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HomeMy WebLinkAbout005-472-002AV e„ .. Justin Smith 473 E. 22nd St., Chico (HOUSING INSPECTION) Justin Smith Q 473 East 22nd St., ico — Permit #4818-78B,P,E,M(remodel & bring up to code/SF) f6 210- N r rnTFu � RO COr.21aN�y�� 473 E. 22nd St, Chico 0A41 rmit#2281-82B(demolish/SF) - Permit#2282-82B,P,E� dcTttlQon & a odel) O 005-472-002 PERMIT#95-149 MALCOM, Maas 467 & 473 E 22nd St., Chico / Cont: Ely Roofing Inc. Reroof/Duplex n �005-472-002 PERMIT#95-1495 MALCOM, Maas 467 & 473 E 22nd St., Chico Cont: Ely Roofing Inc., Reroof/Duplex COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIV ION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 5381:-/741 PERMIT NO. APPLICATIQN AND PERMIT NJ ASSESSOR P CELNU�,jgER OD "F ZONING BUI ING PERMIT OWNER .tatcom Maas TELEPHONE 891--4719 Sq, Fr. OCC. BUILDING VALUATION 1800 2340 ii4�MA�uiTYs St CONTRACTOR'S NAME Lty Rooting Inc TELEPHONE 343-7663 CONTRACTOR'S MAILING ADDRESS 13291 Contractors Dr Chico CA 95926 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Fling Fee $ 20,00 LENDER'S MAILING ADDRESS Permit Fee $ 54.60-- 4.60- ARCHITECT ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS 467 & 473 it 22nd 5t CliCO PERMITFEE $ _. IAT NO. S BDNnSIONS NAME .. � .... PLUMBINGPERMIT Filing Fee 20.00 Solar or eat''pump water heater 23.00 USEOFSTRUCTURE SF ❑ Duplex) . Mobilehome ❑ Other , SPECIFY Water piping 15.00 Each gas water heater or vent .x.15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑, remove & replace Describe Work: p $CE'. roofing W%tiOt asphalt — 18 sqs Mobile Home I S I GI W 1 920.00 PERMITFEE $ ' Contractor ELECTRICAL PERMIT Filina Fee 20.00 I Main Service EOOV OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO I°°°A ) 46.00 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 x%-14 , C'39 Lic. No. 607386 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 , _ . ... .. . .. . .:.: NEW CONST, DWELLING OCCUR OR ADONIS. ( a ACC. BIDS. ) SO. 3.5¢ FT. NEW CONST. MULTI -OUTLET NON-RESID, ( BRANCH CIRCUITS ) 97.50 ( a POWER APPARATUS ) SINGLE OUTLET CIR. Ex. Occup. (OUTLET OR FIXTURES) 2° @ I.°° BAL S° Ex. Occup. (ouTLEEDrs AEsloj°FR.A) 5.00 Temporary Se"rvice 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor 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 5 E a t e !Una MECHANICAL PERMIT - Filing 9 Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number 335-146 (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. } XT/ / 1f� �C J_ (/ Q/ �/ _ Date k)-26-95 Signature+ of Applicant - ❑ Owner A0 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 $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ 74.OU HAZ. 1 D. FEES I IMP I FLOOD CDF PARCEL PD HO ISSUE This permit is hereby issued under the of the Butte County Code and/or indicated above for which fees have By _ / PERMITEXPIRESON applicable provisions Resolutions to do work been paid. Date (D -e . Receipt No. 1h) ?37-7 WHITE-D.D.S.-B.O. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING ION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7 41 PERMIT NO. APPLICATIOI,N,AND PERMIT ASSESSORP ELN ^ -7 _ ZONING `� BUIL6INGPERMIT WN Maas NE TE891-4719 SO. FT. OCC. BUILDING VALUATION 1800 2340 MAIUNGADDRESS GU i11 St CONTRACTOR'S NAME Ely Roofing Inc TELEPHONE 343-7663 CONTRACTOR'S MAILING ADDRESS 13291 Contractors Dr Chico CA 95926 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 20.00 Permit Fee $ 54.00 ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS 467 & 473 E 22nd St — Chico PERMITFEE $ PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 USE OF STRUCTURE SF ❑ DuplexXCX Mobilehome O Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New O Addition O Remodel O Utilities ❑ Installation ❑ Other Describe Work: remove & replace roofing w/hot asphalt - 18. sqs Mobile Home I S I G W 1 920.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filinq Fee 20.00 { aov0 MiSss. Main Service ( 2o000A ORRLELESS 23.00 Main. Service ( , 200A TO IOOOA ). 46.00 f -- • 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 C -1 C- 3 9 Lic. No. 607386 OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: O 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. O 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project. O 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUR OR ADDNS.- ( a ACC. BLDS. ) so' 3.50 FT. _ NEW CONST. MULTI.OUTLET NOWRESID. ('BRANCH CIRCUITS ) 97.50 ( 8 POWER APPARATUS ) SINGLE OUTLET CIR. Ex. Occup. (OUTLET OR FURORES ) 20 Q 1.00 SAL a0 Ex. Occup. ourLEEDTs PaEs D.°FR.a ( ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. O 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 State Fund MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number 538-148 (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) O 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 rovisions. X�� (� _ Date 6-26-95 Signatur of Applicant - ❑ Owner XO 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 Is occ CONST. TYPE TOTAL FEE $ HAZ. I D. FEES I IMP I FLOOD I CDF PARCEL I PO HD 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. - By ate PERMITEXPIRESON 74 (Date " Receipt No. D 3 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT V �. �.. 2282-82B P E M PERMIT N0. • '.._l. "' ++ PERMIT EXPIRES A/Z ` r _ OWNER RON COLEMAN CONTR. owner `.z ASSESSOR PARCEL 46-212-2 ` LOCATION 467 E 22nd St, Chico w f 1' e,; • u `iCs► t• Temp. Power Pole Called PG&E /I //� 6 7 is'/V;/" %�' %� Nb i ,G Temp. Elec. Service 4�9�137-f Z .4W Called PG&E le—W,7—fa (1-7J T4wp. Gas Service R° Called PG&E JOB FINALED (Dat ) 6� Z • ', � Signature J = OK 0 = Not OK - = Not Applicable * = Not Ready MOBILEHOMES tiL �°• MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except N's Date DECKS, COVERS, CARPORTS, ETC. (Plans) 0, except # . 1. Zoning Requirements -Setbacks -Easements 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-Rttrs.-Connec.-Shthg.-Rfg. -Bracing__ 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 5. Alum. Awn.; Columns-Connections-Splice-Decal-Enc�us..res 6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat. or/ P'L"ft./ P. LPG 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. Card -BI Date Card - BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except q s Card -BI Date _ Date Card -BI Date POOLS (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements 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 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/0 to Grade -HD Approval 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 -Enclosures -Panel boards -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 B-1 Date Card -BI Date Card -BI Date Card -61 Date Card B-1 Date Card -BI Date Card -BI Date Card -BI Date J = Of$ " O = ,Not OK Notyable Read *. = Nqt Ready RESIDENTIA1 (Single and Duplex) Dates UNDE LOOK Plans OKexcept #'s Date FRAMING Continued ing req uirements-Setbacks-Easementsroperty Line Firewall &•Openings• Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49 --Ext. Doors -One 3' -Check Garage -3rd story, 2 exits "i- F g., Garage; Soils -Steel- / /" Ftg. Depth -56-,-215irs; Width -Headroom -Rise -Run -Landing -Fire Protection Porches & Decks; Soils -Steel- / /" Ftg. Depth ref. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers _ t emwalls, Main; Steel-Blockouts-Wrapped-Slab i Nailing -Veneer walls, Garage; Steel-Blockouts-Wrapped-Slab- Piers-Fireplace Ftg.-Steel ng Area -Glass Protection -Skylights -Plastic 10e,15.W.V.: Fall -Fittings -Test -2 way C O -Sewer Test -55.-Shear Walls; Nailing -Bolts as Pipe; Size- LA -t&.-Water Pipe; Test -Anchors -Regulator -Service Test 1[3!Electric; Underground -+2-Plenums & Ducts; Clearance -Material -Support -Ins. -1-3.--Girders-Sills-Anchor Bolts -Joists -Vents -Cripples Card -BI Card -BI Date Date Card -BI Date /tl Card -BI Date Card -BI Date i/ L Card -BI Date Card -BI ( Date 2 g Card -BI Date Date FINAL (Plans) OK except N's CardCard BI Date Card -BI Date (� Date PL BING (P�2L2tept p's 56: elight Protection -Landings 52/Tmoke Detector _ Water Ht.;SVa Access omb omb Petr-G6rTnector- In reaFagaj Abews F eep Btiets Meeh. Pfe4ection $5- Water Pipe; Test & Anchors -Nail Protection Test-Fttngs & Anchors -Nail Protection edroom Exiting 1QiSFower Pan; Test, First Floor -Tub Access 6 .I. & Bath Fixtures & T"4 -Awes "IT77est Tub & Shower, 2nd Floor -Tub Access Elec. Trim & Subpanel• Breaker Sizes Lor( as Pipe; Size & Anchors Irs-@-Hails Card -BI Date Card -81 Date _ 6 Ele Outlets at Wood Panel; 4+6 -.&-Ext. 6 Kit_F_ixt. & Aq>iqtta-nce; G4id--- A4x..rap-Cooki earance Card -BI Date Card -BI Date we-f-lec. Outlets & Receptacles at Kit. Counter Date ELE RICAL Permit OK except q's -631. ftiage Fore 6andim@ Glaser 126- Fi ure &Transformer Clearance -Ins. Protection /p/LZ' tr. Htr.;e ovI ce-Co . Air -Connector In ge; e Floor -Meeh. Protection Elec. Receptacles Spacing -Lights &Switches at Doors i Boxes & No. of Conductors -Stapled Ib., Elec. & Mech. Equip. Listed for Location ex Installed Close to Edge of Studs & C.J. AdF ip. Ground made up w/Mech. Fasteners -Bond Gas &Water nsulation-Few72-���4a� t� Qrt'� Duos ppliance Circuits in Kitchen & Conductor Size 7 ps --- - . Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 7 ainage & Wood -Earth Clearance L_ooked-w4deF-F lea- s 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or At, Neutral ❑Yes ❑No instld.: Drive es No; Walks es ❑ No; Vi, -Following rs ❑ s PlpInsulated 28. Service -Riser Conductors & Ground -Main Disconnect 1:S!o; B n-Fi ' o�/ �Z2 ��� 29. E Clearances; Panels -Motors -Me .Equip.,4-LL 7 .C. Unit; D' nect- es aerlQ. 15V Outlet _-_ Clothes Closet Light -Shower Light ZZ ents Above Roof; I.-Clearaaco-te-9fings. — tsc ing �j---/{ 8q -,E Per' r Elec. Trim; G.F.I. R acle-klr�erground Card B -I Date C-`- y Card -BI Date 81 --Ventilation throughout House _ Card B -I Date Card -BI Date Date JECtLA31CAL (Permit) OK except N's n 8 ct' s from Previous Inspections a Meters T ; Gas-El@ie� 2 8 a er & Sewer Connected -C/0 t de -HD Approval C. Ducts; Insulation &Support -- - _ X92 -Meat Fan; Exhaust above Insulation Energy Compliance Certificate -Other Certificates _ ___'S3- evndensate Drain & Overflow; Size & Grade 347 -Furnace -Vent; -Access -Comb. Air -Return Air Vent -115V outlet 95 ttic Access & Platform if Furnace in Attic -------- - ---------------- — Card -BI-_ Date _ Card -BI Date Card -BI Date Card -BI Date Card -BI Card -BI Date Card -BI Date Date B Card -BI Date Card -BI Date )'--L d -BI Date Date RA G Plans) OK except q's Q " / r is at Finl,6 An Sills; Proper Material & Anchors IIIIs; Stu Nailing, Spacing & Bracing-Plates-Sound��l� 68� B ring Walls over Girders & Floor Nailing -_ raft Stop in Walls (rat proof) --- _ i y�J Yi / -C ire Stops; Furred Ceilings -Stairs -Chases -Tub eader & Beam -Size & Bearing angers -Post Caps -Anchors -_Connectors Ing. Joist-Rftr. Ties -Purl in -Roof Brac.-Truss-Shthnq.-Ring. .yq,_.EJrepIace Ties or Type A Flue -Fireplace Throat i �ic Access: Size &_Rom_ex Protection -Draft Stop -Ins. Baffles aj�s � aT rm. Windows o_r_Exili_ng Doors -Sill Hgt. & Dimensions �. _ -4age Fire Protection Framing ,(NQTE:Anentrymust be made each time you visit jobsite) COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE • � 4 /I BUILDING OR PROPERTY ADDRESS A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work Is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. � f• Ole - !. ref.. • C Al 61( w i ;i 1 ,Ji:SedX1-,VEC7co', / Inspector -r"� � `� � '' � Date /• � / t'- VVeRoad, TBUTTE L Vo�i T OP PUBLIC WORKS 6 Chico — Phone: 891-2751 n oe, Orovi Ile — Phone: 534-4541 JYt;gEjI oaradise — Phone: 872-2961, Ext. 57 RECTION NOTICE V BUILDING OR PROPMTY ADDRESS � utine pection indicates that the following violations of County Ordinance I e t at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this 4 7-t7t r, or need additional explanation, please contact this office immediately. - -, r; ,/ 4- Inspector Date K L -f, .- �_ - --- -- i • COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS V 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 534-4541 i' Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE BUILDING OR PROPERTY ADDRESS A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is�mpleted. If you have any question pertaining to this matter, or need additi a exp—nation please contest office immediately. t .�iiii/�•�. /vim/ / I Insector p — % Date ."_ S T RES IDENT IAL ENERGY CONSERVATION STANDARDS CONSTRUCTION COMPLIANCE CERTIFICATE THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN INSTALLED IN CONFORMANCE WITH CURREF NERGY CONSERVATION REGULATIONS AT 117? _9d ' Si (location) BU ILD ING PERMIT NO. 22J!0_ k Z A. P . NO. THE FOLLOWING FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS: (Check each item or write N/A if not applicable) INSULATION: GLAZING:. Slab Edge J Aj G4 Single Glazed 1/ Fdn. Walls f h l'+ Special (Insulated) �j IQ Floors - IV d% CERT. & LABELED WDS .� sat —/I Ceiling/Roof k - t,,7 WEATHERSTRIPPED DRS. _ Ducts ' BACK DAMPERED FANS Circulating Pipes__ INTERMITTENT IGNITION DEVICES APPROVED HEATER [j g/ ✓ .CERT. APPLIANCES APPROVED WTR.HTR.Gj+-c, m I I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO -THE COMPLETENESS OF THIS CERTIFICAT AS SUBMITTED. -' Insulation Applicator Name Signature of (please print) Insulation Applicator State,Contractors_ �4cense No. General'Contractorh Signature of ' General Contractor/ State Contractors_ License No. 41 S (9 2.6 THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION WITHIN THE DWELLING. I CERTIFICATION OF INSULATION RCS -2 ?ART I - GENERAL ADDRESS OF RESIDENCE: DATE OF INSTALLATION COMPLETION: 1J-/0 -K Z 9 -/s- 91 PART II - AREAS INSULATED WALLS ( CGS' sq.ft.) TYPE OF INSULATION: Material -sS 4 Fot y4 Manufacturer's Product I.D. MANUFACTURER: R VALUE INSTALLED APPLIED THICKNESS PART III - CERTIFICATION SAME AND ADDRESS OF CONTRACTOR: NICHOLSON INSULATION CO., INC. POST OFFICE BOX 243 CHICO, CALIFORNIA 95927. CEILINGS ( O(�7 sq.ft.) TYPE OF INSLI ATION: Material �/ �✓ ��ss Form Manufacturer's Product I.D. MANUFACTURER: R VALUE INSTALLED APPLIED THICKNESS INIMUM PER INSTALLED WEIGHT SQUARE FOOT FLOORS ( sq.ft.) TYPE OF INSULATION: Material Form Manufacturer's Product I.D.: MANUFACTURER; VALUE APPLIED INSTALLED THICKNESS I'�Ch55 N Ic,ho I Ae n1 certify that the residence identified. in PART I was insulated as specified (. PRINT NA%fE) in PART II and the installation was conducted in conformance to applicable codes, material standards and regulations. ,n AUTHORIZED SIGN=. -'RE: J TA 014 J . COUNTY OF BUTTE - DiEk'IRTMENT OF PUBLIC WORKS PERMIT NO. e 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION' ANU PERMIT ASSES?ORARCE NUMBER I NG BUILDING PERMIT OWNEA/7 V DA TELEPHONE /✓�-•�/ SQ. FT. OCC. BUILDING VALUATION O DU OWNER'S MAILING DDRES5 O G/ PZfo ew TvZoo, go CONTRACTOR'S NAME TELEPHONE ONTRACTOR'S MAILING ADDRESS Fireplace CO sTlO LENDER ' / UNKNOWN Total Valuation is Filing Fee $ 10,00 L R'S MA LING ADDRESS O Permit Fee $, 00 ARCHITECT OR ENGI R LICENSE NO. Plan Checking Fee $ 670 Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS PLUMBING PERMIT Filing Fee 10.00 Each Trap IfTl 2.00 C)� Repair drainage or vent piping 5.00 Water piping x';00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or ven) 5,00 ©(j Gas piping system 1 - 5 outlets , 00 USE OF STRUCTURE SFDuplex❑ Mobilehome❑ Other SPECIFY Building sewer 0 Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition Remodel Utilities ❑ Installation❑ Other ❑ Describe work: DD.0y2D d, Y` ` , �� O�f/ e, ����, ® Z, 114Zx, Permit Fee $ 100 Contractor ' LF& ELECTRICAL PERMIT Filing Fee 10.(10 Main service 6001 OR LESS 100 AMP OR LESS ////#11 Main service EA. ADD'L 100 AMP 2;50 NEW CONST. DWELLING d OR ADDNS, (ACC. BLD • 1 S q ft __ CONTRACTORS LICENSE LAW I declare under penalty of perjury (check One): ' ❑ I am licensed under provisions of Cnapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No: Cl a s s i f pati on &r-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 CONSTR MULTI -OUTLET NON -REBID BRANCH CIRCUITS) ea POWER APPARATUS S\ NEW CONSTR. ( SINGLE OUTLET CI R NON -R ESID. . / s0 @ moi¢ Ex. Occup OUTLETS OR FIXTURES BAL@1 FIXED APPLNS. OR Ex. Occup.(OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ D Contractor 04-111-4/g'le MECHANICAL PERMIT FiIingFee 10.00 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 marner 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. Heating 01951- Gy ago Cooling Hood / 3.00 Ventilation Pennit Fee S Qv Contractor 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinarces and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to en upon abov mentioned property for inspection purposes. I also �aa�e o s e, i d ify and keep harmless the County of Butte against Iia, dg costs, and expenses which may in any way accrue nt I onsequence of the granting of this permit. X Date 2`2 T,_ T Z Signature of Applicant — Owner Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ S r3 OCCUP. GROUP �_� TYPE of co ST. '1/ W v PARCEL 1/agai D NDall This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRE OR OF PUBLIC BY P od,T EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date _YM - F -Z— Receipt No. WNITE-D.P.W.• TELLOW-ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT I --g� IIERMIT NO. 2281-$2B PERMIT EXPIRES 7 OWNER RON COLEMAN CONTR. owner ASSESSOR PARCEL 46-212-2 LOCATION 473 E 22nd St,. Chico- _ rt, rR I C s a e Temp. Power Pole Called PG&E -�► I' Temp. Elec. Service Called PG&E. Temp. Gas Service Cal led PG&'E JOB AV LED (Date) R42 o 19- L Signature = OK = Not OK = Not Applicable MO-BI,LEHOMES MISCELLANEOUS = Not Ready Date MOBILEHOME UTILITIES (Plans) OK except N's Date DECKS, COVERS, CARPORTS, cTC. (Plans) 0, oxcept is 1. Zoning Requirements -Setbacks -Easements 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 2. Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/O -Concrete _ 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rfirs.-Connec.-Shthg.-Rig. [tracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 5. Alum. Awn.; Columns-Connections-Splice-Decal-Enc..,s-:es 6. Gas; Location -Test -Wrap:/ /"L" ft./ /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors - 7. Utility Clearance 7. Elec. 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 #'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 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/O to Grade -HD Approval 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 -Enclosures -Panel boards -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 B-1 Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date J = OK 0 = Not OK - = Not Applicable * = Not Ready Date UND OOR Plans OK exce t a's Zo ing requirements -Setbacks -Easement tg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 7. Piers -Fireplace Ftg.-Steel 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 9. Gas Pipe; Size -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 6 DateR $L Card -BI Date Card -BI Date Card -BI Date Date PLUMBING (Permit) OK except q's 14. Water Ht.; Vent -Access -Combustion Air 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection __17. Shower Pan; Test, First Floor -Tub Access _ 18. Test Tub & Shower, 2nd Floor -Tub Access 19. Gas Pipe; Size & Anchors Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date ELECTRICAL (Permit) OK except q's 20. Fixture & Transformer Clearance -Ins. Protection 21. Elec. Receptacles Spacing -Lights & Switches at Doors 22. Size Boxes & No. of Conductors -Stapled 23. Romex Installed Close to Edge of Studs & C.J. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water _25. 2 Appliance Circuits in Kitchen & Conductor Size 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or A 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral ❑Yes ❑No 28. Service -Riser Conductors & Ground -Main Disconnect 29. Equip. Clearances; Panels-Motors-Mech. Equip. 30. Clothes Closet Light -Shower Light Card B-1 - Date Card -BI Date Card B-1 Date Card -BI Date Date MECHANICAL (Permit) OK except q's 31. A.C. Ducts; Insulation & Support 32. Vent Fan; Exhaust above Insulation Condensate Drain & Overflow; Size & Grade 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 Card -BI Date Card -BI Date Date FRAMING(Plans) OK except q's 36. Sills; Proper Material & Anchors 37. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound 38. Bearing Walls over Girders & Floor Nailing__ _ _ 39. Draft Stop in Walls (rat proof) _ 40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. Header & Beam -Size & Bearing 42. Hangers -Post Caps -Anchors -Connectors 43. Cing. Joist-Rftr. Ties -Purl in -Root Brac.-Truss-Shthng.-Rfnp. 44. Fireplace Ties or Type A Flue -Fireplace Throat 45. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 46. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing RESIDENTIAI,(Single and Duplex) (Date FRAMING (Contin s 48. Property Line ued) Firewall & Openings 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 66. Elec. Outlets & Receptacles at Kit. Counter 67. Garage Fire Door; Swin -Landing-Closer 68. A.C. Duct in Garage -Damper 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor -Meth. Protection 70. Plb., Elec..& Mech. Equip. Listed for Location 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 72. Insulation -Foam -Looked in Attic 1) Yes 73. Guard Rails & Deck Construction -Post Caps 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 75. Following instld.: Drive ❑ Yes [-]No; Walks ❑ Yes ❑ No; Planters ❑Yes ❑No 76. Stucco; Brown -Finish 77. A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opn s. 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground 81. Ventilation throughout House 82. Glass Protection 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 85. Water & Sewer Connected -C/O to Grade -HD Approval 86. Energy Compliance Certificate -Other Certificates I Date Card -BI Date I Date Card -BI Date I Date Card -BI Date Comments at Final: (NOTE: An entry must be made each time youvisit jobsite) 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 52. Siding -Nailing -Veneer 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 54. Glazing Area -Glass Protection -Skylights -Plastic 55. Shear Walls; Nailing -Bolts Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FINAL (Plans) OK except q's 56. Ext. Steps -Door & Sidelight Protection -Landings 57. 58. Smoke Detector Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meth. Protection 59. Bedroom Exiting 60. G.F.I. & Bath Fixtures & Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 66. Elec. Outlets & Receptacles at Kit. Counter 67. Garage Fire Door; Swin -Landing-Closer 68. A.C. Duct in Garage -Damper 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor -Meth. Protection 70. Plb., Elec..& Mech. Equip. Listed for Location 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 72. Insulation -Foam -Looked in Attic 1) Yes 73. Guard Rails & Deck Construction -Post Caps 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 75. Following instld.: Drive ❑ Yes [-]No; Walks ❑ Yes ❑ No; Planters ❑Yes ❑No 76. Stucco; Brown -Finish 77. A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opn s. 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground 81. Ventilation throughout House 82. Glass Protection 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 85. Water & Sewer Connected -C/O to Grade -HD Approval 86. Energy Compliance Certificate -Other Certificates I Date Card -BI Date I Date Card -BI Date I Date Card -BI Date Comments at Final: (NOTE: An entry must be made each time youvisit jobsite) "eta Nemorandum Inter®Depart; nc�tal FROM: S SK�y,aEi2 �YI II 1 T �7 �a 'SUBJECT: �U 6S j��t d a,;,tJ V w f DATE: o ;5d OI GV PIIt rCy Gl�+[� � 4 aj bee" 19,—,As�Pcl a b[d �IILKdve�% U COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT N0. ASSESSOR PARCEL NUMBER • ZO, NG —Z BUILDING PERMIT OWNER�v /A (�,(/^ Lam'/ T LEEPsHONE ✓'_ SO. FT. OCC. BUILDING VALUATION OWN R'S MAILING ADDRESS �j CONTRACTOR'S NAME T LEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ /3'-6 L) ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee .a' Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS - Permit fee $ . BUILDING ADDRESS 7 ti PLUMBING PERMIT _690 Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 i Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF�Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New Additio Remodel Utilities❑ Installation❑ Other Describe work: `��'�D�%f� ,l Pe ee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 1001 OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST OR ADONS. �ACCLBLDGS.LING CCUP.y1 / 20 sq ft - CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): FI 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. cerise se No. Classification el,, 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) ❑ 1 am exempt under Sec. , Business and Professions Code for this reason NON.RESID R BRANCH GIRCTITS 2.50 ea NEw -CONISTR. (POWER APPARATUS b) NON RESD. ( SINGLE OUTLET CIR. Ex. Occup o BoL@1 oR FIXTURES BAL ED250 A FXED APPLES, OR Ex. Occup. OF TLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 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. [�'rshall 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 3 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 County of Butte to enter upon the above-mentioned property for inspection purposes. I also a to save, ' emnify and keep harmless the County of Butte against all Iia iii les, jud en s, co and expenses which may in any way accrue again SIP Coun i cons nce of the granting of this permit. X Date `� �, _(�-.Z_ Signature of Applicant — Owner ❑ Controctor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE z)Js OCCUP. GROUP TYPE OF CONST. PARCEL PD HD SSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIR RC TOR OF PUBLIC By PERMIT E 7- the applicable provi- resolutions to do fees have been paid. WORKS Date o-g—Az ./ /�./ / X Receipt No. WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT / COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovi Ile, California 95965_ Telephone: 534-4541 ��/�' APPLICATION AND PERMIT .U1 IGG IVF1 W11LQL1VCD V 11 liV 1 VI �UIIC N CIIICI uNVn Ine This permit is hereby issued under the applicable provisions of ab v -mentio proper r 'Esp t' purposes. the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. X Date , DIRECTOR OF PUBLIC WORKS Signotur?�OP-erlmi{ee or Agent / R ceipt No. T!'�� IV ite-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant By Building permit expires Date Date 5 BUILDING Owner i �" SQ. FT. OCC. BUILDING VALUATION Mailing Address r Telephone No. a-7 Contractor Mailing Address Fireplace Total Valuation Telephone No. Permit Fee Building Address Plan Checking Fee&/or Penalty Permit Fee ,(jt9 (Sc PLUMBING No.1 @ I FEE PERMIT FILING FEE J$3.00 .p0 Each Trap 1.50 31 (:,D co L C_6 Repair drainage or vent piping 1.50 J.5-6 A. P. NO. Zoning 8 Planning Water piping 1.50 /, b � Each gas water heater or vent 1.50 l 5 C7 Sargon Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 —d EQA Parking plans Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 L.Bldg. Plans Recd Parcel A r0val Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER CK permit Fee $ L� $ CK n 1 c7 c n4 ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 3" Q® Main service 600V OR LESS - 100 AMP OR LESS 5.00 Single Family i� Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service OIER 600V 1100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW CONST. DW CCUP. OR ADONS. AC 22sgft �(� 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 NEW CONSTR. MU AHLTI-OR T NON-RESID � BRANCH CIRCUITS 2.50ea NEW CONSTR (POWER APPARATUS B NON-RESID. `SINGLE OUTLET CIR, 250 Ex. Occur){OUTLETS OR FIXTIIRES g L1@ Ex. OCCU FIXTLETS (RESID.) EA) APPLNS. OR p• OU2•�O 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 $icy'Col ©( WORKMEN'S COMPENSATION INSURANCE I 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. permit is issued I shall not employ any person in any manner s0krI certify that in the performance of the work for which this to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 3,,.C> C) Heating 1&57_0 (�® Cooling d _ _ ojrj Ventilation Hood 2.00 (>© Permit Fee $ p $ (S( 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 buildin9ilconstruction, and hereby Land Development Fee $ TOTAL PERMIT FEE $ .U1 IGG IVF1 W11LQL1VCD V 11 liV 1 VI �UIIC N CIIICI uNVn Ine This permit is hereby issued under the applicable provisions of ab v -mentio proper r 'Esp t' purposes. the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. X Date , DIRECTOR OF PUBLIC WORKS Signotur?�OP-erlmi{ee or Agent / R ceipt No. T!'�� IV ite-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant By Building permit expires Date Date 5