HomeMy WebLinkAbout007-200-067I
A—P, V5 17
ROBERT STUBBLEFIELD
12.Ma-yfair.Dr. ,,Chico
Permit 1423-73B,P
_(new single family)
.007-r200-067 94-0424B�I
MCKINMEY, HARRY
12 --MAYFAIR, CHICO
qONT: HARWARD"& CO: I /9/
v VINYL SIDING .& REPLACE-WINDOWS/SF
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PERMIT<NUMBER _ g 1423-73B,p
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{ PERMIT EXPIRES
DOWNER Robert Stubblefield
CONTR•
owner
' "LOCATION (A. P. 44-38-67 �
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i,
12 Mayfair Dr., Chico
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s
DATE
-73
REMARKS OR CORRECTIONS
COUNTY OF BUTTE
Department of 'Public Works
BUILDING INSPECTION RECORD
Zoning
:d
Setback✓� /
Forms
Foundation
Piers &Girders '"�
Rgh. Plumbing c��&V
74
Bond Beam
legce
Rein. Stee
Gas Piping & T
ound. Vents,
Framing
Plmg. Topout ' —72)
Rough Elec.
Wtr. Htr.
�—
Furnace �
Kitchen Vent
Firewall
Garage Vents
Sanitation & Water^
ELECTRIC
�—���
GAS
BUILDING
Tempor
Temporary
Cert. of Occup.
Final (�_
�
Final
Final
--7
DATE
-73
REMARKS OR CORRECTIONS
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Oroville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X Date
ignature of P�ermitee r Agen
Receipt No. w ��
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte Court Code and/ res lutions to do work indicated
above for w ees hav a aid.
D EC PUBLIC WORKS
By Date -7—.,-2 - 2J
VF
Building
ate • `.,-
Building permit expires Date .)..i.:l,2. 4k
BUILDING
Owner
/%
SQ. FT. OCC. BUILDING VALUATION
Mailingddress `-
Telephone No.
Fireplace
Contractor f
Total Valuation
Mailing Address _ _
Permit Fee
P I an Checki ng Fee &/or Penalty
t
Teleph ne No
aa
Permit Fee $
$
Building Address
B ` i
PLUMBING No. @ FEE
PERMIT FILING FEE $2.00
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
Q� /
A. P. No. Q (p
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
Fees
W.C.
Sanitation
FireDept.
FireZone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
Declaration
Parcel M a P
60 ' R/W
Improvements
P
Lawn sprinkler system 2.00 P:::]
Bldg. Plans Recd
Parcel Approval I
Plans Approval
Permit Fee $
$
NOVJ�JAD TION ❑ UTILITIES ❑ OTHER
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service incl. 1 meter ry
4 •_ _ S
Additional meters, each 1.00
Sub -panel (12 or less) (more than 12)
Single Family Duplex ❑ Mobil Home ❑ Others ❑
anger Cook -top or Oven 1.00
r Heater or Space Heater 1.00
Li ht fixtures C7 pal 020
R s., s itc es & fix o lets "j
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State California Business & Professions Code under the name
s e a
•
oo Ex. Fan r F.A. Furn. Moto 1.00' ' O
vap. cooler, ar. is . D.W. 1.00 : 010
Air conditioner or heat p myr
Water pump
Mobil Home FaciI Ae 5.0(
Temp. Power Pole 5.00
License No. fro zClassification C/ Z)
Misc. wiring
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $ o01 C,$
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.
have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
❑pI certify that in the performance of the work for which this
ermit 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. @ FEEPERMIT
FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
1 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
$ C
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X Date
ignature of P�ermitee r Agen
Receipt No. w ��
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte Court Code and/ res lutions to do work indicated
above for w ees hav a aid.
D EC PUBLIC WORKS
By Date -7—.,-2 - 2J
VF
Building
ate • `.,-
Building permit expires Date .)..i.:l,2. 4k
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WOR�Gx-cJ
7 County Center Drive — Oroville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
Signature of Permiteg/or Agent
Receipt No. �/6.1 U2 O a
White-D.P.W. — Yellow -Assessor — Pi
Date �� /
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 q
By Date
Building permit expires Date , f�.:..7.•
BUILDING
'
Owner
SQ. FT. OCC. BUILDING VALUATION
Mailing Address ��� ,
`
Telephone No.
Fireplace 1045:2
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee $ °
$ D�
Building Address ��� e °
PLUMBING No. @ FEE
PERMIT FILING FEE $2.00 -
•,
Each Trap 1.50 O CJ
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heatery vent 1.50
A. P. No. ��
Zoning 8 Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
Fees
W.C.
San ita n,Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
I Parking arcel
Plans Declaration
Parcel Ma P
60' R/W
Im rovements
P
Lawn sprinkler system 2.00
Bldg. Plans Rec'd
Parcel Approval
Plans A val
Permit Fee $
$
NEW ADDITION ❑ UTILITIES ❑ OTHER ❑
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service incl. 1 meter
Additional meters, each 1.00
Single Family 14Duplex ❑ Mobil Home ❑ Others ❑
Sub -panel (12 or less) (more than 12)
Range, Cook -top or Oven 1.00
Water Heater or Space Heater 1.00
Light fixtures 25
ball 10.
10
Receps., switches & fix outlets zooms
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:
Hood, Ex. Fan or F. A. Furn. Motor 1.00
Evap. cooler, gar. disp. or D.W. 1.00
Air conditioner or heat pump
Water pump
Mobil Home Facilities 5.00
Temp. Power Pole 5.00
License No. Classification
Misc. wiring
Elra—m—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.
o-1—Frave placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
[z]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 property for inspection purposes.
Signature of Permiteg/or Agent
Receipt No. �/6.1 U2 O a
White-D.P.W. — Yellow -Assessor — Pi
Date �� /
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 q
By Date
Building permit expires Date , f�.:..7.•
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Orovi Ile, California 95965
Telephone: 53,4-4541
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
Date la /^�3
Signature of Permitteee oorr/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 is fees paid.
F PUBLIC WOR//KS
By
Date
•ermif expires Date...
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mai I i ng Address
Telephone No.
Fireplace
Contractor 04
Total Valuation
r
Mailing Address
p
lepne til u!,
Permit Fee
Plan Checking Fee&/or Penalty
Permit Fee $
$
Building Address
PLUMBING
No.
@
FEE
PERMIT FILING FEE $2.00
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. C9
Zoning & Planning
Gas piping system 1 - 5 outlets
1.50
Each additional outlet .30
Fees
W.C.
ire Dept. Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
I Parcel
Declaration
Parcel Ma P
60' R/W
Im provements
Lawn sprinkler system 2.00
Bldg. Plans Recd I
Parcel Approval
Plans Approval
Permit Fee
$
$
NEW ADDITION ❑ UTILITIES 0TH R ❑
ELECTRICAL
No.
@
FEE
PERMIT FILING FEE $3.00
Main service incl. 1 meter
Additional meters, each
1.00
Sub -panel (12 or less) (more than 12)
Single Family Duplex ❑ o me Others ❑
Range, Cook -top or Oven 1.00
Water Heater or Space Heater
1.00
Light fixtures balldlo
Receps., switches & fix outlets1-
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 o
Hood, Ex. Fan or F. A. Furn. Motor
1.00
Evap. cooler, gar. disp. or D.W. 1.00
Air conditioner or heat pump
Water pump
Mobil Home Facilities 5.00
Temp. Power Pole 5.00
� /� A 2�
License No. o—L-F�d SC"CF % Classification c' ^
Misc. wiring
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee
$
$
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.
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 J$3.00
cS �—
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
43
1 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 property for inspection purposes.
Date la /^�3
Signature of Permitteee oorr/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 is fees paid.
F PUBLIC WOR//KS
By
Date
•ermif expires Date...
I
p+c�-t. ,.,ry,.w-. ..., - .. >e i1/' •:`H�,h+^,':.t ,...r: ;+.^.E xvT3':r, • x ;5:.: l �, a T'M'i�: `F?t�7i"1e 'Y'S(1 K•r'.'�''.si"'�i'r['r--nw.-..�Smrwn..r,.;,�r.�.'drs'.7r'yr�, ;4 `
1 007-200-067
- MCKINNEY, HARRY 94-0424B
12 MAYFAIR, CHICO
CONT: HARWARD & C0.'
VINYL SIDING & REPLACE WINDOWS/SF
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COUNTY OF BUTTE - DEPARTMIENT OF DEVELOPMENT SERVICES - BUILDVISION
7 County Center Drive 0?8ville, Ctilifomicv 95965 - Telephone (916) 5J38 -541,E PERMIT NO.
APPLICATION AND PERMIT VL1
ASSESSOR PARCEL NUMBER
007-200-067
ZONING
R1
BUILDING PERMIT
OWNER
HARRY 11111MCKINNEY
TELEPHONE
894-6342
SQ, FT, OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
12 MAYFAIR CHICO 95928
CONT ES . 10 066
CONTRACTOR'S NAME
HARWARD & CO
TELEPHONE
893-5898
CONTflACTO R'S MAILING ADDRESS
. RR LANE. 7 CHI 95928
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee $
20,00
Permit Fee $
126.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
12 MAYFAIR CHICO
PERMIT FEE $
146.00
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
I ;
Solar or heat pump water heater
23.00
Water piping
15.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Each gas water heater or vent
15.00
USE OF STRUCTURE
SFXd Duplex ❑ Mobilehome ❑ Other
SPECIFY
Gas piping system 1 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
@20.00
TYPE OF WORK
Nevr 'Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other �J x
Describe Work EXnRHR VINYL SIDING -REPLACE WINDOWS
PERMIT FEE_ $
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service ( BOOV OR LESS )
200A OR LESS
23.00
Main Service ( 200A TO 1000A )
46.00
NEW CONST. DWELLING OCCUP.
OR ADONIS. ( & ACC. BLDS. )
SO.
3.50 FT.
CONTRACTORS LICENSE LAW(
10e lore under penalty of perjury (check one)
I am a licensed under provisions of Chapter 9, Division 3 of the Business and
Professions Code and m license is in full force and effect.
License No. /; Classification �'% ,
❑ I, as the owner, or my employees with wages as the sole compensation, will do
the work, and the structure is not intended or offered for sale. (Sec 7044)
O I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
❑ 1 am exempt under Sec. Business and Professions Code
forthis reason
NEW CONST. MULTI -OUTLET
.NON-RESID. ( BRANCH CIRCUITS )
@7.50
POWER APPARATUS )
3 SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES )
B20 @ 1.50
Ex. Occup.FIXED A RESID OR
( OUTLETS IRESID.1 EA. )
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
WORKER'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ This permit is for $100.00 (valuation) or less.
- 1 have placed on file with the County of Butte Dept. of Development Services,
RBuilding Division a Certificate of Workmen's Compensation Insurance or a
Certificate of Consent to Self -insure.
❑ 1 shall not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California.
Notice to Applicant: If after making this statement, should you become subject to the
Worker's Compensation provisions of the Labor Code, you must forthwith comply with
such provisions or this permit will be revoked.
PERMIT FEE S
Contractor
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
—Hood
6.50
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 Butte County Ordinances and California 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 agree to save, indemnify and keep harmless the County of Butte against all
liabilities, judgments, costs, Ad expenses which may in any way accrue age. St said
County in consequen of the granting of this permit.
X X– C n Date �, /G C_. 6 V
Signat a of Applicant `Owner ❑Con ractor ❑Agent
An OSHA permit is required for excavations over 5"0" deep and demolition or
construction of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
OCC
CONST. TYPE
TOTAL FEE $ 146.00
HAZ.
D. FEES
IMP
FLOOD
COF
PARCEL PD
HD
ISSUE
This permit is hereby issued under the applicable
of the Butte County Code and/or Resolutions
indicate d'ab ve for which fees have been
By l
PERMIT EXPIRES ON
IDa tel
provisions
to do work
paid.
Date
156063
Receipt
WHITE-D.D..D. S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING (VISION
7 County Center Drive - Oroville, Califernia'9S-965 - Telephone (916) 538- 541nPER_ MIT NO.
APPLICATION AND PERMIT J�- ll�' )�
ASSESSOR PARCEL NUMBER
007-200-067
ZONING
R1
BUILDING PERMIT
OWNER
HARRY iiX,'MCKINNEY
TELEPHONE
894-6342
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
12 MAYFAIR CHICO 95928
CONT EST 10,066
CONTRACTOR'S NAME
HARWARD & CO
TELEPHONE
893-5898
CONTRACTOR'S MAILING ADDRESS
CHICO3851 MORROW LE #7, 95928
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee $
20,00
Permit Fee $
126.00
ARCHITECT OR ENSINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
12 MAYFAIR CHICO
PERMIT FEE $
146.00
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15,00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Each gas water heater or vent
15.00
USE OF STRUCTURE
SFXX Duplex ❑ Mobilehome ❑ Other
SPECIFY
Gas piping system 1 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
@20.00
TYPE OF WORK
Nevv]r,Addition ❑ Remodel CIUtilities ❑ Installation ElOther (XX
Describework:EXTERIOR VINYL SIDING—REPLACE WINDOWS
PERMIT FEE J$
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service ( 800V OR LESS )
200A OR LESS
23.00
Main Service ( 200A TO 1000A )
46.00
NEW CONST. DWELLING OCCUP.
OR ADONIS. ( & ACC. BLDS. )
SO.
3.50 FT.
CONTRACTORS LICENSE LAW
I e re under penalty of perjury (check one)
I am a licensed under provisions of Chapter 9, Division 3 of the Business and
rofessions Code and m license is in full force and a fect.
License No. Classification
❑ I, as the own r, or my employees with wages as th ' sole compensation, 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 contractors. (Sec 7044)
❑ I am exempt under Sec. Business and Professions Code
forthis reason
NEW CONST. MULTI -OUTLET
•NON.RESID. ( BRANCH CIRCUITS )
@7.50
( POW ER APPARATUS )
8 SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES )
BAL. @ 1.500
Ex. Occup. OF APPWS. OR
p' ( OUTLETS (RESID.1 EA. )
S.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
WORKER'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ This permit is for $100.00 (valuation) or less.
have placed on file with the County of Butte Dept. of Development Services,
Building Division 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 Worker's
Compensation laws of California.
Notice to .Applicant: If after making this statement, should you become subject to the
Worker's Compensation provisions of the Labor Code, you must forthwith comply with
such provisions or this permit will be revoked.
PERMIT FEE $
Contractor
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
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 Butte County Ordinances and California 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 agree to save, indemnify and keep harmless the County of Butte against all
liabilities, judgments, c sts, d expenses which may in any way accrue agai st said
County in conseque a granting of this permit.
X Date
Sign t e of Applicant - CMwner ❑ Conractor ❑ Agent
An S A permit is required for excava ions over 5"0" deep and demolition or
con c ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 146.00
HAZ-
D. FEES
IMP
FLOOD
CDF
PARCEL PD
HD
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicate ve for which as have been paid.
By Date
PERMIT EXPIRES ON o2
(Date)
Receipt No. 156063
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
I
FEB -22-1994 10:06 GP,AI,! I TE I PISLIPAIJCE 1 915 853 2505 P. 00 1 CID 1
rKVUV%.eR
G.L. Anderson Insurance Serv.
Granite Insurance Services
11031 Sun Center Dr., #130
Rancho Cordova, CA
9567(
PHONE9 6-853-2500
INSURED
Harward-9 Company
Don Hary rd
90
Circle
CorddoaCA
95670
CSR CM 02/294
THIt CERTIFICATE IS ISSUED AS A MATTER OF INFORMAT:AN ONLY A115
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THI''. CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
----------- POLICIES BELOW.
--------------------- ------------- -
COMPANIES AFFORDING COVERAGE
- --------------------------
-----------------------------------------------
COMPANY LETTER A Superior National
--------------------------------------------------------------------------
COMPANY LETTER13 Valley Insurance Company
------------
----- -----------------------------------------------------------
COMPANY LETTER C
-- -------------------------------------------------------------------------
COMPANY LETTER D
I COMPANY LETTER E
COVERAGESFOR i►�E POLICY
TH!S IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE IEISURED NAMED ABOVE
PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO
WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED 14EREIN IS SVBJE'T TO
ALL TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH POLICIES. LIMITS ——
SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS --------------
--
--------------------------- —-------- — ---------------
CO TYPE OF INSURANCE POLICY NUMBER POLICY DATEEFf POLICY EXP LIMIT
Taff---------- ------------------ ---------------------------I-------------- --- ---- GENERAL AGGTEGATE — 2, 000, O O
BI
BI
A
GENERAL LIABILITY
ERI COMMERCIAL GE11 LIABILITY
I I CLAIMS MADE I X] OCC.
I I OWNERS'S B CONTRACTOR'S
PROTECTIVE
II
AUTOMOBILE LIAB
( ] ANY AUTO
(I ALL OWNED AUTOS
(I SCHEDULED AUTOS
OD HIRED AUTOS
IM NON—OWNED AUTOS
I I GARAGE LIABILITY
------------
I—] ----------
EXCESS LIABILITY
I I UMBRELLA FORM
I I OTHER THAN UMBRELLA FORM
WORKED COMP
EMPLOTERSf LIAR
-----------
OTHER
CP013291-01
---------------------------
CP013281-01
06WCP60377—B
__ '-----------------------------------
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
09/01/9309/01/94
--------------
09/01/93
RE:
------------------
'ROD-COMP/011 ASG.
--------------
2,000,00C
'ERS & ADV. INJURY
1,000,00
___
9ACH OCCURRE►ICE
----------
1,000,00
°IRE DAMAGE
[ANY ONE FIRE)
50,000
9ED. EXPENSE
(ANY ONE PERSON)
5,000
-------------------
COMB. SINGLE LIMIT
--------------
1, 000, OO
BODILY INJURY
(PER PERSON)
BODILY INJURY
(PER ACCIDENT)
PROPERTY DAMAGE
EACH OCCURPENCE
AGGREGATE
ISTATUTOFY LIMITS
1,000,000
EACH ACCIDENT
DISEASE—POI. LIMIT
,000, 00C
1,000 1
DISEASE—EA(H EMP.
----------------------------------
1,000100C
------------
CALIFORNIA OPERATIONS
> CERTIFICATE HOLDER ��°�raa==e==a==C��"��as=a:coo=> CANCELLATION.<===________——'--°°-------
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1NE EX-
- PIRATION DATE THEREOF, THE ISSUING COMPANY WILL 210W YI4 MAIL 10
COUNTY pF BUTTE a DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, )=
DEVELOPMENT SERVICEl9 s ,d
Is
FAX DEPT. OF 538--2140 -------------------- ------------•--- ------.��--x------------
naOV LLEYCCENTER DRIVE a AUTHORIZED REPRES TAT
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Certify t1l4t
Joan
K._Kearr}ey
__lige Authurtzat'toit
to •tan
for
all permits
heeded
at
-------
for for Ilarw4rd 6 (:I)reI)OIly
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state comp, Volk y r 1956I117
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MONO
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