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Home My WebLink About069-430-033t - 69-43-33 Judy Myrickl;�l?$�� 49 La Mirada,Oroville ,Permit # 2858-82B(-reroof/SF) contr: Oroville Const, Oroville, 069-43.0-033-- PERMIT #97-2480 'MYRICK, Zelma 49 LaMirada.,, °Oroville Cont: Christiansen.Roofing' Reroof/SF B07-1988 069-430-033 MISCELLANEOUS Electrical MISC ELECTRICAL WIRING 49 LA MIRADA AVE MYRICK, CONNIE M LLaKEEM 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.net\dds PROJECT INFORMATION Site Address: 49 LA MIRADA AVE Owner: Permit No: B07-1988 APN: 069-430-033 MYRICK, CONNIE Issued Date: 09/20/2007 By KCG Permit type: MISCELLANEOUS 856 E ANDREWS AVE Subtype: Electrical FRESNO, CA 93704 Expiration Date: 09/19/2008 Description: MISC ELECTRICAL WIRING (559) 225-8503 Occupancy: Zoning: AR1 Contractor Applicant: Square Footage: MYRICK, RICHARD L. ADMI Building Garage Remdl/Addn 856 E ANDREWS AVE FRESNO, CA 93704 Other Porch/Patio Total (559)225-8503 FEE INFORMATION DBE Misc Residential Wiring $58.00 Total Charged: $58.00 Fees Paid: $58.00 Balance Due: $0.00 Receipt No: B4697 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county hat 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 1 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 pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. 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 X 09/20/2007 the applicant to a civil penalty of not more than five hundred dollars [$500]; PI ase check one of the following: Contractors Signature Date 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 WORKERS' COMPENSATION DECLARATION OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). ❑I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractor's License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors License Law.). Carrier. Policy Number: Exp. Date: (This section need not be competed if the permit is oror on�llars ($100) or ass. ❑ I AM EXEMPT under Section B. 8 P.C. for this reason: I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS D 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' X 09/20/2007 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owner's Signature Date provisions. X 09/20/2007- Ihereby certify that I have read this application and state that the above information is cored. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Signature y Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. 1 agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, including death, and property damage caused by, arising out of, or in any way connected with HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the perty caner or am authorized to act on the property owners behalf. G G(,�Ar V(c�/20/2007 CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Permitte [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) FP Owner [] Contractor OR: Agent for Owner 1:1 Agent for Contractor FILE COPY Lender's Address City State Zip .- BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER INFORMATION Last NameF' t Name Mailing Address k�—e City F VewU, . State ZiP9 -2,-7 C' Phone SSq— 2 Z57$So3 Fax _ E-mail CONTRACTOR Name ►4M C Ir—W A �� \ 1 Address City State Zip Phone Fax E-mail Zip Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE C) X PROJECT LOCATION API Zf 3 D Property Address d+ t City O d'o U) PERMIT NO. 7-1 BIN # 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: G t V ►' Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning I FloodZone SRA Yes No Occ. Type Const. Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. ° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal ° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. I PERSONALLY PLAN TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEMENT. &OR NO) Q9HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: ADDRESS CITY PHONE CONTRACTORS LICENSE NO 4. I PLAN TO PROVIDE PORTIONS OF THE 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 WORKr 7 4 -E I'e cl V 1 G Description: MISC ELECTRICAL WIRING Reference Number: B07-1988 Applicant Name: MYRICK, RICHARD L. ADMIN Owner's Name: MYRICK, CONNIE AP # : 069-430-033 Signature of Property Owner: ,1,1 Date: Z U ZU O:7 <., 069-430-033 PERMIT #97-2480 MYRICK, Zelma 49 LaMirada, Oroville ' 1 Cont: Christiansen Roofi g 'k Reroof /SE 1 i s • P • t i COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-754 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT D ASSESSOR PARCEL NUMBER 069-430-033 , ZONING BUIL61NG PERMIT OWNER ZELIMA MYRICK TELEPHONE SO. FT. OCC. BUILDING VALUATION 0.00 OWNER'S MAILING ADDRESS CONTRACTOR'S NAME CHRISTIANSEN ROOFING TELEPHONE CONTRACTOR'S MAIUNG ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS ' Total Valuation $ ARCHITECT OR ENGINEER UCENSE NO. Filing Fee $ 20.00 Permit Fee $ 23.00 ARCHITECT OR ENGINEERS MAIUNG ADDRESS Plan Checking Fee $ BUILDING ADDRESS S, 49 LA MIRADAI Energy Plan Checking Fee $ $ OROVILLE PERMIT FEE $ 43.00 LOT NO. SUBDNISION'SNAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑t Duplex [IMobilehome ❑ Other SPECIFY Solar or heat.pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: REROOF 14 SQ COMP Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home. S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 Main Service zoo oa v ss 23.00 LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that 1 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 License Class C`3 9 Lic. No. �i r'i"/y OWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 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. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service ( 200A To 46.00 CCU000A NEW CONST. DWELLING OCCUP. OR ( a Acc. stns. SO CNS. NEW sIOT AULTI.OUTLET - --FT. 97,50 OWER APPARATUS a SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES 20 Q 1.00 BAL @ .50 Ex. Occup. ourLEEDrs RES D.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring23.00 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. B"llhave 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' corppensation insurance carrier and policy number are: Carrier -1% 11,A/. Siw. 115+1"d Policy Number Tco t'r—s—.. 1? (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. ,% X[.�'s•�ritA Date _11//47/ �i Signature of Applicant - ❑ Owner}"ConVactor ❑Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee 7$77 Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 43.00 FEES IMP I FLOOD I CDF I PARCEL 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 �^`. B /►! :f Dat7cv PERMIT EXPIRES ONlU r i) Ip provisions to do work paid. f to Receipt No. O WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISI 7 County Center Drive - Oroville„,California 95965 - Telephone (916) 538-754 PERMIT NO. (Rev. 12/96) APPLICATIO14AND PERMIT �7 ASSESSOR PARCEL NUMBER 069-430-033 ' ZONING BUI ING PERMIT OWNER ZELMA MYRICK TELEPHONE SO. FT. OCC. BUILDING VALUATION 840.00 OWNERS MAILING ADDRESS _ CONTRACTOR'S NAME CHRISTIANSEN ROOFING TELEPHONE ' CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 23.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 49 LA MIRADA Energy Plan Checking Fee $ $ OROVILLE PERMIT FEE $ 43.00 LAT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF IK Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: REROOF 14 SQ COMP Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service 20.A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class C-3!? Lic. No. �'��j /y 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 W:L200A CCU000A NEW CONST. DWELLING OCCUP. OR ADDNS. ( 8 ACC. BLDS. SO 3.5¢FT_ NEW NON-RESDT M SCI OUTLET 97.50 POWER APPARAruS a SINGLE OUTLET CIR. EX. Occup. OUTLET OR FIXTURES p BAL @ .50 LUS. OR Ex. Occup. OUTLETSA(RRESID.) EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the rformance 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 workeorppensation insurance carrier and policy number are: Carrier 7P�,i�/ omits. 1&i Policy Number o9 9"-f — 9 (o (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. • _ X��o�fd2�i7�� Date _/I/9/� % Signature of Applicant - ❑ Owner fGontractor ❑ Agent An OSHA permit is required for excavations over 60” deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 43.00 HOZ. D FEES IMP FLOOD CDF PARCEL Po 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 B Date PERMIT EXPIRES O 0 �X� provisions to do work paid. 0 a Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT (Rev. 12/96) COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville,,,California 95965 - Telephone (916) 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER Ol y�_��3 —T `a ZONING - BUILDINGPERMIT OWNER �) - TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS ' C N7 CTOWS NAM • TELEPHONE C TORS MAJUNd ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS ' Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ LZ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS Energy Plan Checking Fee $ $ PERMIT FEE 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: +444 Gas piping system t - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service 0.v oa mss 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. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A To I000A 46.00NEW CONST. DWELIJNG OCCUP. ( NRA s0 3.5¢FT: DONS . MUAOTco�B NON-RESID. @7.50 POWER APPARATUS a swGLE OUTLET CIR. Ex. Occup. OUTLET ORFDRURES 20 100 BAL ® .30 Ex. Occup. G E A.1 OR PPLE. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirin 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 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.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, 1 shall forthwith comply with those provisions. X Date Signature of Applicant - ❑ Owner ❑ 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 $ occ CONST. TYPE TOTAL FEE $ HAZ. D. FEES IMP I FLOOD I CDF PARCEL pp HD ssUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date Date Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT I. COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS + 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION hD PERMIT PERMIT„NO. !Al ASSESSOR PARCEL Nil ,ER ' ZONING BUILDING PERMIT OWNER I � , �J r TELEPHONE SO. FT. OCC. BUILDING VALUATION - OWNER'S MAILING ADDRESSLI w CONTRACTOR'S NAME TELEPHONE" -? CONTRACTOR'S MAILING ADDRESS ' y It.,.t ,, , I , , , Fireplace CONSTRUCTION LENDER -I j-) J �' ^1 UNKNOWN Total Valuation $ Filing Fee 10.00 LENDER'S MAILING ADDRESS Permit Fee $ t,', 0, ARCHITECT OR ENGINEER Cl LICENSE N0. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDIN(G'ADDRESS) PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 V ("� Water piping LOT NO. SUBDIVISION NAME i__1 PARCEL MAP Each qas water heater or vent 5,00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF[q Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition Q Remodel ❑ Uti lities ❑ Ilnstallation❑ Other 4� Describe work:_ 1ty Ile l t�\\N ' Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 M100V OR LESS main service 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. ( DWELLING OCCUP.at 20 sq ft OR ADDNS. ACC. BLDGS. / CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): Q 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. ^'- 2 '� i) -;f � 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 NEWCONSTR -OUTL T 2.50 ea NON.R ESID BRANCH CIRC ITS NEW CONSTR. POWER APPARATUS S NON.RESID. (SINGLE OUTLET CIR. / Ex. Occup OUTLETS OR FIXTURES 5 L25 .(FIXED APPLNS. OR Ex. Occupo UTLETS (RESID.) EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 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 shal I be deemed revoked. 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 Countyot 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 Iiabilitie5, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. ` ,, X /� J �:., j7' . .r.�. Date �: ,' ; �—t may. r Signature of Applicant — Owner E Contractor 0'—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 $ TOTAL PERMIT FEE $ OCCUP. GROUP I TYPE OF CONST. PARCEL PD ND 59UE This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS BY Date ' �'�� PERMIT EXPIRES Date C� '� Receipt No. !7/9/? WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/5'&--A,541 APPLICAT6WAWD PERMIT , 7 r111111I ..�, ASSESSOR PARCEL NUMBER 6914 3-33 ZONINGPERMIT BUILDING OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER;'SfqALINJ A ssAft 'r �a O - CONT CT 0 R'S NA E ITELEPHONE MVIr CONT C O A I D ESS Fireplace CONSTRUCTION LENDER 1�1UfTRNOWN Q Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ r't On ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ r,� BUILDIN A RESS 1d�. PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE ,, SF L7- Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Additior,0 RemodPAE1 Utilities ❑ nstal lation ❑ Pther Describe work: X_ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 00V OR Main service 100 AMP ORSLESS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.a) 22 sq ft OR ADONS. ACC. BLDGS. CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): [ � I am licensed under provisions of Chapt. 9, Div. 3 of the Businesss0@250 and Professions Code and my license is in full force and effect. 0 � License No. 1-7 5-Oep 6 Classification ;�J ❑ 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 CONSTR. -OUTLET 2,50 ea NON.RESID BRANCH CIRCUITS) NEW CONSTR. / POWER APPARATUS D NON-RESID. %SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 50 BAL0100 Ex. Occup.OUTLETS FIXED P(RESID )LINIS REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 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 Consent to Self -Insure. 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. 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 expenses which may in any way accrue again County in c nsequence of the granting of this permi . X Date 2 Signature of Applicant — Owner ontroctor 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 $ TOTAL PERMIT FEE $ occuP. GROUP TYPE OF CONST. PARCEL PD I NO I ISSUE This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. IRE OF PUBLIC WORKS ,/ ByDate —C T PERMIT EXPIRES ate Receipt No. 11.9111:7 WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT