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.