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Home My WebLink About078-090-029D'7g- D q D=- Q� WISE, William A. 1131-71B* 335 71B y 805-72(.B)±* 4j ' 2247-73P,E*** PERMIT#97-1753 r r v RUSSEL, Dorothy 6090 Lincoln Blvd., "Ovil {. 6090 Lincoln Blvd., Oroville ..(new boat storage bldg.) -� -� Repair E1e Serf MH (*addn. to boat storage b 10��%� (Addition -Boat storage bldg % a ,7,y' (***gas & elec. o ly for ex. mo Te Y 036-270-052.. ,..PERMIT#97-1753'. RUSSEL, Dorothy 6.090 Lincoln Blvd., Oroville Repair Ele•Ser/MH �9l L, OFFICE COPY Address --------------- GAS Date .t. Meter By CT Rllt� 4e--�' Meter By Dat ' 1 r r r COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION .•4 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. (Ret.•12/96)--t APPLICATION AND PERMIT 97--- z 1 AS SESSOR PARCEL NUMBER 36-270-052 ZONING BUILDING PERMIT OWNER DOROTHY P.USSEL � TELEPHONE 533-4530 SQ. FT. .00C. BUILDING VALUATION OWNER'S MAILING ADDRESS PO BOR 1149 OROVILLE .. 95966 .. ��'` • ` CONTRACTOR'S NAME { OWNER TELEPHONE �. CONTRACTOR'S MAIUNG ADDRESS CONSTRUCTION LENDER ` Fireplace LENDER'S MAIUNG ADDRESS ( Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. —Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAIUNG ADDRESS -. Plan Checking Fee $ BUILDING ADDRESS 6090 IJINCOLN BLVD Energy Plan Checking Fee $ OROVILLE, 95966 PERMIT FEE $ LOT NO. SUBDNISION'S NAME t PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome p 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 Q. Installation ❑ Other ❑ A Describe Work: REPLACE DAMAGED ELEC SERVICE r Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 Main Service i..A oa o=ss 23.00 2-1.00 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 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 Main Service ( 200A TO 10-A 46.00 NEW CONST. DWELLING OCCUR so OR ADDNS. ( & ACC. BUDS. 3.5¢FT_ NEW CONST. MULTI -OUTLET NON-RESID. ANC @7.50 EPPARATUCIR.S PSIOWE E 8NGLR AOUTLT 20 @ 1'00 OUTLET OR FIXTURES Ex. Occup. BAL @ .50 Ex. Occup, ouTEEors RESo.1El 5.00 Temporary Service_ 23.00 Mobile Home.Facilities 20.00 Misc. Wiring 23.00 pp *t nrv 1 7 - m,aPERM T F E S M 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 MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling ` Hood 6.50 Ventilation PERMIT FEE $ Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) fl, 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 forthwith comply with those provisions. X ��. _ Date �__ Signature of Applicant - ❑ Owner ❑ Contractor UrrAgent l . An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 66.00 HAZ. D. FEES IMP I FLOOD I COF PARCEL I PD HD ISSU 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. y � B A I' tC/tp�✓/�f `U Date 7 � j Q � PERMIT EXPIRES ON /�,? 0 �l ? / Dafe r Receipt No. 2 2 q;Z 7h, WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 7 LM COUNTY OF BUTTE- DEPARTMENTQF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. (Rev.12/96) • APPLICATION AND PERMIT 97 ASSESSOR PARCEL NUMBER 36-270-052 , ZONING BUILDING PERMIT OWNER DOROTHY RUSSEL TT IT24530 SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS PO BOX 1149 OROVILLE, 95966 ' CONTRACTOR'S NAME OWNER TELEPHONE ' CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE N0. Filing Fee $ 20.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Permit Fee $ Plan Checking Fee $ BUILDING ADDRESS 6090 LINCOLN BLVD Energy Plan Checking Fee $ OROVILLE, 95966 $ PERMIT FEE $ LOTNO. SUBONISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome 10 Other SPECIFY Each Trap7.00 Solar or heat um water heater 23.00 Water piping 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities 1� Installation ❑ Other ❑ Describe Work: REPLACE DAMAGED ELEC SERVICE Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service EIIV OR LES3 2o0A OR LESS 23.00 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 Divisibn 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 for the following reason: R3L 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 200A TO 1000A 46.00 NEW CONST. DW EWNG OCCUR OR ADDNS. ( a ACC. B.S. SO 3.5¢FT; NEW CONST. AUnL�TI-CUTCLET NON•RESID. @7.50 POWER APPARATUS & SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES B20 @ I.00 Ex. Occup. ourLEEDrsAPRESIo.O50 EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PRIE PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) 1* 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 comply With those provisions. X �Date F7 Signature of Applicant - ❑ Owner ❑ Contractor 13"Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE'$ 66.00 NAZ. D. FEES IMP FLOOD COF PARCEL PD HD ISS This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have ByD PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. to 2i 7 Q A Date Receipt No. 2, % WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT-- COUNTY OF BUTTE DEPARTMENT O D �_'.LOPMENTSEWVICES -BUILDING DIVISlN 7 COUNTY CENTER DRIVE - OR11 OVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541 PERMIT AP. PL''IC I TION DATA SHEET OWNER: ( ASSESSOR PARCEL NUMBER: Proposed Building se: �G, L , ,�'Uy- Building Inspector: �' Date: At time of permit application, I was advised the following data must be submitted prior to pe proidIssing and/or issuance: �,, e-,, Date Received By ❑ 1. All items have been submitted .-------------------='-----=--------------------------------------------------------- i t ❑2. Plot plans, 3/4'sets, signed by the preparer of plans.-- '-------------------------------------------------------- ❑3. Complete plans, 3/4 sets, signed by the preparer of plans. ------- --------------------------------------------- E14. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. -------- ❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ----------------- 06. Energy Design Compliance and supporting documentation. ---------------------------------------------------- 117. --------------------------------------------------- ❑7. Statement of Intent for Non -Heated and A/C Buildings. ---------------------------------------------------------- El8. Hazardous Material Form. ------------------------------------------------------------------------------------------ ❑ 9. Manufactured Home data and installation instructions including Tie Down Specifications .------------------ ❑ 10. Fees of $ t/, G, —`�� ❑ 11. Impact fees as shown on the attached schedule. ----------------------------------------------------------------- ❑ 12. California Department of Forestry plan approval/fees.--------------------------------------------------------- 1113. --------------------------------------------------------❑13. Flood elevation certificate. ---------------------------------------------------------------------------------------- ❑ 14. Sanitation and plot plan approval HealthDepartment. -------------------------------------------- Ell 5. ------------------------------------------ ❑15. City of Chico plumbing permit. ------------------------------------ .. --------- ----------------------------------------------- ❑ 16. Plot plan and business license approval from the City of Biggs. ----=----------=----------- I ------------------- ❑ 17. Planning approval for (A) Use: (B) Parking: __________________________ ❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel.----------------------- ❑�croachment Permit for driveway (construction approval prior to occupancy). ---------------------------- d. Pre -inspection for A!F4�� -- required Request to Buil ing Inspector on - ❑21. Contractor's license information. (Number, Name Style, Classification).--- ----- -------------------- 022 Workers' Compensation carrier and policy number ----------------------- - - - --------- Owner -Builder Verification (Given o owner ❑, Mailed to owner . ----- t%- ----------------------------- g A4. Letter of signature authorization. ---------------------------------------------------------------------------= --- .r r 025. Recorded copy of Agricultural Acknowledgment Statement. 026. Letter of intent on building use. ---------------------------------- ❑ 27. Manufactured Home utility clearance. -------------------------- 028. Existing violations and/or expired permits. -------------------- ❑29. 0433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ 030. Other: When you issue the permit,process as follows 11 Mail to owner, ❑Mail to contractor. C&TelephoneS,,33— /6 and hold for pickup at 0/'0 office. ❑ Deliver with inspector. (Date) Applicant: /Date: V Ia `1, 7 Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution Date: By: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By: 1. Index permit application for the above items numbered: ❑ Plan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Divisiorcounter, by Date' Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Plans reviewed by: Date: Plans approved by: Date: Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: Yellow Copy - Department of Development Services, Building Division. (Rev. 12/96) COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION! AND PERMIT ASSESSORPARCELNUMeEA _ — 7� ZONING BUILDING PERMIT OWNER A 11 SO. FT. OCC. BUILDING VALUATION OW S MA AD iESs ` CONTRACTOR'S RAME cd TELEPHONE ' CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER [Fireplace LENDER'S MAIUNG ADDRESS ' Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing FBA $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS HARING ADDRESS Plan Checking Fee $ BUILDI GADDRESS v ) Energy Plan Checking Fee $ $ PERMIT FEE $ LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF O Duplex O MobilehomqR�,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 O Remodel ❑ Utilities M Jnstallation O Other O Describe Work: /4 92 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service q OOR R LESS 23.00 !gyp LICENSED CONTRACTOR'S DECLARATION 1 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 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. O I 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: O 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. ❑ I 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 (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 forthwith comply with those provisions. X _ _ Date Signature of Applicant - ❑ Owner O Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service 200A TO J0 A46.007, NEW CONST. DWELLING OCCUR So OR ADDNS. ( a ACC. BUDS. 3.50FT: T. NON -RID. MULT I.OLJTLET @7,50 POWER APPAIiATUS 8 SINGLE OLRLET C'0. Ex. Occup. OUTLET ORFD(TURES 20 ''00 BAL O .SO LM Ex. Occup. GFIxuT,EE°TSA AFs OR F. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 — 2. , pa -� PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST.E TOTAL FEE $ :.ALI.TYFEES IMP FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date Date Receipt No. 2-ZU?ee WHITE •D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT RECEIVED) 2�8 I SEP 0 8 1997 OWNER-B� �;�1_ :1NVERIFICATION 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 personally plan to provide the major labor and materials for construction of the proposed property improvement: YES 0 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: PHONE: CITY: 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: PHONE: CITY: 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 NUMBER: DATE: 4VC21197 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 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. For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such 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 should 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 materials and other co_etsy-is S?00 or more for the entire project, and such persons are not licensed as -contractors -or subcontractors, then youmay be an employer. ' ♦ 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 security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ 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 abouty our obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited 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 contractors 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" on the reverse side of this form so that we can confirm that you are aware of tiiese mailers. The building permit will not be issued until the verifcadon is returned. i rely, Mic el C. Vi ira, C.B.O. Ma ger, Building Inspection NOTE. This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code OVER r U RUSSELL'S STORAGE 6102 LINCOLN BLVD. OROVILLE, CA. 95966 COUNTY OF BUTTE BUILDING DIVISION KENNETH R. BRYCE IS AUTHORIZED TO SIGN FOR THE REQUESTED PERMIT. WE ARE PERFORMING OUR OWN REPAIRS. SUCERELY DOROT RUSSELL OWNER r7 tt LS 1) LOCATION: A.P* ZONING: CONTRACTOR: PRE -INSPECTION FOR - DATE To INSPECTOR: Lo PERMIT HISTORY:]NONE 1,1;��FOLLOWS: - TYPE OF OCCUPANCY. I BUIELDING INSP'ECTOR'S REPORT inj Description: c9mmerciabusnee Residential/# of Units: Currently occupied. AbandonedNacant. ric: es J'No Electric is currently On caoff Condition of electrical? Mobile Home: Y 11( .-,�rrently Oii( I r pan None[ NaturalivA,,p o e Obvious pfoblems: sanitation: I Plumbing working Yes[ VKNOI I es Potable water Y N Well: Yes[ ] No[ I Obvious Sewage Problems: Action Recommended: k"IIssue Hold Y Off[ MWF' .—, noh-- M 0 1-1 1 M WISE, William A. 1131-71B* 335-71B 7-5P, 805=12 y/ . - a 2247-73P,E*** 36-27- 6090 Lincoln Blvd., Orovil (new boat storage bldg.) - -71 (*addn. to boat storage b (Addition -Boat stora e bldg x/2 (***gas & elec. oily ,tor ex. mo; lie ag 73 CO G X0,2 � heY4 44 61 ' (Rev. 12/96) COUN BU PARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 Court nter D e - Oroville, California 95965 - Telephone (916) 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 36-270-052 ZONING - BUILDING PERMIT OWNER DOROTHY RUSSEL TE IT24530 SO. Fr. OCC. BUILDING VALUATION OWNER's MAILING ADDRESS PO BOX .1149 OROVILLE, 95966 CONTRACTOR'S NAME OWNER TELEPHONE ' CONTRACTORS MAIUNG ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ Filing Fee $ 20.00 ARCHITECT OR ENGINEER LICENSE NO. Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 6090 LINCOLN BLVD " Energy Plan Checking Fee $ OROVILLE, 95966 PERMIT FEE $ LAT NO. SUBDNIS IONS NAME PARCEL MAP - PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF O Duplex ❑ Mobilehome JI Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New O Addition ❑ Remodel ❑ Utilities 9( Installation O Other O Describe Work: REPLACE DAMAGED ELEC SERVICE Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home SG W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service p 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. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: (�L 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 Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUR OR ADDNS. ( 8 ACC. BUDS. SO 3.5QFT, ,tO" IC ONMULTI-OUTLET @7,50 POWER APPARATUS a SINGLE ounET cIR EX. Occup. OUTLET OR FDRURES .00 BAL 20 1.50 Ex. Occup. OEAa oR� 5.00 .00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PRE INSPE121112IN (MH) 23 -nn ),i nn PERMIT FEE $ 66,00 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: O 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. O 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 (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) 1%-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 comply with those provisions. X Date __ Signature of Applicant - O Owner ❑ Contractor L"Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 66.00 HA2. D. FEES IMP FLOOD CDF pgpCEl pp HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date _ Date Receipt No. 22- yZ 90y WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT