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007-320-012
t 4 - I 4 i t f M i f I I t 4 - I 4 i t f M i f I ' rsZ,�11'buplex Investors 2950 Way, lot 12, LindGardens #3' Chico C -D Units Pei m' Yk539-78B( ew duplex) Cont : Lamb .& Rice Chico/ rmi #7414 -78 -(yard sprinkling system) duplex i .2 '007- ' 320-012 06-0998 BRITON, GARY 2950 JOLYN WAY, CHICO .. Cont: OWNER RE ROOF i 19 -01 N Butte County Department of Development Services. Ne�'rc aa� O T E S 7 County Center Drive, Oroville, CA 95965 (530)538-7601 vnwv.buttecounty neVdds c�vw�y I e RESIDENTIAL APN: uV ► l nn) �/ Permit No4�m . Site Address:NY / 1%/" l �G Contractor. V V yl 421.1 Type of Permit ..._ qDj/ SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUBSTANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE ,t bl-Wvi CZvnf2 31 u�'V (D DATE DATE JOB FINALED: r L SIGNATURE: t r i r ..._ qDj/ SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUBSTANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE ,t bl-Wvi CZvnf2 31 u�'V (D DATE DATE JOB FINALED: r L SIGNATURE: OK MANUFACTURED HOMES MISCELLANEOUS DATE PERMANENT FOUNDATION Lj SOFT -SET DATE D E C K S'C O V E R S'C A R P O R T S 'GARAGE S 1 Zoning -Setbacks -Easements 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 2 Ftg§; Soils -Sz-DpthSpacing-CnnctrsStee I 3 Sewer; Loctn-Test; Fall/C/O-Concrete 3 Decks, Girders/Joists-Dcking-Brcing 4 Wtr; Loctn-Test-Easement Needed -Regulator Stairs-Guard/Handrails 5 Elec Loctn-Clrncs-Grnd Amp -Concrete 4 Wood Awn; Posts-Beams-Rftrs-Cnnctrs-Shthg 6 Yard Gas; Loctn-Test-Wrap . Nat ❑ or LPO Frmg-Brcng Inch Sz Ft Lngth 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs 7 Blckng; Sz-Spacing-Marriage Line 6 Carports; Wndws-Doors 8 Gas; MH Test-Demand-Valve-Cnnctr 7 Electric 9 Elec MH Cntnty Test-Crossovers-Breakers-Clrncs 8 Frmg; Sills-Anchrs-Studs -Rftrs-Trusses i 10 Drain; MH Test -Fall -Flex Cnnctr 9 Siding; Nailing -Veneer -Stucco -Lath 11 Wtr & Sewer Connected -00 to Grade 10 Roof; Shthg-Roofing 12 Gas and Electricity Tagged 11 Ext; Steps -Doors -Landings 13 Tie Downs ❑ Foundation ❑ 12 Braced Wall pnls 14 Exits IS Cert of Occupancy °moo ° °�• 16 HUD Label/Insignia Numbers Serial Numbers DATE JPOOLS 1 Setbacks -Easements 2 Soils; CompactionStructure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -lining 4 Elec Rcptcls/Lting; Distance-GFI 5 Elec Pool Lting; 15 volts-DFI o'`a o� o•� o`s 6 Elec Encisrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w1V-Crcltng Egp-Htr 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg Bokes-Enclsrs=pnlboards-Insultn to Main Conduit 9 Health Dept Apprvl 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Enclsr, Fencing Alarms 13 Bonding, Diving board or Slide Pool Drawing I OK = Not OK _ RESIDENTIAL (Single & Duplex) DATE JUNDERFLOOR DATE PLUMBING 1 Zoning -Setbacks -Easements -Flood -Slope 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 2 Ftg Main; Soils-Elec Grnd Ftg Dpth 54 Wtr Pipe; Test & Anchr-Nail Prtctn 3 Ftg Garage; Soils-Steel-Elec Grnd Ftg Dpth.. 55 DWV; Test Fittings & Anchr Nail Prtctn 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth 56 Shwr Pan; Test, First flr-Tub Acc 5 Stemwalls Main; Steel-BlockouLs-Wrapped 57 Test Tub & Shwr, 2nd fir - Tub.Acc 6 Stemwalls Garage; Steel-Blockouts-Wrapped 58 Gas Pipe; Sz & Anchrs 6a Hold Downs and Special Anchrs 59 Fire Sprinkler; Test 7 Slab, Steel Wrapped 60 Yard Gas Piping 8 Piers-Frpic Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test it Wtr Pipe; Test-Anchrs-Rgltr-Service Test 12 Elec Undrgrnd DATE IMECHANICAL 13 Plenums & Ducts; Clrnc-MaterialSupport4nsultn 61 AC Ducts Insults & Support 14 Girders-Sills-Anchr Bolts Joists-Vnts-Cripples 62 Vent Fan, Exhaust abv Insultn 15 Acc & Vntltn 63 Condensate Drain & Ovrflw, Sz & Grade 16_ Insulation 64 Furnace -Vent Acc-Comb Air RtrnfVent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic \c \r 2 \C O` p\ Q+ 0\ DATE FRAM I N G 17 Sills Proper Materials & Anchrs DATE FINAL 18 Walls Studs -Nailing Spacing & Braces-PlatesSound 66 Ext Steps -Door & SideLt Prtctn-Landings 19 Bearing Walls over Girders & fIr Nailing 67 Smoke Detector 20 Draft Stop in Walls (rat proof) 68 Furnace Vnts-Cirnc-Comb, Air-Cnnctr 21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs In Garage; abv-flr-Ducts-Mech Prtctn 22 Headers & Beams-Sz & Bearing 69 Bedroom Exiting 23 Hangers -Post Caps-Anchrs-Cnnctns 70 GFI & Bath Fxtrs & Tub AccSpa 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac TrussShthg 71 GFI Arc Fault 25 Frpic Ties or Type A Flue-Frplc Throat Clmc 72 Elec Trim & Subpnl, Breaker Sts & Labels 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop4ns Baffles 73 Stairs, Guard/Handrails 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 74 Frpic or Stove, Clmc-Hearth 28 Garage Fire Prtctn Flaming -RC Channel 75 Elec Outlets at Wood Pnl, Int & Ext 29 Prprty Line Firewall & Opngs 76 Ktchn, Fxtr & Appinc; Gmd-Air-Gap-Cooking CImc. 30 Ext Doors -One T -Check Garage 3rd Story, 2 Exits 77 Elec Outlets & Rcptcls atKtchn Counter 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 78 Garage Fire Door, Swing -Landing -Closure 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 79 AC Duct in Garage -Damper 33 Siding -Nailing Veneer 80 Wtr Htr; Vnts-DImc-Com Air Cnnctr-PRV; abv fir 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc Mech Prtctn; LPG Appince Undr House 3" drain 35 Glazing Area -Glass Prtctn-SkyUs-Plastic 81 Plmb; Elec & Mech Eqp Listed for Lottn 36 Shear Walls; Nailing -Bolts 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 37 Brace Int/Ext Wall pnls 83 Insultn-Foam-Looked in Attic 38 Insultn-Walls-Ceilings 84 Guard Rails & Deck Cnstrctn-Post Caps 39 Infiltration-Walls-Wndws 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Drnge Planters DYes DNo \� 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Plmb Appinc-Frplc-DIrnc to Opngs 90 Wtr Well, Dscnnct, Elec, Plmb 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd DATE JELECTRICAL 40 Fxtr & Tmsfrmr Clrnc4ns Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 92 Vntltn thru House 42 Sz Boxes & No Of Cndctrs Stapled 93 Glass Prtctn 43 Romex Installed Close to Edge of Studs & CJ 94 Corrections from previous Inspctns 44 Eqp Grnd made up w/Mech Fstnrs 95 Gas Test -Meters Tagged, Gas-Elec 45 Grndng Electrode Bond Gas & Wtr 96 Wtr & Sewer Cnnctd-C10 to grade -HD Apprvl 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 97 Energy Cmpinc Cert -Other Certs 47 Subfeed Wire Sz w ❑ CU or DAL 98 Address Posted AC Wire Sz s, D CU or DAL 99. Fire Sprinkler 48 Range Circ OCU orDAL Oven Circ ya OCU or DAL Insulated Neutral DYes DNo 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp Clrncs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP060998 B. C. Building Permit 01-16-04 pg 1 LICENSED CONTRACTORS 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 Issued Date: 05/01/2006 APN: 007-320-012-000 the Business and Professions Code, and my license is in full force and effect. Site Address: 2950 JOLYN WAY CHI License Class : License Number: Map Index: Date: Contractor: Description: RE -ROOF (44 SQ) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: BRITTON GARY ETAL permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a ALBRIGHTSON COURTNEY & MONICA signed statement that he or she is licensed pursuant to the provisions of 2950 JOLYN WAY # A the Contractor's State License Law (Chapter 9 commencing with Section CHICO, CA 95973-0479 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: BRITTON GARY ETAL Code: The Contractors' State License Law does not apply to an ALBRIGHTSON COURTNEY & MONICA owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, 2950 JOLYN WAY # A provided that such improvements are not intended or offered for CHICO, CA 95973-0479 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of (530)899-0878 proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor: not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Business. and Professions Code Date: 0% Owner: l�_ License #: 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 Architect: is issued. Engineer: ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 0 S. F. Policy #: Valuation: $0.00 Census Code: ❑ 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 ��� 5� become subject to the 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 �` V forthwith comply with those provisions. Date: ' Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the ResohilJons to do work in icated above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) i- (`p Name: BY _ Date: 1 Address: PER T EXPIRES ON: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: ffi7u 2 N e Y H L$ PL G (1 I S at4,� Signature: z- t IDate: S/ I 12--,,70 Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 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 provide the major labor and material for construction of this proposed property improvement: YES.[ c-1 NO [ ]. 2. I HAVE [&-+HAVE NOT [ ] 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: CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I have hired the following person to coordinate; supervise, and -provide the major work NAME: _ ADDRESS: PHONE: 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: PROPERTY OWNER DATE:yy NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. Thi.-, verifratinn must be completed and returned to our office before we are permitted to issue the Butte County Department of Development Services usr ADMINISTRATION `BUILDING GIS PLANNING o o �� a o a 7 County Center Drive _G - Oroville, CA 95965 0 (530) 538-7541 Telephone COU (530) 538-2140 Facsimile OWNER -]BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the 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 your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government 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. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact 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 contractor 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 contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Sincerely, Scott Rutherford Chief Building Inspector NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. �UT%'E. BUTTE COUNTY 0 O DEPARTMENT OF DEVELOPMENT SERVICES 0 0 BUILDING PERMIT APPLICATION 0 O AND SUBMITTAL REQUIREMENTS _ 24 HOUR INSPECTIONC OROVILLE: (530) 538-7636 - CHICO: (530) 891-2834 O —'fir "�� r O OFFICE #: (530) 538-7541 - A FEE WILL BE REQUIRED AT TIME OFAPPLICATION CD(��j�y Website: www.buffecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name L _G irst Name��� � Address 5l] To L, -y WAY City C 11 CCU State GA Zip 155 Phone (5 3 8'V0 c`i Fax eJ i4 E-mail --Re, I bR-t 4 J r- —ZI , C a APPLICANT INFORMATION CONTRACTOR Name City G �C J State CA Address Phone 30 8 _ o Fax City State Zip Phone Fax E-mail Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER --Name- City G �C J State CA Address Address Phone 30 8 _ o Fax City No St Tip Phone Map Book Fax E-mail Planner State License Number APPLICANT INFORMATION Name L r OnJ Address _ v O ( y IJ w l - City G �C J State CA 'p7 Z -S 1 Phone 30 8 _ o Fax E-mail APPLICANT SIGNATURE X �/� For office use onl Zoning Property Address Flood Zone Cross Street Al,yoj4 SRA ves No Occ. Type Const Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. BIN # PROJECT LOCATION AP# Property Address City Cross Street Al,yoj4 WORKER'S COMPENSATION Policy Number Carrier If hiring anyone oftAgnk license contractors; a certificate of worker's compensation be shown at the time of permit Issuance. LENDING AGENCY Name Address _..._ ....._._. _ ...... Description or_Scope of-W...ork:-._....___-.._.. _.... _._... OI=2rl if t ua e-5— L{(20 , FT,_ =LA 2 Sq FT- Living Garage Open Cov [--Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by -.6 . Amount: 291-50—Bldg SRA Receipt #:.Ep 5D2�11'7 Sheriff �SMIP II -1-oG _91.50 TotalII Iler Date. K:IFORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 REV 8-12-05 SUBMITTAL & PERMIT REQUIREMENTS. The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxesl ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual,- (B) Marriage line info, (C) Floor Plan, (D) Tie down oi� fnd plans, all in duplicate ❑ 7. Metal bidgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8.. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Building Permit Application Without Required Clearances Form ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction. approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). _ ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538.7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSSUILDING F0RMS1BIdgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 PERMIT NO. 5339-78B PERMIT EXPIRESAw OWNER Morseman Duplex Investors : CONTR. owner LOCATION (A.P. 44-37-19 nnrt ) 2950 Jolyn Way, lot 12, Lindo Gardens#3, Chico. • i ' Temp zower Pole Called PG&E Taft-Elec. Serv. Z -ZZ. �% g- /Called PG&E - IX. — 9' Gas Serv. / Called PG&E JOB FINALED —.`2 '- (Date) (Signa ure) E R S._; T, COMPANY UCENGED CONTRACTOR ` Phone: 342-4764 P. O. Box 3506 — Chico, California 95926 INSULATION (Batted or Blown) Date 19--/-E� To rClk-A THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH THE CURRENT ENERGY REGULATIONS, CALIFORNIA ADMINISTRATIVE CODE, TITLE 25, STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT: I 2�CiNNS Street Lot Number Tract No. EXTERIOR WALLS Manufacturer Q If 2— Thickness/Typ R Value CEILINGS Batts: Manufacturer Thickness R Valu Blown: Manufacturer s�J Thickness \ '� No. Bags �j� Wt./Bag Sq. Ft. Covered 501� R Value / �! FLOORS Manufacturer Thickness/Type R Value SLAB ON GRADE Manufacturer Thickness/Type R Value Width of Insulation Inches FOUNDATION WALLS ,_Manufacturer Thickness/Type R Value l i OjlON�TR�ACTO C T a/ 1 LICENSE NUMBER �/&r= J� BY T TLE `— DATE iw LICENSE NUMBERN hTITLE '� DATE ACCEPTED SAVE ENERGY - INSULATE! RSETH COMPANY (Authorized Representative) v a 110 N��ZN L I --%,. 7irl. a-! for: i.? •.¢.cu SiR1�l+weW.iieeSt jiLl1W+�.ia�.a'.ec'+r.!i.w: � �: �_ _ - - .rw.i.w.-}.� Lc T ION -is . fa r re or .=Pbjl 711. el ktia'(S' w.ill b -a p Love a-! for: i.? •.¢.cu SiR1�l+weW.iieeSt jiLl1W+�.ia�.a'.ec'+r.!i.w: � �: �_ _ - - .rw.i.w.-}.� Lc T ION -is . fa r re or .=Pbjl 711. el ktia'(S' w.ill b -a •' ' ' �` COUNTY OF BGTTDEkRTMENT OF PUBLIC WORKS FIRE SPRINKLERS BUILDING INSPECTION RECORD Framing Test Water Water Hti. BUILDING BUILDING (Cont'd) PLUMBING Setback — jW,Firewall Soll Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings - % Windows 3rd Floor Stemwall Siding To out i Slab --- '` Roof Sheathing Water PIR192. Piers - Roofing treMr@r Garage - Fdn. Vents Fixtures Footings -- - Garage Vents Water Htr. Stemwa I I Insulation Heaters Slab / Prov. for physically Appliances Carport handicapped Conformance of ex. Gas Piping&Test Footings - structure Temp. as Slab Final Sanitation Patio FIR LACE Final Footin sFootin . ELE RICAL Masonry Walls -- Rough Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Water Hti. Stucco Final ------= Subpanels Mesh MECHANICAL Gird. Fault Prot. Scratch Heating Service Brown 42 -/:g - Cooling Temp. Pole Finish Ducts Underground Interior Lath�"^-- Ventilation Permanent Door Closer Final 7 Cl Final MOBILEHOME UTILITIES - - - - - - - - - - - - - - - - - - Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping OB16EHOMEINSTALL&IiO�i1--------------Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT n339� authorize representatives of the County of Butte to enter upon the above -menti ed property for inspection purposes. X J Date v /� gnature of Perm0fee /Agent Receipt No. J kj_//&� 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 P BLIC WORKS �. BY ,�-:—. i1.r i _. Date Building permit expires Date BUILDING Owner 7 AJ Wef SO. FT. OCC. BUILDING VALUATION _ QO Mailing Address d Tel phone No. 3 2 7 Contractor �,J - tC. Mailing Address Fireplace 2- 6'io d . Ua Total Valuation Telephone No. Permit Fee Building Address Plan Checking Fee&/or Penalty Permit Fee DO. D PLUMBING No. @ FEE PERMIT FILING FEE J$3.00 Each Trap 1.50 _ - Verification Oplyj� �Lpd Repair drainage or vent piping 1.50 A. P. No. Ct , ? --( j �6/.� J �Zonin 8 lannin Water piping 1.50 Each gas water heater or vent 1.50 Fees W . -99i Fire Dept. Fire Zone Use Permit Gas piping system 1 -5 outlets 1.50 EGA Parking Plans I Parcel'L? Declaration I 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 /� n-16 -' ParcerovaI Plans Approval Lawn sprinkler system 2.00 NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ Permit Fee $ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 600v OR LESS 100 AMP OR LESS 5.00 Single Family ❑ Duplex ® Mobil Home ❑ Others ❑ Main service EA. ADD'L 100 AMP 2.50 t Main service OVER 25.00 100 AMPP OR LESS O Main service EA. ADD'L 100 AMP 1.00 NEW OR ADDNST ( ACCLBLOGSLING CCUP. Y\ 20Sgft / 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: T NEW CO ID ( BRANCH CIRCUITS) 2.50ea NEW RESID, BRANCH CIRCUIT NEW CONSTR. (POWER APPARATUS 9 NON-RESID. SINGLE OUTLET CLIR. Ex. Occuo(OUTLETS OR FIXTI1RES g L�j FIXED APLNS Ex. Occup. ( OUT ETS P(RESID )REA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Liv nse No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ MECHANICAL No. @ 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 liability4cWm for Workmen's Compensation. ❑ I have placed on file with the County of Butte a certificate of W 'kmen'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. PERMIT FILING FEE $3.00 Heating p AZ Cooling Ventilation Hood J 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 Land Development Fee $ TOTAL PERMIT FEE authorize representatives of the County of Butte to enter upon the above -menti ed property for inspection purposes. X J Date v /� gnature of Perm0fee /Agent Receipt No. J kj_//&� 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 P BLIC WORKS �. BY ,�-:—. i1.r i _. Date Building permit expires Date Jhis-sbt of plans, and s*pecifi cations MUST be le'pf on fhe-jo6 at all firn,�s anJ* Unlawful , makefa�rzy ch'a'a9('?'s" " If , f, is Un ul to fq�'a era ions,on,sarne.,wifhouf i written permission .466'All *Deparfrnonf of Pub* lic Works, County Butte. NOTE-2—All Materkd;. & WoAmanship Shall Be in Accordance with , Rocognix6d . Good Practices and of a quality prescribed for the'S . pe'ifi cled use in the Uniform Buildin4, Plumbing & Mech6aical. "as And f6 Natimal 'AM.-Ai"I t"*"_ I 1 1. The Bldg. Setback shall side property line and 50,4.' 'From .the 15,0-00, centerline of the road,,. perrnifflih§Amaxi_ mum of a:2 ff„ eave overhang but entir out Of all easements; An 0% 0. , A -AS60fid'syste"m and 16cation of build-` lIng `dt6in 'stub -out to be' as per sofe" County ,Health Dept Ra. quireimentsi,, 01- A I 0 -See-Ma'fer Ptan' R leotbuildin .5339--78 -.-.BUTTF- COUNTY 0 I'..'11UILDING DF-PARTMNI ,,A RP RO V E /V, -t.j.-pv, t//-, 4)/ Y " _ COUNTY OF BUTTE—"'DJg-ARTMENT 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 urposes. X Date Signature of Perm it'eelvll Agent Receipt No. to 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. DIRECTO F PU IC WORKS By Datef Ile permit expires Date BUILDING Owner & SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. A Contractor Mailing Address ._�� ,(�S �.�� Fireplace Total Valuation e ' � S � Telephone No. Permit Fee Building AddressPlan S� Checking Fee&/or Penalty Permit Fee PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 vr_�- Each TraD 1.50 q© r r 4,� A gv—ci© y -"Z5 ss # G v o Repair drainage or vent piping 1.50 A. P. No. L� — Bd) Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 F e SeRitatieri Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 p EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 /819°MP?.no Re d b Parcel A roval Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Permit Fee $ BE ELECTRICAL No. @ FEE 019 le PERMIT FILING FEE $3.00 600V OR LESS Main service 100 AMP OR LESS 5.00 Single Family ❑ Duplex Mobil Home ❑ Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service OVER 100 AMPP OR LESS O 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW OR ADDNST ACCLBLDGSLING CCUP. 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 style of: /�/ % / c-14� - NEW RESID, BRANCH CIR T 1 NON.RESID � BRANCH CIRCUITS/ 2.50ea NEW CONSTR. (POWER APPARATUS .&, NON-RESID. SINGLE OUTLET CIR, Ex. Occup{OUTLETS OR FIXTURES 6 L@; FIXED APPLNS. OR Ex. Occup. (OUTLETS (RESID•) EA) 2.00 Temporary service 10.00 License No.61-" Classification l� Mobile Home Facilities 15.00 Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ MECHANICAL No. @ 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 Wo en's Compensation. rZW'I have placed on file with the County of Buttea 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. 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 Land Development Fee $ TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection urposes. X Date Signature of Perm it'eelvll Agent Receipt No. to 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. DIRECTO F PU IC WORKS By Datef Ile permit expires Date COUNTY OF BUTTE = ` DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT �y7 BUILDING Owner �.rs� �. �`z Vafi% SQ. FT. OCC. BUILDING VALUATION Mai I i ng Address Telephone No. Contractor yj Mailing Address � -�1 7 ' Fireplace Total Valuation Q Telephone No. =7 Permit Fee Building Address Plan Checking Fee&/or Penalty Permit Fee PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 �l.�o� G� Repair drainage or vent piping 1.50 � A. P. No. Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 Pees _8�rn Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Ma p 60' R/W Improvements p Each additional outlet .30 Building sewer 5.00 BI Parcel Approval Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Permit Fee $ $ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service BOOV OR LESS 100 AMP OR LESS 5.00 Single Family ❑ Duplex t2 Mobil Home ❑ Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service OVER 100 AMPP OR LESS O 25,00 Main service EA. ADD'L 100 AMP 1.00 NEW CONST OR ADDNS. ACCLLING 0 BLOGSCCUP. 5)2¢Sgft 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: q t PAR SAFFf- 14 IF L lnle NEW CONSTR MULTI.OUTL T NON.R ESID BRANCH CIRCUITS/ 2.50ea NEW CONSTR. (POWER APPARATUS .&, NON-RESID. SINGLE OUTLET CIR. Ex. Occuo{OUTLETS OR FIXTIIRES B L@; FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 p.o [3�X 3,Rrt C,{1� 4Sr 1 3,q Mobile Home Facilities 15.00 License No. � Classification C21 Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ MECHANICAL No. @ 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. 119 1 have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. r -1I 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. PERMIT FILING FEE $3.00 .0e:5 Heating U r Qp fj0 Cooling , O Ventilation Hood 2.00 �L.� Permit Fee $ a3l oc$ 6C 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 Land Development Fee $ TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspe'ctionn,purposes. X �4—�C JDate 11 1 Signature of PPermitee or Agent 11 tl Receipt No. , g3er,9o :5 a_ 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. RECTOR PUBLIC WORKS P By - DateW11,7O ZLg permit expires Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Telephone: 5344541 APPLICATION AND PERMIT X993 o, R eipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Building permit expires Date BUILDING Owner Mp2SC-i-4pJ VVPL,6:1(, IOUGSrOOS SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Contractor FOY. SLECTE L(. 10L.- Mailing Address ,3VIr 6LILI E kjy Fireplace Total Valuation D�a�i�.%E 1✓/T ���(� j.��2%30 FTA -e hone No. Permit Fee Building Address 2850 JOLy� 4Y Planng Fee&/or Penalty Permit FFeeee Permit PLUMBING No.1 @ FEE PERMIT FILING FEE J$3.00 Each TraD 1.50 /' LOT Z. IL._ItiDo 6hepoi$ � � i+�� Repair drainage or vent piping 1.50 �f A. P. NO 4 4— 3.7- i -5 Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 F SatMla49N Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 Parcel Approval Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Permit Fee $ is ELe::'tx tcA- .. Foe BP4 5339-1 g ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 tQ5 600V OR LESS Main service 100 AMP OR LESS 5.00 Single Family ❑ Duplex Mobil Home ❑ Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service OVER eooV 25.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 1.00 NEW CONST. ( DWELLING ') 2P Sq ft O OR ADDNS. ` ACC. BLDGS 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: , NEW CONSTR. (MULTI -OUTLET 1 NON.RESID BRANCH CIRCUITS) 2.50ea NEW CONSTR. (POWER APPARATUS 8 NON-RESID. SINGLE OUTLET CIR. Ex. OCCUD(OUTLETS OR FIXT11RE5 B 10f EX. OCCUp. (OFUT LETS P(RESID )REA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License Na � Classification �� 34,,+� Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ MECHANICAL No. @ 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. 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. PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 1 1 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 authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 94 d4�w-�IR X �_... - -' °-—°�--�A-T_ Date — Land Development Fee $ TOTAL PERMIT FEE $ This permit is hereby issued under the applicable provisions of theJ3utte County Code and/or resolutions to do work indicated ve for which fee have been paid. TOR OF PUBLIC WORKS iDl� / t ///7 o, R eipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Building permit expires Date COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 �% -4541 Tel ephbne: 534 ;71�" € APPLICATION AND PERMIT / BUILDING Owner aT r SO. FT. OCC. BUILDING VALUATION a f Mailing Address 520 COHASSET RD. ' CHICO, CA. 95926 Telephone 8 Contractor LAMB & RICE LANDSCAPING Mailing Address 2294 CEANOTHUS AVE. Fireplace Total Valuation CHICO, CA. 95926 Tee a -_t82 Permit Fee Building Address 2950 JOEYN WAY - CHICO Plan Checking Fee&/or Penalty Permit Fee PLUMBING No.1 @ FEE PERMIT FILING FEE J$3.00 Each Trao 1.50 Repair drainage or vent piping 1,50 10 `I.� A. P. �- -3400.4 ' Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 4041 S W . Sani�aiian Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 Rldg PI R '-a Parcel ApEroval Plans Approval Lawn sprinkler system 2.00 ° NEW ® ADDITION ❑ UTILITIES ❑ OTHER ❑ Permit Fee $-00 $ YARD SPRINKLING SYSTEM ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 600V OR LESS Main service 100 AMP OR LESS 5.00 Single Family ❑ Duplex.0 Mobil Home ❑ Others ❑ Main service EA. AOD•L too AMP 2.50 DUP EX OVER800V Main service 100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW LING O OR ADDNST % ACCLBLDGS.CCUP, !i� :20 sq ft 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: LAMB & RICE LANDSCAPING NEW RECO " . BRANCH CIRCUITS T NON-RESID BRANCH CIRCUITS 2.50ea NEW CONSTR (POWER APPARATUS 8 NON-RESID. SINGLE OUTLET CIR, Ex. Occuo(OUTLETS OR FIXTURES g L�; XED APLNS. Ex. Occup. (OUT ETS PRESID.)REA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. 311135 Classification C-27 Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ MECHANICAL No. @ FEE WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor A ' h I b' d ' t I' b' I' PERMIT FILING FEE $3.00 Heating Co a whlc requires every emp oyer to a Insure agalno Ia I Ity for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. yI 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. 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 in ection purposes. Date 12-22--1 Signature of Permitee or g nt Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Coo I i Venti Iation Hood 1 1 2.00 Permit Fee $ $ Land Development Fee $ TOTAL PERMIT FEE 1$5 Op 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. ryoZJI�9,41060'y- IRE T R OF UBLIC WORKSS BDale _ �74 Building permit expires Date Q2