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069-430-037
L A. P. J.P. WALTMAN G9-93-37 19 LaMirada Avenue, Orovi _ CONTR:' Weir `Roofing; ' Oro.— r-7- . \ Permit 3763-73B (reroof.) 069-43-0-037 r ` " u91=:415'6; " WALTMAN, BEA. CONTR: GEORGE, DON 19 LA MIRADA AVE, OROVILL REROOF/SF '• 069-430-037 MORRISON, MARVEL 06-2079 19 LA MIRADA AVE, OROVILLE Cont: GEORGE &SONS • n RE ROOF 4v- + � q- 7-oL B07-0966 069-430-037 MISCELLANEOUS Gas Reconnect RELOCATE TANK LPG /TRENCH & N 19 LA MIRADA AVE MARVEL MORRISON t 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: 19 LA MIRADA AVE Owner: Permit No: B07-0966 APN: 069-430-037 MARVEL MORRISON Issued Date: 05/02/2007 By TMP Permit type: MISCELLANEOUS 19 LA MIRADA AVE Subtype: Gas Reconnect OROVILLE, CA 95966 Expiration Date: 05/01/2008 Description: RELOCATE TANK LPG /TRENCH, (530) 589-0257 Occupancy: Zoning: AR1 Contractor Applicant: Square Footage: AMERIGAS PROPANE LP AMERIGAS PROPANE LP Building Garage Remdl/Addn 11030 WHITE ROCK RD STE 100 11030 WHITE ROCK RD STE RANCHO CORDOVA, CA 95670 RANCHO CORDOVA, CA Other Porch/Patio Total (916) 631-3133 (916) 631-3133 FEE INFORMATION DBP Gas System (enter outlets) $55.00 Total Charged: $55.00 Fees Paid: $55.00 Balance Due: $0.00 Receipt No: B2912 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 AMERIGAS PROPANE LP 717843 / A C-20 C-36 / 01/31/2008 Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that 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 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Divisio 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 a elle 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 05/02/2007 the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: Contracto s 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 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 WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: HAVE the work himself or herself or through his or her own employees, provided that such improvements ❑I 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.). r[]l.W<_E 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: LJ 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 ACE AMERICAN INSpolicy 4441627 07/01/2007 Carrier. Policy Number. ExpDate: . Contractor's License Law.). (This section nee not a comp elect if the permit is or one hundred otters ($100) or less.) ❑ I AM EXEMPT under Section B. & P.C. for this reason: ❑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' X 05/02/2007 compensation provisions of Section 370 the Labor Code, I shall forthwith comply with those Owner's Signature Date provisions. X 05/02/2007 I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Signatutg Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I 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 prop r or am =on the property owner's behalf. n 05/02/2007 CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Permittee [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) ❑ Owner 1:1 Contractor - OR; Agent for Owner gent for Contractor FILE COPY Lender's Address City State Zip . W. , BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION OFFICE #: (530)5'18-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER INFORMATION Last Name jA4 / per '_- First Name /%eve Mailing Address % L 47 �� rads Y2 City State Zip Phone 5?O S8 �p O2S Fax E-mail CONTRACTOR Name x,,12 cr1" Address / ,/_�Y A, , r 9 City C? -_L P State Zip Phot3�o g YG 62 F �30 �W-3 % E-mail �f Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City =Addtess - City Fax State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name Aar t Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE 'l h PERMIT NO. 00q-6 1 PROJECT LOCATION API O Property Address City BIN it 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 FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning Flood Zone SRA I Yes No Occ. Type Const. License De&iY Page 2 of 2 CONTRACTOR'S BOND: This license filed Contractor's Bond number 5799211 in the arr $12,500 with the bonding company SAFECO INSURANCE COMPANY -OF AMERICA. Effective Date: 01/01/2007 Contractor's Bonding History BOND OF QUALIFYING INDIVIDUAL(1): This license filed Bond of Qualifying Individual i 5799210 for TERRELL VON WESTOVER in the amount of $12,500 with the bonding cor SAFECO INSURANCE COMPANY OF AMERICA. Effective Date: 01/01/2007 BQI's Bonding History * it * Workers Compensation Information * * * This license has workers compensation insurance with the ACE AMERICAN INSURANCE COMPANY Policy Number: WLRC4441627 Effective Date: 07/01/2006 Expire Date: 07/01/200; Workers Compensation History Personnel List License Number Request Contractor Name Request Personnel Name Request Salesperson Request Salesperson Name Request © 2006 State of California. Conditions of Use Privacy Policv http://www2.cslb.ca.gov/CSLB_LIBRARY/License+Detail.asp 05/02/2007 License Detail ' ' Page 1 of 2 California Home wednesday. N alinf,orrja License Detail CALIFORNIA CONTRACTORS STATE LICEN Contractor License # 717843 DISCLAIMER A license status check provides information taken from the CSLB license data base. Before on this information, you should be aware of the following limitations: . CSLB complaint disclosure is restricted by law (B&P 7124.6). If this entity is subject tc complaint disclosure, a link for complaint disclosure will appear below. Click on the lin button to obtain complaint and/or legal action information. . Per B&P 7071.17, only construction related civil judgments reported to the CSLB are disclosed. . Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. . Due to workload, there may be relevant information that has not yet been entered ont Board's license data base. Extract Date: 05/02/2007 * * * Business Information * * * AMERIGAS PROPANE L P 11030 WHITE ROCK RD STE 100 RANCHO CORDOVA, CA 95670 Business Phone Number: (916) 631-3133 Entity: Partnership Issue Date: 01/22/1996 Expire Date: 01/31/2008 * * * License Status * * * This license is current and active. All information below should be reviewed. * * * Classifications * * * ClassI Description 0 GENERAL ENGINEERING CONTRACTOR C20 WARM -AIR HEATING, VENTILATING AND AIR-CONDITIONING C36 PLUMBING * * * Bonding Information * * * http://www2.cslb.ca.gov/CSLB_ LIBRARY/License+Detail.asp 05/02/2007 069-430-037 06-2079 / ! MORRISON, MARVEL NOTES 19 LA MIRADA AVEN, OROVILLE Cont: GEORGE & SONS RE ROOF ! I RESIDENTIAL APN: Permit No. Owner. Site Address: Contractor. _ Type of Permit: CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED T SPECIAL INSPECTION ITEMS VERIFY USE PERMlr CONDITIONS SUBSTANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE DATE JOB FINALED: SIGNATURE:' i dr S f i t Owner. Site Address: Contractor. _ Type of Permit: CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED T SPECIAL INSPECTION ITEMS VERIFY USE PERMlr CONDITIONS SUBSTANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE DATE JOB FINALED: SIGNATURE:' i dr S . =OK o = Not OK MANUFACTURED HOMES - DATE Lj PERMANENT FOUNDATION 0 SOFT -SET 1 ZoningSetbacks-Easements 2 Soils; Special MH Support Sketch 3 Sewer, Lorin -Test Fa11/C/0-Concrete 4 Wtr; Loctn Test -Easement Needed -Regulator 5 Elec Loctn-CImcs-Grad • Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap Nat Q or LPO Inch Sz Ft Lngth 7 Blckng; SzSpacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntrdy Test-Crossovers-Breakers-Clmcs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -C/O to Grade 12'Gas and Electricity Tagged 13 Tie Dowrls Q Foundation ❑ 14 Exits 15 Cert of Occupancy 16 HUD Labetfinsignia Numbers Serial Numbers i I t Drawing MISCELLANEOUS - DECKS -COVERS -CA RPO RTS•GARAGES 1 ZoningSetbadrs-Easements 2 Figs; SollsSz-DpthSpacing-CnncfrsSteel 3 Decks, Girders/Joists-Oclgng-Brcing Stairs-CuardlHandrails 4 Wood Awn; Posts-Beams-Ms�nnctrsShthg• Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice4Decal-Encisrs 6 Carports;.Wndws-Doors . 7 Electric 8 Frmg; Sills-AnchrsStuds-Rftrs Trusses 9 Siding; Mailing -Veneer -Stucco -Lath 10 Roof. Shthg-Roofing 11 Ezt; Steps -Doors -Landings 12 Braced Wall pnis 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptds/Lting; Distance -GH 5 Elec Pool Laing; 15 volts-GFI 6 Elec.Ericlsrs; Conduit Entries -Terminals -listed 7 Elec Bonding; Metal w!5'-Crcltng Egp4itr 8 Elec Grndng; Eqp wl5' Crclbng Eqp-Pool Ightg Boxes-Encisrs-pn1boards4nsultn•to Main Conduit 9 Health Dept Apptirl , 10 Plmb; Cir Test4ft Supply Test 11 U Niche , 12 Endsr, Fencing -Alarms 13 Borldmg, Diving board or Slide = Hot OK RESIDENTIAL (Single & Duplex) DATE JUNDERFLOOR DATE PLUMBING 1 ZoningSetbacks-Easements-FloodStope 53 Wtr Htr; Vent Acc-Cmbstn Air Baffle 2 Ftg Main; Soils Flet Gmd Ftg Dpth 54 Wtr Pipe; Test & Anchr-Nail Prtctn 3 Ftg Garage; Soils-Steel-Elec Gmd Ftg Dpth 55 DWV; Test Fittings & Anchr•Nail Prtctn 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth - ' 56 Shwr Pan; Test, First flr-Tub Ace 5 Stemwalts Main; Steel-Blockouts Wrapped 57 Test Tub '& Shwr, 2nd fir - Tub Ace 6 Stemwalis Garage; Steel-Blockouts Wrapped 58 Gas Pipe; Sz & Anchrs 6a Hold Downs and Special Anchrs 59 Fire Sprinkler; Test 7 Slab, Steel Wrapped 60 Yard Gas Piping 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way C10SewerTest r s� 10 UF, Gas Pipe; Sz Anchrs-Sz Test ° 4f 0�s} 11 Wtr Pipe; Test-Anchrs-RgitrService Test 12 Elec Undrgmd DATE M E C H A N -I C A L 13 Plenums & Ducts; Clmc.-MaterialSupport4nsultn 61 AC Ducts Insulin & Support " 14 GirdersSills-Anchr Bolts-Joists-Vnts-Cripples 62 Vent Fan, Exhaust abv Insulin 15 Acc & Vntltn 63 Condensate Drain & Ovrflw, Sz & Grade - 16 Insulation 64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet 65 Attic Acc & Pltfrin if Furnace in attic ;0 dd #4 DATE 15RAMING 17 Silts Proper Materials & Anchrs DATE F 1 N A L 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 66 Ext Steps -Door & SideLt Prtctn-Landings 19 Bearing Walls over Girder&A fir Nailing 67 Smoke Detector 20 Draft Stop In Walls (iat proof) 68 Furnace Vnts-Clmc-Comb, Air-Cnnctr 21 Fire Stops,'Flir•rea Ceilings -Chasers Tubs In Garage; abv flr Duds -Meth Prtctn 22 Headers & BeamsSi &•Bearing. 69 Bedroom Exiting 23 Hangers-Post'Caps Anchrs-Chnctns 70 GFl 8 Bath Fxtrs &Tub Acc-Spa 24 Ceiling Joisf-iifir Ttes-Purli�-Roof Brac Tn=Shthg 71 GFl Arc Fault 25 Ftplc Ties o. Type A Flu, . . Ic Throat CIrnc 72 Elec Trim & Subpnl, Breaker Szs & Labels 26 Attic Acc'; Sz &Rinz pitct/i-brafi Stop -Ins Baffles 73 Stairs, GuardMandraiis 27 Bdrm Wndws or Ezfting Doors -Sill lit & Dimensions 74 Frplc or Stove, Cimc-Hearth 28 Garage Fire Prtdd Framing -RC Channel 75 Elec Outlets at Wood Pnl. Int & Ext 29 Pretty Line Firewall & Opngs' , 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clmc 30 Ext Doors -One 3' -Check Gauge 3rd Story, 2 Exits 77 Elec Outlets & Rcptcls at Ktchn Counter 31 Stairs; Width-Hdrm-Rise-Run-I_andng-Fire Prtctn 78 Garage Fire Dobr, Swing -landing -Closure 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Oti&grs 79 AC Duct in Garage -Damper. 33 Siding -Naffing Veneer - 80 Wtr Htr Vnts-Cimc-Com Air Cnnctr-PRV; abv fir 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Ace Mech Prtctn; LPG Appince Undr Horse 3' drain S 35 Glazing Are PrtctnkyLts-Ptastic _ 81 Pimb• Elec & Mech Eqp Listed for Locbt 36 Shear Walls; Nailing -Bolts 82 Elec Rcptcls in Garage (GF) Romex Prtctn 37 Brace Int/Ext Wall pnls 83 Insultr Foam -Looked in Attic 38 Insultn4Nalls-Ceilings 84 Guard Rails & Deck Cnsbvtn-Post Caps 39 Infiltration-Walls-Wndws 85 Fndn Vnts & Crawl Hole Door Dmge & Wood -Earth 86 Clmc Dmge Planters Q Yes Q No 87 Stucco Brown-Ffnbsh 88 AC Unit Dscrtnct, Elec-Pimb 89 Vnts abv Roof, Plmb-Appinc-Frplc-Clmc to Opngs DATE ELECTRICAL 90 Wtr Well, Dscnnct, Elec, Pimb 40 Fxtr & Tmsfrmr Clmc-Ins Pdc n 91 Ext Elec Trim, GFl Rcptci-Undrgmd 41 Elec Rcptcis Spacing-1-ts & Switches at Doors 92 Vntltn thru House 42 Sz Boxes & No Of Cndctrs Stapled 93 Glass Prtctn 43 Romex Installed Close to Edge of Studs & CJ 94 Corrections from previous Irspc ns 44 Eqp Gmd made up w/Mech Fstnrs 95 Gas Test -Meters Tagged, Gas-aec 45 Grndng Electrode Bond Gas & Wtr 96 Wtr & Sewer Cnnctd-/O to grade -HD Apprvl 46 2 Appinc Cires In Ktchn & Cndcr Sz GFl 97 Energy Cmpinc Cert -Other Certs 47 Subfeed Wire Sz oa ED] cu or ❑AL 98 Address Posted AC Wire Sz ya Q CU or 0 AL 99 Fire Sprinkler 48 Range Clic oa Q CU or AL Oven Circ gaCU or DAL Insulated Neutral gYes 0 N �s• 49 Service -Riser Cndctrs & Gmd Main Dscnnct 50 Eqp Clmrs pnls-Motors-Meth Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector o'er vTs o'`� BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP062079 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. 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. r lj Ste' License Class: License Number: v r Date: ��"2�'00Contractor: 6 �0 F: �Uts 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 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 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, 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 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.). ❑ 1 am Exempt under Article 3 of the Business and Professions Code Date: Owner: WORKERS' COMPENSATION DECLARATION I 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 ssued. ave 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:4;44'> c 6-, 61 0 <?S• �L�n� Policy #: 0-7/3 ❑ 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 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. Date: Applicant: 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. Issued Date: 08/29/2006 APN: 069-430-037-000 Site Address: 19 LA MIRADA AVE ORO Map Index: Description: RE -ROOF (22 SQ) Owner: MORRISON MARVEL K 19 LA MIRADA AVE OROVILLE, CA 95966 530-589-5910 Applicant: GEORGE & SONS ROOFING 1090 HURLETON ROAD OROVILLE, CA 95966 530-5894443 Contractor: GEORGE & SONS ROOFING 1090 HURLETON ROAD OROVILLE, CA 95966 530-589-4443 License #: 682274 Architect: Engineer: Total Square Ft: Valuation: Census Code: .,�132e5o Z--219-OCA 0 S. F. $0.00. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resoluti n to do work indicated above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) B�1 p Ali (�} L�, f �f u t v' sL` Date: y' ) By: I� Name: PERMIT EXPIRES ON: ) 229 -vet 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 hergby 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 r document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name:c��_ f r i= ��2C� L" Signature: Date: ❑ Owner ontractor ❑ Agent for Owner ❑ Agent for Contractor n n o..:i .... -.;t ni 1A_nA — 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP062079 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under Issued Date: 08/29/2006 APN: 069-430-037-000 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.6 F' C Site Address: 19 LA MIRADA AVE ORO License Class: �3 - License Number: Date: �- 25 -dG Contractor: �f�iZG/6 .�Ui15 Map Index: Description: RE -ROOF (22 SQ) 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 Owner: MORRISON MARVEL K permit to construct, alter, improve, demolish, or repair any structure, prior 19 LA M I RADA AVE to its issuance, also requires the applicant for such permit to file a OROVILLE, CA signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 95966 7000) of Division 3 of the Business and Professions Code) or that he or 530=589-5910 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, will do the work, and the structure is not Applicant: GEORGE &SONS ROOFING pp 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 1090 HURLETON ROAD such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for OROVILLE, CA 95966 sale. If however, the building or improvements are sold within one 530-589-4443 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 Contractor: GEORGE & SONS ROOFING not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed 1090 HURLETON ROAD pursuant to the Contractors' State License Law.). OROVILLE, CA 95966 ❑ 1 am Exempt under Article 3 of the Business and Professions Code 530-589-4443 Date: Owner: License #: 682274 WORKERS' COMPENSATION DECLARATION I 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 Architect: Labor Code, for the performance of the work for which this permit Engineer: _rlssued. I haYZ ve 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:_ Total Square Ft: 0 S. F. Valuation: $0.00. Policy #: D 7/ Census Code: ❑ 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 the workers' compensation laws of California, 1 b and agree that if -I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall I forthwith comply with those provisions. �-2�-UCS Date: Applicant: 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 permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resoluti n to do work indicated above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) . n� /� Date: (1-g- acs BY 2 Name: ' PERMIT EXPIRES ON: %49 -5J Address: (Date) ❑ 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 for r document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: Signature: L uu- Date: - o�� " 0 �C_1 0 Ownerontractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 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 WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.neVdds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name - first me Address cilyorzouakL St Phone�� _ 5 / Fax E-mail APPLIC NT SIGNATURE X C)l For office u e only: CONTRACTOR Name � Xn i Addressl octo K6c.-\ _;�)ICk City Stat Zip%%% Phone 3-9 _ 3 Fax E-mail Date Approved: lic.6 Cass3 APPLIC NT SIGNATURE X C)l For office u e only: ARCHITECT/ENGINEER Name Flood Zone Address SRA I Yes City State Zip Phone Page Fax E-mail Date Approved: State License Number APPLIC NT SIGNATURE X C)l For office u e only: APPLICANT INFORMATION Name Flood Zone Address SRA I Yes City Stt, I Zip:, Phone Page Fax E-mail Date Approved: APPLIC NT SIGNATURE X C)l For office u e only: Zoning Propertyddress I1 LA M t 2tz�'dp"- Flood Zone Cross Street SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERNHT NO. BIN # LOCATION // ''PROJECT AP# Ol0 — © . '? Propertyddress I1 LA M t 2tz�'dp"- City ©eriU Cross Street WORKER'S COMPENSATION Policy Number d-7 i 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: e 'O i3. Lk, (ZTRP- F U'j 4o Sq FT- Lju+ O Garage Open Cov ❑ Structu a 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. I I Received by: • Kr. , Amount: t) 3 (. � o Bldg I I Pade 1 of 2 Receipt #: � 6Idl D Cwk0 OM Date: $_Zq 0G Sheriff Other Total REV 8-12-05 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 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 faxesl ❑ 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 manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate ❑ 7. 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. ❑ 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. Building Permit Application Without Required Clearances Form ❑ 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. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 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 KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 �.%.I3�`•�r�v�aVr'�4t?*"i'�t!.�j-.Y^i+.'�.—t�'`YVr'..�`r47''}i��"*-'^'il:N`'�'b��."iib'.�'�k'.!,�Y�ea•"'/"�•CR'`NilCisa:�_'?�"""'S4;..°ys�I K?H�,�'{'4��1��r. w'��,n�yA�,°5.'yn��;r�J�Y�t��'rr�?i��w,r�'.S"r`=1.Y,--^�l.R ��. t 069-43-0-037 91-4156 WALTMAN, BEA CONTR: GEORGE, DON 19 LA MIRADA AVE, OROVILLE REROOF/SF '5jV t ' t _ �t- . _'�''`%y�" SI�!%^rl�±i%�hH'Yty T.�4JLD.R+'�RT'" '1",'"S+. S'`,.r-.�.,�,,.Ix.�y�..�'tN"/�"`7'"'{�.!'J�vF�,ti'("14'�3'v-f`-'s"FP'>7G. .�"�"`..�%•+-.. _. n.. , COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. f f 7 County Center Drive - Orovllle, California 95985 - Telephone: 916/538.7541 APPLICATION AND PERMIT ASSESSOR PARCEL N,UMBER - .- 3 iPs-BUILDING ZONING PERMIT oWAR " 7:7M 6J10. #w1w TELEPHONE 6Q + SO. FT. OCC. BUILDING BUILDIjN/G.V�AyLUUArT�ION nK. �t•'7 Z, e" OWNER'S MAI ING �A?DDR ESS �,V, //® /1/% �Gl , N4 i / !L [!7 CONTRACTOR'S NAME I 6 co� TELEPHONE CONTRACTOR'S MAILING ADD RE S Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 15,00 LENDER'S MAILING ADDRESS Permit Fee $.j ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILD (yNJjGA/DP/]RESS _ /'^^I„ -LTA+. y. � :(rj,/`,/r., �V f': tlr' �L.�;, i�a wyv, ..r.AS'�. ?'rk•..4. ...Y,IM. .t. .-iM1 �C :i:'�3'�.w.%4.- Permit }@@ $ _ PLUMBING PERMIT `�'�—` `Fhi_n. gFee 15.00 Each Trap 1 5.00 Solar or heat pump water heater 1 20.00 LOT NO. JSUBDIVISION NAME t w- PARCEL MAP i Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SFXDuplex❑ Mobilehome❑ Other ���`` SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities[]. Installation❑ Other' Describe work: /1 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 u ' Main service 600V OR LESS 18.50 r 200A OR LESS _ Main service 200A TO IOOOA) CONTRACTORS'LICENSE LAW I declar under penalty of perjury (check one): .t_ l 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. �-�-�1� Classification f'_`�� ❑ 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-urider:Sec"""`� •= Business and -Professions Code .. for this reason �' _37.50 NEW CONST. / DWELLING OCCUPM 3.64 sq.ft. OR ACDNS. l ACC, BLDGS. NEW CONSTR. ULTI-OUTLET NON•RESID BRANCH CIRC ITS @ 5.00 POWER APPARATUS e\ (SINGLE OUTLET CIR. / Ex. Occup(OUTLETS OR FIXTURES 20 75 FIXED APPLNS, OR EX. Occup. OUTLETS (REST 0.1 EA,� I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 .. - 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 s 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. 4 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. Contractor MECHANICAL PERMIT Filing Fee .15.00 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 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 liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence,of,"the granting of this permit. %����'�� _/' �•� Date�� %�"'-�� Signature of Applicant — Owner❑ Ctractor,,R 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 S Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $Q�i/CJ HAz I DFEES I IMP I FLOOD I CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provi- sions of the -Butte County Code and/or resolutions to do ,{ n,'t P '6 work indicated above for which fels have been paid. i " 'a blRECTOR,0_F PUBLIC,sWORKS By /tel il/ �t.11i�,rii.�./� Date /'M PERMIT'EXPIRES Date �'� /4!7,�. M- r Receipt No. "f —'e- WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovllle, California 95965 - Telephone: 916/538.7541 APPLICATION AND PERMIT PERMIT 1140. ASSESSOR P RCE BZrgN -v% NG BUILDING PERMIT OW Rl /' TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS r , CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRE S r . t° Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ y00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILD G ADpRE55 Permit fee PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 �,( USE OF STRUCTURE SIXDuplex❑ Mobilehome❑ Other T� SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W 615.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other Describe work: / r— (� Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200AA 00OR LESS 2OR LESS 18.50 Main service 200ATO1000AI 37.50 CONTRACTORS LICENSE LAW I de la under penalty of perjury (check one): 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Profession ode and my license is in full f�ofrce and effect. License No. Classification C _, ❑ 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) El 1, as the owner, am exclusively contracting with licensed con ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST./ DWELLING OCCUPM OR ADONS, l ACC. BLDGS. II 3.64 sq.ft. NEW CONSTMULTI-OU NON-RESID BRANCH CIRC ITS ^ 5.00 POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 76 IXED APPLNS. OR Ex. Occup. OUTLETS (RESID.I EA.� I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00tract- Misc. Wiring g 15.00 Permit Fee $ — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. 10 1 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. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating Cooling g Hood 6.50 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 liabilities, judgments, costs, and penses which may in any way accrue against. g County in consequence the granting of this permit. X Date Signature of Applicant — Owner ontractorX Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 sstories in height. Mobile Home Installation Fee S Ener Inspection Fee $ Energy P occ CONST TYPE TOTAL FEE $®� HAz 11 FEES IMP FLOOD COF PARCEL PD HD ISSU This permit is hereby issued under the sions sions of utte Coun y C*fs work I dic ed wve DIRE OKS By PERMI EXPIRES DateD applicable provi- solutions to do been paid. to Receipt No. U o WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -I SPECTOR. GOLDENROD -APPLICANT PERMIT NUMBER - B - 3763-73B P E PERMIT EXPIRES OWNER' J. P. Waltman CNTR: Weir Roofing, Oro. LOCATION (A.P. 34-45-37 19 LaMirada Ave., Oroville A 1 pT 7- 7J } COUNTY OF BUTTE Department of Public Works c - f BUILDING INSPECTION RECORD Zoning Setback Forms Foundation Piers &.Girders Fireplace Rgh. Plumbing Bond Beam Lath & Plaster Rein. Steel Gas Piping & Test Found. Vents 4 Framing Plmg. Topout Rough Elec. Wtr. Htr. Furnace Kitchen Vent Firewall Garage Vents Sanitation & Water ELECTRIC GAS BUILDING Temporary Temporary Cert. of Occup. Final Final Final DATE REMARKS -OR CORRECTIONS COUNTY OF BUTTE Z-. DEPARTMENT OF PUBLIC WOR 7 County Center Drive — Oroville, California 95965 Telephone: 5331230, Ext. 259 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. P X W_,L/ Date ignature of Permitee or Agent Receipt No. White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -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 PUBLIC WORKS By— Date �� f Building Permit Expires Date d BUILDING Owner SO. FT. OCC. BUILDING VALUATION s Mailing A dress Fireplace Contractor I .. Total Valuation Mailing Address Permit Fee �f r Plan Checking Fee &/or Penalty Permit Fee vfl 2,00 Building Address ' PLUMBING No. @ FEE PERMIT FILING FEE $2.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. Zoning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .50 Fire Zone Fire Dept. Sa"Re4" Planning Building sewer 5.00 Plans Fee W. R/W I Encroachment Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ OTHER Permit Fee $A.A $ "— -# ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) USE OF STRUCTURE Single Family Duplex ❑ Others ❑ Range, dryer or water heater 1.00 Oven, Cook -top or space heater 1.00 Light fixtures Receps., switches & fix outlets 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 Y, Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Misc. wiring License No. Classification ❑ i am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 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. ❑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 No. @ FEE $ PERMIT FILING FEE $3.00 Heating Cooling Ventilatio rb ermit Fee 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 ,5j Instrumentotiontr�e s cm1On $0.07/$1000 Evaluation $ TOTAL PERMIT FEE $ ao - authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. P X W_,L/ Date ignature of Permitee or Agent Receipt No. White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -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 PUBLIC WORKS By— Date �� f Building Permit Expires Date d