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Home My WebLink About078-210-009ROSERIO GUZMAN j5388 Farley, Oroville �,ontr: Norms Roofing, Oroville 2-83B reroof & smoke detector/ Permit#286 i , SF 8!3 6 959 999 PERMIT#97-1440 PADILLA, Fran 5388 Farley St., Oroville� Cont: Butte Roofing Co. �� Reroof/SF B08-0542 078-210-009 MISCELLANEOUS Wall Furnace WALL FURNACE CHANGE OUT 5388 FARLEY ST BELSHE, SUE 012. ajo.064 pA-Bio-oo9 ��--r�� BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION t Site Address: 5388 FARLEY ST Owner: Permit No: B08-0542 APN: 078-210-009 BELSHE, SUE Issued Date: 03/27/2008 By TMP Permit type: MISCELLANEOUS 5388 FARLEY Subtype: Wall Furnace OROVILLE, CA 95966 Expiration Date: 03/27/2009 Description: WALL FURNACE CHANGE OUT Occupancy: Zoning: R1 Contractor Applicant: Square Footage: ARTIC AIRE OF CHICO INC ARTIC AIRE OF CHICO INC Building Garage Remdl/Addn 2350 PARK AVENUE 2350 PARK AVENUE CHICO, CA 95928 CHICO, CA 95928 Other Porch/Patio Total (530)895-3330 (530)895-3330 FEE INFORMATION DBM Heater (Wall) $59.00 Total Charged: $59.00 Fees Paid: $59.00 Balance Due: $0.00 Receipt No: B6823 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License ARTIC AIRE OF CHICO INC 234913 / B C20 C 2 / 01/31/2010 Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed 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 pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects X 03/27/2008 the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: Contr ors Signature Date ❑ 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 WORKERS' COMPENSATION DECLARATION OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractofs License Law does not apply to an owner of the property, who builds or improves thereon, and who does I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements E]I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). ❑I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractor's License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Cartier: ACE AMERICAN INSpolicy Number:RSCC4444706A Exp Date:12/31/2008 Contractor's License Law.). (This section need not be completed if the permit is for onT a hundre dollars ($100) or less. ❑ I AM EXEMPT under Section B. 8 P.C. for this reason: ❑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 the Workers' Compensation Laws of California, and agree that if I should become subject to the workers'X 03/27/2008 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owners Signature Date provisions. X03/27/2008 I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Sign t Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, including death, and property damage caused by, arising out of, or in any way connected with HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the property owner or am authorized to act on the property owner's behalf. CONSTRUCTION LENDING AGENCY Jp 03/27/2008 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Nam a mittee [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) 0 Owner ❑ Contractor OR. ElAgent for Owner nt for Contractor FILE COPY Lenders Address City State Zip BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION **PLEASE PRINT CLEARLY** OWNER Last Name is Ae First Na 3U Address CitytateL22 SRA Zip h Phone Fax E-mail APPLICANT SIGNATURE X For office use only: CONTRACTOR Name Name 1L � SRA Address I No e City1 _'', Y State Book Zip Phone Fax Q _ E-mail Lic. #� �Q i Class r a APPLICANT SIGNATURE X For office use only: ARCHITECT/ENGINEER Name Flood Zone Address SRA City I No State Zip Phone Book Fax E-mail City State License Number APPLICANT SIGNATURE X For office use only: APPLICANT NAME Name Flood Zone SRA I Yes I No Address Type Const , ` AV Book Page e 0\_k e City Date Approved: State Zipa `1a Phone , 3 _ Fax 157Y) -$ E-mail 1, ca. r I ce x r APPLICANT SIGNATURE X For office use only: Zoning Flood Zone SRA I Yes I No Occ. Type Const Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT 506 BP BIN # LOCATION AP# � el , I f1 r ooCf d�c Property Aress �j V City 3k Cross Street WORKER'S COMPENSATION Policy Number Carrier mer i r \ \ l If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance, LENDING AGENCY Name Address Description or Scope of Work: Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: Amount: Bldg SRA Receipt M Sheriff SMIP Date: Other OVER FOR SUBMITTAL REQUIREMENTS I I Total I I Artic Aire . 2350 Park Aveinue Chico, CA 95928 (530)895-3330 Fax (530)8929930 Contact: Karrie Johnson Lic. B• C20 -C2 X234.9,1 3 Worker's Compensation. ACE American Insurance Co. #RSCC4444706A Permits To Be Pulled Permit Information Job Name: Job Address: 5-.3 City & Zip Code:__ Phone Number: Type Of Job: hange Out Cut — In Move Unit Type Of Equipment. - Package Unit Split System . A/C.Only Heat Only Heat Pump Package Unit Wall Furnace Heat Pump Split System Equipment Size: BTU Cooling: BTU Heating:_% Type Of Permit Required: r Mechanical Plumbing Electrical Location: Roof Attic Ground Closet Wall Basement Notes: BUTTE COUNTY DEVELOPMENT- SERVICES - Complainant: Address: .. Phone Number: Other Comments: Inspector must draw a plot plan with all building locations: Additional comments from Inspector: 2 036'350-009 PERMIT# 9 7-144_� PADILLA-, Fran 5388,Farley St., Oroville -Cont:-Butte Roofing Co. Reroof/SF 90 4a� l�T+tin53�'!rziawgR°j'�' .`'++yd= a "*�•T'Tj„?�`.' a', 7�i :. .;-:•r.'�':.+1.:.1:.-F.�=�t.'..r:'`t��.,7'�`#+::(�y''i`.rr.:�Fn°f'l�::T'I�"'�: �''��*"_ _ COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County :Center Drive - Oroville,01 California 95965 - Telephone (916) 538-75 PE MIT NO. APPLIC41J AND PERMIT ASSESSOR PARCEL NUMBER 350 — 00 t ZONING BUILDINGPERMIT OWNER TELEPHONE J SO. FT. OCC. BUILDING VALUATION OWNER'S MA NG ADDRESS 6s- Ssl CONTRACTOR'S NAM TELEPHONE- CO TOR'S MA UNG ADDRESS • �. (� f' _ Fireplace CONSTRUCTION LENDER UN OWN Total Valuation $ Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ 3 /n ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDINGADDRESS _ PERMITFEE $ PLUMBINGPERMIT Filing Fee 20.00 i i T - .'•a,sr 11F.0.n T O:.Im. .-.Ir.s Jo- i':, "If 7.00' LOT NO. SUBDI'VISION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF,N Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ A Other.Z�UAy ' Describe Work: "� /L�y / Mobile Home S I G I W @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filin Fee 20:00 Main Service ( 000V OR LESS - 200A OR LESS ) 23.00 Main Service.,( zooA To I000A ) 46.00 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 iinn,full f rce-and effect. �^ 1 % /�� Class (� Lic. No. J (p ! b LTD O NER-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-_- - -. i_ _ • .. • J _:. L ..i NEW CONST. DWELLING OCCUR so. OR ADDNS. ( d ACC. BLOS. ) 3.50 FT. NEW CONST. MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) d SINGLE OUTLET CIR. Ex. Occup. (OUTLET OR FUTURES ) BAL @ 15500 License FIXED APPWS. OR Ex. Occup. ( OUTLETS (RESID.) EA ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor WORKERS' COMPENSATION DECLARATION i 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'.corppensation insurance carr' r and policy number are: Carrier MECHANICAL PERMIT* Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number ') / (The above sections need -not 6e completecT'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 manne'r 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. A,%_ _ Date _7— 3 —�__ 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 $ Occ CONST. TYPE V TOTAL FEE $ HAZ. D. FEES IMP FLOOD CDF PARCEL PD 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. Date By f I�"/ / .t-�/ // PERMITEXPIRESON (Dte) Receipt No. (;j 4 d WHITE•D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVIS 7 County Center Drive - Oroville, Califor.,ia 95965 - Telephone (916) 538-75 EMIT o. APPLICATI-ON AID PERMIT _ ASSESSOR PARCEL NUMBER (_ — 250 , Do 1O �r.7 C.J�J ZONING BUILD NG PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S LINO ADDRESS COMOR'S NAM a TELEPHONE.' CO 'S NO ADDRESS �. Fireplace CONSTRUCTION LEN E UN OWN Total Valuation $ Filing Fee $ 20.00 LENDER'S MfJUNG ADDRESS Permit Fee $ ell. 0 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDINGADDRESS O-PPERMITFEE $ , 0 PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF uplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ AUtilii6_es ❑ Installation ❑ Other Describe Work: — Mobile Home S G W @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filina Fee 20:00 Main Service OOOV OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO I000A ) 46.00 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 i full f rc nd effect. // �-7 / ��-7� License Class Lic. No. S(p L F� Vy 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. ❑ 1, 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 NEW CONST. DWELLING OCCUR OR ADDNS. ( a ACC. BLDS. ) SO. 3.50 FT. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 ( POWER APPARATOUTLET US ) 8 SINGLE CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 @ I.00 BAL so FIXED APPS. OR EX. OCCUp. ( OUTLETS (RESID.) EA ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor 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' en atio insurance carr' r and poi c number ar Carrier MECHANICAL PERMIT Filing Fee 20.00 9 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be complete 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 fortwith comply with th se pro 'ions. X ate 7- Signature of Applicant - ❑ Owner ❑ Contractor 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 Is Occ CONST. TYPE TOTAL FEE $ / HAZ. I D. FEES I IMP I FLOOo CDF PARCEL PD 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. YMzdJ/D to PERMITEXPIRESON () (Date) Receipt No. f WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT ^ wP.� il Permit#2862-83B Roserio Guzman J-- COUNTY OF BUTTE -ENT OF PUBLIC WORKS 7 County Center Drive - Orovill alif is 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER r _,. F5 ..,-.. `� ZONING BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS CONTRACTOR'S NAME A.In AW 1.Ie DOS/ ) G TELEPHONE CONTRACTOR'S MAILING ADDRESS y(/ �� L Fireplace CONSTRUCTION LENDER I UNKNOWN Total Valuation $/-) V Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 2500 ARCHITECT OR ENGINEER --W%,3-at I LICENSE NO. I Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ 7Sr% BUILDING, ADDRESS �1 �y�L�� 14 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF ❑�[ Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home TSTG W 10.00 e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other'0 Describework: �%P _�lit/)SlF L� Tc_ rro Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V OR LESS 100 AMP OR LESS 10.00 __ i Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ( ACC. BLDGS. 2t/20sgIt CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Bus ness and Professions Code and m license is in full force and effect. 0 e S y r ,� -� License No. Classification F1 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 CONSTR (MULTI -OUTLET 2,50 ea NON -REBID BRANCH CIRC ITS NEW CONSTR. / POWER APPARATUS &) NON-RESID. %SINGLE OUTLET CIR. Ex. Occu 20@50C P�oX oR FIXTURES BA1.030 IED A PLINIS R Ex. OCCUp. OUTLETS (RESID )EA,) 2.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 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. Q 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. 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. 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. 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 the granting of this permit. t X �� 7�vt G� �+ Lff� Date �- — '' 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 $ TOTAL PERMIT FEE $ 3st t9�� OCCUP. GROUP I TYPE OF CONST. [-IPARCELI 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,OF PUBLIC 1 ( By. (�� —Date PERMIT EXPIRES Dated the applicable provi- resolutions to do fees have been paid. WORKS e_-) —� A'� �� _'• �n9 Receipt No. �% 7 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT J COUNTY OF BUTTE - DE T1JT OF PUBLIC WORKS PERM�T�O. 7County Center Drive - Oroville, Cdrin�,5965 - Telephone 916/534-4541 0 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER - 5__ ZONING BUILDING PERMI OWNER bS TELEPHONE SQ, FT. OCC, BUILDING V LUATION O OWNER'S MAILING ADDRESS CONTRACTOR'S NA E/7 TELEPHONNEE O 6 CO T ACTOR'S MAILING ADDRESS Fireplace CONST RUC TI N LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 2461,61 7 ARCH I ECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ ` G7 BUILDING ADDRESS �� PLUMBING PERMIT Filin Fee 10.00 9 Each Trap 2.00 Solar Water Heater 20.00 ,45 Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SFW Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home S G W 10.00 e TYPE OF WORK New F] Addition [_1 Remodel❑ Utilities❑ Installation[] Other Describe work: AQ=TVn0� ASW4—_P14_ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 OR LESS Main service 100 AMP OR LESS 100 10.00 �— Main service EA. ADD'L 100 AMP 2.50 NEW CONST. (/ DWELLING OCCUP.& OR ADDNS. l ACC. BLDGS. t 2/20sgft 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 m license is in full force and effect. Y License No.,9_0 o� 4, -7 g,s Classification _�("° — A1, 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 CONSTR ULTI.OUTLET 2.50 ea NO.-RESID BRANCH CIRC ITS NEW CONSTR.POWER APPARATUS &' NON.RESID. % SINGLE OUTLET CIR. Ex. Occup(OUTLETS 2e50e o X OR FIXTURES SA0L®300 IED A PLNS Ex. Occup. OUTLETS (RESID )REA.� 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 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. 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. 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. Ialso 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 inconsequ n n of the granting of this permit. J %��+ - Dates/�-5-/F .5 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 $ TOTAL PERMIT FEE $ 3:5- :5I OCCUP. GROUP I TYPE O1- CONST. I JPARCFLJ PD HD 199UE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DI TO OF PUBLIC BY PERMIT EXPIRES Dat the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. !%-7 WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT