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079-270-075
r J �.9`+�"'r�f _ ,.x..y.+wC `" �.'•ir�'�:� j..:d�� K-�- ••w .+.,• - � a ,�- t _ -sr ' N•-, r �;',k+- - •.�t " . , .. ;- '^ � � - . a ` - _ ... - .+w}s�e.rr++ii.�;�...�^ -.w., ^` .+ qtr F F Z: - ._. � a.A _ ����.• sin..- n• h. _ �. 7 % _ cont ,,. _ ,� .. . BiiEL �C . •BERRY' / D ,,,,,. '-' � Circle Dr., �( ! � u; conte: A'-1 D7 Masonry, Oro ale �"�� �� ` � j - Permit #2800-76B(tear down' & •replace 'EQ44k,I Damaged fireplace/SF) ? Lev n�^7•f �n� � - . �V� f { CIA T(, R�YBEE� 36 Circle Drive, Oroville W/7 s Permit#235-86B,E(convert carport to, t shop &,replace garage door) p 079-270-075' 41t. • 06 1793 WILLIAMS, JOE 36 CIRCLE DR, OROVILLE ' �'•' J ` - Cont: CHRISTIAN ROOFINGS y a RE ROOF • � i F 1 P cn J 7. 079-270-075 0&1793 NOTE S. 6 CIRCLE DRNqR0VILLE,;:)03 t'- 3. C cn�.'CHRISTIAN ROOFING` RE ROOF � ��n 4 RESIDENTIAL AFk: A;,' Permit No. -�7 Owner. Site Address: Contractor. Type of Permit: DATE JOB F04ALED: SIGNATURE- +=OK o = Not OK MANUFACTURED HOMES DATE I Li PERMANENT FOUNDATION SOFTSET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Lorin -Test; Fall/C10-Concrete 4 Wtr, Loctn Test-Easeinent Needed -Regulator 5 Elec Loctn-Clmcs-Gnid 'Amp -Concrete 6 Yard Gas; Loctn Test Wrap Nat ❑-or LPQ Inch Sz Ft Lngth 7 Bickng; SzSpacing-Marriage Line 8 Gas; MH Test -Demand Valve-Cnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-Dimcs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -C10 to Grade 12 Gas and Electilcity Tagged 13 Tie Downs Q Foundation 14 Exits 15 Cert of Occupancy . 16 HUD LabeVinsignia Numbers Serial Numbers de r MISCELLANEOUS - ID E C K S*C OV E R VC A R P 0 RTS *G A RAG E S ISCELLANEOUS- DECKS'COVERVCARP0RTS`GARAGES 1 ZoningSetbadks-Easements 2 Ftgs; SoilsSz-DpthSpacing-Cnnc rsSteel 3 Decks, Girders/Joists-Dcking-Brcing Stairs-DuardlHandrails 4 Wood Awn; Posts-Beams4Utrs-CnnctrsShthg. Frmg-Brcng - 5 Alum Awn; Columns-CnnctnsSplice-Decal-Encisrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills AnchrsStuds4Utrs Trtisses 9 Siding; Nailing-VeneerStucco-Lath ` 10 Roof, Shthg-Roofing 11 Ext; Steps -Doors -Landings .12 Braced Wali pnis oe DATE POOLS 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptds/Ung; Distance -GR 5 Efec Pool 4ting; l5 volts -GR 6 Elec.Enclsrs; Conduit Entries Terminals -Listed TElec Banding; Metal w/5'-Crdtng Egp4itr 8 Elec Grndng; Eqp w/5' Crdtng Eqp-Pool Ightg Boxers-pnlboards-lnsultn-to Main Conduit 9 Health De ft Apprvl . 10 Plmb; Cir Test-Wtr Supply. Test 11 Lt Niche ' 12 Endsr, Fencing -Alarms 13 Bondmg, Diving board or Slide a = Nat OK ESIDENTIAL (Single & Duple wait (UNDERFLOOR 1 Zoning -Setbacks -Easements -Flood -Slope 2 Ftg Main; Sails-Elec Gmd Ftg Dpth 3 Fig Garage; SoilsSteel-Elec Gmd Ftg Dpth 4 Fig Porches/Decks; Soils -Steel Ftg Dpth 5 Stdmwalls Main; Steel-Blockouts Wrapped 6 Stemwalls Garage; Steel-Blockouts-Wrapped 6a Hold Downs and Special Anchrs 7 Slab, Steel Wrapped 8 Piers-Frpic Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test 11 Wtr Pipe; Test-Anchrs-RgltrService Test 12- Elec Undrgmd 13 Plenums & Ducts; Cimc-MaterialSupport4nsultn 14 GirdersSills-SillsBolts-Joists-Vnts-Cripples 15 Ace & Vntitn 16 Insulation DATE FRAMING 17 Silts Proper Materials & Anchrs ,.. 18 Walls Studs -Nailing Spacing & Braces-Plates-Sound Bearing Wails over Girders & fir Nailing 20 Draft Stop In Walls (rat proof) 21 Fire Stops; Furred CeilingsStairs-Chasers Tubs 22 Headers 8 BeamsSi &' Bearing' 23Hangers-Posf'Caps-Anchrs;Citnctns 24 Ceiling Joisf-Rftr Tjes-Purlin-Roof Brac TuS nshthg 25 Frplc Ties or Type A Flue=Flc Throat Cimc 26 Attic Ac -c"; Sz &'Rriur .p tctrr-Draft Stop -Ins Baffles 27 Bdrm Wndws orExiting l)oorsSill Ht & Dimensions 28 Garage Fire Prtcbi Framing -RC Channel 29 Prprty Line Firewall & Opngs' . 30 Ext Doors -One 3' -Check Garage 3rd Story, 2 Exits 31 Stairs; Width-Hdrm-Rise-Run4-anding-Fire Prtctn 32 Plywd on Roof Ovrhng Attic Vnts-Rftr Outrgrs 33 Siding -Nailing Veneer - 34 Stucco Lath Weep Screed-Fndtn Vnts-Undrfir Ace 35 Glazing Are Prtetnkytts-Plastic . 36 Shear WallsS ; Nailing -Bolts 37 Brace IntiExt Wall pnis 38 insultn-Walls-Ceilings 39 Infiltration -Walls -W ndws DATE_ JELECTRICAL 40 Fxtr & Tmsfrrnr Cimc-Ins Prtctn 41 Elec Rcptcls Spacing-Dts & Switches at Doors 42 Sz Boxes & No Of Cndetrs Stapled 43 Romex Installed Close to Edge of Studs & CJ 44 Eqp Grnd made up w/Mech Fstnrs 45 Grndng Electrode Bond Gas & Wtr 46 2 Appinc Cires in Ktchn & Cndctr Sz GFl 47 Subfeed Wire Sz 93 Q Cu or ❑ AL AC Wire Sz ca ❑ CU or ❑ AL 48 Range Ckc oa Q CU or ❑ AL Oven Circ ya 0 CU or El AL Insulated Neutral EJ Yes ❑No 49 Service -Riser Cndctrs & Gmd Main Dscnnct 50 Eqp Clrncs pnis-Motors-Meth Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector o',QTS o'• unit IPLUMBING 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 54 Wtr Pipe; Test & Anchr-Nail Prtctn 55 DWV; Test Fittings & Anchr Nail Prfctn 56 Shwr Pan; Test, Fust fir -Tub Ace 57 Test Tub & Shwr, 2nd fir - Tub Ace 58 Gas Pipe; Sz & Anchrs 59 Fire Sprinkler; Test 60 Yard Gas Piping Q, DATE MECHANICAL 61 AC Ducts Insultn & Support 62 Vent Fan, Exhaust abv Insulin 63 Condensate Drain & Ovrflw, Sz & Grade 64 Furnace -Vent Acc-Comb Air RbTuVent 115 Outlet 65 Attic Ace & Pitfrin if Furnace in attic DATE FINAL 66 Ext Steps -Door & S1deLt Prtctn-Landings 67 Smoke Detector 68 Furnace Vnts-Cimc-Comb, Air-Cnnctr In Garage; abv-fir-Ducts-Meth Prtctn 69 Bedroom Exiting 70 GFl & Bath Fxtrs & Tub Ace -Spa 71 GFl Arc Fault 72 Elee Trim & Subpnl, Breaker Szs & Labels 73 Stairs, GuardlHandraiis 74 Frplc or Stove, Cimc-Hearth 75 Elec Outlets at Wood Pnl, Int & Ext 76 Ktchn, Fxtr & Appinc; Gmd Air -Dap -Cooking Cimc 77 Elec Outlets & Rcptcls at Kfchn Counter 78 Garage Fire Door, Swing -Landing -Closure 79 AC Duct in Garage -Damper. 80 Wtr Htr, Vnts-Cimc-Com Air Cnnctr-PRV; abv fir Mech Prtctn; LPG Appince Undr House 3' drain 81 Plmb; Elec & Mech Eqp Listed for Lorin 82 Elec Rcptcls in Garage (GFl) Romex Prtctn 83 Insults -Foam -Looked in Attic 84 Guard Rails & Deck Cnstrctn-Post Caps 85 Fndn Vnts & Crawl Hole Door Dmge & Wood -Earth 86 Cimc Dmge Planters Q Yes 0 No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Pimb 89 Vnts abv Roof, Pimb-Appinc-Frple-Cimc to Opngs 90 Wtr Well, Dscnnct, Elec, Pimb 91 Ext Elec Trim, GFl Rcptcl-Undrgmd 92 Vntltn thru House 93 Glass Prtctn 94 Corrections from previous Irispctns 95 Gas Test -Meters Tagged, Gas-Elec 96 Wtr & Sewer Cnnctd-C/O to grade -HD Apprvl 97 Energy Cmpinc Cert -Other Certs 98 Address Posted 99 Fire Sprinkler BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 .. PERMIT NO. BP061793 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under Issued Date: 07/25/2006 APN: 079-270-075-000 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 : License Number: raSr/y_-2� Site Address: 36 CIRCLE DR ORO / , , 14 . Map Index: Date: Contractor. ! i Description: RE -ROOF 37 SQ.'S COMP OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: WILLIAMS LIVING TRUST permit to construct, alter, improve, demolish, or repair any structure, prior C/O WILLIAMS JOE G. & MARGARET J. to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of TRUSTE the Contractor's State License Law (Chapter 9 commencing with Section 36 CIRCLE DRIVE 7000) of Division 3 of the Business and Professions Code) or that he or OROVILLE CA 95966 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the (530) 532-9280 applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 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 (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: CHRISTIANSEN ROOFING COMPANY owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one P O BOX 2749 year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of OROVILLE, CA 95965 sale.). (530) 532-9338 ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed Contractor: CHRISTIANSEN ROOFING COMPANY pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 of the Business and Professions Code P O BOX 2749 Date: owner: OROVILLE, CA 95965 (530) 532-9338 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 License #: 651425 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 the Labor Code, for the performance of Architect: the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Engineer: Carrier: Policy #: Total Square Ft: 0 S. F. ❑ I certify that in the performance of the work for which this per is issued, I shall not employ any person in any manner so as to Valuation: $0.00 become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' Census Code: compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: _J/���Ls/�%/ Applicant: <�/ /L✓�ir� �ioQ!��7 WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. ( ) l N / L v CONSTRUCTION LENDING AGENCY . ls here issued under th p licable provisions of the Butte County Code and f fes have been This perm(hs. I hereby affirm that there is a construction lending agency.for the 3097 Civ.) Resoluti to do ork indicated ab e whit paid. /f/�` performance of the work for which this permit is issued (Sec BY: / Date: (J Name: r PERMIT EXPIRES ON:- v Address: iDate ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. Health 8 Safety Code is not applicable to the scheduled construction of this project. ❑ Notification in accordance with Section 19827.5 of California ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that 1 have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. • e r Print Name: c / X+'r :Signature: Date: 16-6wner ontractor ❑ Agent for Owner ❑ Agent for Contractor b. c. twnaing rermit u i- io-uv py i BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP061793 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under Issued Date: 07/25/2006 APN: 079-270-075-000 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. /9 License Class : f License Number: a /tz�c- Site Address: 36 CIRCLE DR ORO r' Map Index: Date: zhjContractor: �r ; o '""�OOWWNER-BUILDER Description: RE -ROOF 37 SQ.'S COMP DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: WILLIAMS LIVING TRUST permit to construct, alter, improve, demolish, or repair any structure, prior C/O WILLIAMS JOE G. &MARGARET J. to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of TRUSTE. the Contractor's State License Law (Chapter 9 commencing with Section 36 CIRCLE DRIVE 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any OROVILLE CA 95966 violation of Section 7031.5 by any applicant for a permit subjects the (530) 532-9280 applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 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 (Sec. 7044, Business and Professions Code: The Contractors' State License Law, does not apply to an Applicant: CHRISTIANSEN ROOFING COMPANY owner of property who builds or improves thereon, and who does such work himself or herself. or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one P O BOX 2749 year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of OROVILLE, CA 95965 sale.). (530) 532-9338 ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: CHRISTIANSEN ROOFING COMPANY ❑ 1 am Exempt under Article 3 of the Business and Professions Code Date: Owner: P O BOX 2749 OROVILLE, CA 95965 WORKERS' COMPENSATION DECLARATION (530) 532-9338 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 License #: 651425 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 the Labor Code, for the performance of Architect: the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Engineer: Carrier: Policy #: . ❑ I certify that in the performance of the work for which this permit is Total Square Ft: 0 S. F. issued, I shall not employ any person in any manner so as to Valuation: $0.00 become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' Census Code: compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date:J�IO Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. % CONSTRUCTION LENDING AGENCY This permit fs hereW issued under theApalicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resoluti s to dgpork indicated ab e f whic f es have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) �) Date: Name: tJ BY: fj PERMIT EXPIRES ON: U Address: Date ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. , I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. r�� P1d/I Signature: Print Name: iG1499iG Date: 9'6-w ontractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 Assessor Inquiry - Main Asmt: 079-270-075-000 Feeparcel: 079-270-075-000 Owner: WILLIAMS LIVING TRUST Situs Address 36 CIRCLE DR OROVILLE j NameAddress WILLIAMS LIVING TRUST C/O WILLIAMS JOE G it MARGARET J I TRUSTEES 36 CIRCLE DRIVE OROVILLE CA 95966 r...................................................................................... ................................................................................................................................ Status Date ............ ............... ACTIVE j .... .... ...... ...................................................................................................... Taxability (Descr ........ ..... _................ ....... .... ....... ...... 000 j NORMAL OWNERSHIP .Code r...................__....._............................-............................................................................................................................. ..TRA Base Date 091-001 ................................_.......................................... ............................................................................................................................................................... Creating Doc# j Date 198GRO433600 Current Doc# Date 2004ROO76418 112/15/2004 .. ...........-........................................................................................................................................................................................................................... Terminating Doc# I Date . 1 ..................... Neighborhood C --- .Supl Cnt'.... ........... .............. 036..........,..............................................,......................... ...... ........................................ .................................._................................... Asmt Description ........... .............................. ............................ 36 CIRCLE DRIVE Land Use 1 ( Land Use 2 ............................................. _......................... Zoning 1 ( Dwell 1 6.R5 00 .......................................... ..................................... ......................................................................_........................ Acres ( SgFt ........ ................................................... 1.62 10 ............................................................................................................................................................................................. SSN1 JSSN2 - Parcel fa t Section I TownShip (Range _ Description ............................................................................................................................................................................................... TPZ I Ag Pres I Etal j Bonds [_] ❑ I171 :.................................................................................................................... ..... Cl Multi.: --90 MH Flag1....1Flag.2.. _............ ........................... .............. 1 3 ._ Asmt PP ( Tax PP Appeal Split ................................ ................ ............. ......_..... ..�.....................E-^.._L..... ............... ......-.......... Ll i V L1 ............. _.._..._.....--.-................. .............. ............................... Comments ................ .. Remap from 036-220-186.000 ............................_..._...._...__............_... -- ..._...................__...._.__.._._...................................._..........._......__......................_............................._...__..._.._.......... ............... .... _.............. .... _...... .... ..... _. Main Notes Net j 151,377 RIC # ................... : ................................................................... TRIDate i Status ...................................................................... Descriptici; ENROLLED is BASE YEAR Ownership Detail Ownership History I Exemptions , Mfg Homes ( Attributes Value History Situs Sales 'I Ready. - BCIIMPTS200010/27/200510:OB.30 PM BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF A PPL ICA TION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Nameirst Na �Q Address r• City (D /.. Sta Zipq�� Phone Fax E-mail CONTRACTOR ARCHITECT/ENGINEER Name r , City � / Address Zi City� St Zip5p, PhoneS��'�3 Fax Map Book E-mail Lic. # Planner Cla APPLICANT INFORMATION ARCHITECT/ENGINEER Name City � / Address Zi City Fax State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT INFORMATION Name /•iS Address �� t _: 57 4, City � / State Zi Phone-93� Fax E-mail APPLICANT SIGNATURE X�/ For office use only: Zoning Property Address Flood Zone Cross Street SRA I Yes INo Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT MJ J&_! 6 BIN # PROJECT LOCATION AP# — 0'7\5 l Property Address Cross Street WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors; a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: p Sq FT- Living Garage Open ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): Page 1 of 2 EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: Amount: �y Bldg SRA Receipt #: " ' Sheriff SMIP Date: Other Total REV 8-12-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets,of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Building Permit Application Without Required Clearances Form ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. 'Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). _ ❑ 9. Lefler of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSSUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 1 l t`235 -86B E PERMIT NO. , PERMIT EXPIRES a OWNER CRAIG BYBEE CONTR. owner ASSESSOR PARCEL 36-22-186 i; LOCATION 36 Circle Dr, Oroville n l i F z r f' f, f Temp. Power Pole Called PG&E p; 9 Temp. Elec. Service g Called PG&E Temp. Gas Service .j -Cal led PG&E JOB FINALED (Date) Signature _%t = OK - 0 = Not OK - = Not Applicable MOBILEHOMES * = Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch _ 2, Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/0 -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Locatiort-Test-Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors 7. Utility Clearance 7. Elea Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except k's 1. Zoning Requirements -Setbacks -Easements Card -BI Date Date Card -BI Date POOLS (Plans) OK except q's 1. Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances 4. Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector - 5. Elec.; Pool Lighting; 15 volts-GFI - 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater - 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes -Enc losures- Pane lboards-Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date f V = OK O = Not OK Not Applicable Not Ready RESIDENTIAL (Single and Duplex) � = Date UNDERFLOOR (Plan§4,OKDate FRAyartvG�ontinued) 1. Zoning requir ents-Setbacks-Easements 4 P erty Line Firewall & Openings 2. Ftg., M i oils-Steel-Elec. Grnd.- / /" Ftg. Depth Ext. D - e 3' -Check Garage -3rd story, 2 exits 3. E1g. r g ; oils -Steel- / P. Ftg. Depth rsj tdth-Headroom-Rise-Run-Landing-Fire Protection 4. 1F es Decks; Soils -Steel- / /" Ftg. Depth 511VDy400d on Roof Overhang -Attic Vents -Rafter Outriggers _ aIIs, Ma n; Steel-Blockouts-Wrapped-Slab 5 iding-Nailing-Veneer temwalls, Ga age; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access Piers-Firepl a Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall Fittings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; Sile-Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground _ 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date FINAL (Plans) OK except N's 5aw-EXeps- oor & Sidelight Protection -Landings Card -BI Date Date Card -BI Date PLUMBING (Permit) OK except q's . Smoke Detector 14. Water Ht.; Vent -Access -Combustion Air 58. ce; ents-Clearance-Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection Water Pipe; Test & Anchors -Nail Protection _15. 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. xiting _ 17. Shower'Pan; Test, First Floor -Tub Access fixtures & Tub Access _ 18. Test Tub & Shower, 2nd Floor -Tub Access 19. Gas Pipe; Size & Anchors §1. ec. Trim & Subpanel: Breaker Sizes -Labels 62. 4ffkr9-*-Ratts- - 6 e or ove; Clearances -Hearth 64-Elso-4)"tfets-at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. EI�Outlets & Receptacles at Kit. Counter Date - E AL Permit OK except N's 6te4arage Fire Door; Swing -Landing -Closer 68. 69. A.C. Duct in Garage -Damper Wt . -Ht,., - earance-Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection _ xture &Transformer Clearance -Ins. Protection -- E eceptacles Spacing -Lights & Switches at Doors -- e Boxes & No. of Conductors -Stapled 70. ec. &Mech. Equip. Listed for Location ec. Receptacles in Garage; (G.F.I.)-Romex Protec. Romex Installed Close to Edge of Studs & C.J. 2 quip. Ground made up !/Mech. Fasteners -Bond Gas & Water 72, oked in Attic ❑Yes 73 Goafd-Re4s-8-Gook Construction -Post Caps _!trcuits in Kitc & Conductor Size 26, Subfeed Wire Size �/ g or AI-A.C. Wire Size / / ga. Cu or Al 74. .......,r.�� &Crawl Hole Door -Drainage &Wood -Earth Clearance &4 UaaU Looked under Floor ❑Yes _-_ - 2 RangeCirc. / / ga. Cu or AI -Oven Circ. / / ga. Cu or AI, sulated Neutral -Yes ❑No 28. Se 'ce-Riser Conductors & Ground -Main Disconnect - -- - 29_Equip. fearances; Panels-Motors-Mech. Equip. 75. 76. ns rive ❑ Yes E)No: Walks ❑ Yes ❑ No; Planters ❑Yes 1J_ No S4neee-5rCt7f1"FTTiish 77, tsconnect-Clrnces-Brkr. & Cond. Size -115V Outlet - Card B -I Card B -I - 30. Clothes C set Light -Shower Light _ // - - ---------- �V-Dale ✓1 � Card -BI Date84e Date ((( Card -BI Date 78, Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. Wataca4eit, Disconnect, Electrical, Plumbing Trim; G.F.I. Receptacle -Underground entsl othroughout House 82. P Glass Protection Date MECHANICAL (Permit) OK except q's _ Vorrections from Previous Inspections 84 has Test -Meters Tagged; Gas -Electric 31. A.C. Ducts: Insulation &Support _- 32, Vent Fan: Exhaust above Insulation 33. Condensate Drain & Overflow; Size &Grade . 85 Water & Sewer Connected -C/O to Grade -HD Approval 8 nergy Compliance Certificate -Other Certificates _ Card -BI Card -BI 34. Furnace -Vent Access -Comb. Air -Return Air Vent_ -_115V outlet 35. Attic Access & Platform if Furnace in Attic -- --- - -Card-BI Date Card -BI - Date Date Card -BI Date Dat Card -BI Date Card -BI Card -131 Date Card -BI _Date Date Card -BI Date Comments at Final: Date FRA G(Plans) OK except q's 3 Sil roper Material & Anchors 3 alts: Studs -Nailing, Spacing & Bracing-PI_ates-Sound- aring Walls over Girders & Floor Nailing top in Wal rat proof) _tops: Furred Ceilings -Stairs -Chases -Tub 41 eader & Beam -Size ..& Bearing rs-P'6�i -Anchors-Connectors 4 Ing. Joist- f -Purlin-Roof Brac.-Truss-Shihng.-Rfnq. ep ace Ties or T A Flue -Fireplace Throat 1�A+M tze & Romex Protection -Draft Stop -Ins. Baffles _ . in ows or Exiting Doors -Sill Hgt. & Dimensions 47 arage Fire Protection Framing _ (NOTE: Anentrymust be made each time youvisit jobsite) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKSPERMIT NO. 7 County Center Drive - Oroville, Cali6orr is 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT ASSESS R PAR E NUMBE -- ZONI G BUILDING PERMIT owN 14 EL Ho E� o/ SQ. FT. OCC. BUILDING VALUAYION ✓� OWN 'S MAIL DREto S t CONT CTOR'S NAME 7 ELEP HONE CON A TOR'S MAILING ADDRESS Fireplace CON T UCTION LENDER UNKNOWN Total Valuation I $ Filing Fee $ 1000 LENDER'S MAILING ADDRESS Permit Fee $ "MT OR ENGINEER LICENSE NO. Plan Checking Fee ,$' Energy Plan Checking Fee $ ARCM TECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS r� Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 ©!`Q 0 ' 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 SF ❑ 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 ❑ i lities ❑ Installation[).,ther Describework _ C�_ 16961u00OV, 14dELECTRICAL Permit Fee $ Contractor PERMIT Filing Fee 10.00 If Main servic 't o o Ess s 10.00 Main service EA. D'L too A P 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 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 NEW CONST. DWELLING OC LOGS. 2 New CONSTR.( A �) Yx¢sgft 119. pp ULTII.OUTL T NON.RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS tr SINGLE OUTLET CIR. Ex. Occu zAL0 30 p OUTLETS OR FIXTURES SL0 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID,) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ 0 , 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 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, I d ments, costs, and expenses which may in any way accrue agai t said Coun in consequence of the granting of this p rmit. k J� X Date I �` v � Signature of A p icant Own Contractor ❑ Agent ❑ An OSHA perm) is required for ex ovations over 5'0" deep and demolition or construct- ion of structures over 3 stories in h Ight. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ 97.75 occuP. CONST.TYPEJ PLooD ARCEL PD HD �-- se This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIREC OF PUBLIC By PE EXPIRES Date the applicable prov'i- resolutions to do fees have been paid. WORKS Date Receipt No. WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT in . Y COUNTY OF BUTTE - DEPARTMENT.OF *PUBLIC WORKS - BUILDINGIDIVIION � 7 COUNTY CENTER DRIVE - OROVILLr,--C&LutFORNIA 95965 - TELEPHONE: 9t16/534�4541 .r0 PERMIT APPLICATION DATA SHEET Permit No.- OWNER GY , A. P. No. Proposed Building Use v Permit Fee Based Upon: Complete Contract. Price DPW Valuation Ottber ( x d in) Building Inspector / Date At tim�otf ermit application, I was advised the following data must be submitted prior to permit processing andJorance: DATE RECEIVED APPROVED 1. All items have been submitted. . . . . . . . . . . 2.^ Plot plans in duplicate/triplicate. . . . . . . . . . . 3. Complete plans in duplicate/tri.plicate. . . . . . . . .'' 4. Complete engineered plans and calcs. . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. CUSD "Fees Paid" Stamp on Floor Plan . . . . . . . . 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . 9. Letter of signature authorization. . . . . . . . . . . 10. Sanitation approval from Health Dept. 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner[], Mail to ownerEl 15. Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . . . Pre-Insp17. Pre -inspection for Required- Building request to (Date) p q Building Inspector 18. � o ii u Acknowledgment cnle 19. Other nstrut oapprovarequired prior to occupancy) When you issue the permit, process as follows: l?v Mail to owner. _ '� Telephone _ and hold for pickup at office Other /vE /U "i/e.0 Mai I to contractor. _Deliver w/inspector. Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone Mail Other By Date Plans checked by Date Plans approved by Date oz's Other Copy—DPW t ,PER:9AIT NO. 2800-76B ;,_ PERMIT EXPIRES 'QWNER Buel C. Berry A-1 Masonry, Oroville CONTR. tLOCA710N (n:P. 36-22-47 & 101 ) 36 Circle Dr.,Oroville Temp. Power P le Called P &E Temp. Ele . Serv. Call PG&E Temp. Gas Serv. ailed PG&E i o INALED (Date) (Sign ure) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RUM BUILDING BUILDING (Cont'd) PLUMBING Setback _-- Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor " Footings Windows 3rd Floor StemwaII Sidin To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings StemwaI l Garage Vents Insulation Water Htr. Heaters Slab Prov. for physically handicaooe Appllances Carport Footings Slab Patio Footings Masonry Walls Relnf. Steel ex. FIREPLACE Footing -,)- • '% Throat Stucco Final Mesh MECHANICAL Scratch Heatin Brown Cooling Finish Ducts Interior Lath Ventilation Door Cioser Final DATE e -f --7G • REMARKS llw�- r<, �:ye-5 OR CORRECTIONS__ 0 Z<, -- I f A Gas Piping & Ti Temp. Gas Sanitation Final Fixtures Motors Water Htr. Subpanels Grd. Fault Pri Service Temp. Pole Undergrouni Permanent Final (NOTE: An entry must be made on this form each time you visit the job site.) ICA L COUNTY OF BUTTE -- DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Uroville, California 95965 Telephone: 534-45410 022 APPLICATiON'AAD PERMIT l/ f ti��UUU authorize representatives of the County of Butte to enter upon the above -m ioned roper for inspection purposes. Date Signature of Z_k ee or Agent Receipt No. '--At QIY— White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant 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. DIRECTOR OF PUBLIC WORKS wt MA Building permit expires Date s 8 BUILDING Owner SQ. FT. OCC. BUIL VALUATION Mailing Address 3 CIrCL� ®rov6 C Telephone No. Fireplace Contractor _ P% Ay Total Valuation Mai I i ng Address :?Q411 /rp a'6' ,q y I- Permit Fee Plan Checking Fee &/or Penalty ,k,p L. Telephone No. _U/ 0 Permit Fee $ Pu T Building Address -3 4:� C "ff it -e- PLUMBING No. @ FEE PERMIT FILING FEE $3.00 f-0 L1, Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No.Gas Zoning 8 Planning piping system 1 - 5 outlets 1.50 Each additional outlet .30 6Rer _aa� FireDept. FireZone L Use Permit Building sewer 5.00 EQA I Plans Parkin Declaration Parcel Map 60' R/W Improvements Lawn sprinkler system 2.00 ans ec Parcel Approval Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER 2q ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Nt RGA Y4- L �C �. Main service 600v OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 Single Family Duplex ❑ Mobil Home ❑ Others ❑ VR 600V Main service 100EAMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW OR ADDNST ( ACCLBL SLING LOGS. &) 20sgft NEW CONSTR. MULTI -OUTLET NON-RESID, BRANCH CIRCUITS) 2.50ea NEW CONSTR-POWER APPARATUS & NON-RESID. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Ex. Occup(OUTLETS OR FIXTURES) 50 BAL Ex. Occu FIXED APPLNS, OR p•(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. 2-f b ZoeClassification ,r2 q E Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for W men's Compensation. 1 have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. ❑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 the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation [t2.00 Hood Permit Fee $ $ 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 TOTAL PERMIT FEE p i H authorize representatives of the County of Butte to enter upon the above -m ioned roper for inspection purposes. Date Signature of Z_k ee or Agent Receipt No. '--At QIY— White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant 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. DIRECTOR OF PUBLIC WORKS wt MA Building permit expires Date s 8