HomeMy WebLinkAbout078-220-009LEW PRATT�_./n�J\ �q a�D-o0�
V i% 9r 'r
{ 18 Las Plumas Way, /
` Permits#2 782-86B (reroof /SF) e
3932-90B
f PRATT, Lew
18 Las Plumas Way, Oroville
(siding/sf) o
e
�D �
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND. PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
36-55-09
ZONING
R1
BUILDING PERMIT {
OWNER -
LEW PRAW
TELEPHONE
533-5531
SQ. FT. OCC. BUILDING VALUATION
Est. $500
OWNER'S MAILING ADDRESS
18 Las Plumas Way, Oroville CA 95965
CONTRACTOR'S NAME
Owner
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
None
UNKNOWN
Total Valuation is
Filing Fee $ 10.00
LENDER'S MAILING ADDRESS
Permit Fee $
ARNCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
18 Las Plumas Way, Oroville
Permit fee $ 20.00
PLUMBING PERMIT Filing Fee 10.00
Each Trap 2.00
Solar or heat pump water heater 20.00
LOT NO.
S UBDIVISION,NAME
PARCEL MAP
Water piping 5.00
Each qas water heater or vent 5.00
USE OF STRUCTURE
SF RX Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets 5.00
Building sewer 5.00
Mobile Home S I G I W 1 110-00e
TYPE OF WORK.
New❑ Addition❑ Remodel❑ Utilities❑ Installation[] Others®
Describe work: Re—Siding on Portions Of SAF _
Permit Fee $
Contractor
ELECTRICAL PERMIT Filing Fee 10.00
sOOV OR LESS
Main service 10.00
100 AMP OR LESS
Main service EA. ADD'L 100 AMP 2.50'
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.SINGLE
License No. Classification
1, 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
oR ADDNST DWEACCLLIN GOCCUP.es S. 2'/20sgft
NEW CONSTR ULTI.OUTLET 2,50 ea
NON.RESID BRANCH CRC"
POWER APPARATUSa
OUTLET CIR.
EOccu 20@500
Ex. Occup(OUTLETS OR FIXTURES eAL@30
FIXED APPLNS. OR \
Ex. Occup. OUTLETS (RESID.) EA./ 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. byirin 9 15.00
Permit Fee $
�
WORKMEN'S COMPENSATION INSURANCE
I declare finder 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.
Ipl 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 10.00
Heating
Cooling
g
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.
also agree to save, indemnify and keep harmless the County of Butte against
all liabiliti judgments, co d expenses which may in any way accrue
against s ' County in c nse ue a of the granting of this permi .
X Date
Signotur /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.
g
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $ 20.00I
HAz
CUA
PARK
SCHL
FLo
PAR
PD
HD
ISSUE
This permit is hereby issued under the applicable provi-
sions of the Butte County Code and/or resolutions to do
work indicted above for which fees have been paid.
DIRECT.OR`OF PUB 'WORKS
N`
r
By /Iif?1�!`�/i;1,% Date l 1/1 q
PERMIT EXPIRES Date � ` `? /� �
Receipt No.mo�
WHITE-O.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
.__
/ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
ZONING
`r
36-55-09
R1
- BUILDING PERMIT
OWNER TELEPHONE
SO. FT. OCC. BUILDING VALUATION
LEW PRATT 533-5531 :]
Est. $500
OWNER'S MAILING ADDRESS tl
18 Las Plumas Way, Oroville CA 95965
CONTRACTOR'SNAME
TELEPHONE
Owner
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
Nonp
Filing
LENDER'S MAILING ADDRESS
Fee
$ 10.00
Permit Fee
$
ARCHITECT OR ENGINEER LICENSE NO.
I
Plan Checking Fee
$
None
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee
$
Penalty
$
BUILDING ADDRESS
Permit fee
$ 20.00
18 Las Plumas Way, Oroville
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
SF ba Duplex❑ Mobilehome❑ Other
Mobile Home S G W
10.00e
SPECIFY
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other)M
Permit Fee
$
Describe work: RP—Ri di no an Pnrti ons of 911F _
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 100 AMP OR1 OR LESS10.00
Main service EA. ADD•L 100 AMP
2.50
CONTRACTORS LICENSE LAW
NEW
EOR ADDNSCONSTDWEACCLLIN
S./
2y22sgft
I declare under penalty of perjury (check one):
GOCCUP.&\
NEW CONSTR ULT' -OUTLET
2.50 ea
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
NO N.RES'D BRANCH CIRC ITS
POWER APPARATUS &)
and Professions Code and my license is in full force and effect.
(SINGLE OUTLET CIR.
License No. Classification
Ex. Occup(OUTLETS OR FIXTURES
20@502
9ALe 30
1, as the owner, or my employees with wages as their sole compen-
FIXED APPLNS. OR
Ex. Occup. OUTLETS (RESID.) EAJ
2.00
sation, will do the work,and the structure is not intended or offered
Temporary service
10.00
for sale. (Sec. 7044)
❑ I,
Mobile Home Facilities
15.00
as the owner, am exclusively contracting with licensed contract-
ors.(Sec. 7044)
Misc. Wiring
g
15.00
❑ I am exempt under Sec. , Business and Professions Code
for this reason
Permit Fee
$
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
MECHANICAL PERMIT
Filing Fee 10.00
❑ The permit is for $100.00 (valuation) or less.
Heating
❑ 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.
Cooling
g
INA I shall not employ any person in any manner so as to become subject
Hood
3.00
to the W. C. laws of California.
Ventilation
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
permit Fee
;
provisions or this permit shall be deemed revoked. 6
1
Contractor
I certify that I have read this application and state that the above information
Mobile Home Installation Fee
$
is correct. I agree to comply to all County Ordinances and State Laws relating
Energy Inspection Fee
$
to building construction, and hereby authorize representatives of the County of
occ
Butte to enter upon the above-mentioned property for inspection purposes.
CONST TYPE
20.00
I also agree to save, indemnify and keep harmless the County of Butte against
AL
TOTAL $
E
FEE
all liabiliti judgments, co d expenses which may in any way accrue
HAZ CUA PARK L
PAR PD HD IssuE
against s ounty in c nse ue a of the granting of this permi .
%�
This permit is nereby issued under the applicable provi-
Date
sions of the Butte County Code and/or resolutions to do
Signatur of Applicant — Owner Contractor ❑ Agent Y I
work in ' ted above for which fe s have been paid.
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
DIRT F PUB 1
ORKS
ion of structures over 3 stories in height.
Receipt No.
BY1.
i
Date
WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT
PERMIT EXPIRES Date
A SSE4TR PARCEL NUMBE
OW ER
(`a
O R'S MAIL
EING RESS
1 c
C
Oh TRACTOR'S NAME
F y/'
CONTRACTOR'S MAILING ADD
•i
CON T UCTION LENDER
7
LENDER'S MAILING ADDRESS
ARC%41 ECT OR ENGINEER
UILDING ADOR
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916.'538-7541
APPLICATION AND PERMIT
ZONI
MAILING ADDRESS
PERMIT NO.
BUILDING PERMIT
TELEPHONE
ft SO. FT. I OCC. I BUILDING VALUATION
14.
LEP 1
UNKNOWN
V ,Vhn
LOT NO. SU BOIVISION NAME I PARCEL MAP
USE OF STRUCTURE
SF Duplex❑ Mobilehome❑ Other
� SPECIFY
TYPE OF WORK }�,(
New❑ Addition❑ Remod� 1�1tilities❑ Installation❑ OtherW
Describe work: 5 ! (-.!/ 1 YI a n V h
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)
❑ 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
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for S100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Cart;'; t
Fireplace
Total Valuation $
Filing Fee S 10.00
Permit Fee $ /010
Plan Checking Fee $
Energy Plan Checking Fee $
Penalty I $
Permit fee S "jn n/
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2,00
Solar or heat pump water heater
20.00
Water piping
5,00
Each gas water heater or vent
5,00
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S G W
10-00ea
Permit Fee
$ ;
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 8001 OR LESS
100 AMP OR LESS
10.00 I
Main service EA. ADD'L 100 AMP
2.50 j
NEW CONST. / DWELLING OCCUP.d,\
OR AODNS. 1 ACC. BLDGS. lI
'h2sgIt
NEW CONSTR. ULTI-OUTLET
N O N.R ESID BRANCH CIRC ITS
2.50 ea
POWER APPARATUS e
SINGLE OUTLET CIR.
'
Ex. OCCUp(OUTLETS OR FIXTURES
20050t
e ALO 30t
EX. DCCUp. OU L TS (R ESIO )REA.)
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00
Permit Fee
S
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
Heating
I Ica e
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.
Cooling
Hood
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 County oT
Mobile Home Installation Fee
Energy Inspection Fee
i
Butte to enter upon the above-mentioned property for inspection purposes. DCC CONST TYPE
TOTAL FEE $ A9, o
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 "Az cuA PARK sc"JFLD PAR I Po I Ho I ISSUE
against said County in consequence of the granting of this permit.
XThis permit is nereby lssuea uraer the applicable provi-
Date sions oT the Butte County Code and/or resolutions to do
Signature of Applicant — Owner 01 Contractor ❑ Agent ❑ work indicated above for which fees have been paid.
An OSHA permit is required for excavations over 5'0" deep and demolition or construct. DIRECTOR OF PUBLIC WORKS
ion of structures over 3 stories in height.
Receipt No. By Date
WMIT[-O.P.W., T[LLOW-A3e[33001, PINK-INSPLCTOR, COLa[NROO-APPLICANT PERMIT EXPIRES Date
COUNTY OF BUTTE - Depaxtment of Public Works
7 County Center biive, Orovill;;2,, CA 95965 Phone: 916-538-754.1
MMER-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 major labor and materials for construction of
the proposed property improvement (yes or no) �..
2. I,.7v /have not) L,-' signed an application for a building permit
for the proposed work.
34 -Name 1 have contracted with the following person (firm) to provide the proposed
construction:
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:
Property Owner
Social Security mb r
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.
Permit#2782-86B
Lew Pratt
18 Las Plumas Way
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Orovi I I e,0.3aIiforn)a 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
ZONING
_
BUILDING PERMIT
OWNEWR"
"I n... nA74A
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNER'SS.'M AILING ADDRESS-• O
CONTRAC- / r
/V/
TELEPHONE `r
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
5 7
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
A _ l
Penalty
$
BUILDING ADDRESS / A/J A �� ��
/ 1 .{j/
r
Permit fee
^
$ ; 1
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SFE Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G I W
0.00 ea
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ UtilAies ❑ Installatiion❑ Other-[
Describe work: i -j i L
�-
f
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
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
Q 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. OR ADDN5. ( DWELLING OCCUP.&) ACC. BLDGS. yZcsgft
NEW CONSTR. MULTI -OUTLET 2,50 ea
NON-RESID BRANCH CRC ITS
/POWER APPAIRATUS h
(SINGLE OUTLET CIR. /
2ooaoe
Ex. Occup OUTLETS OR FIXTURES eAL@30
FIXED APPLNS.
Ex. OCCUp. R
OUTLETS ((RESID )EAJ 2.00
Temporary service 10.00
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 10.00
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 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 saitl:County iii
/consequenceof thegranting of this perrm`it. �y/
X �_z Ie"/t ��A_71/ Date - /;/n r',•
Signature f Applicant - Owner D' Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures overnn3 stories in height.
Mobile Home Installation Fee
$
Energy Inspection Fee $
TOTAL PERMIT FEE $
Occup.
CONST,TYPIJ
IFI-0.131PARC111
PD
NO
SSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
/ DIREC O OF PUBLIC'WORKS
B y +an I /
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
Date
/ y
Receipt No. L .Y%�7 i
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 AND PERMIT
PERMIT NO.
ASSW.9R PARCrUMEq
ZONING
BUILDING PERMIT
O WNET„E P¢t°NE
OWN LI G ADDR J
SQ. FT. OCC. BUILDING VA ATION
CONTRACTO S A TELE
CONTRACTOR'S MAILING ADDRESS
I Fireplace
CONSTRUCTION LENDER UNKNOWN
LENDER'S MAILING ADDRESS
Total Valuation $
Filing Fee
Permit Fee
'
$ 10.00
$ 50
ARCHITECT OR ENGINEER LICENSE NO.
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Plan Checking Fee
Energy Plan Checking Fee
Penalty
$
$
$
BUILDING ADDRESS
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
`
SolaY or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME PARCE A
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G I W
10.00 ea
TYPE OF WORK
New ❑ Addition ❑ Rem el ❑ Uti ties ❑ Instal at' ❑ 0th rA
Describe work:- _
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 1111 OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penaltyof perjury
p f y (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Bus(neSS
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 CONST. DWELLING OCCUP.p ,
OR ADDNS. ACC. BLDGS. �Z¢sgft
NEW CONSTR MULTI -OUTLET
NON-RESID BRANCH CIRC ITS 2.50 ea
POWER APPARATUS tr
(SINGLE OUTLET CIR.
Ex. Occu 20®5/e
Occup(OUTLETS OR FIXTURES eAL030
FIXED APLNS.
Ex. OCCup. OUTLETS P(RESID )REAJ 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
g
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
Filing Fee 10.00
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 County of
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to ave, indemnify and keep harmless the County of Butte against
all liabilit'e , udgments sts, and expenses which may in any way accrue
against s ounty one ence of the granting of this per fit. �y
%� Date
Signotuy Df Applicant — Owner Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition of construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
TOTAL PERMIT FEE $
7CCUP.
CONST.TYPE
FLOOD
PARCEL
NO
M
This permit is hereby issued under
sions of the Butte County Code and/or
work indi ted above for which
DIRE F PU
B
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
1 WORKS
Date
00,
Receipt No. �l
WNITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
r O.
COUNTY OF BUTTE - Department of Public Works
7 County Center Drive, Oroville, CA 95965 Phone: 916-534-4541
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 major labor an materials for construction of
the proposed property 'mprovement (yes or no) '
2. I (have/have not) igned an application for a building permit
for the proposed w rk.
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:
Property Owner
Social Security N b
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.