Loading...
HomeMy WebLinkAbout073-140-00173 14-01 F�'% illiam H. Holmes 4avl'W side of Oro-ForbestoHy., miles "past Miners Ranch Rd., Oroville Permit ##4462-75P,E (util./MH) ELEC. GAS SUPPORT STRUCTURE REQ. COMPACTION TEST REQ i 73-14-1} Permit #6538778B,P,E(couered deck-& ramada/t ave ,tra' er 73-14-1 Contr: Solar Sun -King, Marysville Permit#4930-80P,E(solar w/h system)SF 073-140-001 PERMIT#95-1540 HOLMES, William & Marce 3915 Forbestown Rd., Forbestown Cont;.George RoofingA. 1 Reroof/SF 073-140-001 06-1458 BENITREZ, RUSS 3915 FORBESTOWN RD, QROVILLE Cont: CHICO ELEC/ ELEC-200 AND 6 �'! •O'! B07-0196 073-140-001 MISCELLANEOUS Electric Panel REPAIR ELECTRIC PANEL & MAST 3915 FORBESTOWN RD«C RUSS, BENITREZ E ,0 �Z HOLMES, Bill 569-66B 6 581-66P i , 3- 14- 01 -_66E w/s Oro-Forbestown Rd. 9001 no. o spring (new singl family) t i3 , . 1 � 4 r f 73 14-01 F�'% illiam H. Holmes 4avl'W side of Oro-ForbestoHy., miles "past Miners Ranch Rd., Oroville Permit ##4462-75P,E (util./MH) ELEC. GAS SUPPORT STRUCTURE REQ. COMPACTION TEST REQ i 73-14-1} Permit #6538778B,P,E(couered deck-& ramada/t ave ,tra' er 73-14-1 Contr: Solar Sun -King, Marysville Permit#4930-80P,E(solar w/h system)SF 073-140-001 PERMIT#95-1540 HOLMES, William & Marce 3915 Forbestown Rd., Forbestown Cont;.George RoofingA. 1 Reroof/SF 073-140-001 06-1458 BENITREZ, RUSS 3915 FORBESTOWN RD, QROVILLE Cont: CHICO ELEC/ ELEC-200 AND 6 �'! •O'! B07-0196 073-140-001 MISCELLANEOUS Electric Panel REPAIR ELECTRIC PANEL & MAST 3915 FORBESTOWN RD«C RUSS, BENITREZ E ,0 �Z HOLMES, Bill 569-66B 6 581-66P i , 3- 14- 01 -_66E w/s Oro-Forbestown Rd. 9001 no. o spring (new singl family) t i3 , . 1 � 4 073-140-001 06-1458 V e _ BENITREZ, RUSS IN O T E S 71-3915 FORBESTOWN RD, OROVILLE Cont: CHICO ELEC I' ELEC-200 AMP RES IDEiNTIAL I . APN: Permit No. Owner. I Site Address- ; Contractor. II Type of Permit i t I OFFICE COPY AM SS GAS Meter By Date i ELECTRIC / Meter By / I � 1 Date ,ice% SPECIAL CONDITIONS CHECKED BY 0 SRA 0 FLOOD CERTIFICATE EQUIRED ❑ FIRE SPRINKLERS REQUIRED1 Q SPECIAL INSPECTION ITEMS yy y Q VERIFY Q USE PERMIT CONDITIONS Q SUBSTANDARD HOUSING LETTER 5 Q ENCROACHMENT PERMIT Q REINSPECTION FEE PAID ❑ ENV HLTH CLEARANCE 0 f DATE JOB FINALED; ` 111d7 SIGNATURE: BUTTE COUNTY PERMIT NO. DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT BP061458 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE M (530) 538-7541 B. C. Building Permit 01-16-04 pg 1 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 06/19/2006 APN:O73-140-001-000 the Business and Professions Code, and my licenseis in full force and effect' . Gj �L l License Class License Number: S I Site Address: 3915 FORBESTOWN RD ORO : Date: 6 Zl� 6 Contractor: co L%c-�,Qic Map Index: Description: ELECTRIC SERVICE UP -GRADE TO 200 OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the AMP Contractors' Stale License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which 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 Owner: BENITREZ, E. RUSS signed statement that he or she is licensed pursuant to the provisions of 3915 FORBESTOWN RD the Contractor's State License Law (Chapter 9 commencing with Section OROVILLE CA 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 95966 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).): ❑ 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 (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: CHICO ELECTRIC owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees. provided that such improvements are not intended or offered for 36 WEST EATON ROAD sale. If however, the building or improvements are sold within one CHICO, CA 95973 year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose,of (530) 891-1933 sale.). ❑ I, as owner of the property, am -exclusively contracting with licensed. contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: CHICO ELECTRIC and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 36 WEST EATON ROAD ❑ 1 am Exempt under Article 3 of the Business and Professions Code CHICO, CA 95973 Date: owner: (530) 891-1933 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: License #: 454345 ❑ 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. Architect: ❑ 1 have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 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: aC 14 I -A tnS U Nt:1✓ %rY10�" '7 � 'Z ��/ Total Square Ft: 0 S. F. ' Policy #: -D6 � �-� Valuation: $0.00 I certify that in the performance of the work for which this permit is Census Code: 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 provisions. , Date: Applicant: WARNING: Failure tos re workers' compensation coverage is unlawful, and shall subjec an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation; damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. C.CI ��• �� CONSTRUCTION LENDING AGENCY This permit is hereby Issued under pp cable provisions of the o tla County Code and/or I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) . Resolutions to o work indicated bov for which fees have been paid. r Name: By: Date: PERMIT EXPIRES ON:. Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. O Attached are copies of the required E.P.A. notification forms. I hereby certify that I have -read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of agy officialdo utte County. I hereby' authorize represhntatives of Butte County toenter upon the above mentioned property for inspection purposes Print Name: \.4�V�C.Ir Signature: Date: ❑ Owner ❑ Contractor ❑ Agent for Owner Qf{G[ Anent for Contractor B. C. Building Permit 01-16-04 pg 1 BUTTE COUNTY AREA DEPARTMENT OF DEVELOPMENT SERVICES 2 INSPECTION CARD MUST BE ON JOB SITE 24 Hour Inspection Line: (530) 538-7636 (Oroville) (530) 891-2834 (Chico) Office: (530) 538-7541 Fax: (530) 538-2140 Website: www.buttecounty.net/dds Permit No: B07-0196 Issued: 02/01/2007 Address: 3915 FORBESTOWN RD Area: OROVILLE Owner: RUSS, BENITREZ E APN: 073-140-001 Applicant: CHICO ELECTRIC Map Page: Permit Type: Electric Panel Description: REPAIR ELECTRIC PANEL & MAST Flood Zone: None SRA Area: Yes Side Setback: Other Setback: Setback From Centerline of Street: ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING Inspection Type IVR INSP DATE Setbacks 132 Foundations / Footings 111 Pier/Column Footings 122 Grade Beams 114 Eufer Ground 216 Forms/Steel/Holdowns 122 Do Not Pour Concrete Until Above are Signed Pre-S;—-------------------COPY-------------F Gas 1 OFFICE COPY Bldg Permit: M GasI Masoi Address: Masol Undei Unde% GAS By: Date. Sheari Electric By: �� Datz Undei Under` -Slab Plumbing _ 411 Gas Piping 403 Do Not Install Floor Sheathing or Slab Until Above Signed Holdowns/Straps 122 Shearwall/B.W.P.-Interior 135 Shearwall/B.W.P.-Exterior 135 Roof Nail/Drag Trusses 129 Do Not Install Siding/Stucco or Roofing Until Above Signed Rough Framing 128 Rough Plumbing 406 Rough Mechanical 316 Rough Electrical 208 Gas Piping 403 Shower Pan/Tub Test 408 Fire Sprinkler Test 702 Fire Sprinkler Final 702 Finals Building Final 802 Electrical Final 803 Mechanical Final 809 Plumbing Final 813 Pool Final 802 Mobile Home Final 802 Inspection Type 1 IVR I INSP DATE Do Not Insulate Until Above Signed Wall Insulation 117 Ceiling Insulation 118 Do Not Cover Until Above Signed T -Bar Ceiling / RC 145 Stucco Lath 142 Stucco Scratch 143 Stucco Brown 144 Swimming Pools Setbacks 132 Pool Plumbing Test 504 Gas Test 404 Pre-Gunute 506 Pool ElecBonding/Light Nitch 502 Pool Fencing/Alarms/Barriers 503 Pre -Plaster 507 Manufactured Homes Setbacks 132 Blocking/Underpining 612 Tiedown/Foundation System 611 Site Utilities/Trench Insp. 137 Gas Test Yard 404 Manometer Test 605 Continuity Test 602 Skirting/Steps/Landings 610 Coach Info Manufactures Name. Date of Manufacture: Model Name/Number: Serial Numbers: Length x Width: Insignia: Public Works Fina 538-7681 Fire Department/CDF 538-7111 Env. Health Final 538-7281 Sewer District Final **PROJECT FINAL 1 801 � rrolect rinai is a 4-ernucaie of vccupancy for (xesiaennai unry) PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE. IF WORK HAS COMMENCED, YOU MAY PAY FOR A 1 YEAR RENEWAL 30 DAYS PRIOR TO EXPIRATION Inspector Copy JI = OK MANUFACTURED HOMES MISCELLANEOUS �OATE PERMANENT FOUNDATION SOFT -SET 1 Zoning -Setbacks -Easements. 2 Soils-, Special MH Support Sketch 3 Sewer; Loctn-Test; FalUC/0-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-DIrncs-Grnd Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap . Nat O or LPO Inch Sz Ft Lngth 7 Blckng; Sz-Spacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Dnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-DIrncs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -/0 to Grade 12 Gas and Electricity Tagged 13 Tie Downs, O Foundation O 14 Exits 15 Cert of Occupancy 16 HUD LabeUlnsignia Numbers Serial Numbers DATE ID E C KS -COV E R S`C A R P O R T S 'G A RAGES 1 Zoning -Setbacks -Easements 2 Ftgs; Soils Sz-OpthSpacing-Cnnctrs-Steel 3 Decks, Girders/Joists-Dcking-Brcing Stairs-Guard/Handrails 4 Wood Awn; Posts-Beams-Rftrs•Cnnctrs-Shthg Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Encisrs 6 Carpgrts; Wndws-Doors 7 Electric 8 Frmg; SiI1s-Anchrs-Studs-Rftrs-Trusses 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls DATE P00LS 1 Setbacks -Easements 2 Soils;.CompactionStructure Stability 3 Pool Structure; Steel-Dnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI 5 Elec Pool Lting; 15 volts-GFI 6 Elec Enclsrs; Conduit Entries Terminals -Listed 7 Elec Bonding; Metal w/5-Crcltng Egp•Hbr 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg Bozes-EncIsrsTnlboards-Insultri to Main Conduit 9 Health Dept Apprvl 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Enclsr, Fencing -Alarms 13 Bonding, Diving board or Slide o'`• �� dr 0'a` lie �r °� 0 • .. Pool Drawing = OK Not OK RESIDENTIAL (Single & Duplex) UAIL JUNDERFLOOR DATE IPLUMBING I ZoningSetbacks-Easements-Flood-Slope 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 2 Ftg &Iain; Soils-Elec Grnd Ftg Dpth 54 Wtr Pipe; Test & Anchr-Nail Prtctn 3 Ftg Garage; Soils -Steel -Flet Grnd Ftg Opth. 55 DWV; Test Fitting' & Anchr Nail Pcfctn 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth 56 Shwr Pan; Test, First fir -Tub Ace. 5 Stemwalls Main; Steel-Blockouts-Wrapped 57 Test Tub & Shwa, 2nd fir - Tub•Acc 6 Stemwalls Garage; Steel-B(ockouts-Wrapped 58 Gas Pipe- Sz & Anchrs 1 63 Hold Downs and Special Anchrs 59 Fire Sprinkler- Test 7 Slab, Steel Wrapped 60 Yard Gas Piping 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test °' 0� - lie 1.1 Wtr Pipe; Test-Anchrs-Rgltr-Service Test 12 Elec Undrgrnd DATE MECHANICAL 13 Plenums & Ducts; Clrnc-MatedalSupport-Insultn 61 AC Ducfs Insultn & Support 14 GirdersSills-Anchr Bolt" oists-Vnts-Crippies 62 Vent Fan, Exhaust abv Insultn 15 Ace & Vntltn 63 Condensate Drain & Ovrflw, Sz & Grade 16• Insulation 64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet 65 Attic Ace & Pltfrm if Furnace in attic DATE IFAAM I NG 17 Sills Proper Materials & Anchrs 18 Walls Studs -Nailing Spacing & Braces-PlatesSound 19 Bearing Watts over Girders & fir Nailing 20 Draft Stop in Walls (rat proof) 21 Fire Stops, Furred Ceilings -Stairs -Chasers Tubs 22 Headers & Beams-Sz & Bearing 23 Hangers -Post Caps-Anchrs-Cnnctns 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac TrussShthg 25 Frplc Ties or Type A Flue-Frplc Throat Clmc 26 Attic Ace; Sz & Rmx Prictn-Draft Stop4ns'Baffles 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 28 Garage Fire Prtctn Framing -RC Cliannel 29 Prprty Line Firewall & Opngs 30 Ext Doors -One T -Check Garage 3rd Story, 2 Exits 31 Stairs; Width-Hdrrn-Rise-Run-Landing-Fire Prtctn 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 33 Siding -Nailing Veneer 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Ace 35 Glazing Area -Glass P rtctn-SkyLts-P las tic 36 Shear Walls; Nailing -Bolts 37 Brace Int/Ext Wall pnls 38 lnsu ltn-Walls-Ceilings 39 Infiltration -Walls Wndws s` s` o'er m o'er m DATE JELECTRICAL 40 Fxtr & Tmsfrmr Clmcans Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 42 Sz Boxes & No Of Cndctrs Stapled 43 Romex Installed Close to Edge of Studs & CJ 44 Eqp Grnd made up w/Mech Fstnrs 45 Gmdng Electrode Bond Gas & Wtr 46 2 Appinc Cires in Ktchn & Cndctr Sz GFl 47 Subfeed Wire Sz g QCU or AL AC Wire Sz y, Q CU or Q AL 48 Range Circ g. MCU or AL Oven Circ ga MCU or MAL Insulated Neutral MYes MNo 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp Clrncs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector o'' `e` °. 4le0s? . DATE IFINAL 66 Ext Steps -Door & SideLt Prtctn-Landings 67 Smoke Detector 68 Furnace Vnts-Clrnc-Comb, Air-Cnnctr, In Garage; abv-flr-Ducts-Mech Prtctn 69 Bedroom Exiting 70 GFl & Bath Fxtrs & Tub AccSpa 71 GFl Arc Fault 72 Elec Trim & Subpnl, Breaker Sts & Labels 73 Stairs, Guard/Handrails 74 Frplc or Stove, Clmc-Hearth 75 Elec Outlets at Wood Pnl, Int & Ext 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clmc T7 Elec Outlets & Rcptcls at Ktchn Counter 78 Garage Fire Door, Swing -Landing -Closure 79 AC Duct in Garage -Damper 80 Wtr Htr; Vnts-CImc-Com Air Cnnctr-PRV; abv fir Mech Prtctn; LPG Appince Undr House 3" drain 81 Plmb; Elec & Mech Eqp Listed for Lottn 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 83 Insultn-Foam-Looked in Attic 84 Guard Rails & Deck Cnstrctn-Post Caps 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Dmge Planters MYes QNo 87 Stucco Brown -Finish 88 AC Unit Dscnnd, Elec-Plmb 89 Vnts abv Roof, Plmb-Appinc-Frplc-Clmc to Opngs 90 Wtr Well, Dscnnct, Elec, Plmb 91 Ext Elec Trim, GFl Rcptcl-Undrgrnd 92 Vntltn thru House 93 Glass Prtctn 94 Corrections from previous Inspctns 95 Gas Test -Meters Tagged, Gas-Elec - 96 Wtr & Sewer Cnnctd-C/O to grade -HD Apprvl 97 Energy Cmpinc Cert -Other Certs 98 Address Posted 99 Fire Sprinkler 0` V-. BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds CHICO ELECTRIC 36 WEST EATON ROAD CHICO, CA 95973 (530)891-1933 DBE Single Phase Service-Resid CHICO ELECTRIC I Building Garage Remdl/Addn 36 WEST EATON ROAD CHICO, CA 95973 Other Porch/Patio Total (530)891-1933 FEE INFORMATION $55.00 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires CHICO ELECTRIC 454345 / B C-10 / 04/30/2008 I HEREB IRM LIN PEN OF PERJURY that I am licensed under provisions of Chapter (commenc g ith Sectio 000) f ivision 3 of the Business and Professions Code, and my license is in full fo nd effect. X lL 02/01/2007 Date 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 /II HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by LJ 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: ZENITH INSUIRANCEpolicy Number..Z067728702 Exp. Dale:10/01/2007 (This section need not a completed if the permitis or one hundred dollars ($100) or less.) ❑1 CE9WY THAT I HE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSU D, I shall not ploy any person in any manner so as to become subject to the Workers' Com n tion law of alifo 'a, and ree that if I should become subject to the workers' comp ns ion provi io s of lction 3780 of the Labor Code, I shall forthwith comply with those X 02/01/2007 Signature Date WARNING: LURE TO SECURE 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) Lenders Address City State Zip Balance Due: $0.00 Receipt No: 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: 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 (Sec. 7044, Business and Professions Code: The Contractors 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 Provessions 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.). ❑ I AM EXEMPT under Section B. 8 P.C. for this reason: IX 02/01/2007 Owners 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 inj inclu i death, and property damage caused by, arising out of, or in any way connected with th is uan o his emit I hereby acknowledge that issuance of this permit does not authorize the u o occu an y any si ewalk, street, or subsidewalk. I hereby authorize representatives of Butte C n to a er h bove entioned property for inspection purposes. I hereby certify that I am the pr a own r r autho z d to act the property own s behalf. &.�96,L e iL4i, 02/01/2007 ❑ Owner ❑ Contractor OR. DAgent for Owner. Agent for Contractor FILE COPY �1. 1 PROJECT INFORMATION Site Address: 3915 FORBESTOWN RD Owner: Permit NO: B07-0196 APN: 073-140-001 RUSS, BENITREZ E Permit type: MISCELLANEOUS 3915 FORBESTOWN RD Issued Date: 02/01/2007 By KCG Subtype: Electric Panel OROVILLE, CA 95966 Expiration Date: 02/01/2008 Description: REPAIR ELECTRIC PANEL & MAS (530) 675-9456 Occupancy: Zoning: A2 CHICO ELECTRIC 36 WEST EATON ROAD CHICO, CA 95973 (530)891-1933 DBE Single Phase Service-Resid CHICO ELECTRIC I Building Garage Remdl/Addn 36 WEST EATON ROAD CHICO, CA 95973 Other Porch/Patio Total (530)891-1933 FEE INFORMATION $55.00 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires CHICO ELECTRIC 454345 / B C-10 / 04/30/2008 I HEREB IRM LIN PEN OF PERJURY that I am licensed under provisions of Chapter (commenc g ith Sectio 000) f ivision 3 of the Business and Professions Code, and my license is in full fo nd effect. X lL 02/01/2007 Date 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 /II HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by LJ 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: ZENITH INSUIRANCEpolicy Number..Z067728702 Exp. Dale:10/01/2007 (This section need not a completed if the permitis or one hundred dollars ($100) or less.) ❑1 CE9WY THAT I HE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSU D, I shall not ploy any person in any manner so as to become subject to the Workers' Com n tion law of alifo 'a, and ree that if I should become subject to the workers' comp ns ion provi io s of lction 3780 of the Labor Code, I shall forthwith comply with those X 02/01/2007 Signature Date WARNING: LURE TO SECURE 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) Lenders Address City State Zip Balance Due: $0.00 Receipt No: 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: 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 (Sec. 7044, Business and Professions Code: The Contractors 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 Provessions 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.). ❑ I AM EXEMPT under Section B. 8 P.C. for this reason: IX 02/01/2007 Owners 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 inj inclu i death, and property damage caused by, arising out of, or in any way connected with th is uan o his emit I hereby acknowledge that issuance of this permit does not authorize the u o occu an y any si ewalk, street, or subsidewalk. I hereby authorize representatives of Butte C n to a er h bove entioned property for inspection purposes. I hereby certify that I am the pr a own r r autho z d to act the property own s behalf. &.�96,L e iL4i, 02/01/2007 ❑ Owner ❑ Contractor OR. DAgent for Owner. Agent for Contractor FILE COPY �1. 1 r BUTTE.COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds , **PLEASE PRINT CLEARLY** OWNER INFORMATION _ Last Name Name Mailing Address .2 d4,3 .OW A) 1�D City State Zip�� Phone Fax E-mail APPLICANT INFORMATION CONTRACTOR' Name City Address D� City t State CSR Zip 9 52 75 Phone 1 _ + � 3� Fax E-mail Lic. # �, I Class �� Q APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail mm �=;"i 1i3' E�0M �N 0 PERMIT NO. 5,1)1 - BIN # PROJECT LOCATION API Property Address rJ shW)i City r Ile CA . I WORKER'S COMPENSATION Policy Number Carrier Zvtta*YJ �o. FYhiring 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: Sq FT- Living Garage Open Cov 0 • Structure Built without Permits 0 Proposed Change of Occupancy (Note previous use): For office use only: Zoning Flood Zone SRA I Yes I No Occ. Type Const. BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION M (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE M (530) 538-7541 PERMIT NO. BP061458 B. C. Building Permit 01-16-04 pg 1 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 06/19/2006 APN: 073-140-001-000 the Business and Professions Code, and my license is in full force and effect. ` 3L/ US � Site Address: 3915 FORBESTOWN RD ORO License Class : License Number: b ZD / Date: Contractor: � ( fn�CCi ��PG-�',Ql� Map Index: Description: ELECTRIC SERVICE UP -GRADE TO 200 OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the AMP Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which 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 Owner: BENITREZ, E. RUSS signed statement that he or she is licensed pursuant to the provisions of 3915 FORBESTOWN RD the Contractor's State License Law (Chapter 9 commencing with Section OROVILLE CA 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 95966 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).): ❑ 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 (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: CHICO ELECTRIC owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for 36 WEST EATON ROAD sale. If however, the building or improvements are sold within one CHICO, CA 95973 year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of (530) 891-1933 sale.). ❑ I, as owner of the property, am exclusively contracting with licensed. contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: CHICO ELECTRIC and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 36 WEST EATON ROAD ❑ I am Exempt under Article 3 of the Business and Professions Code CHICO, CA 95973 Date: Owner: (530) 891-1933 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: License #: 454345 ❑ 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. Architect: ❑ I have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: G Carrier: em t-kl, 111 S U&YMG>✓ �sYlpAN '7 Total Square Ft: 0 S. F. �%- Q 7"DI Policy #: Z�%i �' SCJ Valuation: $0.00 I certify that in the performance of the work for which this permit is Census Code: 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 provisions. Date: 2� loow Applicant: e workers' compensation coverage is WARNING: FailIsubjec unlawful, and shaemployer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation; damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. / /• �� GO CONSTRUCTION LENDING AGENCY This permit is hereby issued undert pplicable provisions of the o tie County Code and/or I hereby affirm that there is a construction lending agency for the Resolutions to o work indioated bov for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) r ' Name: By: Date: PERMIT EXPIRES ON: Address: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have -read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of a official focrsrord Barrie utte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes Print Name � xeAl-_ Signature: / Date:VIP— ❑ Owner ❑ Contractor ❑ Agent for Owner nt for Contractor B. C. Building Permit 01-16-04 pg 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REOUIRED AT TIME OFAPPLICATION Website: www,.buttecounty.net/dds **PLEASE PRINT CLEARLY** O N INFORMATION Last Name (_ OSS C1e��tZ�c� t irst Name r X3 Address 3Gt 5 R OW\(N 'E2 City v (l\ Sta Slate, t Zip c'l Sir �b Pho a Fax## Fax ' E-mail CIE APPLICANT INFORMATION CONTRACTOR Name C�\C.SJ C1e��tZ�c� t Address Zip Cifyte Fax Sta Zip CIS �tZ,6 Phone Page Fax## E -ma 53,3 `tl - I �t33 Li �� 5 CIE APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Page Fax ' E-mail Date Approved: State License Number APPLICANT INFORMATION Name • vtG x Cdti;uwc-4�2 Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X For office use only: Zoning Flood Zone SRA Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner - Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. A //// BP:- BIN P,-BIN # PROJECT LOCATI fON AP# �� 06 Property Addr, City ✓ �GiJ Cross Street WORKER'S COMPENSATION Policy Number - � Z� Carrier z/_1r`\�� �hSvvGv\re 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 escription or Sco a of W rk. Go i=r io Sq FT- Living Garage Open Cov ❑ 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 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. G Received by: Amount: S- C Bldg SRA Receipt #4 Sheriff Date: SMIP - Other Total SUBMITTAL & PERMIT REQUIREMENTS ' The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Building Permit Application Without Required Clearances Form . ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the. following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license inform dtion.'(Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. . If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the.person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION K1FORMS\BUILDING F0RMS\81dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 073-140-001 PERMIT#95-1540 HOLMES, William & Marce 3915 Forbestown Rd., Forbestown -" Cont; George Roofing , - Reroof/SF 7/ADX i i ri�, �3 ..1 •. F. -.,...,F .v-•7u1'-`r,»`r--Y+.�'.y....r^.ri'w!r.YYf"7!`:,'�'yfn7i:P^.v ,�.F;,.r -. , .. t COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISI0 7 County Center Drive - Oroville, Calbrnia 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION 'AIMPERMIT ASSESSOR PARCEL NUMBER ZONING BUILDIN PERMIT OWNER t.t%1llittrtt ',<r .� 111 f. •� /� .t,� �" TELEPHONE SO. FT. OCC. BUILDING VALUATION /` .� t f� 49, OWNERS MAILING ADDRESS 3 9/51' /mol' t At ,t, / ► %t' L" CONTRACTOR'S NAME eorac Rood i ►-IA TELEPHONE 33 - 39 CONTRACTORS MYUNG ADDRESS V Aar— I Fireplace ., CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ �,� wp ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDINGADDRESS S// PERMITFEE $ �O PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar Or heat pump water heater 23.00 USEOFSTRUCTURE SF X Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer _JSJ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work:e! i�1a�• l l 1 Mobile Home GI W1 @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filina Fee 20:00 Main Service eoov OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO I000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class (` — y Lic. No. �/'.�.Z Z G OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License 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. ❑ 1, 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 reason NEW CONST. DWELLING OCCUP. OR ADONS. ( 8 ACC. BUDS. ) So. 3.5¢ FT. NEW CONST. MULTI.OUTLET I NON-RESID. ( BRANCH CIRCUITS ) 97.50 ( POWER SINGLE APPAOURATUS ) 8 TLET CIR. Ex. Occup. (OUTLET OR FIXTURES ) 2e @ x.50 sAL S0 Ex. Occup. ( OUTLETS (RES D.�EA) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor 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 S 4 - A41, MECHANICAL PERMIT Filing Fee 20.00 9 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number 2 1_1-+,$"�>F' (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' compensation provisions of section 3700 of the Labor Code, I shall forthwit�com ty�with those provision f —1 l X Date h Signature of Applicant - Y/Owner ❑ Cont or .❑ Agent / An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stori�es^i-n} height. Mobile Home Installation Fee is Energy Inspection Fee Is Occ CONST. TYPE TOTAL FEE $ O HAZ. D. FEES I IMP I FLOOD I CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. B `� h Date PERMITEXPIRESON //0 (D Receipt No./ r % WHITE-D.D.S.-B. . CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISI0 7 County Center Drive - Oroville, Calif2rnia 95965 - Telephone (916) 538-7541 PERMIT NO. APPLIC&ION AND PERMIT _ ASSESSOR PARCEL NUMBER �o© r ZONING BUILDIN PERMIT OWNER'/'ie Lf C 'e_ P flyniOWNERS TELEPHONE SO, Fr, OCC. BUILDING VALUATION MAILING ADDRESS 3 9/ /Ca Ow H %1��• o h esfawv, 95/ POO dD • �r� CONTRACTOR'S NAME eor r- fZ00_ 1I n TELEPHONE -s 33-4393 CONTRACTOR'S qUNG ADDRESS ISM/J); Fireplace CONSTRUCTIONLENDER UNIwOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $ 000 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Plan Checking Fee $ECT ' ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESSIC// ,.y, 3 (,K F & k � ` D t `� Ado r wn PERMITFEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDNISION'SNAME PARCEL MAP Solar or heat pump water heater 23.00 USEOFSTRUCTURE SF X Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: RTE o/ — [ 1 Q Mobile Home ISI GI W @20.00 PERMITFEE g Contractor ELECTRICAL PERMIT Filina Fee 20.'00 Main Service000V OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9(commencing Section with 7000) of Division 3 of the Business and ProfessionsCode, and m license is in full force and effect. License Class C �— '3 � Lic. No. �/$�d2,2� (� OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License 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 reason NEW CONST. DWELLING OCCUR SO. OR ADDNS. ( a ACC. BLDS. ) 3.50 FT. NEW CONST. / MULTI.OUTLET NON-RESID. \ BRANCH CIRCUITS ) 97.50 POWER APPARATUS 8 SINGLE OUTLET CIR. ) Ex. Occup. ( OUTLET OR FIXTURES zo p Loo BAIL .00 EX. Occup. OUTLETS (RESID) ( ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE S Contractor 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 �'j� e,?kr_ AAeyd Policy Number _ -7 T — —5-0 (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' compensation provisions of section 700 of the Labor Cod I shall fort .com ith those ision X _ ate /(� _ Signature of Applicant - wner ❑ Co or gent An OSHA permit is requir or excavations over 60" deep and demolition or construction of structures over 3 stors in height. ' MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE S Contractor Mobile Home Installation Fee Is Energy Inspection Fee is occ CONST. TYPE O TOTAL FEE $ HA2. I D. FEES IMP I FLOOD I COF PARCEL PO HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. 0 B Date !D PERMITEXPIRESON %� fpmi) Receipt No. 9� WHITE-D.O.S.-B. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT on t,JPERMIT NO. - 1 . P E r M UTIL. IP&MIT NO. 44.62-75P,E PERMIT EXPIRES TT OWNER William H. Holmes } CONTR. OWner f -I LOCATION }}(A.P• 73-14-01 jVW side of Oro-Forbestown Hwy., 1 i miles $past A cd Oroville i aed C � •rn i / ;�W_ 4 0 r t 1' 1 1 f Temp. Power Pole Called PG&E Temp. Elec.,Serv, Called PG&E Temp Gas Serv. ! Called PG&E /JO .y 7 � FINALED o�' (Date) � a ( I (Signature) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback —//— Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Fini 2nd Floor Footings Windows N 4 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Piping Piers Roofing Sewer 9— Garage Garage Fdn. Vents 04 Fixtures Footings_ Garage Vents Water Htr. Stemwal Prov. for physic ly Slab handicapped Heaters Appliances Carport Conformance of ex. Footings structure Gas Piping & Test Temp. Gas Slab Final J Sanitation Patio FIREP CE Final Footings Footing EL CTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam RE SPRINK LNaS Motors Framing Test Water Htr. Stucco Final Subpart Is Mesh ECHA CAL Grd. Fault Prot. Scratch Heating Service V — Z4 Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final (� DATE REMAR S OR CORREC IONS lo, 1,167! G. u.1A- I (� /� �.0 �� 15* 45 �¢/ w /3 OCI�c�'� 90221? e 7;.�v& c. 7-L& s X44D W7, -OT SIC, Dob 1;'V) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive – Oroville, California 95965 Telephone: 534-4541 / APPLICATION AND PERMIT v V-Sifgnoture Permitee por Agent By Date Receipt No. E®a `7 Bu' in permit expires Date White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant j P p. BUILDING Owner c SQ. FT. OCC. BUILDING VALUATION Mailing Address 6 70' kl Telephone No. "aha Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee Building AddressPLUMBING No. @ FEE PERMIT FILING FEE $3.00 , / Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping +.58 „ Each gas water heater or vent 1.50 3 '' A. P. No. ` 7— Z°" i Gas piping system 1' - 5 outlets 1.50 Each additional outlet .30 F Wk.- Son Fire Dept. Fire Zone JIF Use Permit Building sewer –r399 %�•bU EQA Parking Plans P Parcel Ma D la p 60' R/W Im rov ents p Lawn sprinkler system 2.00 . PI s Recd Par Approval Plans Approval Permit Fee $ $ O NEW ❑ ADDITION ❑ UTILITIES OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 •(90 Main service incl. 1 meter .pp Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) – Single Family ❑ Duplex ❑ Mobil Home Others EL Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures ba11@10 Recaps., switches & fix outlets CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Hood, Ex: Fan or F.A. Furn. Motor 1.00 Evap, cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities Temp. Power Pole 5.00 License No. Classification Misc. wiring I am exempt from the Contractors License Laws of the State of California. Permit Fee $ MECHANICAL No. @ FEE WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions,of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 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 Workmen's Compensation Laws of California. PERMIT FILING FEE $3.bo Heating Cooling Ventilation Hood J 2.00 Permit Fee $ $ 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 in ction purposes. e X �" Date TOTAL PERMIT FEE $ This permit is hereby issued under the applicable provisions of the Butte County Code and/or. resolutions to do work indicated above for which fees have been paid. ^ DIRECTOR OF(f)JBLIC WORKS V-Sifgnoture Permitee por Agent By Date Receipt No. E®a `7 Bu' in permit expires Date White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant j P p. rf. _47•�..�^ W � "'oo, ole i COUNTY OF BUTTE - DEPARTMENT 6F PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICA ION AND PERMIT PERMIT NO. ASSESSOR PARCEL UMB R.q_„y l — 1NG BUILDING PERMIT lA/7 A4 CS TELEPHONE SO. FT. OCC. BUILDING VALUATION7-Z6ZM OEoMgLING S y� X 4 yC/&V VI 64 ?5'4V1 RACTOR'SNV,Y /A)"�V /I ?• T PHO �V CONTRACTOR'S MAILING ADDRESS MAkys I/iLC45�0 * 4S �G / CONSTRUCTION LENDER UNKNOWN Fireplace Total Valuation $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUI DING ADDRESS ' S/D� GA�'U _�/35'/Jjfl{/�(fy. PLUMBING PERMIT Filing Fee X0.00 l ��2 /�'� �• /�/��•, /-� �, i��s.. �N�l� 1��� Each Trap 2.00 Repair drainage or vent piping 2.00 &C 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 SPECIFY Building sewer Lawn sprinkler system 2.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lies ❑ Installation❑ Other Describe work: .5�� A� W f� SPIS rcM _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee /0.00 Main service 600V OR LESS t00 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONSTDWELING OR ADDNS. ( ACCLBLDGS. OCCUP. &) 22 Sq ft 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) 1, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ 1 am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR MULTI -OUTLET 2.50 ea N..-RESID BRANCH CIRC ITS NEW CONSTR. POWER APPARATUS &) NON-RESID. %SINGLE OUTLET CIR. Ex. Occup OUTLETS OR FIXTURES 50 BALe10Q FIXED APPLNS. OR Ex. Occup. (0UTLETS (RESID.) EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring Sol PA -- Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 3.00 WORKMEN'S COMPENSATION INSURANCE 1 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. ISiI� I shall not employ any person in any manner so as to become subject yt� 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 ag ins said County in consequence of the granting of this/permit X 1 ✓'� Date Sig ature of Applicant — 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 $ OCCUP. GROUP I TYPE OF CONST, I PARCEL PD I HD I ISSUE This permit is hereby issued under siopalof the Butte County Code and/or workndicatedabove for which /' IR1ECTOR OF PUBLIC I �.ric�'” PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date�E� GSU L.. S/ / Receipt No. "* 2 /79 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT �Jj COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 -..f APPLICATION AND PERMIT PERMIT NO. %f ASS ESSO ARCEL UMB l 7 r ZG;-dIr G_.--0 P�"v BUILDING PERMIT °p)& / 1.M �c(pLs' T7� 2_62 SQ. FT. OCC. BUILDING VALUATION O V-1 1 9 S M /y4L� Cz R E_55 - 4/6�� �J� / CrtQ �J�VR A /\A�,-,tD"AFD S NV ()� %���. 7� /iiT Pe CONTRACTOR'S MAILING ADDRESS M v, I& C4UroexlbA CONSTRUCTION LEND R -111�tfl UNKNOWN I Fireplace Total Valuation $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BU IN ADDRESS PLUMBING PERMIT Filing Fee f0.00 ,�r -Ael /)`r , �1i, /41�f )W4*, ,w Each Trap 2.00 Repair drainage or vent piping 2.00 to4oIV/UiC_ 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 SPECIFY Building sewer Lawn sprinkler system 2.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti li (es ❑ InstallationE, Other Describe work: 150/_h P_ ' Permit Fee $ Q Contractor ELECTRICAL PERMIT Filing Fee 1000 Main service 1000 AMP ORV OR LESS5.00 Main service EA. ADD -L 100 AMP 2.50 NEW CONST.(DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. 22 sq ft - 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) '�l, 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 U TI.OUTLET NON.RESID, BRANCH CIRC ITS 2.50 ea NEW CONSTR ( POWER APPARATUS &) NON-RESID. SINGLE OUTLET CIR. Ex. OccUp(OUTLETS OR FIXTURES BAL@1 AL�0c FIXED APP LNS, OR Ex. Occup.(OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring �'Q(r/�� .&.25- 17's-0 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. 1'S 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 3.00 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. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgmentscostsand expenses which may in any way accrue a s said Count��of he granting of this permit. X Date o Si nature of Ap licant — Owne Contractor ❑ Agent ❑ An OSHA permit is required for excovat ns 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 $ OccuP. GROUP I TYPE OF CONST. PARCEL PD HD ssuE This permit is hereby issued under sio of the Butte County Code and/or w rk ndicated above for which 1 ECTOR OF PUBLIC �I ✓ PERMIT EXPIRES Date_ 2 the applicable provi- resolutions to do fees have been paid. WORKS �� ate � / f�-7 Receipt No. Z/ l WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT . k "PERMIT NO. 6538-78B,P,E PERMIT EXPIRES William Holmes ,OWNER J; CONTR. owner LOCATION (A.P. 73-14-1 ) NW/S Oro-Forbestown Rd.,12 mi.past Robinson Mill Rd., Forbestown z i Temp. Power Pole Calle PG&E t Temp. ec. Serv. C led PG&E Te p. Gas Serv. Called. PG&E JOB. G FINALED �� a (Date) (Signatur i COUNTY OF BUTTE — DEPARTMENT OF�,PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms VParapets Heating 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor StemwalI Sidina To out Slab Roof Sheathing. Water Piping Piers Roofing wySewer Gas Piping Garage Fdn. Vents Fixtures Footings Stemwa I I Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for physically handicapoed Conformance of ex. jaAFtw4ure Appliances Gas Piping & Test Temp. as Slab Inal Cl O Sanitation Patio IR LACE Final Footings // io— Footing ELECTRICAL Masonry Walls Throat Rou h Reinf. Steel Final Fixtures Bond Beam_ t i FIRE SPRINKLERS Motors sa I T Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Door Closer Ventilation Final ftmanent inal d MOBILEHOME UTILITIES ------------------ Elec. Service ec. Pede Water Piping Sewer Gas Piping OBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping ' Drainage Gas Piping DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE —rDEFARTMENT OF PUBLIC WORKS 7 County Center,DrIve - w Oroville, California 95965 ) //Y —gi -7f ` Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1 Date Signature ofAPermit e o e /f� Receipt No. ! s v White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR Qf� PUBLIC WORKS By >41 Date c-) -/) - / BuIIg permit expires Date 3 5 b BUILDING Owner Vh UA AM SQ. FT. OCC, BUILDING VALUATION CO CF7 4jt� //- Mailing Address ?1O. (3 Cox. (0 "c-S_JV wAJ C& 95(34-I Contractor .0w'V EsL Mailing Address Fireplace Total Valuation 21j(a0 Telephone No. Permit Fee 100 2 Building Address0&1 :5 C OF 0120-1 �/F�ply— PI anChecking Fee&/or Penalty Permit Fee pz -wo,IIIJ Rw 02- M), PAST S PLUMBING No. @ FEE r D' .?U JN, tsp. 1 Mid P -O" N PERMIT FILING FEE $3.00 , 00v Each Trap 1 1.50 (. O ioeeEsTOW Repair drainage or vent piping 1.50 •� A. P. No. % J., 4- 0 -g-L Zoning & Planning Water piping 1.50 11,50 Each gas water heater or vent 1.50 F Vli,e� ation Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Map I 60' R/W I Impr vements Each additional outlet .30 Building sewer 5.00 Bldg. ane Recd L-01 Parcel A royal Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER COI)EV-0D EL A -1Q Permit Fee $ &, 00 $Ice ELECTRICAL No. @ FEE i6 L/ 1� PERMIT FILING FEE $3.00 3, 00 800V OR LESS Main service 100 AMP OR LESS 5.00 (�� 1TY Single Family ❑ Duplex ❑ Mobil Home L� Others Uv Main service EA. ADD'L 100 AMP 2.50 y1, t Q �/ , Main service OVER 600V 25.00 100 AMP OR LESS Main service/ EA. AOD'L 100 AMP 1.00 NEW CONST. OR A.C.S. ACCLBLDGS.LING CCUP &) 20sq ft C LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: • NEW NON-RESIESIDt , /MULTI-OUTL T CON ICONTRACTORS BRANCH CIRCUITS) 2.50ea NEW CON STR POWER APPARATUS & NON-RESID. SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTIIRES BAL@; Ex. OCCU FIXED APPLNS. OR p• OUTLETS (RESID.) EA) 1 2.001 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 DQI am exempt from the Contractors License Laws of the State of California. Permit Fee $ rj ,00 $ Gj Ot WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner Foas to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 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 Land Development Fee $ TOTAL PERMIT E FE $ 6s ?✓� authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1 Date Signature ofAPermit e o e /f� Receipt No. ! s v White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR Qf� PUBLIC WORKS By >41 Date c-) -/) - / BuIIg permit expires Date 3 5 b