HomeMy WebLinkAbout079-390-020109M ol WON I =8
01-2753
THOMAS, ROBERT
4331 FOOTHILL BLVD,
OROVILL
PROPANE HEATER
& �__ 26 01-2784
THOMAS, ROBERT
4331 FOOTHILL BLVD, OROVIL
NEW ELEC SERVICE PANEL
01-2870
THOMAS, ROBERT E.
4331 I-OODTHILL BLVD OROVILLE
CONT: OWN ER
1-120 PIPING TO SERV NEW WELL
01-3042
THOMAS, ROBERT
4331 FOOTHILL BLVD, OROVIL
FOUNDATION FOR EX SF
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT - 6/ an V2.
ASSESSOR PARCEL NUMBER
036-390-020
ZONING
AD —
BU I LD I NG P ERM IT _3a y,Z,
OWNER
TUOHOTIE
SO. FT. OCC. - BUILDING VALUATION
OWNERS MAILING ADDRESS
mIU
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
$1
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
9Q PIP
BUILDING ADDRESS
x-33? FOOTHILL BLVD. 9ROVILLE
Energy Plan Checking Fee
$
$
PERMIT FEE
$
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
PLUMBING PERMIT
Ming ee 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 ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: TNCTnT T m /��7 mTnnT T
�v'xz��()p4 �T1()N VL'PIIL'
YTCTTAT(' DWELLING
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
@20.00
PERMIT FEE
$
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service 200AORLESS
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.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
for the following reason:
I, as owner of the property, army 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 1000A
ToNG
46.00
NEW CONSTDWELLING
. CUP.
WEWEE OCCU
OR ADDNS. ( a ACC. Bins.
SO
3.50FT.
NEW SIDMULTI-OUTLET CIRCUITS
@7,50
OWER APPARATUS
a PSINGLE ourLEr CIR.
OUTLET OR FIXTURES
Ex. Occup.BAL
20 p 1.00
o .50
FIXED APPINS. OR
Ex. Occup. ourLErs RESID. EA
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wirina
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
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEE
$
Policy Number
(The above sections need not be completed 4 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 visions of section 3700 of the Labor Code, I shall
f h comply with os provisions.
X Date �0
Signature of Applicant - X Owner ❑ Contractor ❑ Agirit
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 62.00
HAZ.
D. FEES IMP
--
FLOOD COF
PARCEL PO HD
ISSUE
This permit is hereby issued under the
of the Butte County Code and/or
indicated above for which fees have
By
PERMIT EXPIRES ON /
I J(pit.)
applicable provisions
Resolutions to do work
been paid.
6
Date
3d Z
Receipt No. 3373011$iii_00
WHITE-D.D.S.-B.D. CANAR •ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
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 provides the major labor and materials for construction of the proposed
prop improvement : YESNO 0
2. I HAVEM HAVE NOT 0 signed an application for a building permit for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction:
NAME:
ADDRESS:
PHONE:
CITY:
CONTRACTOR'S 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 • (" c�5e I L<_9eA U
F-IItW
PHONE:
CITY:
CONTRACTOR'S 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: v
PROPERTYOWNER:
SOCIAL SECURITY NUMBER:
DATE: i l &EI) S /
NOTE. This Owner -Builder Verification is required by Section 19831 and 198.32 of the
California Health and Safety Code. This verification must be completed and
returned to our office before we are permitted to issue the permit
OVER
OWNER BUILDER INFORMATION I I
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of property
improvements specified.
For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such
a permit. Building permits are not required to be signed by property owners unless they are personally, performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business
license from the city or county. They are also required by law to put their, license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should
be aware of the following information for your benefit and protection:
♦ If you employ or otherwise engage any persons other than your immediate family, and thework(including materials
and other costs) is 5300 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer. `I
♦ If you are an employer, you must register with the State and Federal Governments as an employer and you are
subject to several obligations including *state and federal income tax withholding, federal social security taxes,
workers compensation insurance, disability insurance costs, and unemployment compensation contributions.
♦ There may be financial risks for you if you do not catty out these obligations, and these risks are especially serious
with respect to worker's compensation insurance. X11, r`TA ,, ;
1
♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and,
if you wish, the U.S. Small Business Administration). For more specific information about your obligations under
State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an `-`owner builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building
permits are not required to be signed by property owners unless they are performing their own work personally.
Information about licensed contractors may be obtained by contracting the Contractors State License Board in your
community or at 1020 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you
are aware of these matters. The building permit will not be issued until the verification is returned.
n, t
4icy,
C. Vi iia, C.B:O.r, Vi '7
NOTE: This Owner -Builder Information is required by Section 19830 of die California Health and Safety Code-
OVER
ode
OVER
a
�-271-011-
0%3 0 � Z --
BUTTE COu w r- .1
BUILDING DEPARTMEI-o
'APPROVFr
New Foundation on North East Corner of Exisiting Residence For: Scale: 1/8" = 1'-0" Pg 1
Robert and Debra Thomas
Foothill Blvd. @ Lower Wyandotte (42oid q)&v1iJ ka O,
Orovillle, Ca. 95966 -43c3
Drawn by: Russell Koehn DBA Pacific West Design SYN O3(p ^ 9 2Z — d ZC
11
12" Min. 6" Min.
BUTTE COUNt It
90ILDING DEPARTMEN
New Foundation on North East Corner of Exisiting Residence For:
Robert and Debra Thomas
Foothill Blvd. @ Lower Wyandotte (4331 rc.,T Iuujo)
Orovillle, Ca. 95966 - ct:�,3
Drawn by: Russell Koehn DBA Pacific West Design A, t)
Scale: 12" = 1'-0" Pg 2
3" Min.
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BUTTE COUNt It
90ILDING DEPARTMEN
New Foundation on North East Corner of Exisiting Residence For:
Robert and Debra Thomas
Foothill Blvd. @ Lower Wyandotte (4331 rc.,T Iuujo)
Orovillle, Ca. 95966 - ct:�,3
Drawn by: Russell Koehn DBA Pacific West Design A, t)
Scale: 12" = 1'-0" Pg 2
I
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rn
O
N5.
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ni
O
o 0
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Cl
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IDN
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00
BUTTE COUNt It
90ILDING DEPARTMEN
New Foundation on North East Corner of Exisiting Residence For:
Robert and Debra Thomas
Foothill Blvd. @ Lower Wyandotte (4331 rc.,T Iuujo)
Orovillle, Ca. 95966 - ct:�,3
Drawn by: Russell Koehn DBA Pacific West Design A, t)
Scale: 12" = 1'-0" Pg 2
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 Cougty Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO.
(Rev. 12/96) - APPLICATION AND PERMIT 01-28'10
ASSESSOR PARCELNUMBEA 036-320-020
ZONING
-
BUILDING PERMIT
OWNER
ROBERT E. THOMAS
TELEPHONE
538-7226
SO. FT. OCC. BUILDING VALUATION
OWNERS MAIUNG ADDRESS
C/o BUTTE CO. DISTR
CONTRACTOR'S NAME
0
TELEPHONE
CONTRACTORS MAIUNG ADDRE S
CONSTRUCTION LENDER
Fireplace
LENDER'S MAIUNG ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDINGADDRESS
4331 FOMILL BLVD., OROVITI.E. CA 95965
Energy Pian Checking Fee
$
$
PERMIT FEE
$
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00 15.00
Each as water heater or vent
15.00
TYPE OF WORK
New O Addition ❑ Remodel O Utilities O Installation ❑ Other O
Describe Work: WATER PIPING TO SERVICE NEW WELL T •
FROM HOUSE TO GARAGE
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home IS I GI W1
@20.00
PERMIT FEE
S 35,00
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service . A OR V 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:
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 200A TO 1000A
46.00NEW
CONST. DWELLING OCCUR
OR ADDNS. ( e ACC. BUDS.
sD
3.5¢FT:
plOµq�,pT MUCH 1JTLET11.
@7,50
APPARATUS
6 SINGLE OUTIM CIR.
Ex. Occup. ourLE-rOR FIXTURES
00
BAS @':50
Ex. Occup..OUTLFIXETS Aa ) EEA
5.00
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.)
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'
com sation laws of California, and agree that if I should become subject to the
ensation provisions of section 3700 of the Labor Code, I shall
y with those provisions.
kcm
X Date 11171w
Signa ure lican - caner ❑ Contractor O Agen
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
MECHANICAL PERMIT
Fling Fee 20.00
Heating
—Cooling
Hood 6.50
Ventilation
PERMIT FEt $
Mobile Home Installation Fee $
Energy Inspection Fee $
OCC
CONST. TYPE
TOTAL FEE $ 35.00
HAZ.
D FEES IMP
I FLOOD
I CDF
PARCEL
I PD
I HD
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated bove for w Ich ees have been paid.
B Date
PERMIT EXPIRES ON 11-7-2002
ate
Receipt No. 337055
WHITE-D.D.S.-B.D. CANARY-ASSES90R PINK -INSPECTOR GOLDENROD -APPLICANT
'* COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PE MIT NO.
(Rev. 12/96) APPLICATION AND PERMIT 01 - °�7,S-
ASSESSOR PARCEL NUMBER
036-320-020
ZONING
BUILDING PERMIT
OWNER
ROBERT E- THOMAS
TELEPHONE
38-7226
SO, Fr, OCC. BUILDING VALUATION
. OWNERS MAILING DRESS
Co BUTTE CO. DISTRICT ATTORNEY OFFICE
NAME
CONTRACTOR'S �R
0WLV l:
TELEPHONE TELEPHONE
CONTRACTOR'S MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Film Fee $ 20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS
4331 FOOTHILL BLYS.
Energy Plan Checking Fee $
$
PERMIT FEE $
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT Filing Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap 7.00
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 ❑ Installation ❑ Other ❑
Describe Work: ELECTRICAL SERVICE PANEL (NEa)
Gas piping stem 1 - 5 outlets 15.00
Building sewer 15.00
Mobile Home I S I G I W @20.00
PERMIT FEE t
ELECTRICAL PERMIT Fling Fee 20.00
Main Service ".A OR LESS 23.00 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.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
w 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
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 y person in any manner so as to become subject to workers'
co pen ti la sof California, and agree that if I should become subject to the
wo p sation provisions of section 3700 of the Labor Code, I shall
M with those provisions.
X __ Date
Sign atuffl'offAfI I - 79 Ow-ner ❑ 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 200A TO 1000A ..46.00
NEW CONST. DWELLING OCCUP. SO
OR ADDNS. ( & ACC. BUDS. 3.5QFT;
=RES1D. ' ANCHOLRLET @7,50
PowER APPARArus
8 SINGLE OUTLET CIR.
20
Ex. Occup. OUTLET OR FURES @''00
DnBRI. Q .so
FIXED ALNS
Ex. Occup. ouT REES,6.) R, 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE $ 43.00
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEt $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 43.00
HAZ.
D FEES IMP
FLOOD
CDF
PARCEL
PO
HD
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County C and/or Resolutions to do work
indicated . ove for w Ich f es have been paid.
`
y Date 10-30-2001
PERMIT EXPIRES ON 10-30-2002
pate)
Receipt No.
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
■
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 PERMIT NO.
(Rev. 12/96) APPLICATION AND�PERMIT
--�� 01-2753
ASSESSOR PARCEL NUMBER 036-320-020
ZONING
BUILDING PERMIT
OWNER
ROBERT THOMAS
TELEPHONE
538-7226
SO. FT. OCC. BUILDING VALUATION
.OWNERS MAILING ADDRESS
C/O DIST ATTORNEY'sS OFFICE BME CO 25 COUNTY
CONTRACTOR'S NAME TELEPHONE
OWNER CENTER DRIVE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDERS MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filin Fee $ 20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS
4331 F $
Energy Plan Checking Fee $
PERMIT FEE $
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT Filing Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap 7.00
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 ❑ Installation ❑ Other ❑
Describe Work: INSTALLATION OF PROPANE HEATER
Gas piping system 1 - 5 outlets 15.00 15.00
Building sewer 15.00
Mobile Home IS I GI WF 920.00
PERMIT FEE $ 35,00
ELECTRICAL PERMIT Filing Fee 20.00
Main Service 2IIA 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.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
w 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
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
Main Service IIIA TO 46.00
NEW CONST. DWELLING OCCUCCUP. SO
OR ADDNS. ( a ACC. Bins. 3.5¢FT:
NEWCONST.MULTI.OUTLET 97,50
Por APPARATUS
8 SINGLE OUTLET CXR.
.00
EX. Occup. OUTLET OR FIXTURES BAL O x.50
Ex. Occu . OFIx� SPP oEl 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE S
MECHANICAL PERMIT Filing Fee 20.00
Heating PROPANE 15.00
Cooling
Hood 6.50
Ventilation
PERMIT FES $ -35.00
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'
corppensatiows of California, and agree that If I should become subject to the
w scttion provisions of section 3700 of the Labor Code, I shall
o th those provisions.
X Date
Signature o Applicant -NO Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee Is
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 70.00
HAZ.
I D. FEES IMP
I FLOOD
COF
PARCEL
Po
HD
I ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated bove foris fees have been paid.
;
B. Date 10-26-2001
PERMIT EXPIRES ON 10-26-2002
ate
ReceiptNo. 336764
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
I
OWNER:
LOCATION: 4331 R LA Vl d I hlvd,(o t �'P
iCONTRACTOR: i
DATE:
A.P.#:
ZONING:
DATE TO INSPECTOR: o jq PERMIT HISTORY: [XJNONE [ JAS FOLLOWS:
TYPE OF OCCUPANCY:
ing Description:
[ ] Commercial/Usage:
[ ) Residential/# of Units: _
[ ] Currently Occupied.
[ ] AbandonedNacant.
•ic:
[ ] Yes [ ] No
Electric is currently:[ ] On
Condition of electrical?
1i
BUILDING INSPECTOR'S REPORT
[ ] Off
Natural[ ] Propane[ ] None[ ]
Mobile Home: Yes[ ] No[ ]
Currently On[ ] Off[
A
Obvious problems:
:ion:
Plumbing working Yes[ ] No[ ]
Well: Yes[ ] No[ ] Potable water: Ye
Obvious Sewage Problems:
cription of Damaged Area:
spector:
] No[ ]
z
PAGE OF
CDF / BCFD DAILY INCIDENT LOG
bAY/bATE FROM 080O / DAY/DATE TO 0800 o2 -2? ;Z
i%Ir 4, ` !'/C' bbt 44 MA►It TVbt
SAVED: OTHER EQUIP: MEDICS !J,l
LAND USE: ACRE/TYPE TOTAL
OWNER/TENANT WRA
0
R. p. 3 - / B.I.
MISC.:
4444i4,444444#### #+#++++++##+##+######*##+#+++++++#,++++ -AJ++++#######++#
EPORT TIME START TIME CONTROL TIME R.O. STA.
LOCATION: BAT.
o CAUSE: . ENGINES: CDF BCFD CO# OFFICER:
so WT DOZ CREW AA AT HC ,S
SAVED: OTHER EQUIP: .5;-- _A0 MEDICS
LAND USE: ACRE/TYPE TOTAL
OWNER/TENANT WRA
B.I. -�/, s�
MISC.:
k",CAUSE:
-•A—
SAVED: OTHER EQUIP: MEDICS S
LAND USE: ACRE/TYPE TOTAL
OWNER/TENANT WRA
O R.P. B.I.
MISC.:
DAMAGE: SQ WT DOZ CREW AA AT HC
SAVED: OTHER EQUIP: ;EZZ2 MEDICS ae5z_
LAND USE: _ ACRE/TYPE TOTAL
A
#+4J
V
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