HomeMy WebLinkAbout007-320-014John lsrape
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Lot olyn WaJy, Lindo Gardens t
#3, Chico
Permit #6724-77B(new dup ex�
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'PERMIT NO. 6724-77B
PERMIT EXPIRES
OWNER John Drake
CONTR. owner
LO P 44-37/-20 ort.
olyn Way, lof Lindo Gardens#3,Chico
Ar
Temp. Power Pole
Cal -led PG&E
Temp. Elec. Serv.
Called PG&E
Temp. Gas Serv.
Called PG&E
JOB
FINALED
(Date)
(Signature)'---"
To: BUILDING DZ'PA-R-Pkfe-;T
Frcm: ENVIRMZENT AL. 9ZALTH'
Re. Seca®-- and/or Water and/or Addition Clearance(s)
ly
LOCATION AP#
Plans are approved 'for: Sewage Disposal
CP . Water Supply,.'
?:fold up final for: Water Supply�
.,;:Inal Clearance, ok for: Water. Su
pply
Qcaranc-- is. for a bedroom (home or mobile home). Other
Ilie ae-:H tions) will be
117
Sanitarian- Date
pp-Re1 COMPANY
QI !e LICENSED 'CONTRACTIJR
Phone: 342-4764
P. O. Box 3506 — Chico, California 95926
INSULATION (Batted or Blown)
Date ✓�/ 14
Tm, i
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:
J�
Street Lot Number Tract No.
EXTERIOR WALLS ��
Man ufactu rertl�"M jr, Thickness/Type ®A`_R Value
CEILINGS
Batts: Manufacturer Thickness R Value
Blown: Manufacturer - Thickness /U�'J No. Bags � Wt./Bag
Sq. Ft. Covered R Value Z!2
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
GEN O LICENSE NUMBER
BY TItLE DATE Q
INSUL ION fNTRACT . R LICENSE NUMBER V
B ITLE DATE
(DATE)
ACCEPTED
SAVE ENERGY - INSULATE!
ERSET COMPANY
(Authorized Representative)
3
COUNTY OF BUTTE - ftlOARTMENT OF PUBLIC -WORKS
BUILDING INSPECTION RECORD
Water Piping Sewer Gas Piping
MOBILEHOMEINSTALLATWN--- Support Elec.Continuity
Water Piping s Drainage, Gas Piping
DATE
• . ris•
LJ
60
-J � s -
(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 — Uroville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
Nl gnoture of
Permitee or Agent _ I By Date — —7f
Receipt No. </ Cl j%
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant BUI ing permit expires Date—� 7
BUILDING
Ownerr
ake
SQ. FT. OCC. BUILDING VALUATION
92
Mailing Address 910
Cl
Telepho e N
I r
Fireplace 71ANd
Contractor
Total Valuation Ef
Mailing Address
Permit Fee
Plan Checking Fee &/orPenalty
Telephone No.
Permit Fee
IS
Building Address
PLUMBING No.1 @ FEE
PERMIT FILING FEE $3.00
Lay
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50
Y O 9t�'ica�icn 6 I
Each gas water heater or vent 1.50
A. P. No. y�� �� Y
Zoning n'
Gas piping system 1 - 5 outlets 1.50 .
Each additional outlet .30
s
Sa on FireDept.
FireZone
Use Permit
Building sewer 5.00
EQA P king Parcel ' rovem is
�P eclaratio P 0R/W Im P
Par r v Plans App val
Lawn sprinkler system 2.00
Permit Fee $
NEW ADDITION U (LIT ES ❑ OTHER ❑
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3,00
Main service soov OR LESS
100 AMP OR LESS 5.00
Main service EA. ADD'L 100 AMP 2.50
Single Family ❑ Duplex Mobil Home ❑ Others ❑
ER 60
Main service 10 0 AMP oR LESS 25.00
Main service EA. ADD'L 100 AMP 1.00.
NEW OR A.D.S. ( DACCLBLDGLINGOCCUP. &) 2¢sgft
NEW CONSTR. MULTI -OUTLET
NON•R ESI D, BRANCH CIRCUITS) 2.50ea
NEW CONSTR. (POWER APPARATUS &)
NON RES,D. (SINGLE OUTLET CIR.
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
Ex. Occup(OUTLETS OR FIXTURES)50 @25t
BAL@1
Ex. OCCUP•(FIXED APLNS. OR
OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Lice No. Classification
Misc. Wiring 6.25
am exempt from the Contractors License Laws of the State of California.
Permit Fee $
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑ I ha placed on file with the County of Butte a certificate of
men'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 $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
autho ' representatives of the County of Butte to enter upon the
abo a -me 'oned property for' ection purposes.
1
-15� 0
TOTAL PERMIT EE
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 UB IC WORKS
Nl gnoture of
Permitee or Agent _ I By Date — —7f
Receipt No. </ Cl j%
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant BUI ing permit expires Date—� 7
fhrs set of plans•-;aspaeificat♦o
xept on t1ia., job. a/a I tinges- and T4 is ry#e fwl 'to A -6-'
make any chanes or' alterations on saint wit#wu1 e
written permisson\from theQ56arnt of Pu' e' Lro ;1
S
Works', County of
T
• r GQi 20 TSAC.
�:.. /
39- TZ'
, .--. •
a BlrJgc set acC sh IL b 5 ft. from the -
si.'proper+ life; ft. from the �8 _
oety e�xlipe o i brig a maxi-
mull o.2 ft eat ver }i ngbuf 0ttrely
out r afh ea_ mets -
i o as
G'. .
Sepcc'system and, location of bui
. ing• drain, stub-out..YQ .be as per t10
Z.t�. Bunte
County HeaEth Dept. Re- '
quirerrents.
o` _
i
' -. ..... - >83:ao� _ . ,. ::. 93.x,' .-•... ..
37p$9.►�Zd W
7,1
See Master F1Wh:on _file for building =
plans.
// N0T._E�..
BUTTE COUNTY `- A LL To�*N E S�AL4. v6 Gom,=,AGTEr
BUILDING DEPARTMENT
APPROVED
COUNTY OF -BUTTS — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Oroville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
, f 6 9'- Zf
authorize representatives of the County of Butte to enter upon the
above -me ntio ed roperty for inspection purposes.
r
r
X r Date 5 d X2
$i oture of Prm/
eri-teee or Agent
Receipt No. ✓ , 7 76:Y
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By Date
Building permit ex pir Date
BUILDING
Owner ��
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Contractor �� /� /�
Mailing AddressFireplace
o�"I
Total Valuation
-P;),e0.
No.
j
Permit Fee
Building Address
Plan Checking Fee&/or Penalty
Permit Fee
PLUMBING
No.1
@
FEE
PERMIT FILING FEE
$3.00
3,00
Each Trap 1,50
Z
Repair drainage or vent piping 1.50
A. P. filo. Z.1 7 &,e7
Zoning a Planning
Water piping
1.50
� D
Each gas water heater or vent L 1.50
C7,0
es
Sa+ti�e4ion
Fire Dept.
Fire Zone
Use Permit
Gas piping system 1 - 5 outlets 1.50
p V
EQA
Parking
Plans
Parcel
Declaration
Parcel Map
60' R/W
Improvements
Each additional outlet .30
Building sewer 5.00
ParCBI A royal I
Plans Approval
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
Permit Fee $
60
�. 2 Z
ELECTRICAL
No.1
@
FEE
PERMIT FILING FEE
$3.00
600V OR LESS
Main service 100 AMP OR LESS 5.00
�''j�U
Duplex Mobil Home ❑ Others ❑
Single Family ❑ L
Main service EA. ADD'L 100 AMP 2.50
(�
G� �
Main service OVER .00V
100 AMP OR LESS
25.00
Main service EA. ADO'L 100 AMP 1.00
NEW CONST. OR ADDNS. ACCLBLDGSLING CCUP. 7i� 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:
)
C 12 O / ic%0
NEW BE ID MULTI-OUTL T
NON.RESN' BRANCH CIRCUITS)
2.50ea
NEW CONSTR POWER APPARATUS B
NON.RESID. SINGLE OUTLET CIR.
Ex. Occup{OUTLETS OR FIXTIIRES 50@@
BAL@1
EX. Occup `FIXED S, OR 2 00
• OUTLETTSS ((REREBID.) EA)
Temporary service 10.00
Mobile Home Facilities 15.00
/� / n3
License NoL..-b`.��3I3� Classification C�
Misc. Wiring 6.25
❑ 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.
v I certify that in the performance of the work for which this
1 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 $
$
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
$
r_ TOTAL PERMIT FEE$
[
authorize representatives of the County of Butte to enter upon the
above -me ntio ed roperty for inspection purposes.
r
r
X r Date 5 d X2
$i oture of Prm/
eri-teee or Agent
Receipt No. ✓ , 7 76:Y
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By Date
Building permit ex pir Date
COUNTY OF QUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965
Telephone: 534-4541 a /
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
AX X Date
Signature ofermitee or/Agge
Receipt No.7 7Z 24 5'"
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.
,JDIRECT.OR OF PUBLIC WORKS
By C Date
Building permit ex-ir
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Contractor _.
Mai I i ng Address /
Fireplace
Total Valuation
i
ele hone No.
Permit Fee
Building Address
Plan Checking Fee&/or Penalty
Permit Fee
PLUMBING No. @ FEE
aG�1�
PERMIT FILING FEE $3.00
Each Trap 1.50
Repair drainage or vent piping 1.50
Zoning & Planning
Water piping 1.50
Each gas water heater or vent 1.50
s
6ent[Mn
Fire Dept.
Fire Zone Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parkirig .1
Plans
Parcel
Declaration
Parcel Map
60' R/W
I Improvements
Each additional outlet .30
Building sewer 5.00
Parcel Approval
I Plans Approval
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
Permit Fee $
$
77
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service 100V OR LESS
100 AMP OR LESS 5•00
Single Family ❑ Duplex ® Mobil Home ❑ Others ElMain
service EA. ADD'L 100 AMP 2.50
Main service OVER 600V 25.00
100 AMP OR LESS
Main service EA. ADD'L 100 AMP 1.00
NEW CONSOR ADDNST* � ACCLBLOGSCCVP• S) 20sq 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.
NEW CONST.ES'.. MULTI.OUTL T
NON -REBID BRANCH CIRCUITS) 2.50ea
NEWCONSTR. POWER APPARATUS 9
NON-RESID. SINGLE OUTLET CIR.
EX. OCCUP(OUTLETS OR FIXTURES I BAL 21
S, OR 2
Occup Ex OUTLETTSS (RE (RESID.) EA) 00
(OUTLETS
Temporary service 10.00
Mobile Home Facilities 15.00
License No. /33 I Classification C V3 S 2—t3
Misc. Wiring 6.25
❑ 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 FEEPERMIT
FILING FEE $3.00 CL 00
Heating A*DO
Cooling 3 r 00
Ventilation.
L2.00
Hood ,00
Permit Fee $
$JT G
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
$ 3 (J
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
AX X Date
Signature ofermitee or/Agge
Receipt No.7 7Z 24 5'"
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.
,JDIRECT.OR OF PUBLIC WORKS
By C Date
Building permit ex-ir
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORK
7 County Center Drive — Oroville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
oenx?p
authorize representatives of the County -of Butte -to enter upon the
above-mentioned property for inspection&urposes
tlat%
x - Date
Signature of 4 Permitee/orr en
Receipt No. /83&
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
a r which feLhe been paid.DIR COF PUBLIC WORKSS9.21 p�
By Date / �.2o r ��
Building permit expires Date �-24— 9
BUILDING
Owner JOHN D DRAKE
SQ. FT. OCC. BUILDING VALUATION
Mailing Address 520 COHASSET RD.
CHICO CA. 95926
o.
342-8985
Contractor I);AMB & RICE LAND 'S CAPING
Mailing Address 2294 CEANOTHUS AVE.
Fireplace
Total Valuation
CHICO CA. 95926
A r{,j
3142-56( 2
Permit Fee
Building Address 2947 JOLYN WAY — CHICO
Plan Checking Fee&/or Penalty
Permit Fee
(LOT 14)
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00 3.0
Each TraD 1.50
Repair drainage or vent piping 1.50
i� �7
A. P. No. lq— / �' G� �A��
Z
Zoning & Planning
Water piping 1.50
Each gas water heater or vent 1.50
F
SaaitaUGo
FireDept.
Fire Zone
Use Permit
Gas piping system 1 -5 outlets 1.50
EQA
Parking
Plans
ParcelEach
Declaration
I Parcel Map
60' R/W
I Improvements
additional outlet .30
Building sewer 5.00
Parcel Approval I
Plans Approval
Lawn sprinkler system 2.00 2.
NEW ® ADDITION ❑ UTILITIES ❑ OTHER ❑
Permit Fee $ 5.00$
5 1C
YARD SPRINKLING SYSTEM
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service 6001 OR LESS
100 AMP OR LESS 5•�0
Single Family ❑ Duplex Mobil Home ❑ Others ❑
Main service EA. ADD -L 100 AMP 2.50
DUPLEX100
Main service OVER 6001 25.00
AMP OR LESS
Main service EA. ADO'L 100 AMP 1.00
NEW CONSDWELING OR ADONST ( ACCLBLDGS.CCUP. 4) 21isgft
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 CONSTR BRANCH CIR T
NON-RESID, (BRANCH CIRCUITS) 2.50ea
NEW CONSTR (POWER APPARATUS 6
NON-RESID, SINGLE OUTLET CIR,
Ex. OCCUD(OUTLETS OR FIXTURES B L:;
FIXED APP LNS. OR
Ex. Occup. (OUT LETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
_
.License No. Classification
Misc. Wiring 6.25
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
E] .1 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 forMhwh this
permit is issued I shall not employ anyi,,person)in -ah- manner
so as to become subject to the Workmen's Compens__atibn Laws`of
California. t�#' ' ` -1 `]t
( '�I �,1 ({
1 certify that I have read this applicationandstate that the above
information is correct. I agree to comply to all • County,Ordifianceksi
and State Laws relating to buildirtd. constructioi,::arid-hereby,�A
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
Land Development Fee
$
$
TOTAL PERMIT FEE
$ 5 OC
authorize representatives of the County -of Butte -to enter upon the
above-mentioned property for inspection&urposes
tlat%
x - Date
Signature of 4 Permitee/orr en
Receipt No. /83&
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
a r which feLhe been paid.DIR COF PUBLIC WORKSS9.21 p�
By Date / �.2o r ��
Building permit expires Date �-24— 9
014CUNTY
0p SIL O' ORK
(6)7 �
AM SEP 2 81978
6
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORK
7 County Center Drive — Qroville, California 95965 (�
Telephone: 534-4541 I /
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above -mention dproperty for i ection purposes.
r
X Date
Signature of P rmi a or t
Receipt No/Zf� /_ab
White-D.P.W. - Yeflow-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.
cRECT� PUBLIC WORKS
By Date 7 —/® — 7P
g permit expifTs DVe 4/-4/- — 757
BUILDING
Owner C
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Contractor
Mailing Address`
Fireplace
Total Valuation
r
ele hone No.
,�� Z U
Permit Fee
Building Address
Plan Checking Fee&/or Penalty
Permit Fee
Z
PLUMBING No.1 @ I FEE
c�
PERMIT FILING FEE $3.00
Each Trap 1.50
Z �j S`
Repair drainage or vent piping 1.50
A. P. — _ � Zoning & Planning
Water piping 1.50
Each gas water heater or vent 1.50
F s
Se"ttattmi
Fire Dept.
Fire Zone Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking
Plans
Parcel
Declaration
Parcel Map
60' R/W
I Improvements
Each additional outlet .30
Building sewer 5.00
B4d, Plarv-Ikerd I
Parcel A roval
I Plans Approval
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
Permit Fee $
$
ELECTRICAL No. @ FEE
()
PERMIT FILING FEE $3.0000V
OR
Main service 100 AMP ORSLESS 5.00
Single Family ❑ Duplex Mobil Home ❑ Others ❑
Main service EA. ADD'L 100 AMP 2.50
Main service OVER s 25.00
100 AMP O OR LESS
Main service EA. ADD'L 100 AMP 1.00.
NEW CONST.DWELLING
OR ADDNS. ( ACC, BLD�F? 20 sq ft U
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: ��
e, U�L
NEW RESID,CONST/ BRANCHMULTI-OCIRCUITS)
NON -REBID 1 BRANCH CIRCUITS 2.50ea
NEW CONSTR (POWER APPARATUS.5
NON-RESID, `SINGLE OUTLET CIR.
Ex. Occuo(OUTLETS OR FIXTIIRES 5 L
APPEx. Occup ( FIXEDOUTLETTSS (RE S, OR SID.) EA
• ) .2 00
RE
Temporary service 110.00
Mobile Home Facilities 15.00
License No. 3of36S'— Classification �/y
Misc. Wiring 6.25
❑ I am exempt from the Contractors License Laws of the State of Califomia.
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 rkmen's Compensation.
I 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 $3.00
Heating
Cooling
Ventilation
L2.00
Hood
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 -mention dproperty for i ection purposes.
r
X Date
Signature of P rmi a or t
Receipt No/Zf� /_ab
White-D.P.W. - Yeflow-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.
cRECT� PUBLIC WORKS
By Date 7 —/® — 7P
g permit expifTs DVe 4/-4/- — 757