HomeMy WebLinkAbout072-080-016N
I-
7 08- 6-_ ,` HARMONY BUILDERS _ 2994$ -3
LILLY VICKS% f 2396P
1921 Mt, Ida Rd, Oroville I ' j�— p�—I 12 E
Perm.t 2711-86E(upgrade ele ser/SF) 3
F'
wls Wyandotte -]LaPorte Rd. off Olive wy,0
PermI--# 44-86B(reroof/SF)16 (new, single family)
*addition
CD 12
72=08-16 91-160
- CHILIMIDOS�; Robert A Lynn.,
-1921 Mt ,ida Rd,— roville
Exemption Permit-
(store tractor &„gardening equipment)
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COUNTY OF BUTTE - DEPARTMENT OF,PUBLIC WORKS
7 COUNTY CENTER DRIVE - OROVILLE,,CA—FIFORNIA 95965 - TELEPHONE: (916) 538-7541
AGRICULTURAL BUILDING EXEMPTION PERMIT
PERMIT/NO.
Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to
house farm implements, hay, grain, poultry, livestock, or other horticulutral products. This structure shall not
be a place of human habitation or a place of employment where agricultural products are processed, treated,
or packaged, nor shall it be a place used by the public.
ASSESSOR PARCEL N0. Z2 _0S'>0_
S'>0
ZONING A
OWNER
L�l,�✓/!S G,� JLI n� 1 ISS
PHONE NO.
/V'�4
OWNER'SAMREjm S
LOCATION OF XI G / Z�;) g _
F_
/�/
USE OF BUILDING5
rm�
SIZE OF STRUCTURE
X�SQ. FT.
TYPE OF CONSTRUCTION:
WOOD FRAME STEEL CONCRETE OTHER (Specify)
TYPE OF SIDING
ROOF COVERING �
FLOOR�YPE
S�
ESTIMATED COST OF CONSTRUCTION
$
AG Buildings shall comply with the building front, side, and rear yard requirements of the applicable County
Ordinances as follows: i
FRONT �b SIDES S / REAR S /
AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields.
AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet
from a mobilehome, and 23 feet from a commercial building.
AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and
a mobilehome, and 40 feet from a commercial building.
I declare under penalty of perjury that the building will be used as stated above and the proposed use
conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will
contact the Department of Public Works and will obtain any necessary permits, inspections, and approvals to
comply with the requirements in effect at that time and before occupancy.
Date d Signature of Owner
Permit Fee - $3® The above described AG Building is exempt from a building permit.
Receipt No.
White - DPW, Yellow - Assessor, Pink - B.I., Goldenrod - Applicant
Director ofPublic ks
By �- Date
FLOOD
PARCEL
P.D.JR
ISSUE
F_
I IOOFIN
v
/_
Director ofPublic ks
By �- Date
COUNTY OF BUTTE - DEPARTMENT. -OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - ORUVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541
PERMIT APPLICATION DATA SHEET
Per' i' t w o. /
OWNER A o. 0//17
Proposed Building Use Building Inspector Date /
At time off DATE RECEIVED APPROVED
1 . All items have been submitted . emit application, I was advised the following data must.be submitted prior to permit processing and/or issuance:
(/
V........................ ..........
2. Plot plans in duplicate/triplicate, signed by preparer of plans........
3. Complete plans in duplicate/triplicate, signed by preparer. of plans . .
4. Complete engineered plans and calcs, with wet signature on plans ..
5. Hazardous Material Form ..........................................
6. Energy Design Compliance and supporting documentation .........
7. Statement of Intent for Non -Heated and AC Buildings ..............
8. Engineered truss details and layout in duplicate (required prior to plan check)
9. Mobilehome installation data including manufacturer's installation
instructions.......................................................
10. Fees of $
11. Chico Urban Area fees paid .......................................
12. Park fees paid ....................................................
13. School District fees paid ..............
14. Sanitation approval from Health Department
15. City of Chico plumbing permit .....................................
16. Plot plan and business license approval from City of
(see City for other requirements)
17. Planning approval for (A) Use: (B) Parking: ......
18. Improvements may be required. Contact Land Development Section DPW
19. Driveway permit (construction approval required prior to occupancy)
20. Pre -Inspection for required Pre-Inspec. request to
Building Inspector (Date)
21. Contractor's license information (No., Name Style, Classifications ...
22. Certificate of Workmans Compensation Insurance ..................
23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) .....
24. Recorded copy of Agricultural Acknowledgment Statement .........
25. Letter of signature authorization ...................................
26.
27.
When you issue the permit, process as follows: ail to owner. Mail to contractor.
Telephone and hold for pickup at office. Deliver w/inspector.
Other
Applicant
Copy of Haz-Mat form sent Health Dept. Fire Dept. air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submitted prior to permit issuance: (Circle new item not checked above).
1. Index permit for above items No.
2. Additional items required:
Contractor, designer, owner, was advised of above required data by_phone---nail—counter by _.date
Contractor, designer, owner, was advised of above required data by—phone —ma ll—counter by date
Plans checked by Date Plans approved by Date
Sets of plans on hold in File cabinet AP folder
Copy—DPW
Permi 2711-86E
1921
, Rd, Oro
t
_Lilly Vicks
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F125
• P COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
w- APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR, PARCEL NUM"BER
'��
ZONING
BUILDING PERMIT
OWNER '
TELEPHONE
,
SQ. FT. OCC, BUILDING VALUATION
OWNER'S MAILING ADDRESS
CONTRACTOR'S NAMES /
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS J
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP'
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF [A' Duplex❑ Mobilehome❑ Other
,I SPECIFY
Gas piping system 1 - 5 outlets
1 5.00
Building sewer
5.00
Mobile Home S I G W
10-00 ea'
TYPE OF WORK
New Add ition❑ Remodel❑ Utilities ,Instal latioln❑ Other Q'
Describe work: �r ! i + 0 r 1 ,1'" ('
&11; `j`/Y? ��
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 11001 OR LESS
100 AMP OR LESS
10.00 �7
Main service EA. ADO'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (Check One):
❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the BuslneSS
and Professions Code and my license is in full force and effect.
License No. Classification
❑4. 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 CONST. DWELLING OCCUP.ad 2�,20sgit
OR ADDNS. ACC. SLOGS.
NEW CONSTR. MULTI -OUTLET 2,50 ea
NON.RES10 BRANCH CIRCUITS
POWER APPARATUS &)
SINGLE OUTLET CIR. ) I
0t
Ex. OCCUp(OUTLETS OR FIXTURES °ALsSALO 30
FIXED APPLNS. R )
Ex. Occup. OUTLETS (RESID.)EA.2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00 J�,
f ,'- I rf ) /S
Permit Fee $ {/; /)l
Contractor
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.
O 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.
MECHANICAL PERMIT
FiIingFee 10.00
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
allliabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
1' - /
X ' �' t Date r- �! Y ��
Signature of Applicant — Owner O, Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 storiesinheight.
Mobile Home Installation Fee $
Energy Inspection Fee $
TOTAL PERMIT FEE $ 41� ' f
_CO
occIJ P.
x ST.TYPE
I
IFLOODIPARCELI
PD
[735UF-
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OFPUBLIC
_
By V —�*. _ _ 1*
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Receipt No.
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE
'" DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751•
7 County Center Drive, Oroville — Phone: 53411541
Skywa- and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 -
CORRECTION NOTICE
I it t c -A �--q:�
/1
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correcticn of work is completed. If you have any question pertaining to this
Inspector_ Date 9 t� v
17
KI
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
" 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT NO.
ASSE PAR E UMBE
_
ZONING
BUILDING PERMIT AV V
OWNC
I � �h � . /
TELEPHONE
. I
SO. FT. OCC. BUILDING VALUATION
OWN 'S A L G AD ESS
U171± 44 AV. 0t
CONT CT R'S NAME
ELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE No.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS t
/ ) Kell
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
,_..
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5,00
USE OF STRUCTURE
SF,[r Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home I SFGTw7--]
10.00 ea
TYPE OF WORK
New ❑ Addition ❑ rg odeI ❑ Uti ities n al lati n ❑ Other
Describe work: ✓� aC C G r I, _
r _ 0� pvl
Permit Fee
$
Contractor .
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 6001 OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE 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
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 CONST. DWELLING OCCUP.�
OR ADDNS. ACC. BLDGS.
, /20sgft
NEW CONSTR. ULT' -OUTLET
NO N.RES,. BRANCH CIRCUITS
2,50 ea
POWER APPARATUS &)
(SINGLE OUTLET CIR. /
Ex. Occu
Occup(OUTLETS OR FIXTURES
e®90Q
AL930
FIXED APPLISIS
Ex. OCCUp. OUTLETS ((RESID )REA.)
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. 4Virin
15.00
%I
Pfermit Fee It
$
Contractor
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 shall be deemed revoked.
MECHANICAL PERMIT
Filing Fee 10.00
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.
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_Countmisecionce of the granting of this permit.
Date
Signature of plicant - Owner K Contractor ❑ Agent ❑
An OSHA pe mit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in he' ht.
Mobile Home Installation Fee $
Energy Inspection Fee $
TOTAL PERMIT FEE $
OCCUP.
CONST.TYPEJ
P1.000
PARCEL
I PD
I H0 I ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which fees
D TORO PUBLIC
By L 44
PERMIT EXPIRES Date_
the applicable provi-
resolutions to do
have been paid.
WORKS
LO
DA --�—
Receipt No. oCIE
WNITC-D. P. W., YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT
ff
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION /
7 COUNTY CENTER DRIVE - OROVILIrEjtG-AL<;IFORNIA 95965 - TELEPHONE: 916/534-4541
PERMIT APPLICATION DATA SHEET
OWNER
Proposed Building Use
Permit Fee Based Upon: Complete Contract Price
Permit No.
A. P. No.
DPW Valuation
Building Inspector ��? r �J/ �%AW Date ZZ111 %S
At time of permit application, I was advised the following data must be submitted prior to permit processing
and./or Issuance: 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 calcs. . . . . . . . . .
5. Plans with Energy Design Compliance Statement. . . . . .
6. CUSD "Fees Paid" Stamp on Floor Plan . . . . . . . .
7 Statement of Intent for Non -Heated and AC Buildings.
8. Fees of $ . . . . . . .
9. Letter of signature authorization. . . . . . . . . . .
10. Sanitation approval from Health Dept.
11. Planning approval for (A) Use: (B) Parking:
12. Certificate of Workmen's Compensation Insurance. . . . . .
13. Contractor's License Information (no., name style, classif.)
14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ )
1 Improvements may be required. . . . . . . . . . .
�# Mobilehome Installation ata. . . . . •
7. Pre -Inspection for �Q C� ✓ I C--- Re uired.•Pre-Inspec. request to r.
p q Building Inspector
246
18. Recorded copy of Agricultural Acknowledgment Statement. . .
19. Other
When you issue the permit, process as follows: Mail to owner. it to contractor.
Telephone • and hold for pickup at office. Deliver w/inspector.
Other
'Applicant A4VL4_e_ Date
Copy of plans'sent Health Dept., Fire Dept., Other Date
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 f Date
Plans checked by Date
Plans approved by ;Date
Other:
Copy—DPW
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 Signa=ure.
Please complete and return this information at your.earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit
will
be issued until this verification is received.
/� 1. 1 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 wore.
3. I have contracted with the following person (firm) to provide the proposed
construction:
Name
Address 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
Signed:
G� .
Property Owner
/ ,Social Secu ity u�ber
Date i
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 per-
mitted to issue the permit.
COU Y OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 Cb ty `er Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
ASSE PAR E UMBE
'ZONING
BUILDING PERMIT
OWN 7j
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWN �S A _ G AD ESS
f
CONT T R'S NAME
L)
ELEPHONE
CONTRACTOP.'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
VNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee
$ 10.00
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS -
Penalty
$
BUILDING ADDRESS
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
_
Solar or heat pump water heater
20.00
LOT NO.
SU IVISION NAM
PARCEL MAP
Water piping
5,00
Each pas water heater or vent
5.00
IV OF RUCTURE
OF
SF� Du Ex obi a er
/' SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Home S I G I W
10.00ea
T OF WO
New ❑ Add n ❑ i ❑ Uti it s n tallat n ❑ i Other
Describe ork: C- Y !; _
D�?(
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 10001 OR 0 AMP LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
CO T T S LICENSE LAW
I declare undef pen Ity f p check one):
❑ I am lic ed r provisions of Chapt. 9, Div. 3 of the Business
and Pro a io de and my license is in full force and effect.
License Classification
I, as the o nen, or my employees with wages as their sole compen-
sation, w 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 CONST. DWELLING OCCUP.ad`
OR ADDNS. � ACC. BLDGS. / �20sgft
NEW CONSTR U TI.OUTLET 2.50 ea
NO N.RESID BRANCH CIRC ITS
POWER APPARATUS y�
SINGLE OUTLET CIR.
Ex. OCcup(OUTLETS OR FIXTURES 20030!
eAL030
FIXED
Ex. Occup. OUTLETS PRESID )REA.1 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. bYirin 15.00
- h,
ermit 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
a Cer.ificate of Workmen's Compensation Insurance or a Certificate
of Corsent to Self -Insure. i
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 tris permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
Heating
tCooIin g
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 uoon 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 sal Count i o seq nce of the granting of this permit. D/
Date �-�� — 8l�
Signature of plicant — Owner 5Q Contractor ElOwner❑
An OSHA pe mit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in he'.ght.
Mobile Home Installation Fee $
Energy Inspection Fee $
TOTAL PERMIT FEE $ `Q
Occup.
CONST.TYPEJ
I
I FLOOOJPARCELJ
Po
ND
ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF PUBLIC
BY
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Receipt No. -
WHITE-D.P.W., •EL' -OW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
nib= Permit#2944-86
Lillie Vick
1921 Mt Ida.Rd',
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL,NUMBER
9, _ )
ZONING
BUILDING PERMIT
OWNER J% 1 J `
I,
/ I � (f// � //�
TELEPHONE
SQ. FT. OCC._. BUILDING VALUATION
/) � %
OWNER'S MAILING %TJ � I � 1 e_ ! A• Dvl /// /
CONT(RA'CTOR'S NAME
,l�'
1I1 rIc
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ r ;'
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
,$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee .$
1%/,
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
��' nth/�a
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF 0 Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G I W
1 10.00 ea
TYPE OF WORKrr��II
New ❑ Addition ❑ Remodel ❑ Utilities u, Installation ❑ Other [
Describe work: f'i� A �.- �� �.i / yi�rYl % _
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 6101 OR LESS
100 AMP OR LESS
10.00
Main service EA, ADO'L 100 AMP
2.50
CONTRACTORS LICENSE 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
V1, 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-
ontract-
ors.(Sec. 7044)
ors.
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW OR ADONS. CONST. ACC. BLDGS. DWELLING OCCUP.&)
'/zlEsgft
NEW CONSTRMULTI-OUTLET
NON.RESID BRANCH CIRC ITS
2,50 ea
/POWER APPARATUS e
(SINGLE OUTLET CIR.
EX, Occup(OUTLETS OR FIXTURES
z0eaoe
SALO 30
FIXED
Ex. P(RESID )APLNS.REAJ
Ex. Occup. OUT LE
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00
Permit Fee
$
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
Q The permit is for $100.00 (valuation) or less.
Q 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.
MECHANICAL PERMIT
Filing Fee 10.00
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 riepresentatives 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, sand expenses which may in any way accrue
against said County in consequence of the granting`of this permit.
X / r` ` r ,
Date / ' '� /
Signature of Applicant —r Owner ❑ %.Conrracro� ❑ Agent ❑'
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over3•stories in height./Receipt
Mobile Home Installation Fee $
Energy Inspection Fee $
TOTAL PERMIT FEE $ () 6
Occup.
CONST.TYPE
FLOOD
PARCEL
PD
HD
ISSUE
s oins permit
the (Butte Countyued Code under
work indicated above for which fees/
/^� DIREC�ILIb
By/// �a� ./
PERMIT EXPIRES Date
therovi
solutiions icable to do
have been paid.
WORKS
Date
//- /� y
No. � 7
WHITE-D.P.W., YELLOW -Ase E3SOR, PINK -INSPECTOR, COLD ENROD-APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, Cagh1orniaV5965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT N0.
9l
ASSESO.R PAR LIM 1E
ZONING
BUILDING PERMIT
OWNtR,1
lE
TELEPHONE
SO. FT. OCC.o�%BUILDING VALUATION
—OWN 'S MAILING RESS
._
4d
CONTR C OR'S NAE
C—V
TELEPHONENE
C NTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
`
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
5,00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF�r Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home is G W
10.00ea
TYPE OF WORK �/
New ❑ Addition Elemodei [I Utilities Ins lation❑ Other I J4.
Describe work: i`
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 6101 OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ 1 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-
ontract-
ors.
ors.(Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUP.tr ,
A ) h2sgft
NEW
CCONSTR.� ULTBI OUTLET
NO N.RESID BRANCH CIRC ITS 2.50 ea
POWER APPARATUS &)
%SINGLE OUTLET CIR.
20050t -
Ex. Occu
Occup(OUTLETS OR FIXTURES BAL0AL03030
FIXED APPLNS. OR
Ex. Occup. OUTLETS (RESID.) EA./ 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. byirin 15.00
g
Permit Fee $
Contractor
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 shall be deemed revoked.
MECHANICAL PERMIT
Filing Fee 10.00
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
against said County in con uen9p of the granting of this permit.
°
X � - Date D %
Signature of Applicant — Owner El 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 $
Energy Inspection Fee $
TOTAL PERMIT FEE $ , O
Occup,
CONST,TYPEJ
I
I FLOoo
PARCEL
PD
ND
ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRE PUB
B
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
C ORKS
Date O
Receipt No.
WNIT!-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
,
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 sigiature.
Please complete and return this information at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit
will be issued until this verification is received.
1. I personally plan to provide the major labor and mater'als for construction of
the proposed property 'mprovement (yes or no)
2. I (have/have not signed an aplication for a building permit
for,the proposed work.
3. I have contracted with the following person (firm) to provide the proposed
construction:
Name
Address 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
Signed:
Property Owner
Social Security b/er
Date l�'- �'- (p
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 per-
.nitted to issue the permit.