chico CA 95926 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ yyp� qqp� •�+G++�� 'ka Afffve HighMW Oroville PERMIT FEE $ 59.00 • r PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15,00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SF Q Duplex O Mobilehome ❑ Other SPECIFY Gas piping system 1 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ElOther [ / - Describe Work: Reroof PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( BOOV OR LESS ) 2ODA OR LESS 23.00 Main Service ( 200A To 1000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADONS. ( 8 ACC. BLDS. ) 3.50 FBO- T. CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) l I am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions C��y license is in full fore effect. License No. Classification ❑ I, as the owner, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec 7044) ❑ 1, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) 1:11 am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET .NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) s SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 BAL. @ 1.00 Ex. Occup. ( OUTLETS RESIS. D.! R ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 28 00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. IX I have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. ❑ 1 shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 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 Butte County Ordinances and California 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. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. J(Q 1�" Date I - 19 Signature of AOPY-ncant - ❑ Oner ❑Contractor fS' Agent An OSHA persmit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ ocC CONST. TYPE TOTAL FEE $ 59.00 HAZ. I D. FEES IMP I FI -0110 I COF PARCEL I PD HD ISSUE This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions indicated above for which fees have been DIRECTOR OF PUBLIC WORKS f / By PERMIT EXPIRES ON /Date! provisions to do work paid. ��- � Date I / fp ^ Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT ITS - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 -a(916) 538-75415]L5�Egtv}�T 0. APPLICATION AND PE �� ASSESSOR PARCEL NUMBER 068-140-054 ZONING BUILDING PERMIT drWNEReg Williams TELEPHONE SQ. FT. OCC. BUILDING VALUATION 28 sq. 60.0 = MBYiveR�ighway Oroville CA 95965 Reroof existing roof FourTnoties Roofing Company NT -1416 with comp. ITRL, TDflsa erAMu'rt Chico CA 95926 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ 39.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 4494 Olive Highway Oroville PERMIT FEE $59.00 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15,00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SF 3 Duplex ❑ Mobilehome ❑ Other SPECIFY Gas piping system 1 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @ZO.00 TYPE OF WORK New ❑ Addition ❑ Remodel C)Utilities ❑ Installation ElOther Describe Work: Reroof PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( 2OOV OR LESS ) 200A OR LESS 23.00 Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( & ACC. BLDS. ) 3.50 FT.SO, CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) l I am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Cgtieg�(1(f [Ily license is in full for aDd effect. 44ttS5 [GLo�bb l `.9 License No. Classification O I, as the owner, or my employees with wages as their sole compensation, 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 contractors. (Sec 7044) O 1 am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET •NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) B20 1.00 Ex. Occu FIXED APPWS. OR p' (OUTLETS IRESID.1 EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. C}} I have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. ❑ 1 shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 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 Butte County Ordinances and California 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. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said Co 1ty in consequence of the anting of this permit. \ Date -7 -cj� Signature of A p cant - ElO ner ❑Contractor Agent HA An OS ' t is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 59.00 HAZ. I D. FEES I IMP I FLOOD I CDF PARCEL PD 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. DIRECTOR OF PUBLIC WORKS �7 f j1 Y Date p PER IT EXPIRES ON - 7 lOate Receipt No. / o®� WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT • fl I 1 1�r1 r FIR§- rt't l ni pro '°�rna \ 1 I I � • i f I i i JPERMIT NO: 3479-80B� Es M � a ? PERMIT EXPIRES 7/tIN/ OWNER Greg Williams owner ' CON TR. 34-20-54 LOCATION (A.P. ) 4494 Olive Hwy,-Oroville s • y , - j 1 OJ Temp. Power Pole Called�PG&E Temp. �F Elec. Serv. - Called PG&E Te p. Gas Serv. " i /Called PG&E - JOB � 2� r :j FINALED d (Date) ` (Signature 1 Bond Beam FIRE SPRIM(LERS Motors Framing ;�E* �g�.O P l�O Gr Test Water Htr. Stucco V4,q3 F/ Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts y/ Underground Interior Lath en _ tionI nen Door Closer n ?/ Flrrat 7i�i MOBILEHOME UTILITIES ---------------- ec. Service lec. Pedestal Water Piping Sewer Gas Piping MQBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS �-�- (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS .r BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish I 2nd Floor Footings Windows ;30 c 3rd Floor Stemwal I Siding _2 `_3e -r To out Slab Roof Sheathing ;A- Water Piping Piers Roofing of `-:?©•' kV Sewer Garage Fdn. Vents ZZ IV/Fixtures Footings StemwalI Garage Vents Insulation , Water Htr. Heaters Slab Carport Footings Prov. for physica ly I handica edd Conformance of ex. str re A fiances Gas Piping & Yest Temp. Gas Slab Ina / Sanitation Patio REP ACE Final If Footings Footing N ELECTRI Al_ Masonry WallsThroat I Rough . �'; i - 2 Reinf. Steel n /._' Z l? �" Firfurac L L y Bond Beam FIRE SPRIM(LERS Motors Framing ;�E* �g�.O P l�O Gr Test Water Htr. Stucco V4,q3 F/ Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts y/ Underground Interior Lath en _ tionI nen Door Closer n ?/ Flrrat 7i�i MOBILEHOME UTILITIES ---------------- ec. Service lec. Pedestal Water Piping Sewer Gas Piping MQBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS �-�- (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 695 Oleander Avenue, Chico — Phone 343-4211, Ext. 70 7 County Center Drive, Oroville — Phone 534-4541 Skyway ander lliott Road, Paradise — Phone 877-3435 CORRECTION NOTICE BUILDING OR PROPERTY A #ESS A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work Is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. AV 23, oc r 1 fry � uP t.Jt 774- W/ -c t/ IIV517 Y 4- m/6'/ T W T' a0y/ ©,tom ¢G At�r- 41�- Agk'3F 0zX/ L k.. r ^ Inspector rt Date � � C, RES IDENT IAL ENERGY CONSERVATION STANDARDS CONSTRUCTION COMPLIANCE CERTIFICATE THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN INSTALLED IN CONFORMANCE WITH CURRENT ENERGY CONSERVATION REGULATIONS AT (location) BUILDING PERMIT NO. 3'(79 - Fry A.`iP. NO. l THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS: (Check each item or write N/A if not -applicable) INSULATION: Slab Edge Fdn. Walls Floors _ Walls Ceiling/Roof /q Ducts 66�_g- Circulating Pipes APPROVED HEATER N� APPROVED WTR.HTR.��i GLAZING: Single Glazed Special (Insulated) CERT. & LABELED WDS. & SLIDING DRS. r� WEATHERSTRIPPED DRS. BACK DAMPERED FANS INTERMITTENT IGNITION DEVICES CERT. APPLIANCES � I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO THE COMPLETENESS OF THIS CERTIFICATE.AS SUBMITTED. Insulation Applicator Name Signature of (please print) Insulation Applicator State Contractors License No. J`�,General Contractor/Owner Name ft'mw S ( X Signature of please print) General Contractor/Owner_ ate .tea State Contractors License No. THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION WITHIN THE DWELLING. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION NN PERMIT ' ASSESSOR P RCEL NUMBER -. 3 ZO NG 1 BUILDING PER o 1 TELEPHONE O WNiR1}'S I MAI NG ADDRESS ^ e - V e— SQ. FT. OCC. BUILDING VALUATION CONTRACTOR• NAME `— TF_LEPHONE r\ CONTRACTOR' AILING ADDRESS CONSTRUCTION LENDER - UNKNOWN LENDER'S MAILING ADDRESS I Fireplace Vi It Total Valuation $ Permit Fee ARCHITECT OR ENGINEER - LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDI - D R S I W PLUMBING PERMIT Filing Fee 3.00 Each Trap 2.00 Repair drainage or vent piping 2.00 Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 2.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 2.00 ' TYPE,GF WORK New Addition Remod I -' Utilities ❑ Installation❑ Other ❑ Describe work: �5�1 h� p f� Permit Fee $ Contractor ELECTRICAL PERMIT Filin Fee 3.00 9 Main service 100V OR LESS 100 AMP OR LESS 5.00 �— Main service EA. ADD'L 100 AMP 2.50 NEW CONST. ( DWELINGOR ADDNS. ACCLBLDGSO. 20 sq ft 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 Professions Code and my license, is in full force and effect. 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) I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec.—L.--, Business and Professions Code for this reason NEW CONSTR U TI.DUTL T NON-RESID BRANCH CIRC ITS 2.50 ea NEW CONSTR (POWER APPARATUS &) NON-RESID, (POWER OUTLET CIR. / ' . U EXQCCUp� OUTLETS OR FIXTURES 50@ 250 BAL@10C E X. QCiCiU FIXED APPLNS. OR p•(OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 Permit Fee $ r Contractor WORKMEN'S COMPENSATION INSURANCE 1 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 3.00 Heating Cooling Hood 2.00 Ventilation 1� r 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 to save, indemnify and keep harmless the County of Butte against all liabilities, judg ents, costs, and expenses which may in any way accrue against d Count n on nce of the granting of this permit. Date �� 01 Signature o pplicant — Owner Contractor 1:1 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 $ Land Development Fee $ TOTAL PERMIT FEE $ /1)-7',- ac P. GROUP I TYPE OF CONST. V- N PARCEL PD Ho SSUE This permit is hereby issued under 3ions of the Butte County Code and/or work indicated above for which fees DIRECTQB OF PUBLIC By PERAfT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date �77 11// Q'p Receipt No. LL �� WHITE-D.P.W., YELLO -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT