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HomeMy WebLinkAbout073-160-03173-16-31 OLD FORBESTOWN LODGE .� Old Forbestown Rd' Hrmit#2326.--87-E(-upgrade main ser , ! I \i C. 4 �:. 1ty I ' } OFFICE COPY Address Date ELECTRIC Meter By Dat a yrs 4 { 1ty I ' } OFFICE COPY Address Date ELECTRIC Meter By Dat a yrs J i COUNTY OF, BUTTE - DLPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. (1l/1y 4 ASSESSOR PARCEL NUMBER ZONING, BUILDING PERMIT OW`NE/�•pR//� T/ELEPH NyE SQ. FT. DCC. BUILDING VALUATION OWNER'S MAILING ADDRESS CONTRACTOR'S NAME7 TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS / Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 - Solar or heat pump water heater 20,00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE / SF Duplex❑ Mobilehome❑ Other l 1r� / SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home I S I G I W 10.00 ea TYPE OF WORK , i New ❑ Addition ❑ Remodel Utilities ❑ Installation❑ OtherEll"Permit Describe work: t +L " f, —/�,- , ri.r - J f � _ ov Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 ;)t Sl.� CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business( and Professions Code and my license is in full force and effect. License No. Classification © I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING OCCUP.&\ +/Z�sgft OR ADONS. ACC. BLOGS. / NEW CONSTR ULTI.OUTLET 2.50 ea NON-RESID BRANCH CIRC ITS POWER APPARATUS &I \SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20®50S eAL930 FIXED Ex. Occup. OUTLETS P(RESID )LNS REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring / 15.00 ...i (.,• . /� 'l Permii Fee '' $ Contractor i WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. F] I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ® I shall not employ any person in any manner so as to become subject o to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation —perrnit Fee $ Contractor 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 authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against//said County in consequence of the granting of this permit. / X �fi7�rrt� r � � Date 7& - � Signature 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 a Energy Inspection Fee $ TOTAL PERMIT FEE $ OCCUP, CONST.TYP! I I FLOOD PARCEL _ PD 1 Ho -7 This permit is hereby issued to do under the applicable sions of the Butte Count Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date T 20 -X7 PERMIrT'EXPIRES Date 7- '!ro-rY Receipt No. �JU WHITE-D.P.W., YELLOW-ASSE350R, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT 0� 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-754 APPLICATIOWAND PERMIT D4 ASSE SO ARCEL NUMBER `�� ZONI G BUILDING PERMIT OwNTELEPHONE S0. FT. OCC. BUILDING VALUATION OWNER'S �LLNG A RESS CONTR AME TELEPHONE CONTRACTO'R'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING .PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other /�� SPEC FY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 10.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other ( Describe work: c 1 4,wj: iq e `��(��{.��� ��1/ , Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6101 OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD -L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ 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 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING OCCUP.&\ yzQsgft OR ADONS. ACC. BLDGS. / NEW CONSTR. ULTI.OUTLET 2,50 ea NON•RESID BRANCH CIRC ITS POWER APPARATUS & (SINGLE OUTLET LIR. Ex. OCcup(OUTLETS OR FIXTURES eALO 30 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA, 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 P rmit 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. n I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. 1 agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said Coun y in consequenc of >;he granting of this permit. t/�°JAG X L�% C o L� Date 7— Signature of Applicant — Owner ❑ Contractor [IAgent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ ,, TOTAL PERMIT FEE $ � Occup. I CONST.TyPEJ I FLOOD PARCEL PD I ND I ISSUE This permit is hereby issued under sions of the Butte County. Code and/or work indicated above for which DIRECTOR , PUBLIC By PERM EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS to 7�-��Y Receipt No. WHITE-O.P.W'.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT ,�'orbe�to�t� �.obge50, July 10, 1987 To whom it may concern: By a motion seconded and passed by'the membership present at the stated. meeting of Forbestown Lodge #50, F.& A.M. held this date, Kenneth Lorber is authorised to act in behalf of Forbestown Lodge in obtaining the necessary permitting to up grade and modernize the electrical entry service and wiring of the Lodge hall. s Robert E. Gilbert - W.M. Ra and V. Whiteley, Secty COUNTY OF BUTTE - Department of Public Works 7 County Center Drive,.Oroville, CA 95965 OWNER -BUILDER VERIFICATION Attention Property Owner: Phone: 916-538-7541 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 personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) 2. I (have/have not) signed an application for a -building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed-, construction: Name - - Address City Phone Contractors License No. 4,. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address I City Phone Contractors License No. 5. I will provide some of the work'but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed: C_ Property Owner Social Security Date �71 NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. ;. t'rrt I t^tth• r r,;MJr, _ :Y• r ^r_ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - 7 County Center Drive - Oroville, ,California 95965 - Telephone: 916/538-754.1, APPLICATIOW AND- PERMIT PERMIT • c.SSE SO ARCEL NWBER �� zONI G BUILDING PERMIT :-OWN r n `T/jl{rl' r TELEPHONE 90, S0. FT. OCC. BUILDING VALUATION p, OWNER'S ZLNG AUDRE55 C:ONTR NAME i n -_CONTRACT 'S TELEPHONE MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ •-'ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee ,$ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ AUILDING ADDRE55i_�/_ � /�.l Permit fee $ PLUMBING PERMIT FilingFee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF,STRUCTUREGas SF ❑ Duplex❑ Mobilehome❑ Other �%t Gem �,SPEc FY piping system 1 - 5 outlets 1 5.00 Building sewer 5.00 Mobile Home S I G W 10.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other Describe work: Permit Fee $. Contractor ELECTRICAL PERMIT Filing Fee 10.00 i900V E!!� OR LESS Main service 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 1 2.50 S0 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check.one): F -1I 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 1, as.the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ .I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.M\ +/20sgh OR ADDNS. ACC, SLOGS. NEW CONSTR U TI.OUTLET 2.50ea NO N.RESID BRANCH CIRCUITS) /POWER APPARATUS e) 1 SINGLE OUTLET CIR. EOCCup(OUTLETS OR FIXTURES 20S50Q Ex. °"`e so FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 PiUmlt 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. n I shall not employ any person,in any manner so as to become subject to the W. C. laws of California. )\ I Notice to Appllcint:'If after'making this statement; should you become subject 1 to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions Ior this permit shall be deemed revoked., MECHANICAL PERMIT Filing Fee 10.00 Heating, _ i t Cooling Hood 3.00 Ventilation Penult Fee $ Contractor , 1, - R, i I certify that Fhave-read this-applicationa, and state-that'Ahe 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. I also agree to save, indemnify and keep harmless the County:of Butte against 1 all liabilities, judgments, costs, and expenses which may in any way -accrue j against said Coun y in consequenc of 4he granting of this permit. I EI �����_/i`J r X ;0dor4 hnv/ C �� Date ' Signature of Applicant - Owner ❑ Contractor [I Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- I ipii of structures over 3 stories in height. _ Mobile.Home Installation Fee '$"" -Energy Inspection Fee S TOTAL PERMIT FEE $ _1_?' Occup. CONST.TYPE ;, �; :>- } i' '[FLOOD - PARCEL PD ND IS9UE This permit is hereby issued under sions of the Butte County. Code and/or work indicated above for which DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. is WORKS � a Date Receipt No. — t WNI��;D.. P. W., T;ELlO W-A.l ee �u �, PI/I IE•S ERROD-APPLICANT 4 J,� m