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
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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