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PERGER, LARRY Esc VIRGINIA '
1190 MELROSE DR., OROVILLE
NEW DETACHED GARAGE'
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COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541
(Rev. 12/96) APPLICATION AND PERMIT _A2a
ASSESSOR PARCEL NUMBER
—
ZONING
BUILDING PERMIT
OWNER
REIRGER, VIRGINIA. I-AIRRY
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
d
1200 � 18 21 r,00
.OWNERS MAILING ADDRESS
190 MELROSE DR.,07:0
CONTRACTOR'S NAME TELEPHONE
OWNER
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDERS MAILING ADDRESS
Total Valuation $ 2
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $
20.00
Permit Fee $
225.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS
_-9 L _ Q S E DRD5.
Energy Plan Checking Fee $
PERMIT FEE $
O+
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 gas water heater or vent
15.00
TYPE OF WORK
New XI Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: NEW GARAGE -DETACHED
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I G I W
020.00
PERMIT FEE S
ELECTRICAL PERMIT
Fling Fee 20.00
OV OR
Main Service . ' OR LESS
23.00
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 in full force and effect.POWER
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:
7 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
I i by affirm under penalty of perjury one of the following declarations:
LTA' 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 permitis 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
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply wi those provisions.
XDate Z / o2�d L
Sign re of Applicant - ❑ wner ❑ Contractor ❑ Age
An HA permit is required for excavations over 5'0" deep and demolition or construction
of structures over 3 stories in height.
Main Service 200A To ,000A
46.00
NEW CONST. DW
,"NG OCCUP. SO
OR ADONS. ( a ACC. BLDS. `3.50FT. ? 0
�,pT MULTI.OUC @7.50
_=R
APPARATUS
b SINGLE OLfTLET CIR.
j 20
Ex. Occup. OUTLET OR FD(TURES BAL Q'. 0
Ex. Occu . oflxLmErs R� o�
5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wirina 23.00
PERMIT FEE $ 62.00
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE S
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
T AL FEE $ 453.25
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ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indic ed above for which fee have been paid.
11
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PERMIT EXPIRES
Dafe
Receipt No. 35�F55S 2�
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDEN OD -APPLICANT
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