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Home My WebLink About078-090-032` / | | / ~ . / 6046 LINCOLN -BLVD'.. OROV+-.rTLAICKEY, ELSIEREPAIR-GAS-LINE/SF 01i %9Q -- '- -- ��-- - '-~ '- --r --- . ! . ' ) | . . ` / | , � ° ~' - ! / / ~ .- 6046 LINCOLN -BLVD'.. OROV+-.rTLAICKEY, ELSIEREPAIR-GAS-LINE/SF 01i %9Q -- '- -- ��-- - '-~ '- --r --- r 036-27--O--0-0-5------g-3--3-308 P LACKEY, ELSIE 6046 LINCOLN,. OROVILLE' REPAIR GAS LINE/SF y� 1 3 n 3 ell OPY _ Address GAS Meter By V Q 'Date ELECTRIC Meter By Date d C, . / J COUNTY OF BUTTE - DEPARTMENT "OF DEVELOPMENT SERVICES. - BUILDING DIVIZQ 7 County Center Drive - Oroville, Califolnia 95965 - Telephone (916) 538-7541�ER APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 036-270—W5Z�j BUILDING PERMIT OWNER Elsie A. lacks TELEPHONE 533-2675 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 4975 Virginia Ave. Oroville 959" CONTRACTOR'S NAME Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS i Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 20.00 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 $ 6046 Lincoln Blvd., Oroville PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00• Water piping •15.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SF)] Duplex ❑ Mobilehome ❑ Other SPECIFY Gas piping system 1 5 outlets 1 15.00 15.00 Building sewer 15.00 Mobile Home S G I W @20.00 TYPE OF WORK y New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation C) Other Describe Work: Repair Gas bine PERMIT FEE $',35.04 Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ' "OR LESS ) —2.00.A.0 LESS 23.00 Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADONIS. ( & ACC. BLDS. ) s0. 3.50 FT. CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) ❑ I am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification Ef I, as the owner, 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) O I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) ❑ 1 am exempt under Sec. , Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET NON RESID. ( BRANCH CIRCUITS ) @7.50 , POWER APPARATUS ) & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) BAL.20 @ 1:00 Ex. Occu FIXED APPLNS. OR p' ( OUTLETS (RESID.) EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities20,00 Misc. Wiring 28.00 WORKER'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. ,17 I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE S Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all Butte County Ordinances and California 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. +n J X <.l vim►, q i L� r -.,,-.rte Date/0- - Signature of Applicant -•[]` Owner ❑Contractor ❑Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ DCC CONST. TYPE TOTAL FEES 35.00 HAZ. I D. FEES I IMP I FlOOD I 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 which fees have been paid. IRECTOR OF PUBLIC WORKS ey '� —Date.50-1r9.3 PERMIT EXPIRES ON 5oer 9-d (Da tel 148979 Receipt No. , WHITE-D.D.S.-B.D., CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT OUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISIO 7 County Center Drive - Oroville,•-CclIifoiilia, 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT q 33 Q ASSESSOR PARCEL NUMBER 036-270-005 ZONING M-1 BUILDING PERMIT OWNER Elsie A. Lackey TELEPHONE 533-2675 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 4975 Virginia Ave. Oroville 95966 CONTRACTOR'S NAME Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 20,00 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 $ 6n46 Lincoln 'Blvd-, Orovi;lp PLUMBING PERMIT Filing Fee 20.00 Each Trap 1 7.00 Solar or heat pump water heater 23.00 Water piping 15,00 LOT NO.SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SF)] Duplex O Mobilehome O Other SPECIFY Gas piping system 1 5 outlets 1 15.00 15.00 Building sewer 15.00 Mobile Home S G I W @20.00 TYPE OF WORK New O Addition O Remodel O Utilities O Installation O Other isContractor Describe Work: Repair Gas Line PERMIT FEE $ 35.00 ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( BOOV OR LESS ) 200A OR LESS 23.00 Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. ORADONS. ( & ACC. OLDS. ) SQ 3.50 FT. NEW CONST. MULTI -OUTLET NON -REBID. ( BRANCH CIRCUITS ) @7.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) O I am a licensed under provisions of Chapter 9, Division 3 of the Business and P P 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 compensation, will do the work, and the structure is not intended or offered for sale. (Sec 7044) O I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) O 1 am exempt under Sec. Business and Professions Code forthis reason ( POWER APPARATUS ) & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 @ 1.00 BAL. .50 Ex. Occup.FIXED APPLNS. OR (OUTLETS (RESID.) EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): O This permit is for $100.00 (valuation) or less. 13 1 have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. kr I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all Butte County Ordinances and California 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. 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 against said County in consequence of a granting of this permit. n X E Date/19-5— 7 � Signature of Applicant &Owner O Con ractor O Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ ocC CONST. TYPE TOTAL FEE $ 35.00 HAZ. I D. FEES I IMP I FLOOD I COF PARCEL I PO HD ISSUE Thisermit is hereby y issued under the applicable provisions of the Bu a County Code and/or Resolutions to do work indicat a ov for hich fees have been paid. COR,OF PUBLIC WORKS By Date g c r93 PERMIT EXPIRES ON 94 IDetel Receipt No. 148979 WHITE-D.D.S.-B.O. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT e, COUNTY OF BUTTE'S 'Departmene�of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION 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 ma' bor and materials for construction of the proposed property improvement yes no)' 2. I have have not). signed an application for a building permit fo a 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 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: n Property Owner LCk Social Security Number Date 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. _ 1 COUNTY OF BUTTE .; BlyLDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (91.6) 872-6307 CORRECTION NOTICE k�2 OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work. is completed. F you have any questions pertaining to this matter, or need additional explanation, -' please contact this office immediately. Date 01,17111111 -Inspector REV 10192 %'t xF �_ro 3 iSyA < •f•X'-l. '�.�r.. tom" .��• x+• .j a.Tr ,,jj�,r r•!1s;. �ai"r"V`."ya`-. .� .y.:r s�.?� •, ° r..; r,i;,l`' :`�:�M^x'�iy.•',1;:' ;Yx �'" "'`��^'�}. •. ..gid � _ . i 91-4357 036-27-0-005 , LACKEY, ELSIE CONT: ROYAL FLUSH PLBG W 6046 LINCOLN BLVD, OROVILLE LINE/SF REPAIR GAS • i . e A—��S COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive • Orovllle, California 95966 - Telephone: 918%538-7541 APPLICATION AND PERMIT ASSESSOR P RC N 36-27-05 y G M I BUILDING PERMIT OWNER ELSIE LACKEY 533--"1� SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 6046 LINMLN BLVD OROVILLE CONTRACTOR'S NAME �T /'t ROYAL l �Jl SH PLII ING TELEPHONE ONE CONTRACTOR'S MAILING ADDRESS P.O. BOX 266 PALERMO 95968 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee ,$' Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS s Penalty $ BUILDING ADDRESS 6046 LINCLN BLVD OROVILLE Permit fee $ PLUMBING PERMIT Filing Fee 15.00 j t Each Trap 5.00 i ` Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE f SFX Duplex❑ Mobilehome❑ Other • SPECIFY Gas piping system 1 - 5 outlets 5.00 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Otherk Describe work: REPAIR GAS LEAK Permit Fee $ 20.00 Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 200A OR LESS 18.50 Main service 200A TO 1000A, 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ 1 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) Q I, as the owner, am exclusively contracting with licensed contra ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.& OR ACDNS- ACC. BLDGS. 3.54sq.ft. NEW CONSTR MULTI -OUTLET NON•RESID BRANCH CIRC ITS @ 5.00 POWER APPARATUS6 SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES AL 0 20 Ll 76 Ex. Occup. OUTLETS (RESID.)REA.) I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00ct- Misc. Wiring g '15.00 Permit Fee $ — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. F.1 I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code,„you must forthwith comply with such provisions or this permit shall be deemed revoked., Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating Cooling Hood 6.50 Ventilation Permit Fee $ Contractor I certify that I have read this application,and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 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. Date ! Z - I- _ f 1'%/ Signature of Applicant — Owner ® Contractor ❑ Agent ❑ An OSHA ion of structures tover 3gstories oineheigght ions over S'0” deep and demolition or construct- Mobile Home Installation Fee $ Ener Inspection Fee $ 9Y P OCC CONST TYPE TOTAL FEES 20.00I HAz I OFEES I IMP I FLOOD I CDP I PARCEL I PD I HD I ISSUE This permit is hereby issued under the sions of the Butte, County Code and/or work_ indicated Bove for hi h fees DI ECT � OF PU IC BY r1&4 PERMIT EXPIRE Date 1?- applicable provi- resolutions to do have been paid. WORKS Date 7 `Z off 7 Receipt No. 1(lml.j WHIT[-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY'OF BUTTE DEPARTMENT OF PUBLIC WORKS at 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 K l� CORRECTION NOTICE ^i OWNER PERMIT NO. x A routine inspection indicates that the following violations of County Ordinance ' exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional. explanation, please contact this office immediately.' Ito t� ;f5 r • �rrt t: k: a su f Date / Inspec ,or _ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS DEAMIT NO. �. 7 County Center Drive - OrovIIIe, California 95965 - Telephone: 916/538-7541 APPLIChTION. AN& PERMIT 7 ASSESSOR PARCEL NUMB R 36-27-05 ZONING M 1 BUILDING PERMIT OWNER ELSIE LACKEY 7533'2675 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 6046 LINCOLN BLVD OROVILLE CONTRACTOR'S NAME ROYAL FLUSH PLUMBING TELEPHONE CONTRACTOR'S MAILING ADDRESS P.O. BOX 266 PALERMO 95968 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 6 LINCLNBLVD OROVILLE r Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 1 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SFX Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 5,00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other Describe work: REPAIR GAS LEAK Permit Fee $ 20.00 Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A OR LESS 18.50 Main service 200A TO 1000A) 37.50 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 I, as tf:e 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.A\ 3.Sd sq.ft. OR ADONS. ACC. BLDGS. // NEW CONSTR ULTI.OUTLET NON.RESID BRANCH CIRC ITS @ 5.00 (POWER APPARATUS 6\ SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 @ 750 FIXED APLNS.❑ Ex. Occup. OUTLETS (RESID )REA.1 I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. bVirin 9 15.00 Permit Fee $ — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ®' I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 15.00 Heating Cooling g FHood 6.50 I Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in onsequence of the granting of this permit. X Date Signature of Applicant — Owner ® ontractor ❑ Agent ❑ An OSHA for height.ions over 5'0" deep and demolition or construct- ion of strHA wrest over required Mobile Home Installation Fee $ Energy Inspection Fee $ occ cONSTTVPE TOTAL FEE $ 20.00 I HAz DFEES IMP I FLooDT= HD ISSUE This permit is hereby issued under the applicable provi- sions of the Butt County Code and/or resolutions to do work ' icat ove or w h fees have been paid. CT OF PU IC WORKS B Date ,2 Z PE IT EXP R Date Receipt No. ��r , WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Orovllle, California 95965 - Telephone: 916.`538-7541 APP,UC�TIO-`1 Ab PERMIT ASSESSOR PARCEL NUMBER _ _ ZONING BUILDING PERMIT OWNER �/ <•j TELEPHONE 533 26 `2S SO. FT. OCC, BUILDING VALUATION OWNER'S MAIu ADD ESS LI /NGO(n) 65e0 (/) CONTRACTOPrSNAME r/U TELEPHONE CONTR CTOppR'S MAILING ADDRESS // qq �(y. 170 k Z (o G 1e�M0 �� Jr! 6� Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is rlling FCC $ 15.00 LENDER'S MAILING ADDRESS P -.it Fec $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS I, L/ / '` U V Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 1 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE-- SF,& Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 5: 00 Building sewer 15.00 Mobile Home I S FG JW I @ 15.00 TYPE OF WORK New ii Addition LJ RemodelE] Utilities ❑ Instaallation ❑ Other[q Describe work: R� f�T'�//2 �c/I* 5 Le--l-1k_ Permit Fee $ 120. c9 t� Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 2000AA OR LESS 20OR LESS 18.50 Main service 200A TO 1000A) 37.50 CONTRACTORS LICENSE LAW I declare under penalty p y of perjury Iur y (Check One): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the BuslnesS and Professions Code and my license Is In full force and effect. License No. ClassificationEx. ❑ 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 OCCUPM OR ACDNS. ACC. BLDGS. // 3.6Q sq.tt. NEW CONST R. MULTI.OUTLET NO N.RESID BRANCH CIRC ITS @ 5.00 POWER APPARATUS e (SINGLE OUTLET CIR. Occup( OUTLETS OR FIXTURES 20 7FIXED APLNS.6d \ Ex. Occup. OUTLETS P(RESID )REA.) I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring '15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 15.00 Heating Cooling I Hood 6.50 I Ventilation permit Fee $ I Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature pp ❑ Contractor ❑ Agent ❑ nature of Applicant — owner 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 S Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ -,2 I HAz DFEES IMP I FLOOD CDF I PARCEL I PD I HD I ISSUE This permit is hereby issued under the sions of the Butte County Code and/or sions work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date //' 36 Receipt No. V 7 WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT