HomeMy WebLinkAbout072-200-00593-;1987 B
a
HWY, OROVILLE'7
=FF
RFG/}, g t� 7
MISCELLANEOUS Re -Roof
( `
REROOF 16 SQ
5954 OLD OLIVE HWY
DUNN MAUREEN DOLOR T,
DUB Phillip - 509-68B
450-68E
451-68P
off eIs Olive Hwy. this side of Orovi e-
Forbestown Rd., Oroville
CONTR: Yu-Max,:Builders. Inc. P.O. Box 137
(new)sl le family) Yuba City,-- -
olY _
• i
� c� c�1
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION (IVR): (530) 538-4365
OFFICE: (530) 538-7541 FAX#: (530) 538-2140
ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds
GEORGE ROOFING
6810 LINCOLN BLVD
OROVILLE, CA 95966
(530)533-6393
GEORGE ROOFING
6810 LINCOLN BLVD
OROVILLE, CA 95966
(530)533-6393
FEE INFORMATION
DBMSC Re -Roofing $119.00
LICENSED CONTRACTOR'S DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
GEORGE ROOFING 452266 / C39 B C43 / 2/28/2008
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license
is' full force d effect. l
'X 8/1/2008
-Contractor's Signage Date
I WORKERS' COMPENSATION DECLARATION I
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
I 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.
I`HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
My Workers' Compensation insurance carrier and policy number are;
Carrier: State Fund Policy Number: 272-0000596 Exp. Dater/1/2009
(This section need not be competed if the permitis or oncehundred dollars ($100) or less.
❑I 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 the Workers'
Compensation Laws of California, and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
8/1/2008
SignMture' Date
WARNING: FAILURE TO SE RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
ATTORNEY'S FEES.
. CONSTRUCTION LENDING AGENCY
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for –
the performance of the work for which this permit is issued. (3097 civ. code)
Lender's Address City State Zip
Square Footage:
Building , Garage Remdl/Addn
Other Porch/Patio Total
Total Charged: $119.00 • Fees Paid: $119.
Balance Due: $0.00 Receipt No: B81
OWNER / BUILDER DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance,
also requires the applicant for such permit to file a signed statement that he or she is licensed
pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000)
of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
the applicant to a civil penalty of not more than five hundred dollars [$500];
Please check one of the following: .
❑1, 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 (Seca 7044, Business and Professions Code: The Contractor's License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
the work himself or herself or through his or her own employees, provided that such improvements
are not intended or offered for sale. If, however, the building or improvement is sold within one
year of completion, the owner -builder will have the burden of proof that he or she did not build or
improve for the purpose of sale.).
❑I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code:
The Contractor's License Law dows not apply to an owner of the property who builds or improves
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractor's License Law.).
❑ 1 AM EXEMPT under Section B. & P.C. for this reason:
X 8/1/2008
Owner's Signature Date
I hereby certify that I have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
injury, including death, and property damage caused by, arising out of, or in any way connected with
the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the
use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
County to enter the above mentioned property for inspection purposes. 1 hereby certify that I am the
property eQor am uthorized to act o e roparty owner's behalf.
8/1/2008
-Name of Permittee [SI Print Date
for Owneent
A
Owner 1-1 Contractor �
�R: 9 Agent for Contractor
FILE COPY
`
PROJECT INFORMATION
Site Address:
5954 OLD OLIVE HWY
Owner: •
Permit No: B08-1501
APN:
072-200-005
DUNN MAUREEN DOLOR T,
Permit type:
MISCELLANEOUS
404 FIRST ST
Issued Date: 8/1/2008 By GLB
Subtype:
Re -Roof
LODI, CA 95240
Expiration Date: 8/1/2009
Description:
REROOF 16 SQ
(209) 712-3646
Occupancy: Zoning: FR10
GEORGE ROOFING
6810 LINCOLN BLVD
OROVILLE, CA 95966
(530)533-6393
GEORGE ROOFING
6810 LINCOLN BLVD
OROVILLE, CA 95966
(530)533-6393
FEE INFORMATION
DBMSC Re -Roofing $119.00
LICENSED CONTRACTOR'S DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
GEORGE ROOFING 452266 / C39 B C43 / 2/28/2008
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license
is' full force d effect. l
'X 8/1/2008
-Contractor's Signage Date
I WORKERS' COMPENSATION DECLARATION I
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
I 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.
I`HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
My Workers' Compensation insurance carrier and policy number are;
Carrier: State Fund Policy Number: 272-0000596 Exp. Dater/1/2009
(This section need not be competed if the permitis or oncehundred dollars ($100) or less.
❑I 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 the Workers'
Compensation Laws of California, and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
8/1/2008
SignMture' Date
WARNING: FAILURE TO SE RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
ATTORNEY'S FEES.
. CONSTRUCTION LENDING AGENCY
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for –
the performance of the work for which this permit is issued. (3097 civ. code)
Lender's Address City State Zip
Square Footage:
Building , Garage Remdl/Addn
Other Porch/Patio Total
Total Charged: $119.00 • Fees Paid: $119.
Balance Due: $0.00 Receipt No: B81
OWNER / BUILDER DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance,
also requires the applicant for such permit to file a signed statement that he or she is licensed
pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000)
of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
the applicant to a civil penalty of not more than five hundred dollars [$500];
Please check one of the following: .
❑1, 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 (Seca 7044, Business and Professions Code: The Contractor's License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
the work himself or herself or through his or her own employees, provided that such improvements
are not intended or offered for sale. If, however, the building or improvement is sold within one
year of completion, the owner -builder will have the burden of proof that he or she did not build or
improve for the purpose of sale.).
❑I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code:
The Contractor's License Law dows not apply to an owner of the property who builds or improves
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractor's License Law.).
❑ 1 AM EXEMPT under Section B. & P.C. for this reason:
X 8/1/2008
Owner's Signature Date
I hereby certify that I have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
injury, including death, and property damage caused by, arising out of, or in any way connected with
the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the
use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
County to enter the above mentioned property for inspection purposes. 1 hereby certify that I am the
property eQor am uthorized to act o e roparty owner's behalf.
8/1/2008
-Name of Permittee [SI Print Date
for Owneent
A
Owner 1-1 Contractor �
�R: 9 Agent for Contractor
FILE COPY
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION M (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE M (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OF APPLICATION
APPLICANT SIGNATURE
X
For office use only: V
OWNER
Name
Philip Michael Dunn / Maureen Dunn
Address
27395 N. Kennefick Rd.
City
Galt
State CA
Zip 95632
Phone
209-712-3646
Fax
E-mail
Lic.#
APPLICANT SIGNATURE
X
For office use only: V
CONTRACTOR
Name
GEORGE ROOFING
Address
6810 Lincoln Blvd
City
Oroville
State CA Zip
Phone
(530)533-6393
Fax (530)533-0287
E-mail
dan@abcgc.com
Lic.#
Class
dan@abcgc.com
452266
1 C39
APPLICANT SIGNATURE
X
For office use only: V
ARCHITECT/ENGINEER
Name
N/A
Address
6810 Lincoln Blvd
City
Oroville
State CA Zip
Phone
(530)533-6393
Fax
E-mail
dan@abcgc.com
State License Number
APPLICANT SIGNATURE
X
For office use only: V
APPLICANT NAME
Name
GEORGE ROOFING
Address
6810 Lincoln Blvd
City
Oroville
State CA Zip 95966
Phone
(530)533-6393
Fax (530)533-0287
E-mail
dan@abcgc.com
APPLICANT SIGNATURE
X
For office use only: V
Zoning Flood Zone SRA Yes No
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
PERMIT NO.
NO. /
BP
BIN #
LOCATION
AP# - 0-� S/
Property Address
5954 Old Olive Hwy
Oroville, Ca. 95966
Cross Street
WORKER'S COMPENSATION
Policy Number 272-596
Carrier STATE FUND
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
Description or Scope of Work
Reroof - House - Com
Sq. Footage 16 sq.
❑ Structure Built Without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after
the date of application. In order to renew action on an application after
expiration, a new application, plans and fee will be required.
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who paid the
fee. The request must be made prior to the expiration of the permit and no
construction work has been done. Filing fees, plan check fees for work plan
checked and other department costs are not refundable.
Received by: Amount:
Bldg
SRA
Receipt M BUTTE
Sheriff
COUNTY
JUL 2 5 2008
SMIP
DEVF-Lo pMENI
Other
SERVICES
Date:
Total
REV: George Roofing
F p-"v�4•':1�wsR�'�',: WC2.�Yr��� _'��S+Yi�?:,� 'i
,...�,,..... _ ;, _ ,. .. .;�,..a.. r .taw..,.. rr. ' a ^e• . �'. ,'ti-•-'-tvw'1
072-20-0-005 9,3-1987 B '•
DUNN, MAUREEN "
5954 OLD•OLIVE HWY, 0.OVILLE
CONTR: GEORGE RFG..
_ REROOF/SF
j
i
61,5) y
1
f+
COUNTY OF BUTTE,- DEPARTMENT OF PUBLIC WORKS PERMIT O.
7 County Center Drive- Oroville CaWQfnia 95965 - Telephone: 916.'538-7541
APPLICATION AND PERMIT
ASSESSOR PARCEtFNUMBER
3 0742-p�00
ZONING
f Je- to
BUILDING PERMIT
oNER
t.�
TELEPHONE
,5.9.- 5
SQ. FT. OCC. BUILDING VALUATION
ORR'S MAILING ADDRESS ,
0(�'
CONTRA C T O RS NAME -TELEPHON
n, 3
CONTRACTOR'S MAILIN
/YZ5 DE
Fireplace
CONSTRUCTIOI-VLENDER / UNKNOWN
Total Valuation Is
(70
LENDER'S MAILING ADDRESS
Filing Fee
$ 15.00
Permit Fee
$ 5
ARCHITECT OR ENGINEER
LICENSE NO.
Pian Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILD 1XADDRESS
"5 !� �/d / . !I
Permit fee
$
PLUMBING PERMIT
FIIingFee 15.00
t����/� / �' ' ��7 '���
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 LXJ Duplex❑ Mobilehome❑ Other
ff \\ SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home I S I GJWJ
@ 15.00
TYPE OF WORK
New Addition Li Remodel❑ Utilities❑ InstallationC Other,
Describe work:
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 600v OR LESS
200A OR LESS
18.50
Main service 200A TO 1000A1
37.50
CONTRACTORS LICENSE LAW
I declare under penalty of of (check one):
I am licensed under provisions Of Chapt. 9, Div. 3 of the Business
and Professic s Code and my license is in full force and effect.
License .Jo. -� Classification -�y
❑ 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)
EJ I, as the owner, am exclusively contracting with licensed con
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. / DWELLING OCCUPM
OR ADDNS. 1 ACC. BLDGS. //
3.64 sq.ft.
NEW CONSTR. ULTI.OUTLET
NON.RESID BRANCH CIRC ITS
@ 5.00
/POWER APPARATUS &)
\SINGLE OUTLET CIR.
Ex. Occup(ouTLETs OR FIXTURES
20 750
FIXED APPLNS.
Ex. OCCUp. OUTLETS (RESID.)REAT
I 3.00
Temporary service
j 15.00
Home Facilities
Mobile Hotract-
15.00
Misc. g
15.00
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 15.00
Heating
Cooling
g
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 inconsequence of the granting of this permit. o
X ��/�?�r / .�"��Y✓4r/ Date -� -/�
Si nature of Applicant - owner A0—
g pp ❑ ContractAgen(An OSHA
permit is required for excavations over eep and demolition or construct-
ion of structures over 33 stories in height.
Mobile Home Installation Fee S
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $
HAz
I DFEES I
IMP
I FLOOD
I COF
PARCEL
PD
HD
ISSUE
This permit is hereby issued under the applicable provi-
Bions of the Butte County Code and/or resolutions to do
work indicated above for which fees have been paid.
EC,T,O O_F BLIC WORKS / �.,//f,
By /�"�=�� r Date 4 2 �T
PERMIT EXPIRES Date' /-/7
/ / '
Receipt No. 737 �oG
P
WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT
f
1
I
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT
7 County Center Drive - Oroville, Californiatt5965 - Telephone: 916.538-7541
APPLICATIOWAND PERMIT
ASSESSOR PARCEL NUMBER
07,9-A60—
ZONING
fie- tO
BUILDING PERMIT
OWN R
TELEPHONE
—J)"
SQ. FT. OCC. BUILDING VA UATION
O [I R'S M ILI NG AD KESS I
11, C 0 r v J
CO,y'{QTRACTOR'S NAM r
�8-
TELEPHONE
,153
CP TRACT AILING DRESS
U
Fireplace
CONSTRUCTION ENDER UNKNOWN
Total Valuation is
)
Filing Fee
$ 15.00
LENDER'S MAILING ADDRESS
Permit Fee
$C23,160-
,6
ARCHITECT
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILOI9G ADDRESS
�t
Permit fee
$
PERMIT
Filing Fee 15.00
U�PLUMBING
f
Each Trap
1 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
SFL�1 Duplex❑ Mobilehome❑ Other
l SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home I S I GJWJ
@ 15.00
TYPE OF WORK
New ❑ Addition D Remodel ❑ Utilities ❑ Installation❑ Other �
Describe work: / `_
e_
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 600VORLESS
200A OR LESS
j$,50
Main service 200A TO 1000AI
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check One):
1 am licensed under provisions of Chapt. 9, Div. 3 of the Business
Xand Professions Code nd my license is in full force d effect.
�;
License .Jo. ClassificationED
❑ 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 con
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST.(DWELLING OCCUP.&
OR ADDNS. ACC. BLDGS.
_37.50
3.64 sq.ft.
NEWCONSTR MULTI -OUTLET
NON. RESID BRANCH CIRC ITS
/1 5 00
l:
POWER APPARATUS &
(SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES
20 760
LN \
Ex. Occup. ou OUTLETS PRESID IS. REA.)
1 3.00
Temporary service
j 15.00
Mobile Home Facilities
15.00tract-
Misc. byirin g
'15.00
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.
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.
Contractor
MECHANICAL PERMIT
Filing Fee 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 Iiabilitiesl, judgments, costs, and expenses which may in any way accrue
against County in consequenp of the granting of this permit.
fJ
%� � � �� Date %�
Signature of Applicant — Owner❑ Contractor AgJr,t
-- ``
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 $
occ
CONST TYPE
TOTAL FEES G�
HAz
1) FEES
IMP
FLOOD
COF
PARCEL
PD
HD
ISSUE
This permit is hereby issued under the
sions of the Butte County Code and/or
work indicated above for which fees
D R U LI
By
PERMIT EXPIRES Dat
applicable provi-
resolutions to do i
have been paid.
WORKS /1
Dat 2'S7
Receipt No. �`7�7 ��
WHITE-O.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT