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HomeMy WebLinkAbout071-320-015G Sam Ayres 20 F E/S pri.dirt.� Cemetery Rd.,, j + Way; app .18':., Creek Rd.& Rocker`feller 'Rd.,Bald Rock Permit #4537-80E(elec.serv.for well & future lot development) i I I i I + i I SIO � � 2/ho o?. -.32 0- 0 is 4yr,�s) Sawa,, l S _ . �. map 7 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. J 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER J/- 3 G- /;a ZONING 1 ,> BUILDING PERMIT OWNER ,3p /,// rt Iy, �5 TELE,'HONE ., SO. FT. OCC. BUILDING VALUATION OWNER'SMAILING ADDRESS , CONTRACTOR'S NAME,,(,, n - TELEi!HONE CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER/ I. 11i� i;,L,4�_ UNKNOWN 1 Fireplace Total Valuation $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER) ( E L'�- LICENSE NO. Plan Checking Fee $ Penalty $ ' ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS_ �%�L�! rt_� - Ai'• lT�SO .7. �/% �f��!/r.'!:' l�r� PLUMBING PERMIT Filing Fee 3.00 1 + f . pn . 9P?. i960 EPC Fc.)act-4,sll e��. r Each Trap 2.00 Repair drainage or vent piping 2.00 ! OT 7/117'-i' S . P,641J Ck K Je0. '-j(.Fj ,.Water piping LOT NO.SUBDIVISION NAME / PARCEL MAP Each qas water heater or vent 2.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other CL -•A15 -T %f SPECIFY. Building sewer Lawn sprinkler system 2.00 TYPE OF WORK New[ Addition❑ Remodel❑ utilities El InstallationC Other r.' Describe work: X't-C47 S LeICe Y1✓•t:!-L Td�L�+� �,��(f �J% • Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 3.00 Main service ;o°°V OR o AMP ORLESS5.00 &SOD Main service EA. ADD'L 100 AMP 2.50 NEW CONST OR ACDNS. ( ACCLBLDGS.LING CCUP.&) 20sgft CONTRACTORS LICENS LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. � Classification ®W 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 -;2 ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEWCONSTNON. RESID R BRANCH CI RCT ITS 2.50ea !P1.c;0 NEW CONSTR POWER APPARATUS & NON-RESID• (SINGLE OUTLET CIR. SO a zga Ex. Occup(o OR FIXTURES BAL@IOT ITLETS Ex. OCcup.(OUT ETS XED P(RESID.)REA.) 2.00 (}� Temporary service j 10.00 ' Mobile Home Facilities 15.00 Misc. Wiring 6.25 14F P41"P Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 3.00 WORKMEN'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): 001 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. RA 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. Heating Cooling Hood 2.00 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. 1 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. U` ,�y �� �'� 1 4� X, `�+-----.- Date Signature of Applicant -U Owner ® Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Land Development Fee $ TOTAL PERMIT FEE $ �S•SO OCCUP. GROUP I TYPE OF CONST, PARCEL PD 1 ND 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. DIRECTOR OF B PUBLIC WORKS `— Date y ��"" .tel �... PERMIT EXPIRES Date •"- �'r"` Receipt No. W V/ 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 916/534-4541 APPLICATION AND PERMIT PERMIT NO ASS€ R P L ER /% ZONING -AZ_ BUILDING PERJR o3M ` ,2Es JJ/4\�I /y' r TELEPHONE 51 3 S0. FT. OCC. BU ING VALUATION D�3Q3- 9 4' g A I A/P�R !`� / r V V ®✓�/ V/ (�J �SL CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER UNKNOWN Fireplace Total Valuation $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINE LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUI DING ADDRESS S Pp/. D/P-T Pb APA 750 5. pt 1A)PIA(1 «ME7E91�' PLUMBING PERMIT Filing Fee 3.00 ' App. /86_0 E. PIG P0A)DC-P0.SA km -'y PP, Each Trap 2.00 Repair drainage or vent piping 2.00 %Soi5C= OF /AITLeS - 84519AJ e,40,e_ moi. I�KEF,e er piping LOT NO. SUBDIVISION NAME f I PARCEL MAP Each qas water heater or vent 2.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex[] Mobilehome❑ Other CT sC �' SPECIFY Building sewer Lawn sprinkler system 2.00 TYPE OF WORK New Addition Remodel❑ Utilities❑ Installation❑ Other De ribe work:L�S����E �P_ W�-L— — (V 7— Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee !000 Main service V OR LE ;Doo AMP ORSLESS 5.00 501) Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELING OR ADDNS. ( ACCLBLDGS.CCUP,&) 20sgft CONTRACTORS LICENSE LAW 1 declare under penalty of perjury (check one): ElNON I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR ULT' -OUTLET 2,50 ea D NON-RESID, BRANCH CIRC ITS NEW - CONSTR. POWER APPARATUS .&) & RESID. SINGLE OUTLET CIR ( Ex. Occup(OUTLETS OR FIXTURES a 10¢ FIXED APPLNS, OR Ex. Occup. OUTLETS (RESID.) EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 �/1/% v o Permit Fee $ , sd Contractor MECHANICAL PERMIT FiIingFee 3.00 WORKMEN'S COMPENSATION INSURANCE I decla nder penalty of perjury (check one): permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 9 Heatinhe Cooling Hood 2.00 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. also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrueT1 again aid Coun consequence of the granting of this ermit. t X Date �ci Signature of Applicant — Owner ER Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- on of structures over 3 stories in height. Mobile Home Installation Fee $ Land Development Fee $ �DISO ,_Igo TOTAL PERMIT FEE $ /8 OCCUP. GROUP TYPE OF CONST. PARCEL PD HD ssuE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF UBLIC — BY PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date w3�� Receipt No. 7 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE — DEPARTMENT OF,PUBLIC WORKS — BUILDING DIVISION 7 County Center Drive — 0roville, California 95965 — Telephone: 534-4541 PERMIT APPLICATION DATA SHEET OWNER SAM A`/)2E7-5 Proposed Building Use--`) CL -ECT Sc_ le Permit fee based upon/ Complete Contract Price 1/7 (explain) Building Inspector\ / At time of permit application, I was advised the foll issuance: Permit No. A.P. No. Z/- DPW Valuation Date 7/ -7- ng data must be submitted prior to permit processing anti/or DATE RECEIVED APPROVED 1. All items have been submitted................................................................... 2. Plot plans in duplicate/triplicate............................................................... 3. Complete plans in duplicate/triplicate................................................... 4. Complete engineered plans and talcs ..................................................... 5. Plans with Energy Design Compliance Statement ............................ 6. State Energy Forms No. .................... 7. Statement of Intent for Non -Heated & AC Buildings ................... 8. Fees of $.................................................. 9. Letter of signature authorization............................................................. 10. Sanitation approval from Health Dept.... 11. Planning apppval for ............. . /. 12. Certificate of Workmen s Compensation Insurance ........................ - Contractors -License Information (no., name style, classification) ............................... 14. Improvements may be required. Contact Land Development Section of Dept. Public Works (see addressbelow)........................................./.................................................. Pre-inspe ti n for �Cl(/ S�(/rC� re Ulr d. Pre-inspec. request to p q �1'�l5. bldg.•'nspector ther &0 I _�irs,r - - i _wffiw, When you issue the permit, process as follows: � Mail to owner Mail to contractor. lephone ��3 oi3 an shold�for pickup at office. Deliver w/inspection. Other Applicant _. �)Cz� Date Date Copy of plans sent Health Dept., Fire Dept., Other During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone Mail Other By Date Plans checked by Date Plans approved by Date OTHER: Copy/DPW U COUNTY OF BUTTE - Department of Public Works 7 County -Center Drive, Oroville, CA. 95965 Phone: 916-534-4541 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name -and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your build- ing permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed•property improvement (yes or no) 2. I (have/have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: �- _ Q Address jTU v City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work S igned : , Property Owner CIS Social �urity number ^ Date �_� % r CD NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue, the permit.