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HomeMy WebLinkAbout072-100-001N N ti 0 l 72-10-1 FDITH HENSLEY Appox 800' off NIS pri dirt rd, 800'W Feathervale, app 200'N of Canal Drive U,'ontr : Ford Electric, Oroville Permit##1410-81E (el se/ ch & clew up)SF +,&iQ � u 072'-10-0-001 �,,•,: 3�. 91•-3544 HENSLEY '1 -'ED I TH" ' -V- CONTR : ',. G &.-'T ELECTR I;6' 60. TREE, -V I EW:,YL`N; .OROV'*L_LE- ELEC SERV/SF'" 0 l OF 1 OF yam^-+ tt ` ^e��+:$T�4!.a�'�=e+vy,,7`rir,.,»rr��r�3t���::�-�+yrx.��r�wr�p:,�'s�,��aw,r�;�-�+a�� n L . : e r.'+ �. � �' i? �'r (� ..t �I Wt A - . N 1,11,0.,, ,..44- 1 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO 7 COUhtY Center Drive - OrovIlle, California 05065 - Telei)1161`1191 916,1"538-7541 _7 APPLICATION ANn PERMIT ASSESSOR PARCEL NUMB9M_ 072-100-001 ZONING AR z.5 BUILDING PERMIT OWNER EDM HWSLEY TELEPHONE SO FT OCC, BUILDING VALUATION OWNER'S MAILING ADDRESS .P.O. BOX 603 OROVILLE CONTRACTOR'SNAME G & T ELECTRIC TELEPHONE 1533-4006 CONTRACTOR'S MAILING ADDRESS P.O. BOX 1804 ORM= Fireplace CONSTRUCTION LENDER UNKNOWNNOW, Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee 15.00 Permit Fee $ ARCHITECT OR ENGINEER N= LICENSENO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS 60 TREE VIEW QRQVME Permit fee $ PLUMBING PERMIT Filing Fee 1 15.00 Each Trap 5.001 _I Solar or heat pump water heater 1 20.00F LOT NO. SUBDIVISION NAME 1 PARCEL MAP Water piping 1 7.00 Each qas water heater or vent 7.0 USE OF STRUCTURE SF Duple.M Mobilehome[:] Other SPECIFY Gas piping system 1 - 5 outlets 1 5.001 Building sewer 15.00 Mobile Home S I G I IN 015.00 1 TYPE OF WORK New FI AdditionQ Remodel E] Utilities.:!l InstallationEl Other E] Describe work: RVLACE FIRE DAMAGM 200 AMP SERVICE Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 200A OR 18.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): F;r 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, a$ the owner, or my employees with wages a$ 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 Seca Business and Professions Code for this reason Main service 200A TO I OOOA) _37.501 NEW CONST. DWELLING OCCUP.&) OR"'( ACC. BLOGS. 3.60 sq.ft. _ _W_U -LCONST NEW I L T I -OU T L E T NO N.R ESI 0, BRANCH CIRC ITS @ 5.00 POWER APPARATUS &) SINGLE. OUTLET CIR. I @ Ex. OCCUP( 20 764 OUTLETS OR FIXTURES 4AL IM drA FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00❑ 6 Permit Fee $ 48.50 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): 17 The permit is for $100.00 (valuation) or less. F-1 I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate C Onent to Self -Insure. h a IIsnot 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 Fi I ing Fee 15.00 Heating Cooling Hood 6.50 Ventilation Permit Fee I $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all Co'unty'Ordinances and State Laws relating to building construction,.and hereby authorize representatives of the County ot Butte to enter upon the above-meritioned property for inspection purposes. I also agree to save, inderiln-ify anbikeep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against saidGounty in consequence of the granting of this permit. X Date Si -fu- of Applicant El Contractor EJ Agent ❑ An permit is required for excavations over 5'0" deep and demolition or construct- ion of I structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ Occ 1 CONST TYPE TOTAL FEE $ 48.50 HAZ I D FEES-[ imp I FLOOD COF PARCEL I PD I FID ISSU LV This permit is hereby issued under the applicable proTi- sions of the Butte County Code and/or resolutions to do work,in icAlted above 11 Z A itor which ifees have been paid. DIRECTOR, OF PUBLIC WORKS By WIN ( A 0 yf­t if// J/ Date PE MIT'tXPIRES Date" ' " ff) J 9 t:� I Y, . - I �_ Ylx Receipt No. 101195 1 WHITE-D.P.W., TEL LOW-ASSE3SOR, PINK -INSPECTOR, GOLDEN POD -APPLICANT If- COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. If 7 County Center Drive - Orovllle, California 95965 - Telephone: 916,'538-7541 APPLICATION AND PERMIT ASS SSOR PARCEL NUMBER 072-100-001 ZONING AR 2.5 BUILDING PERMIT IJ OWNER EDITH HENSLEY TELEPHONE SD. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS P.O. BOX 603 OROVILLE CONTRACTOR'S NAME G & T ELECTRIC TELEPHONE 533-4006 CONTRACTOR'S MAILING ADDRESS P.O. BOX 1804 OROVILLE Fireplace CONSTRUCTION LENDER NONE UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ ARCHITECT OR ENGINEER NONE LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 60 TREE VIEW VILLE Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBD.VISION NAME PARCEL MAP Water piping 7.00 Each gas water heater or vent 7.00 USE OF STRUCTURE SF X❑ Duplex❑ 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 ❑ Additicn ❑ Remodel ❑ Utilities I Installation El Other ❑ Describe work: REPLACE FIRE DAMAGED 200 AMP SERVICE Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200AORLESS 18.50 .50 Main service 20GATO 1000AI 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): 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. Y793-31 Classification ^/d FII, as tre 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.&1 OR ADDNS, l ACC. BLDGS. I 3.6asq.ft. NEW CoNSTR M ULTI.OUTLET NON RE D. BRANCH CIRG ITS @ 5.00 POWER APPARATUS & (SINGLE OUTLET CIR. S Ex. Occup(OUTLETS OR FIXTUREFIXED 20 76d APPLNS. Ex. Occup. OUTLETS ((RESID, IREA.� I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 15.00 Permit Fee s 48.50 — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): (] The pe*mit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Cert ficate of Workmen's Compensation Insurance or a Certificate onsent to Self -Insure. I shall not employ any person in any manner so as to become subject to the N. C. laws of California. Notice to Applizant: If after making this statement, should you become subject to the W. C. prcvisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 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 ag-ee to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter Lpon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all Iia s, judgments, costs, and expenses which may in any way accrue agai t sai ounty in co uence of the granting of this permit. X Date %Q C/ Sign ure of ApFlicant — caner ❑ Contractor ❑ Agent An OSHA permi 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 $ 48.50 I1Az DFEES IMP FLOOD CDF PARCEL PD HD ISSU This permit is hereby issued under the sions of Butte County Code and/or wor ndi ted a r whic DI O PU I By PE XP S Date applicable provi resolutions to do j have been paid. ORKS Date lalkb I t Receipt No. IQJIQ5 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT �g 3�. « r �4��4r �Tr:i�'4-.��i!��, y�i�=Ai+.l�'ei�r`�'+�''�f s�Y'''kil '.."a`�i�.,,_ •. _ t y COUNTY OF BUTTE - DEPARTMENT.OWPUBLIC WORKS - BUILDING DIVISION y. 7 COUNTY CENTER DRIVE - OROVILLE,tA'CIPORN IA 95965 -.TELEPHONE: 916/538-7541 PERMIT APPLICATION'DATA SHEET llensA Permit No. OWNERAllV A. P. N i Proposed Building Useae f�'l� -u ding Inspector Date 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, 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. CI-ico Urban Area fees paid ....................................... 12. Park fees paid .................................................... i3• = School�`District fees paid .............. 14. Sanitation approval from Health Department 15. Ci -y 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 (constructsn approv I required prior to occupancy) 20. Pre -Inspection for Ma l� ✓I����� V I 0-4-Inspec. request to Building Inspector (Date) 21. Contractor's license information Y40., 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: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w. /inspector. Other Applicant Date Copy of -iaz-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. Addi':ional items required: Contractor, designer, owner, was advised of above required data by_phone__rnail_counter by ..date Contractor, designer, owner, was advised of above required data by—phone—mall—counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916.538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBERZ In f? -IDD -moo l O IN has BUILDING PERMIT D R if flenS 0- TELEPHONE S0. FT. OCC. BUILDING VALUATION OW�ji� 'S_MAII.CG ADDRESS ,3 Q &v- CO TRACTOR'S NAM — F ( TELEPHON 533_900 CO TRACTOR' M^AI ING ADDRESS _ © 1/ �� Q " Fireplace CON UCTIIOOONN'LENDER VNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ AR HITECT OR ENGINEER LICENSE No. Plan Checking Fee $ Ener Plan Checking 9Y g Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ Bul DING ADDRESSr V` O I^ov� e 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 SF `V Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.001 Mobile Home S G W @ 15.00 TYPE OF WORK New ❑ Addition Ell model ❑ Uti lyti? Installation Other ❑ Describe work: e t tNl �ocA��s�rv��ELECTRICAL Permit Fee $ Contractor PERMIT Filing Fee 15.00 main service 600VORLESS 200A OR LESS 18.50 Main service 200ATOI000AI 37.50 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 .Jo. 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 OCCUPM OR ADONS. 1 ACC. BLDGS. / 3.66 sq.tt. NE w coNSTR ULTI.OUTLET NO N.RESIG BRANCH CIRC 'ITS @ 5.00 ( POWER APPARATUS & (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 76d FIXED APPLNS. OR EX. Occup. OUTLETS IRESID.) EA.� I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 9 15.00 /5 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 a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ 1 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 FiIingFee 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. X Date Signature of Applicant – Owner [IContractor ElAgent❑ i n 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 S Energy Inspection Fee $ OCC CONST TYPE TOTAL FEES , �(� HAz 1 0FEES I IMP I FLOOD COF PARCEL PO I HO I ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date Receipt No. WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT F , rz� PE OWNER: LOCATION: [2 D �r v t e Lo CONTRACTOR: °F" 1 lo- Ct r � _----------- ______=_________________- 4 PRE -INSPECTION FOR: r e, oa , �10 v i am 0,6 U DATE ! l [ A. P. # -/L')0-OO ZONING ` a YoL G )(2- 01 111""- �&rt)1'Lc- DATE TO INSPECTOR /D / p Ae - -- --------------------------- PERMIT HISTORY: E:l NONE [Z AS FOLLOWS: f��I "' OIL4 r c LA i I t TYPE OF OCCUPANCY �S t FIELD - INFORMATION BUILDING USAGE: .� TENNANT : OCCUPIED �HAS ELECTRIC GASS SANITATION FACILITIES QZATED-COOLED PERSON CONTACTED. OTHER COMMENTS: 2 D� ACTION'RECOMMENDED: ISSUE HOLD FOR 1 OTHER: BY DATED / �/ eoA� I. 'C TY OF BUTTE DEPARTMENT }~ OF F'UdLIC WORi�\ ' PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-,4541 /it, i APPLICATION"AND PERMIT - ASSESSOR PARCEL NUMBER ZONING 1` - ' c�. /t� y OWNERR, 7� BUILDING PERMIT , �" A,l 6 f_-`!AAS� I 0A J TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS f f;fnU� icrk, CONTRACTOR'SNAME — TELEPHON/E� CON Rire4'SMVIN6'Ap�E�1���// ' I �.): SS i30' 1�1f14o��- ✓Y1�; l�cS(i! �`� 7? O r (j CONSTRUCTION LENDER V Q f� UNKNOWN Q ,AI �.Q Fireplace Total Valuation $ LENDER'S MAILING ADDRESS ARCHITECT OR ENGINEER �`���•I�` LICENSE NO. Filing Fee $ 10.00 Permit Fee Plan Checking Fee $ $ ARCHITECT OR ENGINEER'S MAILING ADDRESS BUILDING ADDRESS 1 A-,-)nr-n-V RIN8f Al 1S ((�" 1 I T ( fT , .t 0 O }'1) k a 0 4% i "C ion y raj Q Penalty $ Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap Repair drainage or vent piping 2.00 5.00 I t� 0 D-() /V a Ca,,r, -a 1 l.li' . LOT NO.- SUBDIVISION NAME PARCEL MAP Water piping Each qas water heater or vent 5,00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SFR Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 Permit Fee $ TYPE OF WORK New Addition Remodel❑ Utilities 1:1 Installation❑ OtherO Describe work: l P1` r -t Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP 00V OR ORSLESS 5.00 X~Inr� Main service EA. ADD'L 100 AMP 2,50 x v CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ,Q-'� ©'-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. j T //� / ^ License No. Classification ��I ❑I, as the owner, or my employees with wages as their sole corripen- 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. I DWELLING.00CUP.y OR ADONS.,, A ACC. BLDGS. .• ).. 20 sq ft -NEW CONSTR LouH NON-RESID" BRANC.I IRs 2.50 ea NEW CONSTR. (POWER APPARATUS S) NON-RESID. SINGLE OUTLET CIR, Ex, OCCUp OUTLETS OR FIXTURES °O O� BAL�1Cq EX. OCCU IXED APPLNS, OR p•�OUTLETS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 �% ��Y►+ t� p ►S 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. Z11 /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 shal l be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee S 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. 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 consequencelof the granting of this permit. )(�+�� /��a /�;/�� .f Date• ` Signature of Applicant — Owner❑ Contractor MY 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 $ TOTAL PERMIT FEE $ OCCUP. GROUP I TYPE OF CONST. PARCEL PD ND 59 IE 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 PUBLIC WORKS By ``ii�I/ Date ! PERMIT EXPIRES Date . 3 • 1" _ Receipt No. WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMITN 7 Count Center Drive - Oroville, CaKfornia 95965 - Telephone 916/534-4 1 APPLICATION AND PERMIT ,o -a ASSESPI PARCEL NUMBER — I -- ZON NG '-'1__-1 BUILDING PERMIT OWN E TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING A DRESS CON CTO 'S NAME TELEPHONE r ' CO RACTOR'S MAJL.ING AM SS ,� 1)f Fireplace CONSTRUC ION LEfi UNKNOWN Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER • LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 32 12 j2u� �`t C -ca -A -, r Water piping LO O. SUBDIYISION NAME PARCEL MAP Each qas water heater or vent 55,00 Gas piping system 1 - 5 outlets --� USE OF STRUCTURE SF I►S Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ::1 Remodel Utilities Installation❑ Other Describe work: ee S JC Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP ORSLESS 5.00 ^ Main service EA. ADD'L 100 AMP 2:50 NEW CONST. ODWELING R ADDNS. (ACCLBLOGS.CCUF.y) 22 sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I am licersed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License N�. Classification /1 //ems ❑ 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 NNE ON.RESID R BRANCH CIRCUITS) TS 2.50 ea NEw CONSTR. ( POWER APPARATUS e' NON-RESID. SINGLE OUTLET CIR, Ex. Occup OUTLETS OR FIXTURES s �� FIXED APPLNS. OR Ex. Occup.(OUTLETS (RESID.I EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring Q 0 7.50 .d Permit Fee $ Contractor WDRKMEN'S COMPENSATION INSURANCE I declare under penElty 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 If Consent to Self -Insure. L� ' 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 parmit shal I be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3,00 Ventilation Permit Fee S 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, an expenses which may in any way accrue againZaidounty in copse ®nc�of the anting of this permit.This Date Signature of Applican- — Owner ❑ Contractors Age ❑ An OSHA permit is squired for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ occuP. GROUP TYPE OF CONST, PARCEL PD I HD I ISSUE permit is hereby issued under sions of the Butte County Code and/or work indicated above for which D F PUBLIC By E PERMIT EXPIRES Da _ the applicable provi-X resolutions to do fees have been paid. WORKS _ a�te - Z Receipt No. ( WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT