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HomeMy WebLinkAbout068-350-09768-35=97 Keith,,Stutznegger......... 80 Pince ale t vihle% �* "ROGERS, Thomas-J.----*43$ 2913B_ Or Per 22 -821 ,E re_mo a ncl6se 2343P I Aorto` e c ."'Fam_rm)S �8—�% 2 06E 3' I 4 8o = +s/s PiLiu dale• Court 500, off Pine da e, ovi?i 68-35-97 11 (new, single family) PErmit#3649-87B(woodburning.st6ve/SF) :on&remodel Contr: North'State Roofing.: Ermit#3655-87B(reroof/SF).:i r � a I Cfll � M ' Ln COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. W7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICA'r-ION'AND PERMIT ASSESSOR PARCEL NUMBER . f ZONING BUILDING PERMIT OWNER / Fi f I�f 7_r9(O TELEPHONE SQ. FT. OCC.1 BUILDING VALUATION MAILING AILING ADD £SS - nil,) 't N e Gln- fir; �,.,: , l p CONTRACTOR'S NAME r TELEPHONE r 31 CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER '��� UNKNOWN Total Valuation $ FilingFee $ 1(]•00 LENDER'S S M MAILING ADDRESS Permit Fee $ /J n ARCHITECT OR ENGINEER "�Jn o. -,Ener LICENSE NO. Plan Checking Fee $ Plan Checking Fee Energy g $ ARCHITECT OR ENGINEER'S MAILING ADDRESS _ Penalty $ f. BUILDING ADDRESS L� 6 /to Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 yr�y i Solar or heat pump water heater 20.00 LOT NO. - SUBDIVISION NAME PARCEL MAP ' Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF Q Duplex❑ Mobilehome❑ Other / SPECIFY ;� Gas pipingsystem 1 - 5 outlets y 5:00 Building sewer5.00 Mobile Home S G W O.00ea TYPE OF WORK { New ❑ Addition ❑ Remodel 1 ❑ � Utilities ❑ Installation❑ IDther Describe work: -»-� Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V 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): I i ❑ 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 I, as the owner, or my employees with WflgeS as their sole compen- sation, will do the work,and the structure is not intended;or offered for sale. (Sec. 7044) " IJ1, 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 OR ADDNS. \ CONST. / ACC. BLDGS. I , DWELLING OCCUP.N\ �20sgft NEW CONSTR. MULTI -OUTLET 2,50 ea NON.RESID BRA CH CIRCU' TO POWER APPARATUS N (SINGLE OUTLET CIR. Ex. OCCUp(OUTLETS OR FIXTURES eAL930 FIXED S. OR EX. QCCUp. OUTLETS (RE 2.00 TS (RESID,) EA.) Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure: I shall not employ any person in any manner so as to become subject / to the W. C. laws of California. Notice to Applicant: If after making -this statement, should you become subject to the W. C. provisions of the Labor Code, -you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating 7 Cooling g Hood 3.00 Ventilation PermitFeer' _ Contractor $ I certify that I have read this applic6iti6h.ind 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. also agree to save, indemnify and keep.harmless the County of Butte against all liabilities—, judgm nts, cos ._and -expenses which may in any way accrue X ai w s id County i quence of the granting of this p rmyt. Date / SignatureContractor ❑ Agent 1 Applicant —2d'fO.��`Aexlcolviations An OSHA pt rmit is requ over 5'0" deep and demolition or construct- lin height. ion of structJras over 3 storiesin Mobile'Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ OCCUP. CONST.TYPE JSCI1OOLJ FLOOD PARCEL PD 1 ND 1 ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which / B �DIREC��F PUBLIC y. . �, / �fr1Y/� PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date r Receipt No. f / y 7 TC WNITE-O.P.W., YELLOW-ASSE330M, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMvkc-j 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 1.APPLICATI011 AN& PERMIT ASSESSOR PACEL NU BER ZONING BUILDING PERMIT OWNER1 e' t �� TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAI NG AD RSS '^ V ` I T COpkJ`FiACT R• NAMEELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace Iu CONST)RUCTION LENDER VNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ / ARCHI ECT OR ENGINEER 10 V70 -n LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS o \� � I Permit fee ! $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 I/1 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G I W 0.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ tllities ❑ Installation❑ Pther I Describe work: /� S !l Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP LESS 10.00 Main service EA. AOD'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 Professions 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.1 OR ADDNS. ACC. BLDGS. , /2¢sgft NEW CONSTR. U I.OUTLET NON.RESID BRANCH CIRCUITS2.50 ea) POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occup( OUTLETS OR FIXTURES NLs30 FIXED APPLNS, OR Ex. Occup. OUTLETS (RE SID.)EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. �yirin 15.00 9 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Noce 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. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g 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 to save, indemnify and kee -rmless the County of Butte against all liabilitie dg nts, cos expenses which may in any way accrue ail s quence of the granting of this p rm' . Date Signa re o Applicant — ❑ Contractor ❑ Agent An OSHA p rmit is requ ed Fo excavations over S'0" deep and demolition or construct- ion of structu sover 3 stories in he'ght. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ aCCUP. CONST.TYP6 SCHOOL PLOOo PARCEL I PD ND I ISSUE Thispermit is hereby issued under sions of the Butte County Code and/or work indicated above for wheichfs DIRE F PWORKS By PE 1 . EXPIRES Date the applicable provi- resolutions to do have been paid. ate Receipt No. WNITE-O.P.W., YELLOW-ASOCSSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville., CA 95965 Phone: 916-534-4541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. _.1. I personally plan to provide the m ' bor and materials for construction of thgpr ed property improvement (yes no) 2. ve not) signed an application for a building permit foposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I. have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed: Property Owner C_'614 Social Sec rity Num e Date NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. s r. ,.sips- l; ` •`•'1'4H; ..+i; :="'*i�•_ �.-�.�. . ' .. �r1i!i.Cn: ;�ii3awe,�rr�ts+,.�. :.rte r.;..J- ..,y• •r_ t,-:-..!ar7'ty �,}��..."�.i"•�...R��.t,. .. Permit#3655-87 Keith Stutznegger" _ - ' -80 Pinedale Ct,:ORo COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ZONINIr.•,N� 41— BUILDING PERMIT SO. FT. OCC. BUILDING VALUATION OWNER TELEPHONE OWNER'S MAILING ADDRESS CONTRACTOR'S NAMETELEPHONE e CONTRACTOR'S MAILING ADDRESS r 1,6- ' , / Fireplace CONSTRUCTION LENDER NOWN 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 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 qas water heater or vent 5.00 USE OF STRUCTURE SF [g Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home I S I G JW 1 10.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other•Q Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS t00 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW 1 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. (J /z0050C License No.T[ Classification EJ 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.a� +/ZQsgft OR ADDNS. 1 ACC. BLDGS. NEW CONSTR. (.OUTLET NO N•RESID BRANCHCIRC TS 2.50ea POWER APPARATUS tr SINGLE OUTLET CIR. E%• OCCUp(OUTLET3 OR FIXTURES SAL030 Ex. OCCUp. OUTLETS P(RESID.)REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. gel -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. ❑ 1 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 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 expen es which may in any way accrue against said County in consequencerof a gltanting of this permit. X��,��� ' / _ J f _ , Date ,/ t Signature of A Ticant — Owner ❑ Contractor ❑ Agent ❑ An OSHA p rmit 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 $ OCcUP. CONST.TYPC SCHOOL FLOOD PARCEL PD I NO 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 "r Date Receipt No. ' r WHITE-D.P.W.. YELLOW-ASSESSaR. PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS . 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PI Z ASSESSOR PAR 'E NUMBE C e `O t:�NG ��— /BUILDING PERMIT OWNER _ �� TELEPHONE ,SO, FT. OCC, BUILDING VALUATION OWNER' MZT�ING DRESS CONTRA •TO 'S N ME ITELEP ONE CONTRACT 'S MAILING ADRE Fireplace CONSTRUCTION LENDER NKNOWN Total Valuation $ 00 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 qas water heater or vent 5.00 USE OF STRUCTURE SFDuplex❑ Mobilehome❑ Other SPECIFY 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 ❑ Utilities ❑ Installation❑ Other Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 I Main service 100 AMS P ORLESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare der penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the BusinessrPOWER and Professions Co a an my license Is In full fort 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. , Business and Professions Code for this reason NEW CONST. ( DWELLING OCCU1.61) , OR A.D.S. ACC. SLOGS. /20sgft NEW CONSTR. MULTI -OUTLET NON-RESID BRANCH CIRC UITS 2.50 ea APPARATUS e `SINGLE OUTLET CIR. EX. Occup(OUTLETS OR FIXTURES e20 0 SOC ALO 30 FIXED OCCUp Ex. . OUTLETS (RESID )REAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 g d I Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. 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 Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation penult 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. I also agree to save, indemnify and keep harmless the County of Butte against all Ilabiliti judgments, costs, and expen es which may in any way accrue against County in conseq c f e anting of this permit. X Date Signature of A icant — Owner ❑ Contractor ❑ Agent ❑ An OSHA p mit is required for excavations over 5'0" deep and demolition or construct- ion of strut urea over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ OCCUP. CONST.TYPE ISCHOOLIILOODIPAIICELI—PD I ND I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR O P BLIC el By dt✓ PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS - -� Receipt No. 0 ,5 3d c WNITC-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT eautds� of �. OROVILLE, CALIFORNIA r GENERAL CLAIM CLAIMANT: E Keith Stutzinegger 8/9/82 Owner has decided not to build. (Bldg Permit Appin #2215-82B,P,E- ADDRESS: 80 Pinedale Ct. Building Permit fee paid ------------------- $130.00 CITY & STATE: Oroville, CA 95965 IMPORTANT: SEE INSTRUCTIONS DATE OF CLAIM: August $ 9 1982 , ON. REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT 8/9/82 Owner has decided not to build. (Bldg Permit Appin #2215-82B,P,E- ece1p #68933 -dated 772278Z -AP #68-35-97) Building Permit fee paid ------------------- $130.00 Checking e---- $40.00 Retain Filing Fee----------- $10.00 Refund Due-----------------------=---------- 80.00==-----$80.00. Plumbing Permit Fee Paid------------------ $20.00 Retain Filing Fee ------------------------- $10.00 Refund due----------------------------------------------- $10.00 Electrical Permit Fee Paid ------------------ $20.80 e ain Eiling Fee-------------------------- 0.00 RefundDue----------------------------------------------- 10.80 TOTAL REFUND DUE -------------------------------- -------- $100.80 $100 80 TOTAL $.100 �0' 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 co rect as stated. Dated this „day of ,,,,, ,(j, 1 et ��� 1 f,,........., Calif. , , .(,�.�t ............. .............. ...... ..... v...... ..... ... ,.....i................... ' Signature of 1. the undersigned,hereby certify that, to the best of my knowledge, the services or.articles specified above have been performed or de- livered and that there is aBudget Appropriation 0 or Specific Board Approval [D (Check one for a sa Dated this 9th da of August 1982 at Oroville Calif. . ...... ...... .................................... Y ............................. ....... .............................. r ..... .... ... ...... ....... .......... LY e ertment Heed or Authonzed u Dept. Exp Code................................ Code ................................................PAYABLE FROM ......................................................... ............... ....... ........... FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY VENDOR I CODE DEPT. & SUB. PROD• SUB. OBJ. CLAIM NO. INVOICE NO. INVOICE DATE DISC. GROSS AMOUNT ENCUMB. SUB -DIST. i 72-o o �cCk�d u:+z4 �y �wr 641 Au� .dl4i�c-lz .mac° 'ot, . M COUNTY OF BUTTE - 11EP-_iRT`'AENT OF PUBLIC WORKS PERM, NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 �' rrar APPLICATION AND PERMIT ASSE SOR PARCEL NUMBER 8 —j�— , ZONING BUILDING PERMIT ° .7�/7� :57&N/y:6e_ bj SO FT. OCC. BUILDING VALUATION ,Qa OWNERMA� 50„/'rhZ,e//0&Ve 0- CONTRACTOR'S NAME ©al/V ELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is _ 00 Filing Fee $ 10.00 LENDER'S MAILING AD SS Permit Fee $ 50,00 ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ •100 Penalty $ ARCHITECT OR ENGINEER SAILI G ADDRESS Permit fee $ ;0—. _00 BUILD�I� AD S$ /� u� d�� PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 '/ Water piping LOT NO. SUBDIVISION NAMEPARCEL MAP Each qas water heater or vent 5.00 ,OO Gas piping system 1 - 5 outlets a USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OAF WORK New ❑ Addition ,�� R�em�odel,L—'_TI/Utilities ❑ Instal latiop❑ Other ❑ Describe work: A10107— Ar b Tr) jC^"/L1 J W. Permit Fee $ �� 00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main servic00V OR LES e 100 AMP ORS SLESS 5.00 Main service EA. ADD'L 100 P 2.50 NEW CONST. DWELLING S OR ADDNS. ( ACCETI-OUTLET BLDGS. P� 29sq ft �. O CONTRACTORS LICENSE LAW I declare under penalty of perjury p y p I y (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business Professions Code and my license is in full force and effect. �-,(cense No: Classification LM Ir 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' ❑ 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 -0N5TR I -OU L T 2.50 ea NON-RESID BRA CH CIRC ITs NEW CONSTR (POWER APPARATUS &% NON-RESID, SINGLE OUTLET CIR. I Ex. Occup(OUTLETS OR FIXTURES 2i BAL and IXED APPLNS. OR EX. Occup.P(RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check 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 f Consent to Self -Insure. 1 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 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 againstoccuP. all liabilities, judgments, costs, and expenses which may in any way accrue against said ounty o e-of'tiie granting of this permit. X Date a Signor a of pplicant — w Contractor ❑ Agen An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE 70. 006- GRouP TYPE or CONST. PARCEL PD 1 ND 1 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 /over Receipt No. 6 Sg3.3 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT