HomeMy WebLinkAbout079-240-020036-"0
-"2 99-2568
HART, GUY
6030 LOWER WYANDOTTE RD.,
CONR: OWNER
LP TOONATURAL GAS
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COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SEFIVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER 036-280-022
ZONING
BUILDING PERMIT W ---
OWNER HART, GUY
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS 6030 LOWER WYANDOTTS, ORO 95966
CONTRACTOR'S NAME OWNER
TELEPHONE
CONTRACTORS MAILING ADDRESS
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
$
BUILDINGADDRESS 6030 LOWER WYANDOTTE ROAD, OROVILLEEner
gy Plan Checking Fee
$
PERMIT FEE
$
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
Each Trap
7.0023.00
USEOFSTRUCTURE
SF 10 Duplex ❑ Mobilehome ❑ Other
SPECIFY
Solar or heat um water heater
Water piping
15.00
Each gas water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities CX Installation ❑ Other ❑
Describe Work: LP TO NATUMAL GAS
Gas piping system 1 - 5 outlets
15.0015.00
Building sewer
15.00
Mobile Home I S I G I W
@20.00
PERMIT FEE
$
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service 2DDA 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.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:
0'0.,J
1, 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
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.
Main Service TO
46.00
WEE200A
CCU000A
NEW CONST. DWELLING OCCUP. SO
OR ADDNS. & ACC. BLD S. 3.5¢FT.
NON-REOSID. MULTI.OUTLET
97.50
APP U
8 SINGLE OUTLET CIR.
zo @ 100
Ex. Occup. OUTLET OR FD(TURES BAL O .50
Ex. Occup. OtfriEDTs ..,6.LNSOEA
5.00
Tem orar Service 23.00
Mobile Home Facilities
20.00
Misc. Wirina 23.00
PERMIT FEE $
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ 35.00
HAZ.
D FEES IMP
I FLOOD
I CDF
PARCEL
PD
I 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.
B � � ' �+ � tt I/ ,0"?
y •.% �G- Date 11 ! /
..-, = / /
PERMIT EXPIRES ON
/ r Date
Receipt No. 4 l
WHITE-D.D.S.-3.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPAATME14T OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California- 95965 • Telephone (530) 538-7541 PER I NO.
(Rev. 12/96) APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER 036-280-022
ZONING
BUILDING PERMIT
OWNER HART, GUY
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNERS "AILING ADDRESS 6030 LOWER WYANDOTTE, ORO 95966
CONTRACTOR'S NAME OWNER
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHrrECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDING ADDRESS 6030 LOWER WYANDOTTE ROAD, OROVILLE
Energy g Fee
Ener Plan Checking
$
$
PERMIT FEE
S
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
USEOFSTRUCTURE
SF jip 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 ❑ Addition ❑ Remodel ❑ Utilities EX Installation ❑ Other ❑
Describe Work: LP TO NATURAL GAS
Gas piping system 1 - 5 outlets
15.00 15.00
Building sewer
15.00
Mobile Home I S I G W
920.00
PERMIT FEE
$
ELECTRICAL PERMIT
Fling Fee 20.00
OV OR LE
Main Service . '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.POWER
License Class Lic. No.
OWNER -BUILDER DECLARATION.50
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law !9 e 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
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
zrone 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
w s' compensation provisions of section 3700 of the Labor Code, I shall
ith comply with th se provisions.
f Date
Ignat re of plica t - Owner 13 Contractor ❑ en
An OSHA per ' is required for excavations over 5'0" deep and demolition or construction
of structures over 3 stories in height.
Main Service 200A To 1000A
46.00
NEw CONST. DWELLING ffUP. 3.5QSo
NAD oNS. (
Muin ou�TLEST
NO RESID. 97.50
APPARATUS
8 SINGLE OUTLET CIR.
EX. Occup.OUTLET OR FDCTURES Bao p 1.00
Ex. Occup. ofluXnFrsRED°E, 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
Cooling
Hood 6.50
Ventilation
PERMIT FEI= $
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ 35.00
HAZ.
I D. FEES [1"D
I CDF
PARCEL
PO
HD
I ISSUE
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
By
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
Date
Receipt No. 00
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT