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HomeMy WebLinkAbout073-140-007-`r�_ ---"��--- ---- ..----� '73-14-7SZta�-Iey Clark - 'III,,S1S WeI's-s,,,,HIi-.1IRdd- app.k mi.off E/S Or - 'Permit #2082-77 B,i:P**(new sing famil73-1Permit#22 7-80B (1 & 2ndL..P--e-r5<it1'314-8'QB(2 'new open ecks/SF).073-14-007 #98-2268GOLZ, KURT | �PROPANE GAS TANK,LINE,BEAj � . / . . . | . ! } | | / 1 ' | / , ' � ' / � � " ' . � . . . -~ t T. PPERMIq NO. 314-80B PERMIT EXPIRES Stanley Clarl 'OWNER .�+ CONTR. owner ` •.6OCATION (A.P. 73-14-7 ) W/S Weiss Hill Rd., app,k mi.off E/S Oro Forbestown Rd., app.2 mi.N.of water fountair. Forbestown c - I r T, r 1 Temp. Poer Pole F Call H PG&E Temp. lec. Serv. C lied PG&E Te . Gas Serv. Called PG&E FOI ALED > l S �I (Date) (Sign re) awcco COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS Subpanels BUILDING INSPECTION RECORD MECHANICAL Grd. Fault Prot. Scratch Heating Service BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall �— Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finis 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents --, Fixtures Footings Garage Vents Water Htr. Stemwall Insulation Heaters Slab Prov. for phsically Appliances Carport Po handica ed Conformance of ex. Gas Piping &Test Footings st a Temp. Gas Slab(nalVA l Y� Sanitation Patio GS FIR PLACE Final Footings !f Footing ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final I Fixtures awcco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOSILEHOME UTILITIES ------------------ Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping MOBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS ��z �� 4e-� aw (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY PF QL TTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Telephone:,4534-,4541 ' APPLICATION AND PERMIT v/) Owner (—L 2.50ea fJa, Mailing Address 95-77 UocP *rs �- h A V Ex. Occup(OUTLETS OR FIXTIIRES Telephone No. Contractor O Ge3 /J &IZ— 1 2.00 Mailing Address 10.00 Mobile Home Facilities 15.00 Telephone No. Building Address 01610457' w�,yb�51 ��Lv /LD ID G d 12C — Fb-eg 65,7Mw AJ / Jy //Z N v wl/�cc 1=19l A. P. No. Zoning & Planning Fps 1 *1.6. Sa on Fire Dept. Fire Zone Use Permit EQA I Parking Parcel Pians Declaration Parcel Ma P 60' R,I Im rovemen P Bldg. Ploks Recd Parcel roval Plans App al NEW [:]ADDITION [:]UTILITIES ❑ OTHER Single Family ® Duplex ❑ Mobil Home ❑ Others ❑ 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: License No, I am exempt from the Contractors License Laws of the State of California. Permit Fee WORKMEN'S COMPENSATION INSURANCE MECHANICAL PERMIT FILING FEE I am aware of the provisions of Section3700 of the California Labor Heating 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. Classification BUILDING IV % FT. I OCC. I BUILDING VALUATION Fireplace Total Valuation Permit Fee Plan Checking Fee&/ kenalty Permit Fee PLUMBING PERMIT FILING FEE Each Trap Repair drainage or vent piping 'Nater piping Each gas water heater or vent Gas piping system 1 - 5 outlets Each additional outlet Building sewer Lawn sprinkler system Permit Fee ELECTRICAL PERMIT FILING FEE Main service 600V OR LESS 100 AMP OR LESS Main service EA. ADD'L 100 AMP Main service OVER 600V 100 AMP OR LESS Main service EA. ADD'L 100 AMP $3.00 1.50 1.50 1.50 1.50 1.50 .30 5.00 2.00 $3.00 5.00 2.50 25.00 1.00 >--¢ sq ft FEE FEE NEW CONST R. MU LLI•oUI" NON.RESID. BRANCH CIRCUITS 2.50ea NEW CONSTR. (POWER APPARATUS 6 NON.RESID. `SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTIIRES So @ 25¢ IBAL@10@ EX. OCCU P• FIXED APPLNS. OR OUTLETS (RESID.) EA) 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wirinq 6.251 1 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. X Dates J gignatu;peof Permitee or Agent Receipt No. 3q&zj White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Coo I i $3.00 FEE Ventilation Hood 1 2.00 Permit Fee $ $ Land Development Fee $ 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 Pf PUBLIC WORKS B Date uilding permit expires Date - /—v�� �' 4 -V a PERMIT N0. 2082-77B,P,E, PERMIT EXPIRES OWNER Stanley Clark CONTR. owner Ar' LOCATION (A.P. 73-14-7 � S/S Weiss Hill Rd.,app.34 mi. off E/S Oro -Forbes - town Rd.,app.2 mi.N.of Water Fountain,Forbestowr 1 r� Y` Temp. Pder Pole f; Cal ed PG&E c. Temp�Elec. Serv. 77 6 r Called PG&E Tc"mp. Gas Serv. Called PG&E JOB LL FINALED J (Date) (Signatur RESIDENTIAL ENERGY CONSERVATION STANDARDS CONSTRUCTION COMPLIANCE CERTIFICATE THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN INSTA LED IN CONFORMANCE WITH CURRENT ENERGY CONSERVATION REGULATIONS AT S / s _ ( ocation) BUILDING PERMIT NO. '2-08-2-7% A,.' P. NO. 7.2 —/ THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS: (Check each item or write N/A if not applicable) INSULATION: Slab Edge Fdn. Walls Floors -/ Walls -// Ceiling/Roof Ducts Circulating Pipes APPROVED HEATERy�l� APPROVED WTR.HTR. GLAZING: Single Glazed �21� Special (Insulated) CERT. & LABELED WDS. & SLIDING DRS. �. WEATHERSTRIPPED DRS. BACK DAMPERED FANS INTERMITTENT IGNITION DEVICES --- CERT. APPLIANCES I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED. Insulation Applicator Name Signature of (please print) Insulation Applicator State Contractors License No. )(General Contractor/Owner Name/Cicry A C.I ar K � Signature of (please print) �I General Contractor/Owner l.7. Date �� s If State Contractors License No. THIS CERTIFICATE MUST BE ON FILE WITH THE BU ILD ING DEPARTMENT PRIOR TO REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION WITHIN THE DWELLING. ' � X n COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUPABING Setback Firewall �— Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings 7% Windows 3rd Floor Stemwal l Siding To out Slab Roof Sheaths Water Piping, Piers % —G'— Roofing Sewer Garage Fdn. Vents Fixtures r/ / Footings StemwaI I Garage Vents Insulation CS Water Htr. Heaters Slab Carport Footings Prov. for phys cally handicappedd Conformance of ex. str Appliances Gas Piping & Test Temp. Gas Slab eAnafln Patio FI PLACE nal Footings Footing EL CTRI AL Masonry Walls TJILQ&t — 7 [a% Rou h M- Reinf. Steel S b_ Fixtures Bond Beam 12 FOE S94INKILERS Motors Framing_ 3-2 �s�' Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground / MOBILEHOME UTILITIES ----------••------ Uec- Service " -EIeC. Pedestal Water Piping Sewer Gas Piping MOSILEUQMLIUSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE 3 —REMARKS OR CORRECTIONS �a Fi KC6'. oc-� 7-u V "r AE)vrS4_"b aw"Air . 114W s EXPIkED p;10- 2 S aj6PCle "0 C -o"? PkF_7-/_G iJ ,4 ©Z/,1520 0.01.1KA5 ZPd .-4 pe,2 rn. v�Gv�4 C 44 5c, Nsr'E70- lD�c CIK X C_K 90 r P �"t914 �5 Orp, I Aeo� 2-� (NOTE: An entry must be made on this form each time i jo �O' COUNTY OF YUTfff" — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive -- - U;oville, California 95965 /7D�•� Telephone: 534-4541 o . APPLICATION AND PERMIT /n 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 ins ction purposes. fJ X Date `�?/y Z;;g&?/ A Signature f/Permittee or Agent Receipt No. -GM v�� White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant 0 i r5 /00 TOTAL PER IT 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'P JBLIC WORKS BY Date��P/�, ' 77 ding permit expires Date 157_7!4 — _77 BUILDING Owner SQ. FT. OCC. BUILDING. VALUATION Mailing Address ae.eqa ` ele hone Nv)p. G V� Fireplace4AAC, Contractor Total Valuation 60 Mailing Address Permit Fee h127,0 Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ O Building Address -� �� S.� �� / oPLUMBING No.1 FEE PERMIT FILING FEE $3.00 Each Trap 1.50 of," , / v Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 _ A. P. ' -+ Z° Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 !� s VIZ Sa n Fire Dept. Fire Zone Use Permit EQA Parking Parcel60' R/W roveme •ts Parcel Ma Plans Declaration P Im P Building sewer 5.00 Lawn sprinkler system 2.00 Bldg. ans Rec'd Par a royal PI s Approval Permit Fee $ S NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No -1 @ FEE PERMIT FILING FEE $3.00 3 O Main service 600V OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Main service OVER 600V 100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW CONST. ( DWELLING OR AO y�� DDNS. ACC. BLDG 4� 20Sq ft NEW CONSTR. MULTI.O TLET NON.RESID, ( BRANCH CIRCUITS) 2.50ea NEW CONST R. POWER APPARATUS &) NON- RES ID. (SINGLE OUTLET CIR. 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 st le of: Y Ex. Occup(OUTLETS OR FIXTURES) @2514tOq Ex. Occu / FIXED APPLNS. OR p•(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 1 am exempt from the Contractors License Laws of the State of California. Permit 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 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 authorize representatives of the County of Butte to enter upon the above-mentioned property for ins ction purposes. fJ X Date `�?/y Z;;g&?/ A Signature f/Permittee or Agent Receipt No. -GM v�� White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant 0 i r5 /00 TOTAL PER IT 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'P JBLIC WORKS BY Date��P/�, ' 77 ding permit expires Date 157_7!4 — _77 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Driv., ­- California 95965 Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date $ig Katureo m°l`�tee or Agent Receipt No. 513C M2 — 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 abov r which fees have been paid. D OF PU LIC WORKS B Date Building permit expires Date BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address ? T .1.( Telephone No. Contractor Mailing Address Fireplace Total Valuation Telephone No. Permit Fee Building Address � � � ° Planng Fee&/or Penalty Permit t Fee $ PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1,50 Repair drainage or vent piping 1.50 A. P. No. Zoning 8 Planning Water piping 1.50 Each gas water heater or vent 1.50 F &pl Sartidatioaw Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 BI ons d Parcel Approval Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Permit Fee $ $ a,G° ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD•L 100 AMP 2.50 Main service OVER e O 25,00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 1.00 NEW CONST. ( OR ADDNS. ACCLBLDGS.LING CCUP. 6) 2¢sgft 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 st le of: y NEW .ES,., BRANCH CIR T NOW CON D BRANCH CIRCUITS) 2.50ea NEW CONSTR. POWER APPARATUS a NON.RESID. SINGLE OUTLET CIR. Ex. Occur)(OUTLETS OR FIXT11REA I5 L25 Ex. OCCU FIXED APPLNS. OR p• OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit 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. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 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 FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date $ig Katureo m°l`�tee or Agent Receipt No. 513C M2 — 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 abov r which fees have been paid. D OF PU LIC WORKS B Date Building permit expires Date ! 073-14-007, #98-2268 GOLZ, KURT 5 WESTAR CT., OROVILLE OWNER PROPANE GAS TANK,LINE,HEA7 t���l9q s OFFICE COPY Address � GAS " Meter By Dat�O Z� ELECTRIC Meter By Date • � I f COUNTY OF BUTTE jDEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541. PERMjT1tlQ. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 7qT 1 Y'�l! 07 ZONING BUILDING PERMIT OWNER Oot Z. kurt• 1 T01-C-1 Ol} €1- -1 NE 107 SO. FT. OCC. BUILDING VALUATION OWNt3i5; 1n iM,7 i t\ c • onviu CONTRACTOR'S NAME owm �!!�i'�PS TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER FITBpIBCe LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENS E NO. l Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS 1 Plan Checking Fee $ BUILDINGADDRESS 5 WJi.71AR CT • Energy Plan Checking Fee $ $ i PERMIT FEE $ LAT No. SUBDIVISIONS NAME PARCEL MAP l PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF .I7 Duplex ❑ Mobilehome ❑ Other SPECWY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Udlifies 11 Installation ❑ Other ❑ Describe Work: NLW PROPANE GAS TAR AND LINE AND UNDERFLOOR HEATER Gas piping system 1 - 5 outlets 15.00 lbouu Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT . Filing Fee 20.00 Main Service 0."0'. A O'.L500V OR LESS 23.00 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 LIC. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law f e following reason: IV 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 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy, Number (Tbe 'above sections need not be completed if the permit is for work of a valuation one hundred 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 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 comply w' h'tho-se provisions. .� �3 X ! Date Signit6re of A ichrit - p Owner ❑ Contractor ❑ Agent An OSHA permit is reghirkd for excavations over 60" deep and demolition or construction of structures over 3 stories�tn height. 1 Main Service TO 46.00 CCU000A NEW CONST. DWELLMxi OCCUP. SO WP OR ADDNS. 8 ACC. BLL S. 3.5¢FT. T. tNON.REOSID. MULTI.OUTLET 97,50 POWER APPARATUS a SINGLE OUTLET CIR . �(, OCCU OUTLET OR FIXTURES 20 @ 1.0° flAL 50 Ex. Occup. OFIxuTle°s Aa ° A 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Filing Fee 20.00 Heating • Cooling Hood 6.50 Ventilation PERMIT FEE $ 4O.00 Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. n'PE TOTAL FEE $ 75.00 HAz. D. FEES IMP I FLOOD I CDF PARCEL I PD I HO 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. ll By Date - PERMIT EXPIRESON ate Receipt No. �� L".! I/1cl �j WHITE-D.D.S.-B.D. CANARj'=ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE BUILDING DIVISION ig DEPARTMENT OF DEVELOPMENT SERVICES :, 411 Main Street • Chico, CA • (530) 891-2751 7„.County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE 9 OWNER r -ZZ-& PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. rl��--�- 1�7-<�- REV 10/92 Jr COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530)538-7541 PERM (Rev. 12/96) APPLICATION ANDPERMIT 40 zS ASSESSOR PARCEL NUMBER 73-14-07 . ZONING BUILDING PERMIT OWNER golz, kurt T6771 107 SO. FT. OCC. BUILDING VALUATION OW"°'s TLnMR CT. OROVILL CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER , Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS S WESTAR CT. Energy Plan Checking Fee $ $ OROVILLE PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ]p Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities [I Installation ❑ Other ❑ Describe Work: NEW PROPANE GAS TANK AND LINE AND UNDERFLOOR HEATER Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home IS I GI W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 "OOVRMain Service W.A OR LESS 23.00 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.PSING License Class LIC. NO. • OWNER -BUILDER DECLARATION I hereby,pffirm under penalty of perjury that I am exempt from the Contractors License Law ff9rfhe 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 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 Main Service WDA TO 46.00so CCU000A NEW CONST. DWELLING OCCUP. OR ADDNS. ( a ACC. BLnS. SO 3.50FT. RESINEW U MULTI.OUTLET @7,50 S E OUTLET OWERLAPPARATUS CR. Ex. Occup. OUTLET OR FIXTURES BAL @ I: a FU ED APPLNS. OR Ex. Occup. °uT,Ers REs,D, EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating 20.00 Cooling Hood 6.50 Ventilation PERMIT FEE $ 40.00 Polic umber (TiWabove sections need not be completed if the permit is for work of a valuation one hundred 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 workers' compensation laws of California, and agree that if I should become subject to the )cc pe satiprovisions of section 3700 of the Labor Code, I shall workers forthwit com y i e provisions. X Date Sign of A c t - Owner ❑ Contractor ❑ Agent An O A permit is req ' d, or excavations over 5'0" deep and demolition or construction of structures over 3 stories n height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 75 .00 HAZ. I D. FEES IMP I FLOOD COF PARCEL I 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 hich fees have been paid. /� By rt/ V Date PERMIT EXPIRES ON `U— 2—qq Date ReceiptNo. 2 WHITE-D.D.S.-B.D. CANAR -ASSESSOR PINK -INSPECTOR GOLDEN ROD-AFPUCANT ,1 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive e Oroville, California 95965 - Telephone (530) 538-7541 PERMIT NO. (Rev.IM6) APPLICATION AND PERMIT ASSeSSORPArtCElMUM '� -- L� •— D `��— DO ENO BUILDING PERMIT OWN"(�C) l Z Voo /S E- f 1 � 1 SO. FT. OCC. BUILDING VALUATION owrmts WAILING ADDRESS � �- CONTPACTOWS NAME TELEPHONE CONRYCTOR'8 WWNS ADDRESS CONSTRUCTON urpot LENDER'S MAILNe ADDRESS Fireplace Total Valuation b ARCHRECTORENGINEER UCEMENO. Filing Fee S 20.00 ARCWMCT OR ENGMEERy MALJND AD Permit Fee $ Plan Checking Fee b SULDP1OADDRESSOff ,5f ar Energy Plan Checking Fee S S PERMIT FEE _ LOT NO. •ueonslonsrwtE PARCEL MWPLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE Solar or heat pump water heater 23.00 SF Duplex 0 Mobilehome O Other Water piping 15.00 SPECIFY Each gas water heater or vent 15.00 TYPE OF WORK Gas piping ristem t - 5 outlets 15.00 New 0 Addition 0 Remodel 0 UtlGtles Installation O Other 0 Building sewer 15.00 Describe Wo k: Mobile Home S G W @20.00 ' /a , C PERMIT FEE _ �j ~ •QC7. ELECTRICAL PERMIT I-FilingfFee 20.00 Main Service O, 23.00 Main Service 400A TO r ---A 46.00 NEW CONST. owaux+ oocuP. OR ADONS. i ACO. eLOs. 3.5¢SO MULTI.ourixf NOH Resw. 'BRAWN CIRCUM 07.50 PowER APPARATUS i smaLe oun" dR. i Ex. Occup. OUrurr OR MES FD,e- 20 .00 SAL 0 r Poa o A MUM OR Ex. Occup. ourLt�s ESID. EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirino 23.00 PERMIT FEE _ MECHANICAL PERMIT Filing Fee 20.00 Heating�O Cooling Hood 6.50 Ventilation PERMIT FEt3 S Mobile Home Installation Fee S Energy Inspection Fee S °OO COMM TYPE TOTAL FEE $ -% S ,DC ' IIAZ D. MM IMP Fi000 COP PARCEL PD W 6SUE 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. By ReceiptNo.I PERMIT EXPIRES ON F WWIT.n n. S.. R.2 CANARY-ASSFSSOR PINK -INSPECTOR GOLOFNROMAPPLICANT Date OtiVNER-BUILDER VERIFICATION. .j Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I perso7-imp ly plan, e:provide the or labor and materials for construction of the proposed properement :YES NO � 2. I HA HAVE NOT 13 signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction:,,, NA: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of this work, but I have hired the following person to coordinate; supervise, and provide the major work: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: / PROPERTYOWNER: SOCIAL SECURITY DATE: 1/9 - 77- NOTE.- NOTE. This Owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. OVER I OWNER BUILDER INFORMATION - -- Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property-. improvements specified. 3i Foryour protection, you should be aware that as "owner -builder" you are the responsible parry ofj+ecord on st a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. if your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number.on all permits. for which they apply If you plan to do your own work, with the exception of various trades that you plan to subcontract, you�shotrM be aware of the following information for your benefit and protection: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including ataterials and other costs) is x300 or more for the entire project, and such persons are not licensed as contrac�or'`s,.or subcontractors, then you may be an employer. 3'I �.. `.. Nk.. ♦ -. . If you are an employer, you must register with the State and�Federal Governments as an employer and�you are subject to several obligations including state and.federal income tax.withholding, federal social securitytaxess; workers compensation insurance, disability insurance costs; and unemployment c9mpensation contn'butions. ♦ : There may be financial risks for you if you do not carry out these obligations, and•tltese risks are especially tempu.-<s with respect to worker's compensation insurance. `tzi-rr ♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service'(and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. t If the structure is intended for sale, property owners who are not licensed contractors are allowed toperform their work personally or through their own employees, without a licensed contractor or subcontractor, -only under'litntted conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally: • . - . Information about licensed contrac!prs may be obtained by contracting the Contractors State License Board in your - community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" bn the reverse side of this form so that we can confirm dmt.you.... are aware of these matters. The building permit will not be issued until the verification is returned. 1 rely, Mic el C. Vi ira, C.B.O. M ger, Building Inspection NOTE. This Owner-Builder•Injormation is required by Section 19830 of the Caiijornia Heald: and Safety Coda OVER