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HomeMy WebLinkAbout078-210-04336-177-13 hs- DENNIS HALLERF �1)4 5385 Walmer Road, Orovi le Contr: Heritage Heating Permit#239-85B(woodburning stove)SF PERMIT#96-1379 MORRISON, Ron 5385 Walmer Rd., Oroville� Cont; 'Jim Blanton New Roof Structure/SF io PERMIT#96-1818 MORRISON, Ron 5385 Walmer Rd., Oroville Cont: Strang Electric Ele Ser Ch/SF 0/"0' MORRISON, Ronald 97-2566 M 5385 Walmer Road, Or6ville' (replace wall furnace) SF CAA e e0_ � _ __ � � - �� _ � V �I � ® � 036-35-0-043 97-2566 M MORRISON, Ronald X5385 Walmer Road, Oroville replace wall furnace) SF CAA /Z.- COUNTY OF BUTTE -DEPARTMENT OF D�VE�LOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville,California 95965 - Telephone (916) 538-7541. PE MIT NO. (Rev. 12/96) APPLICATION AND PERMIT ASSESs016A1 t 1tll5�jO43 ZONINGR1BUILDINGPERMIT OWNER RONNA�3LDMMRRISON TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNERS NV t2g"!&Opil I'dAY, OROVILLE 95956 TELEPHONE 53R-7559 1 CONTRACTYJ5511rERE& 11Jr ROV2LF, 95965AVETOp / CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGAF W �� ROAD ��jj Energy Plan Checking Fee $ 1""w-';•-.,��" OROVILLE $ PERMIT FEE $ LOT NO. SUBDNISION'S NAME PARC L MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE j Y SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY I Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each qas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation F0 Other ❑ REPLACING WALL MNACE Describe Work: T'I Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W 920.00 PERMIT FEE $ ELECTRICAL PERMIT I Fling Feel 20.00 Main Serviceeoov oR LEsss 2ooA oR LEs 23.00 LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provision of Chapter 9 (commencingwith Section 7000) of Division 3 of the Business and Professions Code, 1 and my license is in full force and effect. Lic. No. �": License Class '� i 7 j n j 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 IOOOA 46.00so NEW CONST. DWELLING UP. OR ADDNS. ( a Acc. BLos. SO 3.5¢FT; NEW CONST. MULTI•oUTLET No RESID. H I 1 97.50 POWER APPARATUS 8 SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES 20 @ I'00 BAL @ .50 Ex. Occup.OFjIxTLE.Ds AE.s o.) EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE t 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. !p_.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 6nr_ fir i r - ,r - C ► .,I_ , •., ., , J c C , : t ./� i� MECHANICAL PERMIT Filing Fee 20.00 Heating 15.00 Cooling Hood 6.50 Ventilation 50 PERMIT FEE $ • Policy Number r,/ I",,, L; 1 /r-7 7 I _ 00 (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 d-� .,1r Date _ / �i Signature of Applicant - O Owner V1. ontractor ❑ Agent AnZOSHA 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 $ 3 �� HAZ. D. FEES IMP FLooD I CDF PARCEL PD 1 HD I 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. By i Date PERMIT EXPIRES ONITE-D.D.S.-B.D. Date rReceiptNo. S165 CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 9965 - Telephone (916) 538-75g �E T NO. (Rev. 12/96) APPLICATION AND PERMIT -� ASSESSORf,(IQC�EJL!U 043 (RJOO(N�ALLD�JMORRISON ZONINGR1BUILDINGPERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S 6VfVOOD WAY, OROVILLE 95966 CONTRACTtPAA 'S NAME I TELEPHONE ' 538-7559 CONTRACTTIfMUIBM!1116s 0 AVENUE, OROVILLE, 95965 ��+i'�� �{ CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ M o o Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGAR7�jIfft WALMER ROAD Energy Plan Checking Fee $ OROVILLE $ PERMIT FEE $ LOT NO. SUBDNISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE y SF Duplex ❑ Mobilehome ❑ Other 9 SPECIFY Each Trap 7.00 Solar or heat um water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation] Other ❑ Describe Work: REPLACING WALL FURNACE Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI G W1 @20.00 PERMIT FEE $ ELECTRICAL PERMIT I Filing Feel 20.00 LE Main Service AORLLEESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter i . 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license IS In II force and effect.POWESINGLE License Class Lic. No. � i 7�? � I 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. ❑ 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 Main Service ( 200A To I000A 46.00 NEW CONST. DWELLING .0CS. OR ADONS. ( a ACC. BLDS. SO 3.52FT. NEW CONST. MULTI.OUTLET NON•RESID. AND @7.50 ECIR.R APPARATUSOUTL a T Ex. Occup. OUTLET OR FIXTURES zo p 1.00 BAS @ .50 LNS Ex. Occup. OUT ETT RES D.GEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 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. _9Llhave and will maintain workers' compensation insurance, as required by Section 1 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 CCLDEn! EAGJ_e /N-Su1ZpNCIE- C0/r100A/NV Policy Number — (The above sections need not 6e 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 h co�with those provisions. y ��fi _ Date /Z L Applicant - ❑ Owner Contractor ❑ Agentmit is required for excavations over 60" deep and demolition or construction /OSHA of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating 15.00 Cooling Hood 6.50 Ventilation .01 PERMIT FEE $ 3 Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 35.00 HAZ. D. FE ES 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. By Date [ PERMIT EXPIRES ON Dale Receipt No. 23165 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California -95965 - Telephone (916) 538-7541 PERMIT NO. (Rev. 12/96) ^ APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER r -35 5 — Q ZONING BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S ADDRESS 3!� (,cye 5-1-L Y. (JO Dia. 9 S CONTRACTOR'S NAME C ,yT tiZ m-2," TELEPHONE CONTRACTOR'S MAILING D SS / LrL / D✓r l e IF5 9,6 CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS ' Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS `�� e,- Energy Plan Checking Fee $ $ 0 r Ui i( -f PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ 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 ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation H Other ❑ Describe Work: �� � w r LA Ya Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 0LES9 Main Service zooA 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.POSINGLE 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 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 t000A 46.00 NEW CONST. DWELLI OCCUP. OR ADDNS. ( a Ate. BLDS. SO 3.5¢x; NON•RESCONSDT MULTI.OUTLET 97.50 8 OUTLET CIR.WER APPARATUS Ex. Occup. OUTLET OR FIXTURES 20 @''50 SAL @ .so Ex. Occup. ourEiEis Ra D., 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Fling Fee 20.00 Heating ` op 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 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 ❑ 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 s�0 TOTAL FEE $ ,PO :HAZ. D. FEES IMP FLOOD CDF PARCEL HD GSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON I the applicable provisions Resolutions to do work been paid. Date Date Receipt No. _ r 3 1 -3 (7 77 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT • i COUNTY OF BUTTE BUILDING.AIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 CORRECTION NOTICE OWNER PERMIT 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. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. / 1 Date 12 3J-9 Inspector REV 10/92 f COUNTY OF BUTTE BUILDING ©IV.ISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 CORRECTION NOTICE X96 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. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. r' avIIA Q",Q '-s r7":> � C Date 21 Inspector REV 101 .vr-.,.+ra,-.,C�:,,;y,. ...,y,,. aWon�.r,�. u,. ...�+J �w���JV` C„/1,.�� eC�r�-�.�..�-.� _�.,. tue 5-3aS7 Q-j p)= W- I IFOFFICE COPY cop�- Address B ELECTRIC 7 Meter By Date ., r-�+. ,-.yfy.:r., ... .. ).-.. ;�.. ^w. �.^�•"�"�"";'r:v .� i -„icy ,r..}.•3r.�'.,..;. .-•.ri+.r::;:y:�. .. �i.•� -�v-:n .-- -.. COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916)_ 538-7541 APPLICAVON AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 035-350-043 zoNlriG i BUILDING PERMIT :a. OWNER RON MORRISON TELEPHONE SO. FT. OCCF - BUILDING VALUATION OWNERS MAILING ADDRESS 5385 WAT-)4ER RD.. OROVI T F CA 95965 4 CONTRACTOR'S NAME STRANG ELECTRIC TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER NONE UNKNOWN Total Valuation Is Filing Fee $ 20.00 LENDER'S MAILING ADDRESS ( Permit Fee $ ARCHITECT OR ENGINEER NONF, LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDINGADDREss 5385 WAI.MER R '' :_.- .. PERMITFEE $ FLUMBINGPERMIT Filing Fee. 20.00 _,Each Trap' 7.00' IAT NO. SUBDIVISION'S NAME PARCEL MAP ) Solar or heat pump water heater 23.00 USEOFSTRUCTURE SF O Duplex ❑ Mobilehome ❑ Other SPECIFY Weer piping • . •. 15.00 Each gas water;heater�or vent 15.00 Gas�`piping. system 1"-- 5 outlets x' 15.00 Buildingyewer„i. 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities Installation ❑ Other ❑ Describe Work: ELECTRIC SERVICE M„fit;t?ERMITFEE — MobileiHorneR'j�.` S G I W 1 920.00 $ Contractor ti , ELECTRICAL PERMIT Filino Fee 20:00 1 OR LESS Main Service ( 2 0A OR LESS 1) 23.00 ” 43.00 Main Service ( 200A TO 1000A ) ' 46.00 t LICENSED CONTRACTOR'S DECLARATION i 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. ,,.. q 5-91 License Class � � /f � Lic. No. �� �.! OWNER -BUILDER DECLARATION = I hereby affirm under penalty of perjury that I am exempt from the Contr ctors 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 ProfessionsCode for this reason NEW CONST. DWELLING OCCUR OR ADDNS. ( & ACC. BUDS. ) SO. 3.50 FT. NEW CONST. MULTI.OUTLET NON REBID. ( BRANCH CIRCUITS ) 97.50 POWER APPARATUS (8 SINGLE OUTLET CIR. ) EX. Occup. •(OUTUET OR FDCTURES ) 20 Q 1.00 SAL .50 EX. OCCU FIXED APPWS. OR p• (OUTLETS (RESID.) EA ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ 43.00 Contractor • WORKERS' COMPENSATION DECLARATION � 1 hereby affirm under penalty of perjury one of the following declaration i 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 MECHANICAL PERMIT Filing Fee 20.00 9 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor 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'HAZ. 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. XC�t, , Date �_. /� —_ Signature of Applicant - ❑(Onner ❑ Contractor ❑ Agent G An OSHA permit is required for excavations over 60" deep and demolition or construction'B structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee, $ OCC CONST. TYPE43. ,TOTAL FEE $ 0 0 J' t 'D. FEES r IMP FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the of the Butte County Code and/or indicated above for which fees have / W�4&Date ! PERMITEXPIRESON I applicable provisions Resolutions to do work been paid. 81 12/96yof 8/12/97 (Date) ReceiptNo. 207462 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF DE�!ELOPMENT SERVICES -BUILDING DI7,09, 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7 ` Me MI NO. APPLICATIORAND PERMIT ` ASSESSOR PARCEL NUMBER 036-350-043 ZONING BUILDING PERMIT OWNER RON MORRISON TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 5385 GIALMER RD., OROVILLEA CONTRACTOR'S NAME STRANG ELECTRIC TELEPHONE CONTRACTORS MAIUNG ADDRESS Fireplace CONSTRUCTION LENDER NONE UNPQ40WN Total Valuation Is Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER NONE LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 5385 WALMER RD, ORCIVITIFPLUMBING PERMITFEE $ PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP Solar or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF CY 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 IN Installation ❑ Other ❑ Describe Work: ELECTRIC SERVICE CHH — Mobile Home S I G W 1 920.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filinq Fee 20:00 Main Service ( e00v OR LESS ) 200A OR LESS 23.00 23.00 Main Service ( 200A TO 1000A ) 46.00 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. ,� U �� L� License Class L' /t� Lic. No. 7 tS 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 NEW CONST. DWELLING OCCUP. OR ACDNS. ( 8 ACC. ) BLDSLICENSED so' 3.5Q FT. UTLE NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 POWER APPARATUS (s SINGLE OUTLET CIR. ) Ex. Occup. ( OUTLET OR FIXTURES) 20 Q 1.00 aAL .50 Ex. Occup. ( OUTLETS ((RRESID.)EA) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ 43.00 Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: I 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 9 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor 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. Date ��Z Signature of Ap Icant - ❑ O er ❑ Contractor ❑ Agent An OSHA permit is required foracavations over 50" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee Is Energy Inspection Fee Is OCC CONST. TYPE TOTAL FEE $ 43.00 HAZ. 1 0. FEES I IMP I FLOOD CDF PARCEL I PD HD ISSUE This permit is hereby issued under the of the Butte County Code and/or indicated ve for which es have BY PERMITEXPIRESON applicable provisions Resolutions to do work a paid. Date 8/12/96 8/12/97 (Date) Receipt No. 202462 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT �� �..-�. �- ,/ � v 1 . [�/ J �N� � �/ � � C/ //f��. //• G ���� ���=' .� '�,� . f - +•. �+[i . i1n.�, t Y ,.. .. -.. .-...... �.-y-T{.. :J'1..n ... --�.., .�'7^S�..w--••R7F•^�••y-rw R ... .. .. -, .... v..^r. .a -w nsT1'p!'1: ( .. ,9C&COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 -Telephone (916) 538-7541 APPLICATION AND PERMIT ZONING BUILDING PERMIT ASSESSOR PARCEL NUMBER 036-350-043 TELEPHONE SQ, FT, OCC. BUILDING VALUATION OWNER RON i fl, liLll. SQ? OWNERS MAIUNG ADDRESS 335 CMINGIN CONTRACTOR'S NAME Jr -1 Bl..12117M CONTRACTOR'S MAILING ADDRESS •1'� CONSTRUCTION LENDER LENDER'S MAIUNG ADDRESS ARCHITECT OR ENGINEER ARCHITECT OR ENGINEER'S MAILING ADDRESS BUILDING ADDRESS 5385 WAUTP. OROwi LOT NO, SUBDIVISION'S NAME USEOFSTRUCTURE SF}❑ Duplex ❑ Mobilehome ❑ Other LICENSE TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: %T�+f ROOF (STICK EPAt''i, l Fireplace Total Valuation $ ELECTRICALPERMIT Fling Fee 4.110C Main Service ( Permit Fee $ Plan Checking Fee $ Energy Plan Checking Fee $ Penalty PERMITFEE $ $ Each Trap MAP Solar or heat pump water heater Water piping Each gas water heater or vent Gas piping system 1 - 5 outlets Building sewer Mobile Home I S I Ul W 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. 131 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION I 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 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' comp nsation provisions of section 3700 of the Labor Code, I shall forthwith comp y with those provisions. Dated ❑ ontractor ❑ rA ent Signatur4 of pplic�nf ❑Owner 9 An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. ReceiptNo. 1 I U"y WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDEN ROD-APPLICA PERMITFEE 1 $ 7.00 23.00 15.00 15.00 15.00 15.00 @20.00 20.00 20.00 Contractor JJ.W ELECTRICALPERMIT Filin Fee 20.00 Main Service ( 20000AA OR LESS ) 2OR LESS 23.00 Main Service ( NEW CONST. ( OR ADDNS. 200A TO 1000A ) DWELLING DS. ) d ACC. BUDS. 46.00 S. 3.50 FTO. NEW CONST. ( NON-RESID. MULTI -OUTLET BCIRCUITS ) X�117.50 l:.RANCH ( & SINGLE OUTLET CIR. ) Ex. Occup. ( OUTLET OR FIXTURES ) 20 Q 1.00 SAL .SO Ex. Occup. ( FIXED APPLNS. OR OUTLETS (RESID.) EA ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor 11 Iw;:r-wK CALPERMIT I Filino Fee 1 20.00 1 F ting ling d 6.50 tilation PERMITFEE $ 1 Contractor Mobile Home Installation Fee $ Energy Inspection Fee $ Occ coNST. TYPE TOTAL FEE $ HAZ. I D. FEES I FLOOD I CDFPARbEL� '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. 1, w / Dat // By — �.�/ d PERMITEXPIRESON V COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 .County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMI No. APPLICAtION AND PERMIT !L ASSESSOR PARCEL NUMBER 036-350-043 R1 ZONING BUILDING PERMIT OWNER RON MORRISON TELEPHONE 589-3709 SO. FT. OCC. BUILDING VALUATION 4,800-00 OWNERS MAILING ADDRESS 335 CANYON DR OROVILLE, 95966 CONTRACTOR'S NAME JIM BLANTON T 589E 5348 CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is i, Rnn nn Filing Fee $ 20.00 LENDERS MAILING ADDRESS Permit Fee $ 72.00 ARCHRECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAIUNG ADDRESS Penalty $ BUILDINGADDRESS 5385 WALMER RD PERMITFEE $ PLUMBING PERMIT Filing Fee 20.00 OROVILLE, 95966 Each Trap 7.00 LOT NO. SUBDN510N'S NAME PARCEL MAP Solar or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF RJ 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 ❑ Other ❑ Describe Work: _ NEW ROOF (STICK FRAME) Mobile Home I S I GI W 1 920.00 PERMITFEE = 35.00 Contractor ELECTRICAL PERMIT Filinq Fee 20:00 Main Service / OOOV OR LESS 200A OR LESS ) 23.00 Main Service ( 200A 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 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, /mill do the work, and the structure is not intended or offered for sale. MI, 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 \ 8 ACC. BLDS. ) so. 3,5¢ FT. CNS. NEW CONST.MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS ) 07.50 ( & POWER APPARATUS ) SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 @ 1.00 BAL 0 .50 Ex. Occup. (OUTLETSIXAPPLN . OR 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE s 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' compensation insurance carrier 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 be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) Ik 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' compen tion provisions of section 3700 of the Labor Code, I shall fort ith compl ith those provisions. A XZ�e�_z___ _ Date 46��---� — Siature ofApp'licantO?�W 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 is Energy Inspection Fee is occ CONST. TYPE TOTAL FEE $ 173.80 HA D. FE IMPFLOOD CDF PARCEL PD HD 5SU 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 BY Date PERMITEXPIRESON a� I (Date) Receipt No. 201 9-11 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTYOF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES - BUILDING DIVISION 1 h 7 COUNTY CENTER DRIVE - OROVILLE 4CArIF6NIA95965 - TELEPHONE (916) 538-7541 PERMIT APPLICATION DATASHEET OWNER 460)1"t) M D P- 4-� A' Proposed Building Use /Vg� Building Inspector P. Nd -9 1? ZI P Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: 1. f DATE RECEIVED BY All,items have been submitted. .........: ............................... 2. Plot plans, 3/4 sets, signed by preparer of plans. f 3. Complete plans, 3/4 sets, signed by preparer of plans. ...................... 4. Engineered plans and calcs, 3/4 sets, with wet signature on.plans. ............. 5. Hazardous Material Form . .......................... ............... . 6. Energy Design, Compliance and supporting documentation.. ,:�* ................ 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). ... . 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $ • •........................................... . 11. Impact fees as shown on attached schedule . .............................. 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval Health Department . ............ 15. City of Chico plumbing permit . ..................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ........... . 17. Planning approval for (A) Use: (B) Parking: 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). ..P . . 20. -I renspection requeis Pre -inspection for required. . to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner Mail to owner ............ 24. Recorded copy of Agricultural Acknowledgement Statement . ................. . 25. Letter of signature authorization . ....................................... . - 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on building use . ......................................... l 28. ................................. Mobilehome utility clearance. ........................................... 29. Documentation of legal access . ..................... 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan check list . ..................................................... i r 33. 34. ..,. When issue the ermit rocess as follows: Mail to Opp er Mail to contractor. Telephoneu�D and hold for pickup at office. Deliver with inspector. Other M Parcel Creation Acreage Applicant ti Date Copy of Haz-Mat form sent Health Dept. . Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance 1. Index permit for above items No. 2. Additional items required: (Circle new item not checked above). Contractor, design U__1_V"s advised of above required data by 1( phone _ mail Counter by _G_ Date ( Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by I qt b ov.�CDate G 2" Sets of plans on hold in j_ File cabinet AP folder Copy - Department of Public Works O.B.-1 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[ 'K] NO[ ]. 2: I HAVE[] HAVE NOT[ ] signed an application for a building permit for the proposed w,o k 3. I have contracted with the following person (firm) to provide the proposed construction: NAMEE: ADDRESS: CITY: PH0NE: CONTRACTOR'S LICENSE NO. 4. I plan to provide potions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: NAY E: ADDRESS: CITY: PHONE: 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: NAIIE ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTY OWNER: 2 SOCIAL SE ,�URTTY NUMBER: 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 Nye are permitted to issue the permit. 0VER r 1 Permit#239-85B Dennis Haller 5385 Walmer Road, 219;19S , --- ;�7 law COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION ANR PERMIT ASSESSOR -PARCEL NUMBER , _-I i _ I ZONING BUILDING PERMIT OWNER ` 1 TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS CONTRACTOR'S NAME, -` TELEPHONE CONTRACTOR'S MAILING ADDRESS, I } Fireplace -�1 '' i , CONSTRUCTION LENDER 1l F' l UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS 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 TSJGJWJ 110-00 e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Installation❑ Other 0` Describe work: �'' ►� �� '�' +� — Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. 2thQsgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ElI 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) ❑ 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 ULT' -OUTLET 2,50 ea NON ESID BRANCH CIRC ITS NEW CONSTR POWER APPARATUS &) NON-RESI D. (SINGLE OUTLET CIR. zo®soa Ex. Occup(o Ts OR FIXTURES` 6AL®so FIXED PK Ex. Occup. OUTLETS (RESID IEA./ 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 1 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 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 $ OCCUP. GROUP I TYPE OF CONST. PARCEL PD HD ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which - DIRECTOR OF PUBLIC By '• PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date, r Receipt No. • • WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION ASID PERMIT ` PERMIT NO, ASSESSOR PA6C^L,NUtv1BE _ ]]��!! ZONING BUILDING PERMIT OWNER C TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 0 ro CONTRA TOR' AMTELEPHONE C TRACTO S MAILING ADDRES Fireplace 1 o CONSTRUCTION LENDER dr\ UNKNOWN Total Valuation is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $J 10� BUILDING ADDRESS 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 E Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 W Mobile Home S I G12:24 10.0 0 e TYPE OF WORK_Permit New ❑ Addition ❑ Remoel ElUti lities ElInst. ation ❑ Other Describe work: Y\ v Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service BOOV OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD -L 100 AMP 2.50 NEW CONST. ( DWELLING OCCUP.& OR ADDNS. \ ACC. BLDGS. 1 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 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) c © 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.( ULT' -OUTLET 2,50 ea NO.-"rSID BRANCH CIRCUITS NEW CONSTR ( POWER APPARATUS &) NON-RESID. SINGLE OUTLET CIR. Ex. Occu BALO30 Ts OR FIXTURES BAL®3OQ FIXED APP LHS. OR P. FIXED Ex. OCCUp. OUTLETS (RESID.) EA.) 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 1 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, a dexpenses which may in any way accrue ounty in conseq en of the granting of this permit. against z2t��— XDate �9 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 $ OCCUP. GROUP I TYPE OF CONST, PARCEL PD I ND ISSUE This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. IRE TO OF PUBLIC WORKS BY Da e PERMIT EXPIRES D e I—,�2 — Receipt No. A&IOD WHITE-D.P.W.. YELLOW-ASSeSSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT