HomeMy WebLinkAbout005-383-0135- 383 13
t N1a;�el Edwards t 7
k ` RTR 958 Wisconsin. C is
I
PERMIT DESIGNATION
DEPARTMENT OF
BUILDING AND SAFETY
1
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1
B -BUILDING E -ELECTRICAL U -USE PERMIT HM -HOUSE MOVING y
P -PLUMBING TV -RADIO -TV ANTENNA V -VARIANCE EP -ENCROACHMENT
T -TRAILER S/W-SIDEWALK NOTICE S - SIGN PERMIT D - DEMOLITION 600. 1
CONTR: Fletcher Crosse Chico
Permit 97-72B (repair fire damage)
Mabel Edwards
LOT
BLOCK
SUBDIV. /
958 Wisconson St.., Chico
CONTR: Fletcher Cross
X6173
TYPE OF
PERMITa
PERMIT NO.
PLAN NO.
DATE IS
(2 new Permit 150-728 ndOWS)
WN IrA6 Iola 116
Morris Kem er_Lr�iy/R�7
,7958 Wisconsin St., Chico
-Permit 6320-76B (new SF)
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Permit ##6752-76P, ,M(plbg; ele, &
for 6320-76 jylA� �•
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PERMIT DESIGNATION
DEPARTMENT OF
BUILDING AND SAFETY
1
I ,
1
B -BUILDING E -ELECTRICAL U -USE PERMIT HM -HOUSE MOVING y
P -PLUMBING TV -RADIO -TV ANTENNA V -VARIANCE EP -ENCROACHMENT
T -TRAILER S/W-SIDEWALK NOTICE S - SIGN PERMIT D - DEMOLITION 600. 1
INSPECTION RECORD
BUILDING APPROVALS
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PLUMBING APPROVALS
PERMIT NUMBERS `
SIG. DATE SIG. DATE SIG. DATE SIG. DATE SIG. DATE
ROUGH -IN
GAS PRESSURE TEST I
WATER PIPING
SEWER LINE
APPLIANCES & VENTS
FINAL
ELECTRICAL APPROVALS
PERMIT NUMBERS
SIG. DATE SIG. DATE SIG. DATE SIG. DATE SIG. DATE
ROUGH -IN
FIXTURES & APPLIANCES
METERS
FINAL I
MISCELLANEOUS APPROVALS
PERMIT NUMBERS
DESIGNATION SIG. DATE SIG. DATE SIG. DATE SIG. DATE SIG. DATE
(03 zo
PERMIT NO. 6320-76B
PERMIT EXPIRES 9
OWNER Morris Kemper
�CON TR.
owner
LOCATION (A.P. 46-1231-13
958 Wisconsin St., Chico
�. r
Temp. Power Pole
Called PG&E
17 ti
1, wp/.Il e c. Se r -72
/ Called'PG&E
J, Gas Serv.
Called PG&E
FINALED
(Date)
":Z' (Signature)
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-"'r COUNTY OF BUTTE'— DEPARTMENT OF PUBLIC WORKS -
BUILDING INSPECTION RECORD
BUILDING
BUILDING (Cont'd)
PLUMBING
Setback (.
Firewall 0-�
Soil Piping
Forms / I
Parapets —
1st Floor % C- %
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows -- /
3rd Floor
Stemwall
Siding --/
To out -i
Slab - -
Roof Sheathing -^/ --i
Water Pi in -
Piers r " % 7
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings IN,
Stemwall
Garage Vents
Insulation
Water Htr. — / 7 '7
Heaters ,-
Slab
Carport
Footings
Prov. for physically
handicapped
Conformance of ex.
structure
Appliances
Gas Piping &Test
Temp. Gas r ------
Slab
Final ^ l
Sanitation
Patio
FIREPLACE
Final
Footings
Footing
ELECTRICAL
Masonry Walls
Throat
Rough
Relnf. Steel
Final
Fixtures
Bond Beam
FIRE SPRINKLERS
Motors
Framing -
Test
Water Htr. --�-
Stucco
Final
Subpanels -
Mesh
MECHANICAL
Grd. Fault Prot. -- / •--�
Scratch
Heating
Service
Brown
Cooling
Temp. Pole
Finish
Ducts
Underground
Interior Lath
Ventilation
Permanent
Door Closer _
Final
Final -3 - / 4- - -7
(NOTE: An entry must be made on this form each time you visit the job site.)
THIS is TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH THE CURRENT ENERGY REGULATIONS,
CALIFORNIA ADMINISTRATIVE CODE, TITLE 2S. STATE OF CALIFORNIA. IN THE BUILDING LOCATED AT:
95.8Wisconsin— �-�
Street um er
EXTERIOR WALLS glass
Manufacturer - -J--M Thickness/Type 3r'f_ib.e_-r-I-R Value -11- - — --
INGS
t _
Batts: Manufacturer Thickness R Value
Bv�w:_t Manufacturer G11X Thickness 4�� No_Bags 25 Wt./beg T 1�1
9_ -
Sq. Ft. Covered �8 5 0 R Value 9
FLOORS
Manufacturer
SLAB ON GRADE
Thickness/Type R Value
Manufacturer Thickness/Type R Value
Width of insulation Inches
FOUNDATION WALLS
Manufacturer Thickness/Type R Value
GENEk' CONTRACTOR LICENSE NUMBER12 06 3�0
BY -LiIJIlB JLA 'LE DATE :3/x9/7-7
INS ION ON4AC SUi,AT I ORICENSE NUMBER 2 12 4 61
BV 1 �/ _^C�e';1 tio-i TITLE Owner DATE Aft_
COUNTY OF- BUTTS ' ' —' b—LEPAiTMENT OF PUBLIC WORKS
7 County Center Drive — Urowile, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned prope y or inspection purposes.
X Date
Signature/of Peer/mitee or Agent
Receipt No. /✓� /��/
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
By Date -LT
Building permit expires Date /.a•, �' 77
BUILDING BUILDING
Owner !�J/ ��
SQ. FT. OCC.
BUILDING VALUATION
Mailing Address
Telephone No.
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee 0
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee $
Building Address �� V15COA,5;1IL,1
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
C,
Each Trap 1.50
Repair drainage or vent piping 1.50
ZonYng Verificafion Only
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No. G — Z 3 — Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
eh additional outlet .30
F
ion
Fire Dept.
FireZo a Use Permit
Building sewer 5.00
EQA
PPlans Declarations
Parcel Map
60' R/W
Improvements
Lawn sprinkler system 2.00
Bldg. Plans Rec'd P-Ir'Parcel Approval
Plans Approval
Permit Fee $
$
NEW ADDITION ❑ UTILITIES ❑ OTHER ❑
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service 100 AMP ORV OR LESS5.00
Main service EA. ADD'L too AMP 2.50
Single Family Duplex ❑ Mobil Home ❑ Others ❑
Main service R 600V
1100EAMP OR LESS 25.00
Main service EA. ADD•L too AMP 1.00
•
NEW OCCUP. &) 2¢Sgft
OR ADDNS. ( DWELING ACCLBLDGS.
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)@�
BAL�1
Ex. Occu FIXED APPLNS. OR
p• ( OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
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 Workmen's Compensation.
❑I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
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
Hood 2.00
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
$
authorize representatives of the County of Butte to enter upon the
above-mentioned prope y or inspection purposes.
X Date
Signature/of Peer/mitee or Agent
Receipt No. /✓� /��/
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
By Date -LT
Building permit expires Date /.a•, �' 77
N
COUNTY OF BUTTE' [YE`PAR.TMENT OF PUBLIC WORKS
7 County Centerbrive — Orovilfe, California 95965 / r
-7Telephone: 534-4541�j
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned prop rty inspection purposes.
it X Date
Signature of a itee or Agent
Receipt No. lgZ 4Q4Qc57--'
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
By t Date
see-bla/4
Ba•W" permit e*Vftes-D3te-
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mai I i ng Address
Telephone No.
x'.•77
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee $
Building Address �`O s
PLUMBING No.1 @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50 1J
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No. �� --
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50 ,
Each additional outlet .30
Fees
VV
aitatiaw
FireDept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
Declaration
parcel Ma P
60' R/W
Improvements
provements
Lawn sprinkler system 2.00
BWy..P—:a.._ _'d
Parcel Approval
Plans Approval
Permit Fee $ ZZjj
$ 1,717-
NEW ❑ ADDITION ❑ UTILITIES OTHER
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00 3 d
/�
Main service 100 AMP OR00V OR LESS5.00
'
Main service EA. ADD'L 100 AMP 2.50
Single Family Duplex ❑ Mobil Home ❑ Others ❑
Main service OVER 600v 25.00
100 AMP OR LESS
Main service EA. ADD'L 100 AMP 1.00
NEW
OR ADDNST ( DACCLBLDGS LING 0P &) 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
St le of:
y
Ex. Occup(OUTLETS OR FIXTURES) 50@254
Ex. Occu FIXED APPLNS. OR
P• OUTLETS (RES ID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
1 am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$ L
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 Workmen's Compensation.
❑I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
certify that in the performance of the work for which this
—yis issued I shall not employ any person in any manner
riplermit
so as to become subject to -the Workmen's Compensation Laws of
California.
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00 5, ,06
Heatingd- Op D
Cooling `l D
Ventilation
Hood 2.00 ,.1'. Q
Permit Fee $ da
$ ,�)L
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
$ 6�
authorize representatives of the County of Butte to enter upon the
above-mentioned prop rty inspection purposes.
it X Date
Signature of a itee or Agent
Receipt No. lgZ 4Q4Qc57--'
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
By t Date
see-bla/4
Ba•W" permit e*Vftes-D3te-
a
LAA
COUNTY OF BUTTE
Department o4' PuIc Works
BUILDING INSPECTION RECORD
DATE REMARKS'OR CORRECTIONS
t.
Zoning
Setback'
-Forms
Foundation
Piers & Girders
Fireplace
Rgh. Plumbing
Bond Beam
'Lath & Plaster
Rein. Steel
Gas Piping & Test
Found. Vents
Framing
Plmg. Topout
Rough Elec.
Wtr. Htr.
Furnace
Kitchen Vent
Firewall
Garage Vents
Sanitation & Water
ELECTRIC
GAS
BUILDING
Temporary
Temporary
Cert. of Occup.
Final
Final
Final
DATE REMARKS'OR CORRECTIONS
V
r,w J r• f�,r -.�. ,. _ 1;�, rla` - i. i).,, .�L r�s•s
t�
COUNTY _0F BUTTE
DEPARTMENT 6F PUBLIC, WORKS'
7 County Center Drive - Oroville, California 95965
Phone: 533-1230, Ext. 259
APPLICATION AND BUILDING PERMIT Al q in
joists - 1st Floors Qj bZj
Joists- 2nd Floor 'O PJB
Fireplace
Joists -Ceiling
Total Valuation-•�
/ / - C Exterior Studs / 0
Permit Fee
Interior Studs
Zr
Plan Checking Fee &/or Penalty Roof Rafters
pC. ,a �� •�O
Total Permit Fee Bearing Walls J��\
CONTRACTORS LICENSE LAW
A. LICE NSED!CONTRACTORS COMPLETE THE FOLLOWING:.
I am licensed under the provisions of Chapter. 9, Diva -3, of the State of California Business & Professions Code under the name
styleof..... �.. j.......r!.L... "............... �......r ........1.:5`.:....°r................................................................................................................
License No> �!�?;� Classification ,,,,,,,,,,,!,�...,,,,,1„•••,•„•_•••......., and certify that the aforesaid license is in -full force'and effect.
B. OWNER -BUILDER & OTHERS COMPLETE THE FOLLOWING:
I am exempt from the Contractors License Laws of the State of California under Sec. 7031.5 because (check one):
0 I. am the owner of the above property and I will contract to have all .of the above work performed by licensed contractors.
(Sec. 7044).
I am the owner of the above property and do not intend to offer it for sale for one year from the date of completion of the
improvements. (Sec. 7044).
Basis, if any, for other statutory exemption .............. :.....................................................................................................
..............:.............................:...
WORKMEN'S COMPENSATION INSURANCE
I am aware of the provisions of Section 3700 of the California Labor Code which requires every employer to be insured against liabil-
ity for Workmen's Compensation. I have placed on file with the County of Butte a certificate of compliance or proof of exemption
pur-suant to Section 3800.
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 County of Butte
to enter upon the above-mentioned property for inspection
purposes. f
ii f % Dace / ry `.
!� .........•..it.r1".. (.............
. ..... .................... .....
SIGNATURE OF PERMITTEE OR AGENT
Receipt No.,,,,,, '
This BUILDING PERMIT is hereby issued under the appli-
cable provisions of County resolutions and/or ordinances.
DIRECTOR OF PUBLIC WORKS
BY...:....4..:.......f
Date -I'
........................................................ y
Permit Eicpires Date..... ? •
Permittee Owner ! /+ r' / / �rif!(�T.. �l
Mailing Address /i/% /'-�40� �^r�
�[
�i-�,.r `
r�
'' / <,'//�f�
A. P. No.•--=�3•- % �5
Fire Zone Zoning,
Contractor.�/�> >F n /1/��' ate.
Sanitation
Planning
,,f�i+t-a
Mailing Address- % / L/
/
Plans Fees,-----
R/W Encroachment
BLDG. Address / a^ µ !+� �' •-x <� .4-11 4+ 7/-
NEW ADDITION REPAIRS /� OTHER
Others 1�lffdi°" �l/ �� l!/JGd� S /
Single Multi
USE OF STRUCTURE Family Duplex O Dwelling E
Others /
FOUNDATION
MATERIAL
EXTERIOR ;���+ 1104RS 8
J Width at Top
Width at Bottom
y
Depth in Ground
SQ. FT.
OCC.
BUILDING VALUATION
R.W. PLATE (Sill)
SIZE` SP�CINQ�
SPAN
C/
K-,
�,.. [,_._
Girders
Od
r
joists - 1st Floors Qj bZj
Joists- 2nd Floor 'O PJB
Fireplace
Joists -Ceiling
Total Valuation-•�
/ / - C Exterior Studs / 0
Permit Fee
Interior Studs
Zr
Plan Checking Fee &/or Penalty Roof Rafters
pC. ,a �� •�O
Total Permit Fee Bearing Walls J��\
CONTRACTORS LICENSE LAW
A. LICE NSED!CONTRACTORS COMPLETE THE FOLLOWING:.
I am licensed under the provisions of Chapter. 9, Diva -3, of the State of California Business & Professions Code under the name
styleof..... �.. j.......r!.L... "............... �......r ........1.:5`.:....°r................................................................................................................
License No> �!�?;� Classification ,,,,,,,,,,,!,�...,,,,,1„•••,•„•_•••......., and certify that the aforesaid license is in -full force'and effect.
B. OWNER -BUILDER & OTHERS COMPLETE THE FOLLOWING:
I am exempt from the Contractors License Laws of the State of California under Sec. 7031.5 because (check one):
0 I. am the owner of the above property and I will contract to have all .of the above work performed by licensed contractors.
(Sec. 7044).
I am the owner of the above property and do not intend to offer it for sale for one year from the date of completion of the
improvements. (Sec. 7044).
Basis, if any, for other statutory exemption .............. :.....................................................................................................
..............:.............................:...
WORKMEN'S COMPENSATION INSURANCE
I am aware of the provisions of Section 3700 of the California Labor Code which requires every employer to be insured against liabil-
ity for Workmen's Compensation. I have placed on file with the County of Butte a certificate of compliance or proof of exemption
pur-suant to Section 3800.
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 County of Butte
to enter upon the above-mentioned property for inspection
purposes. f
ii f % Dace / ry `.
!� .........•..it.r1".. (.............
. ..... .................... .....
SIGNATURE OF PERMITTEE OR AGENT
Receipt No.,,,,,, '
This BUILDING PERMIT is hereby issued under the appli-
cable provisions of County resolutions and/or ordinances.
DIRECTOR OF PUBLIC WORKS
BY...:....4..:.......f
Date -I'
........................................................ y
Permit Eicpires Date..... ? •
FA
PERMIT NUMBER - B 97-72
P
E
• �f s
�S PERMIT EXPIRES �� We&- 73
OWNER Mabel -Edwards
#'
CONTR: Fletcher Cross, Chico
4i LOCATION (A.P. 46-123-13
958 Wisconsin St., Chico
r
f
DATE REMARKS OR CORRECTIONS
ter
COUNTY OF BUTTE
Department of Public Works
A.
BUILDING I SPEC�ION RECORD
Zoning
Setback
Forms
Foundation
Piers & Girders
Fireplace
Rgh. Plumbing
Bond Beam
Lath & Plaster
Rein. Steel
Gas Piping & Test
Found. Vents _
Framing
Plmg. Topout
Rough Elec. _
Wtr. Htr.
Furnace
Kitchen Vent _
Firewall
Garage Vents
Sanitation &
ELECTRIC
GAS
BUILDING
Temporaryo
Temporary
Cert. of Occup.
Final
.�"� Final
Final
DATE REMARKS OR CORRECTIONS
ter
j
NEW ADDITION E] REPAIRS OTHER
iF
MATERIAL.
EXTERIOR a PgRS� a
Others
Single Multi
- COUNTY, OF BUTTE
f
�'
USE OF STRUCTURE
DEPARTMENT Orr,-•P.U'$'LIC WORKS
_
7 County Center Drive - Oroville, California 95965
Width at Bottom
'Phone: 533-1230, Ext. 259
4
Depth in Ground
•
A PPLICATION AND BUIL D 1 N 0 P E R M I T
Fj0 �Q�
Permittee Owner
!� rrt �f'7 / 17 - / - / l� -'�7 /-!-/s
A. P. No. 41
R.W. PLATE (Sill)
Mailing Address
L! �+� I-�� � _� f--� -- Y'l 51 f' � `'I
Fire Zone
Zoning
g
Sanitation
..�"'
Contractor i - == / ' f / C i" %0 r
Planning
Mailing Address
l �' 4 l.��� ���- L `'7 / C i)
Plans `'rT
Fees ''r
W.C.
joists - 1st Floor
1� O� k0
BLDG. Address
� � � �[-fid / #!s -/I
R/W
Encroachment
Fireplace
Joists -Ceiling
J1 <
Total Valuation
j
NEW ADDITION E] REPAIRS OTHER
FOUNDATION
MATERIAL.
EXTERIOR a PgRS� a
Others
Single Multi
Width at Top
USE OF STRUCTURE
Family [� Duplex Q Dwelling O
_
Others
Width at Bottom
Depth in Ground
AO
Fj0 �Q�
SQ. FT.
OCC.
VALUATION
BUILDING VALUATION
R.W. PLATE (Sill)
SIZE A ING
\JSPAN
�^
Girders
�� NO r
1
<C
"
joists - 1st Floor
1� O� k0
Joists- 2nd Floor
ri0<� �O Qj 1',-
_Fireplace
Fireplace
Joists -Ceiling
J1 <
Total Valuation
4 47
Exterior Stdds
Permit Fee
5+ '��
Interior Studs
Plan Checking Fee &/or Penalty
Roof Rafters
11110
Total Permit Fee
----
Bearing Walls
CONTRACTORS LICENSE LAW .i
A. LICENSEDCONTRACTORS COMPLETE THE!F.OLLOWING:
I am licensed under the provisions of Chapter, 9,jDiv. 3, of the State of California Business & Professions Code under the name
styleof, :== 1 r ! •-�..........................................' ....i t�.........................................................................................................................................
License No. '�'a', ',r, „ Classification......,,,,) ,......,',,,,,,,,,,,,,,,,,,,,,, and certify that the aforesaid license is in -full force and effect.
B. OWNER -BUILDER & OTHERS COMPLETE THE FOLLOWING:
I am exempt from the Contractors License Laws of the State of California under Sec. 7031.5 because (check one):
0 I am the owner of the above property and I will contract to have all .of the above work performed by licensed contractors,
( Sec. 7044).
I am the owner of the above property and do not intend to offer it for sale for one year from'the date of completion of the
improvements. (Sec.'7044).
0 Basis,, if any, for other statutory exemption ..................................................................................................................................................................
..................................................................................................................................................:.................................................................................................................
WORKMEN'S COMPENSATION INSURANCE
I am_ aware of the provisions of Section 3700 of the California Labor Code which requires every employer to be insured against liabil-
ity for Workmen's Compensation. I have placed on file with the County of Butte a certificate of.compliance or proof of exemption
pursuant to Section 3800.
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 County of Butte
to enter upon the above-mentioned property for inspection
purposes. _
, K.....'.......:........'........:....................:......................... Date ............................... '
SIGNATURE OF PERMITTEE OR AGENT
Receipt No ........:: ....... /
This BUILDING PERMIT is hereby issued under the appli-
cable provisions of County resolutions and/or ordinances.
DIRECTOR OF PUBLIC WORKS
By .............
Date
Permit Expires Date; „f,,,,;,,,,' �
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