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HomeMy WebLinkAbout078-160-012mom HAY, Bill PERMIT#97— o i 5675 Nicolai Dr., Oroven�f/') Cont: Selig Construction /Q/o� Vinyl Siding/SF ' JAN -26-2007 03:45 PM LOAPUD 5305331750 P.03 7 Lake Ozrowillc Area. Public U slit District* - 1,980 Fagtn street /" (04 0_011 OROVILLE. CALIFORNIA. 99960 .03 V/ 1490) 699.9000 DISTRICT APPROVAL AND VERIFIC TIO_ N_ OF.SUILDIN SEWERS IIdSPECTIOId . This verification.'form form must be submitted to the Butte, County .Dep r3ment of Public Warks. -Building Department prior to issuance of: A building or occupancy permit, whichever fs applicable. Prior to final approval of a•Building or an_Occupancy Permit by Butte County, a copy of.thls verification .form, signed off by Lake Orovllle Area Publlc Utility District, 'must be submitted to. Butte County.... Date: January 17, 2006 Applicant: David Nagle. AppllcantAddress: 5655 Micola.i Ave.., Oroville-,..'17A. 9.5.9.66' ' (530) 534--81 `; 9 Applicant Phone No.;. 5675 Ricola.i Ave. ,• 0roville, CpF ' 95966 Property Locations(s): Villa Verona, A Par -tion of .L 't .#7, Klerk #114 078-169-01-2 A.P. No. (s): Fees du®: Capaci-ty Charge -$1 a 360, 00, C xine ki a► NE°e-$709a 00 SG-Q.R Facilit.,r Charq&-$1,368 Annakatlon-$200400 CO�cr�ac t ��xaetit�cl . hutn�t:c? sew :.r.-conver.-ti rig txom set�,t-,i-c, Fees padd 1/16/07. Application for service ,approved: ' LAKE OROVI LE AREA PUBLIC UTILrr, DIBTRIC'i' lnspectlon(s) made and, succeesfui teet(e) observed: Locatlo• SG 7S I)ate: BY: -97 Lake Oroville Area Publlt Utility Dlstridt rel D U• Date; �--21-.a 'I sy: - In -Service U - Locked Out White - Customer 0reen`- 0/4e F/ntyf . -to tlose Yellow - CuabmeiF/na/ - FOS FIN/ :y'{�.-� Ai+Try-c �.a�-�gf1Gi,�sl,•..1'•F-riN'r'i"...�.,y�C.$r101'��^.dRi'�'17."l.'��'.r} +'. �,iviT3S''7lir"'.,��..sf'.tT�r+..� -'a�l'v� ^aila+sTr".v vy .m.Ze; re t 1:..�^s 1 �'ar_ 036-650-012 PERMIT#97-1880 r HAY', Bill 5675 Nicolai Dr., Oroville Cont: Selig Construction Q Vinyl Siding/SF J d� T, COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 P r lT0 (Rev. 12/96) APPLICATION AND PERMIT jSIIJJ ASSESSOR PARCEL NUMBER 3itl..h ZONING — f"CDING PERMIT OWNEF ILL Twp Al TELr�Pl�pe,�65� a �-. SO. FT. OCC. BUILDING VALUATION h IN13617I1U oPV .Dt:�t1.,AI DR, OROVILLE CONT'.71�U !!NST TViVb21I CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDERS MAILING ADDRESS Total Valuation $ 5026 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDIJG J^ ESR ICOLAI DRIVE, OROVILLE Energy Plan Checking Fee $ PERMIT FEE S 'U LOT NO. SUBDNISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF q Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat.pum water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK X New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ NEW VINYL SIDING Describe Work: Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S I G I W @20.00 PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.00 Main Service loon oa mss 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full ll force and effect. ! / y License Class (_] Llc. NO. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service ( 200A To 1000A 46.00 NEW CONST. DWELLING OCCUP. So OR ADDNS. ( 8 ACC. BLDS. 3.50FT. NEW CONS.9 TS @7.50 NON -RES DT RAMC I CIRCUITS POWER APPARATUS 8 SINGLE OUTLET CIR. Zo 1 .00 Ex. Occup. OUTLET OR FDRURES BAL O .50 Ex. Occup. ourLEIf RES UNS D.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 T: PERMIT FEE _ 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 �,�.t..� %(` T/L Sv/��/l�C (" ��'��/c i' S MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE S Policy Number S'o q 3 -3 (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 G"L'" � ". Date ( � _ Signature of Applicant - ❑ Owner ❑ Contractor , 18. Agent An OSHA permit is required for excavations over 60" deep�� and demolition or construction of structures over 3 stories in height. 11 Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE 101 TOTAL FEE $ HAZ. 1 D. FEES IMP FL000 1 CDF PARCEL PD I 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. �j►�, 9/2/97 By1 Date _ PERMIT EXPIRES ON v 9/2/98WHITE-D.D.S.-B.D. Date ReceiptNo. 70 C/ 6 / \ CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT G` COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES- BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PER No. (Rev. 12/96) APPLICATIONANbPERMIT r7` ASSESSOR PARCEL NUMBER ZONING DING PERMIT OWNEQ,ILL HI?�XX HAY TEL PHONE1657 SO. FT. OCC. BUILDING VALUATION CONTR 5,696 GWNFf�jsOTGOMLAI DR, OROVILLE �oNTI�� 7111ONST T532.0200 CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS ' Total Valuation $ 5,626 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 5675 NICOLAI DRIVE, OROVILLE Energy Plan Checking Fee $ $ PERMIT FEE 3i0l .00 IAT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF [R Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Describe Work: NEW VINYL SIDING Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI GI W @20.00 4 PERMIT FEE S ELECTRICAL PERMIT Fling Fee . 20.00 Main Service ioon oA'ss 23.00 LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect./ /�� License Class C� 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 TO 1 46.00 NEW CONST. DWELLING, EE ING OCCU CUP. OR ADONS. ( 8 ACC. BUDS. SO 3.5a FT. N CO9 NORESIIDT ANCTI N-CICUET @7.50 POWERAPPARATUS &SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURE 20 @ 1.010 BAL o .50 Ex. Occup. ouTLEET Aao�eA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S 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 �/2f/d/�i' �/liS�'���-_(� c5 ��t/7�< eS, Policy Number / ,j q A 7 (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 employ any person in any manner so as to become subject to workers' notD. compensation laws of California, and agree that if I should become subject to theX workers' compensation provisions of section 3700 of the Labor Code, I shall forthw' compI with those provisions. _ X Date _ _ Signature of Applicant - ❑ Owner ❑ Contractor M Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 101.00 HAZ- FEE IMP FLOODCDF PARCEL PD J.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. ate 9/2/97 9/2/98 Date Receipt No. Z WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD•APPLICANT