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HomeMy WebLinkAbout072-061-011I COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT -42212t 2�4( .Odd ASSESSOR PARCEL NUMBER SEE ATTACHED ZONING BUILDING PERMIT OWNER COMCAST COMMUNICATIONS TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 4350 PELL ST SACRAMENTO CA 95838 CONTRACTOR'S NAME WESTCOAST COMMUNICATIONS 343-2473 TELEPHONE CONTRACTORS MAILING ADDRESS 140 MEYERS ST CHICO CA 95928 CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Permit Fee $ Plan Checkin Fee $ BUILDING 10 OROVIADDRESS LLE LOCATIONS SEE CHER Energy Plan Checking Fee $ $ PERMIT FEE $ LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 - Solar or heat um 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: PLACE CATV POWER SUPPLY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home IS I GI W @20.00 PERMIT FEE S ELECTRICAL PERMIT I Fling Feel 20.00 Main Service 2oIA OR LESS id 23.00 230.0 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 commencin wecon e uness anroessons oe, ( 9ith Sti7000 ) of Division 3 of thBsid PfiCd and my license is " full force and effect. ���CIRCUITS License Class — Lic. NO. OWNER -BUILDER DECLARATION I herebyaffirm under penalty of perjury that 1 am exempt from the Contractors License P nY P J ►Y P 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 reason250,00 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 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' compen ati rovisions of section 3700 of the Labor Code, I shall fo ith com w' a provisions. (� Z — ©� X Date Signature o pplicant - ❑ Owner Contractor ❑ Agent An OSHA permit is required for excavaions over 60" deep and demolition or construction of structures over 3 stories in height. Main Service TO 46. 00 WEE200A CCU000A NEW CONST. DWELLING OCCUP. SO so OR ADONS. & ACC. BUDS. 3.50FT, NEW CONS . MULTI -OUTLET @7.50 NON•RESID. BRANCH PowER APPARATUS 8 SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES B20 @ I.00 Ex. Occup. FIXED A IRE,, OR OUTLETS LNS EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ coNsr. TYPE TOTAL FEE $ 250.00 HAZ. D. FEES IMP FLOOD CDF PARCEL pp HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By61 1 PERMIT EXPIRES O the applicable provisions Resolutions to do work been paid. ,4 O Date e Receipt No.1456D WHITE-D.D.S.-B.D. CANARY-ASSESSO INK- PECTOR GOLDENROD -APPLICANT