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HomeMy WebLinkAbout069-370-010f t JOHN TOMLIN 33 Oakcrest Dr,-Oroville �. Contr: Waibel AC,, Oroville Permit #4557-78E,M(inst. heat pump & ele ser_„ch),.SF.. �069u37 0-010 '99 1814 B"'' WARDLOW' ;�'�33 Oak' Crest” Dr' , ORovVvvr e2 p 'e�reroof/SF)),.Univ rs l Roo ng��. . 0 9 370-010 �r 05' 0954 , Y; ��• "�wfFy���1 �R i BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (630) 538-7541 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 the Business and Professions Code, and my license Is in full force and effect. License Class : License Number: Dale: Contractor: 'OWNER -BUILDER DECLARATION I hereby affirm under penalty of. perjury that I am exempt from the Contractors' Stale 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 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 Slate License Law (Chapter 9.commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 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 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, wilt do the work, and the structure Is not Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' Slate License Law does not apply to an owner of properly who builds or improves thereon, and who does 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-bullder 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' Slate License Law does not apply to an owner of properly who builds or Improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' Stale License Law.). ❑ I am Exempt under Article of the Business and Professions Code. Dale: (� Owner: WORKERS' COMPENSATION DECLARATIOW I hereby affirm under penally 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 the Labor Code, for the performance of the work for which this permit Is issued. My workers' compensation insurance carrier and policy number are: Carrier: Policy 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 become subject to the 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.. Dale: V i - c Applicant: WARNING: Fallure 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. 'PERMIT NO. BP050954 Issued Date: 04/13/2005 APN: 069-370-010-000 Site Address: 33 OAKCREST DR ORO Map Index: Description: REPLACE HVAC ADD PROPANE AND GAS LINE Owner: WE'ITZE WILLIAM W & CATHERINE J 33 OAKCREST DR OROVILLE, CA 95966-9420 Applicant: WEITZE WILLIAM W & CATHERINE J 33 OAKCREST DR OROVILLE, CA 95966-9420 Contractor: AFFORDABLE AIR 14755 DENISE DR MAGALIA, CA 95954 530-877-1188 - License #: 839128 Architect: Engineer: Total Square Ft: 0 S. F. Valuation: $0.00 Census Code: CONSTRUCTION LENDING AGENCY This permit I hereby affirm that there Is a construction lending agency for the Resolutions performance of the work for which this permit Is Issued (Sec 3097 Clv.) By. Name: . PERMIT EX Address: sued under the applicable provisions of the Butte Indicated above for gyhich fees have been paid. W V Code and/or )3 O 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safely Code, which regulate the storage, handling and use of hazardous materials. O Notification In accordance with Section 19827.5 of California Health & Safely Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information Is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and stale laws relating to building construction. I acknowledge It Is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize repres nlatives of Butte County to enter upon the above mentioned property for Inspection pur ryes. tl12 Priht Name: j �i� e�l jam/— Signature: 4 Id Dale: ,O7.wner ❑ Contractor , ❑Agent for Owner ❑ Agent for Contractor - r u.... De. a ni_1R_nA nn 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE KILL BE REQUIRED AT TIME OF APPLICATION Website: www.buffecounty.net/dds "PLEASE PRINT CLEARLY" CONTRACTOR OWNER Last Name Gr Z2. Address first Name (, Address 33 Oak D r City /,1r� r I I� Stat C Zip (x, /�/ PhoneyV q_ Z� 13 Fax Elale Email bi11 aj-Pl P1 d Zizc • COm CONTRACTOR Name AAvda&Ur. Name Address Address City Stat Zip Phone f 7-L ( qv Fax Fax E-mail Address Lic. #$�1A ClassC,;tz APPLICANT NAME ARCHITECT/ENGINEER Name CityOvv, /lam Address Bldg City State Zip Phone Fax E-mail State Lice - e Number APPLICANT NAME Name fi Ca vC e/ �tva T��-1)7'. Address 32 CityOvv, /lam SC4- T Bldg Phone / Fax E-mail APPLICANT SIGNATURE X For office use only: AP# Owl- _�?7v- ow Zoning City Flood Zone Bldg SRA I Yes I No Occ. Type Const. Subdivision Name Address Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. 5 c)ns BIN # LOCATION AP# Owl- _�?7v- ow Property Address City Cross Street , %? Bldg WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: Sq. Footagel ❑ 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 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. Page 1 of 2 REV 2-24-05 Received by: Amount: Bldg _W SRA Receipt #: cp4 I :;1-6 Sheriff SMIP Date: ' �� Other Total Page 1 of 2 REV 2-24-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Impact Fees. ❑ Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in Worker's Compensation Carrier and Policy Number. duplicate. ❑ 7. Metal bidgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor 9. Letter of Signature authorization (if required). plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only).. Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530)538.7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSMILDING F0RMS\BIdgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 �.t •-L.. .. ---wr_, v-:is..-.. oz-.-,..-.z ,.. -,�•. ry v.;,k.. :._ ur..c ..s x' .^o-. r :v.acy».=.SW"'.'.a .iC:�W�"z::.:i�^'.'zara� v:�a"'�«N:""V���"'%;,!,Nf(3�T."�"'Ft��lt'�"'��.Y N '„069 "3770-'0 IV,.,99-1814'.'B , �= k ” WARDLOW,,,Onis, 1, 4� ` , `rest-Dr, . . 33.,Oak . C - V�'rer6o'f/SF�) -Universal.Roof ng 1 i Ot lit • �F COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • - Oroville, Califibrnia 05965 • Telephone (530) 538-7541 � `PER_MIT NO. (Rev. 12/96) APPLICATION AND PERMIT �";' f{ ASSESSOR PARCEL NUMBER , �Q/D C (09OWNER ZONING BUILDING PERMIT TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERS ADDRESS �6 CONTRACT? R'S NAME r TELEPHONE •��,. CONTRACTORS MAILING ADDRE$S) 11415 6 r_ , )1 CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ 4" i(o , OV ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ R^ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS Energy Plan Checking Fee $ K,11 , ' $ PERMIT FEE S LOT NO. SUBDIVISIONS NAME PARCEL MAP 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 ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: 4 — 1 r Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G W @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service zoOA 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 Professiol s Code, and my license is in full force and effect.A S'�(` License Class �_- 5� Lic. No. 1 I OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason 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. ❑ I 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 Main Service 200A TO 1000A 46.00 NEW CONST. DWa LING OCCUP. OR ADDNS. ( ACC. S. SO 3.5¢FT. MULTI.OUTLET NON-RESID. ' 97.50 POWER APPARATUS a SINGLE OUTLET Cl.. Ex. Occup. OUST OR FIXTURES Bn0 ® 1.000 Ex. Occup. ° °S RAID.°FA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE S Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ,TrI 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 become subject to workers' compensation laws of California, and agree that f I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X ��-- ' _ i Date r i ?� �l11�1 Signature of Applicant - ❑Owner 6d- Contractor ❑Agent - An OSHA permit 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 $ �3 cam" `� TOTAL FEE $ ( it . � HAZ. ,..,,. D. FE IMP FLOOD COF ......,,,,. PARCEL PO ..� HD _ , ISSU This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicat above for which fees have been paid. ? By I✓ f �lQU Date '1 / PERMIT EXPIRES ON ) ' �' J 0 6 d Deto Receipt No. WHITE-D.D.S.-B. D. ANARY-ASSESSO PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, G`aliforriia 95965 • Telephone (530) 538-7541 D PER IT N ' (Rev.i—V6) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER, I ^_ "J __J,JIJI o/ U BUILDING PERMIT . OWNER iZONING TELEPHONE VVI SO. FT. OCC. BUILDING VALUATION 4' .OWNER MA ADD CONT'S NAME TELEPHONE 3� - CONTRACT QR'S MA. A. S ♦ I CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ 1 q310 00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 33 Energy Plan Checking Fee $ $ PERMIT FEE $ �. LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF X 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 ❑ Remodel 'Utilities ❑ Installation ❑ Other ❑ Describe Work: h� 1 lJl7 �f�h.� ,� , Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home T -9 7G I W 1 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 R LESS Main Service 200.OR IESS 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 and effect.P� •�77 C. / S kq a1 License Class �•• J LIC. NO. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, 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 TO 46.00 CCU000A NEW CONST. DWELLING OCCUP. W: OR ADDNS. ( a ACC. BLDS. SO 3.5QFT. NON-RDSID MULTI.OUTLET 97,50 POWEPPARATUS a SINGLER AOUTLET CIR. Ex. Occup. OUTLET OR FIXTURES 200 1 B.L. Q .50 Ex. Occup. G'EE' A A=ID.GE. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 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 MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) j� 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 become subject to workers' compensation laws of California, and agree that f I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply wi h se provisions. X Date ul� tJ�' , lT Gl61'l 1 Si at of pplic nt - ❑ Owner W Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ cc 3 PE �-J^ TOTAL FEE $ . (D Al. D FE IMP FLOOD CDF PARCEL PD -- HD ISSU This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicat above for which fees have been paid. By ��'Date PERMIT EXPIRES ON - _ (S-�b Date Receipt No. 6- aD WHITE-D.D.S.-B.D. CANARY-ASSESSO INK -INSPECTOR GOLDENROD -APPLICANT I .COUNTY OF BUTTE - DEPARTMENT OF DPVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALT.ORNIA 95965 - TELEPHONE (530) 538-7541 PERMIT APPZ-'ICATION DATA SHEET r OWNER:�96 cn,.� ASSESSOR PARCEL NUMBER: ©%`1- 3"40 ()1 o Proposed Building Use: RA U U Building Inspector: 0,0M Date: 9,5 -9!' At time of permit application, I 4as advised the following,data moat be submitted prior to permit processing and/or issuance: Date Received By 04.. 'All have been submitted.------------------------------------------------------------------------------------ 02. Plot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------ 03. Complete plans, 3/4 sets, signed by the preparer of plans. ----------------------------------------------------- 04. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. -------- ❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------ 06. Energy Design Compliance and supporting documentation. ---------------------------------------------------- 07. Statement of Intent for Non -Heated and A/C Buildings. --------------------------------------------------------- 0 8. Hazardous Material Form. ------------------------------------------------------------------------------------------ ❑9. Manufactured Home data and installation instructions including Tie Down Specifications ------------------- 0 10. Fees of $------------------------------------------------------------------------------------- ❑ 11. Impact fees as shown on the attached schedule. ---------------------------------------------------------------- ❑ 12. California Department of Forestry plan approval/fees.--------------------------------------------------------- 1:113. -------------------------------------------------------.❑13. Flood elevation certificate. ------------------ ;-- ❑ 14. Sanitation and plot plan approval Health Department. ------------------------------------------. ❑ 15. City of Chico plumbing permit.----------------------------------------------------------------------------------- ❑ 16. Plot plan and business license approval from the City of Biggs. ---------------------------------------------- ❑ 17. Planning approval for (A) Use: (B) Parking:-------------------------- 1118. ------------------------.❑18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ----------------------- ❑ 19. Encroachment Permit for driveway (construction approval prior to occupancy). ---------------------------• 020. Pre -inspection for required. Request to Building Inspector on ❑21. Contractor's license information. (Number, Name Style, Classification). --------- -----==-------------------- E3 22. -------.❑22. Workers' Compensation carrier and policy number. ----------------------------------------------- ---------- 023. Owner -Budder Verification (Given to owner ❑, Mailed to owner 0) - -------------------------------------- 024. Letter of signature authorization. -------------------------------------------------------------------------------- ❑25. Recorded copy of Agricultural Acknowledgment Statement. ----------- -------------------------------------- El ---------;=-------------------------------------- ❑ 26. Letter of intent on building use. ----------------------------------------- -- r--------------------------------------- 027. Manufactured Home utility clearance. -------------------------------- ----------------------------------------- 028. Existing violations and/or expired permits. ---------------------------------------------------------------------- ❑29. 0433 A, OGrant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ .--------------- 030. -------------- ❑30. Other: When you issue the permit, process as follows ❑ Mail to owner, 6Mail to contractor (Date) El Telephone and hold for pickup at office. Cl Deliver spector. pplicant: Date: a JS if Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ AirAllu a n ate: By: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By: 1. Index permit application for the above items numbered: ❑Plan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Plans reviewed by: Date:, . Plans approved by: Date: Sets of plans on hold in 0 Plan Cabinet, 13 A.P. folder. Note transfer by: Date: 70M AlJ61#1 ' � s 0 T COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Telephone: 534-4541 APPLICATIN AND PERMIT AUUIun L.ti reNresentauveti of ine t,ounry or t3utte to enter upon the above-mentioned property for inspection purposes. X Signature of Permitee or Agent r Date i Receipt No. AF ' 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 F PUBLIC WORKS By 'y Date Building permit expires Date BUILDING Owner I SQ. FT. OCC. BUILDING VALUATION Mailing Address T ) r Telephone No. Contractor ' Mailing Address / i ' Fireplace Total Valuation Telephone No. Permit Fee Building Address ' Plan Checking Fee &/orPenalty Permit Fee PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 A. P. No. j % /( Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 Fees W. C.- Sanitation FireDept. FireZone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans I ParcelEach I Declaration I Parcel Map - 60' R/W Improvements additional outlet .30 Building sewer 5.00 Bldg. Plans Recd' Parcel Approval Plans Approval Lawn sprinkler system 2.00 NEW eS, ADDITION ❑ UTILITIES ❑ OTHER Permit Fee $ $ ELECTRICAL No. @ FEE 2 -PERMIT r FILING FEE $3.00 600V OR LESS Main service 100 AMP OR LESS 5•Q� Single Family ❑v Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD'L 100 AMP 2.50 OVER Main service OVER s 25.00 AMP OR LESS Main service EA. AOD'L 100 AMP 1.00 NEW CONST. DWELLING OCCUP. 4 OR ADDNS. ACC. BLDGS. 20sq ft 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 le of: style r L ` TLET NEW CONSTR. BRANCHMULTI-OCIRCUITS) NON -REBID (BRANCH CIRCUITS) 2.50ea NEWCONSTR. POWER APPARATUS B NON -RESID. (SINGLE OUTLET CIR. Ex. OccuD(OUTLETS OR FI XT ]RES BALM' Ex. Occu FIXED APPLNS. OR p•(OUTLETS (RESID.) EA) 2.00 ., Temporary service 10.00 Mobile Home Facilities 15.00 _ License No. '��� Classification-+� Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section 3700 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 permit 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 INol @ FEEPERMIT FILING FEE $3.00 Heating Cooling <, r- r' Ventilation Hood 2.00 Permit Fee $ $ /T/ 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 Land Development Fee $ TOTAL PERMIT FEE $ .• '- , AUUIun L.ti reNresentauveti of ine t,ounry or t3utte to enter upon the above-mentioned property for inspection purposes. X Signature of Permitee or Agent r Date i Receipt No. AF ' 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 F PUBLIC WORKS By 'y Date Building permit expires Date COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 Telephone: 534-4541 APPLICATIONAND PERMIT f / EQA I Parking I Parcel Parcel Ma 60' R/W I improvements Pians Declaration P B Parcel Approval Plans Approval NEW'W ADDITION E] UT ❑ OTHER Single Family Duplex Mobil Home ❑ Others ❑ 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: 11111"_41)6Pi A/'&Ol �4ne- License No. C�%n ZIV-3 Classification C -oZn 1 I am.exempt from the Contractors License Laws of the State of California. 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. 10 I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. r -1I 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 the Workmen's Compensation Laws of California. 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. X /%?.L�fi����Date 4 Signature of Permitee or`Aggent Receipt No. % 7g'16 L K) White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant _ BUILDING SQ. FT. I OCC. I BUILDING VALUATION Fireplace Total Valuation Permit Fee Plan Checking Fee&/or Penalty Permit Fee PLUMBING PERMIT FILING FEE Each Trap Repair drainage or vent piping Water piping Each gas water heater or vent Gas piping system 1 - 5 outlets Each additional outlet Building sewer Lawn sprinkler system Permit.Fee ELECTRICAL PERMIT FILING FEE Main service 600V OR LESS 100 AMP OR LESS Main service EA. ADD'L 100 AMP Main service OVER 600V 100 AMP OR LESS Main service EA. ADD'L 100 AMP NEW CONST. / DWELLING OCCUP, y $3.00 1.50 1:50 1.50 1.50 1.50 .30 5.00 2.00 $3.00 5.00 2.50 25.00 1.00 FEE .00 EX. OCCup{OUTLETS OR FIXTI1RES 50@Z59� BAL@1 EX. OCCU FIXED APPLNS. OR P•(OUTLETS (RESID.I EA) 2.00 , O Owner „hn /om2l'I Mobile Home Facilities 15.00 Mailing Address 6.25 e6 /Telephone i No. Contractor �O Mai I i ng Address oaa� z& Tale hone_No. w Building Address ` �� i_r�,S� A. P. No. L "' 3 7 Zoning & Planning F6es Vk—, Sari 191 I Fire Dept. Fire Zone Use Permit EQA I Parking I Parcel Parcel Ma 60' R/W I improvements Pians Declaration P B Parcel Approval Plans Approval NEW'W ADDITION E] UT ❑ OTHER Single Family Duplex Mobil Home ❑ Others ❑ 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: 11111"_41)6Pi A/'&Ol �4ne- License No. C�%n ZIV-3 Classification C -oZn 1 I am.exempt from the Contractors License Laws of the State of California. 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. 10 I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. r -1I 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 the Workmen's Compensation Laws of California. 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. X /%?.L�fi����Date 4 Signature of Permitee or`Aggent Receipt No. % 7g'16 L K) White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant _ BUILDING SQ. FT. I OCC. I BUILDING VALUATION Fireplace Total Valuation Permit Fee Plan Checking Fee&/or Penalty Permit Fee PLUMBING PERMIT FILING FEE Each Trap Repair drainage or vent piping Water piping Each gas water heater or vent Gas piping system 1 - 5 outlets Each additional outlet Building sewer Lawn sprinkler system Permit.Fee ELECTRICAL PERMIT FILING FEE Main service 600V OR LESS 100 AMP OR LESS Main service EA. ADD'L 100 AMP Main service OVER 600V 100 AMP OR LESS Main service EA. ADD'L 100 AMP NEW CONST. / DWELLING OCCUP, y $3.00 1.50 1:50 1.50 1.50 1.50 .30 5.00 2.00 $3.00 5.00 2.50 25.00 1.00 FEE .00 EX. OCCup{OUTLETS OR FIXTI1RES 50@Z59� BAL@1 EX. OCCU FIXED APPLNS. OR P•(OUTLETS (RESID.I EA) 2.00 , O Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 Permit Fee $ MECHANICAL N04 @ I FEE PERMIT FILING FEE $3.00 ,Di Heating 7� ,Ood 4. ID I Cooling -/ ,eDoO 67-1, . I I 1 -1160 1 Ventilation Hood 2.00 Permit Fee $ $ ` Land Development Fee $ TOTAL PERMIT FEE $ (� 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. D OF P LIC WORKS B Date 3Z 7D BeHd+ng permit expires Date — 0��3 /-7 z_