HomeMy WebLinkAbout078-310-018JACpp ON, DAVE
2577 V_BRD OROVILLE
CONT: DENNIS h,ORTOT
REROOF
JACOBSOhI, C.M. ..,... 31368
2581P
3400E
1
2577 V-6 Rd.,.Orville
CONTR: Gene Martin, 2937 Oro Garden Ranch Rd.,
(new, sin le family)p Oroville,
�. y
.:1+�, pace f..:E.��4-.K`. • . .--.. .,,�„� f..+....r.•.w
f
r _
030 1 03-2970
JACOBSON, DAVE
2577 V-6 RD, OROVILLE
CONT: DENNIS NORTON
REROOF
,r
�
r
t
030 1 03-2970
JACOBSON, DAVE
2577 V-6 RD, OROVILLE
CONT: DENNIS NORTON
REROOF
a
(Rev. 12/96)
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 n�..
APPLICATION AND PERMIT V
, Epm'rv�
ASSESSOR PARCEL NUMBER
036-101-064
ZONING
BUILDING PERMIT
OWNER
JACM-MNO DAVE
TELEPHONE
534— 1
SO. FT. OCC. BUILDING VALUATION
Cd 00
2100.00
OWNERS MAILING ADDRESS
2977 V-6 Rn, OROVITTE 95
CONTRACTOR'S NAME
TELEPHONE
514-11489
CONTRACTORS MAILING ADDRESS
4%0 VE RDI ORCULIE Q6i
CONSTRUCTION LENDER
Fireplace
LENDER'S MAIUNG ADDRESS
Total Valuation $
2100.00
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$ 54.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDING ADDRESS
RD, ORMITE$
Energy Plan Checking Fee
$
PERMIT FEE
$ 74.00
IAT NO.
SUBDIVISION'S NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Solar or heat pump 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: RE—ROOF W10W
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I G I W
920.00
PERMIT FEE
S
ELECTRICAL PERMIT
Filing Fee 20.00
600VMain Service A 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. �]
License Class Lic. NO. � i —i
G'
` OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury tthat I am exempt from the Contractors License
Law for the following reason:
❑ I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
Main Service TO lOooA
46.00
W:L200A
NEW CONST. DWEWNG UP.
OR ADDNS. ( DW:
ACC. BLDS.
SO
3.5Q�:
R61pT. MULTNEW.I OUTLETITS
97.50
POWER APPARATUS
a SINGLE OUTLET CIR.
EX. OCCU OUTLET OR FOTTURES
BAIL Q I. 0
FU(ED ALNS. OR
Ex. Occup. ouTLETs PPRESIO. EA
S.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.
❑ 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' 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.
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 74- CO
HAZ.
D. FEES IMP
— _
FLOOD
_
CDF
_
PARCEL
_ __ _
PD
HD
ISSUE
yr
This permit�is hereby issued under
of the Butte CountylCode and/or
indicated labo' a for which fees have
i I
By f -
PERMIT EXPIRES ON
I
the applicable provisions
Resolutions to do work
been paid.
Date -
Date
ReceiptNo.
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD•APPLICANT
./
(Rev. 12/96)
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-75416:9
APPLICATION AND PERMIT ..//
ASSESSOR PARCEL NUMBER
036-101-064
ZONING
BUILDING PERMIT
OWNER
TELEPHONE
—
SO. FT. OCC. BUILDING VALUATION
3S 6O
2100.00
OWNERS MAILING ADDRESS
9977 V_-6 RD, OROVIIIE 95966
CONTRACTOR'S NAME
DFNNT(; NORTON
TELEPHONE
534-1480
CONTRACTORS MAIUNG ADDRESS
4960 VE RD, Ta' 95966
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
2100.00
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$ 54.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDING ADDRESS
_2577 144 RD7 QRQ�ql_l _9
Energy Plan Checking Fee
$
$
PERMIT FEE
$ 74.00
LAT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
Each Trap
7.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Solar or heat pump 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: RE -ROOF WCOMP
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I G W
@20.00
PERMIT FEE
S
ELECTRICAL PERMIT
Fling Fee 20.00
600VOR LE
Main Service zo A 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 i L71 force and effect.✓ q
License Class Lic. No. ?q
-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
46.00
V NG CCU000A
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( 8 ACC. BLDS.
SO
3.5¢FT,
NEW CONST. MULTI.OUTLET
NON•RESID.
@7.50
sPs WEER o QTc R
Ex. OCCU OUTLET OR FIXTURES
B @' 0
q
OWNER
Ex. Occup. ouTiFrs PM.) E
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wirina
23.00
PERMIT FEE
S
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.
❑ 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
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.)
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
erscompensatio rovis' ns Of section 3700 of the Labor Code, I shall
forth ' h comply w' thos pro ions.
V) rDate �' - '
Signature of Applicant - Owner DIContfactor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 storiesin ei ht
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ CONST. TYPE
TOTAL FEE $ 74.00
HAZ.
D. FEES IMP FLOOD CDF PARCEL I PD HD ISSU
is perm- hereby 'ssued under the
of Bu unty ode and/or
indicat d a o fo ich fees have
By
PERMIT EXPIRES ON
applicable provisions
Resolutions to do work
been paid.
%
Dqfte
IS
Receipt No.
WHITE-D.D.S.-B.D. A RY-AS ESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
i
PERMIT FEE PAID $
SRA $
SHERIFF $
OTHER $
AMOUNT RECEIVED $
DATE RECEIVED
RECEIPT # 3qD 631
PERMIT FEE $
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville,,California 95965
• Telephone (530) 538-75413. MIT Noy)
APPLICATION AND PERMIT ll (0
(Rev., 2/86)
23.00
ZONING
ASSESSORPARCELNUMB 3 / -� D I .�• D�ja
BUILDINGPERMIT
E
OWNER::j-1 _ Qr^"A -A� 3 r2^,
�J
I/�JI Yip
/l7-ADDRE
SO. B DI G VA ATION
-
OWNERS S fl �) 5� 1 _
'
cc
r L 5,
a ACC. BLDS.
D S
CO
NEW, O,.^ (
CONSTRUCTION LENDER
07.50
Hood
Fireplace
LENDERS MAILING ADDRESS
Total Valuation $
ARCHRECT OR ENGINEER LICENSE NO.
—Filing Fee $ 20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BuaDMGADDRESS 6AU
Energy Plan Checking Fee $
PERMIT FEE $
LOT NO. SUBDIVISIONS NAME PARCEL MAP
PLUMBING PERMIT Fling Feel 20.00
Each Trap 7.00
USEOFSTRUCTURE
Solar or heat pump water heater 23.00
SF ❑ Duplex [3Mobilehome E3 Other
Water piping 15.00
15.00
SPECIFY
Each gas water heater or vent
TYPE OF WORK
Gas piping system 1 - 5 outlets 15.00
New ❑ Addition ❑ Remodel ❑ Utirlties ❑ Installation ❑ Othh %�
Building sewer 15,00
V
Mobile Home S G W
Describe Work:
PERMIT FEE PAID $
SRA $
SHERIFF $
OTHER $
AMOUNT RECEIVED $
DATE RECEIVED
RECEIPT # 3qD 631
EX. OCCU . OUTLET OR MURES
PERMIT FEE $
Ex. Occup. Lmt�s"P(PLM �ea
ELECTRICAL PERMIT
I Fling Feel 20.00
Main Service
?AOA OR LESS
23.00
Main Service
200A TO 1000A
46.00
NEW CONST.
DWELLING OCWP.
3.5QF
OR ADDNS.
a ACC. BLDS.
Heating
NEW, O,.^ (
_ MUL7nT!ET 1
07.50
EX. OCCU . OUTLET OR MURES
flAL @ .SO
Ex. Occup. Lmt�s"P(PLM �ea
5.00
Tem or
23.0
Mobile Home Facilities
20.99
Wisc. Wiring
23.00
HAZ
PERMIT FEE
$
MECHANICAL PERMIT
Fling Fee 20.00
Heating
PD
Cooling
I ISSUE
Hood
6.50
PERMIT FEL
$
Mobile Home Installation Fee
$
Energy Inspection Fee
$
c:C
coNST. TYPE
TOTAL FEE $ �—
HAZ
D. FEES
IMP
FLOOD
CDF
pARCEl
PD
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 Date
PERMIT EXPIRES ON
(Dale)