HomeMy WebLinkAbout007-330-013V,
John.D. Drake
'M35_`Silver_b'6ll*Rd. Iot'13, JoAu'a
Tree #2, Chico
Permi#new i g1285 -79B( le family
contr: Gore & Whit; Plb'g.,-Chico
Permit 1560-79P(plbg_.for #1285-79)
?-z _)? 4 L X/
—7
4.A
M 'CC 1
K4
i:�C 1
Contr: Ivc e.L and AC, Chico
c
rmlt #26 09 F
—Permit #2609-79M(me'cl�/1285'_7
rTrt-
0 tr Fox
n - F Electric
r ml t# 690_9�
C
Contr: Fox
Permit#369 �AW 02
� -
0-79E (ele/fl�285 79)
J IM PA
3035 Silver Chico
J PA
IM
3035 Si 7verb'
Contr: Servam
ermit#17 -8 P(solar -w-ai-ter h t
,�ea� 08F)
AW.
`Contra- Ser%).qmAt
Oe55�1�46.84--&6-7(gps wqter'heater)SF
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John.D. Drake
'M35_`Silver_b'6ll*Rd. Iot'13, JoAu'a
Tree #2, Chico
Permi#new i g1285 -79B( le family
contr: Gore & Whit; Plb'g.,-Chico
Permit 1560-79P(plbg_.for #1285-79)
?-z _)? 4 L X/
—7
4.A
M 'CC 1
K4
i:�C 1
Contr: Ivc e.L and AC, Chico
c
rmlt #26 09 F
—Permit #2609-79M(me'cl�/1285'_7
rTrt-
0 tr Fox
n - F Electric
r ml t# 690_9�
C
Contr: Fox
Permit#369 �AW 02
� -
0-79E (ele/fl�285 79)
J IM PA
3035 Silver Chico
J PA
IM
3035 Si 7verb'
Contr: Servam
ermit#17 -8 P(solar -w-ai-ter h t
,�ea� 08F)
AW.
`Contra- Ser%).qmAt
Oe55�1�46.84--&6-7(gps wqter'heater)SF
, ��3 �
00 33 0'
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13
1285-79B
'_ -PERMIT NO.
'i PERMIT EXPIRES
OWNER John D. Drake
CONTR. owner
LOCATION (A.P. 44-053-73 port.-
3035-Silverbel.1 Rd lot 13, Joshua Tree#2,Chic(
Af
r.
ki
Temp. Power Pole
Caed PG&E
. E
Temr Elec. Serv. 17
Called PG&E ZQ4 4 0
T inp. Gas Serv. L-11AU
Called PG&E
OB
FINALED
ate) e-1
(Signature)
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WOKS
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont'd) PLUMBING
Setbackewa
52
4a� ZVf
Soil Piping
Forms
Parapets
1st Floor 6`,,-�-
Mai Bidg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
_
Stemwall
Siding
To out
Slab
Roof Sheathing ��
Water Piping
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Stemwa I I
Garage Vents
Insulation 91
Water Htr. -
Heaters
Slab
Carport
Footings
Prov. for phsically
handicapped"
Conformance of ex.
structure
Appliances
Gas PI In &Test
as _75 LlVdjd
Slab
Final 20^
Sanitation
Patio
FIREPLACE
Final
Footinas
Fnntinn _ /r
011 F r TirlrhI
Relnf. Steel I Final -9 - %- 79 t --:*I/ I Fixtures 4-70 -7,q Wldl/
btucco i
Final
Subpanels
Mesh
MECHANICAL-
Gird. Fault Prot. ^2 -o -
Scratch
HeatingService
BrownZ fig
Cooling
Temp. Pole
Finish -%-
7-
Ducts
Underground
Interior Lath �� 4. A
Ventilation
Permanent
Door Closer 9` -%
Final - -
Final
MOBILEHOME UTILITIES ------------------
Elec. Service
Elec. Pedestal
Water Piping
Sewer
Gas Piping
M 1 EHOME INSTALLATION - - - -
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.)
ERSET
Reenn ' COMPANY
QE- a8 LICENSED CONTRACTOR
Phone: 3424764
P.O. Box 628 — Durham, California 95938
INSULATION (Batted or Blown)
Date .5 36,T
To ./ J `'''5;L—Q
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 L_/�%(Oj�CATED AT:
/b!/
Street Lot Number Tract No.
EXTERIOR WALLS /
Manufacturer0-CF Thickness/Type' 2 R Value
CEILINGS
Batts: Manufacturer Thickness R Value
Blown: Manufacturer Thickness No. Bags Wt./Bag
Sq. Ft. Covered" '/// t)_ R Value Z 47
FLOORS
Manufacturer
SLAB ON GRADE
Manufacturer
Thickness/Type R Value
Thickness/Type
Width of Insulation Inches
FOUNDATION WALLS
R Value
Manufacturer Thickness/Type R Value
GEN LICENSE NUMBER Q, v
TITLE y—� `�\ DATE "A
I0.
N UL (TION, ONTRACT� R �� - �% LICENSE NUMBE ��---
BY TITLE&- ��1t / DATE 1/12
SAVE ENERGY - INSULATE!
ACCEPTED RSETH COMPANY
(Authorized Representative)
A
""••• ♦41
RESIDENT IAL
ENERGY GC\SERVATION STANDARDS
CONSTRUCT1ON COMPLIANCE.CERTIFICATE ;
THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN
INSTALLED IN CONFOMANCE WITH CURRENT ENERGY CO SERVATION•REGULATIONS
(location
BUILDING PERMIT NO.' �� S A..P. NO.
OM
THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS:
(Check each item or write N/A if not applicable)
INSULATION:
Slab' Edge_ N
1p�-
Fdn. Walls.
Floors.
Walls OK
Ceiling/Roof C>N(--
Ducts i'-`--,
Circulating Pipes t-10
APPROVED HEATER ►'�5
APPROVED WTR.HTW..
GLAZING:
Single Glazed
Special (Insulated) N
CERT. & LABELED WDS.
& SLIDING DRS.
WEATHERSTRIPPED DRS. `!
BACK DAMIERED FANS CS
INPERMITTENT IGNITION DEVICES ,C. �.
CERT. APPLIANCES
I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLEb
IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO,
THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED.
Insulation Applicator Name
Signature of (please print
Insulation Applicator
State Contractors
License No.
General /Owner N
Signature of y (aMse nt)
.., _ r , /Owner
Zf
Date J 8`7
e Contractors
nse No.
N
THIS CERTIFICATE MUST BE .ON FILE WITH THEN BUILDING DEPARTME:NT'PRIOR TO
REQUESTING FINAL INSPECTION AND SHALL•BE POSTED IN -A CONSPICUOUS LOCATION
WITHIN THE DWELLING.
y.
f
r
THIS CERTIFICATE MUST BE .ON FILE WITH THEN BUILDING DEPARTME:NT'PRIOR TO
REQUESTING FINAL INSPECTION AND SHALL•BE POSTED IN -A CONSPICUOUS LOCATION
WITHIN THE DWELLING.
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
j' r+ 7 County Center Drive — Oroville, California 95965
Tel ephOne: 534.4541
APPLICATION AND PERMIT
aumonze represeniaxives t me t;o y or tsuile io enler upon me
above- ned proper r inspe on purposes.
XDate
Signature of P reit Agent
Receipt No.
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECT PUBLIC WORKS
By Date 3 —7;9
Building permit expires Date
BUILDING
Owner ����
SQ. FT. OCC. BUILDING VALUATION
8140 .221,200-T?i
Mailing Address �Q+ �j44
g'
�T
C��jCO C_�
TeIE
��j^ne No.
(�
Contractor
Mailing Address
Fireplace
Total Valuation
Telephone No.
t
Permit Fee ✓
Building Address 0,5
Plan Checking Fee &/or Penalty
Permit Fee
PLUMBING No.1 @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
% �%(/�Q
Repair drainage or vent piping 1.50
P. No. CFi,j PDA7/
Zoni g ^Planning
Water piping 1.50
Each gas water heater or vent 1.50
S t on Fire Dept.
Fire Zone
Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA Parking
arceI
Declaration
Parcel a p
60' R/W
Im rove ents
p
Each additional outlet .30
Building sewer 5.00
Bldg. Plans Re c Parcel royal
Pla Approval
Lawn sprinkler system 2.00
NEW ADDITION ❑ UTILITIES ❑ OTHER ❑
Permit Fee $
$
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
0V OR LE
Main service 1000 AMP ORSLESS 5.00
Single Family Duplex ❑ Mobil Home ❑ Others ❑
Main 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
NE W
OR ADDNS.CONST. ACCLBLDGS.CCUP. 4� 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:
NEW CONSTR BRANCHCIR-OUTLET
NON.RESID BRANCH CIRCUITS 2.50ea
NEWCONSTR. POWER APPARATUS 8I
NON .RESID. SINGLE OUTLET CIR.
Ex. OCCUO(OUTLETS OR FIXTURES SB L2;
FIXED APPLNS. OR
Ex. OCCup.�OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
91 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.
❑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.
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
$
aumonze represeniaxives t me t;o y or tsuile io enler upon me
above- ned proper r inspe on purposes.
XDate
Signature of P reit Agent
Receipt No.
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECT PUBLIC WORKS
By Date 3 —7;9
Building permit expires Date
%UV!051-ILIA TREE . 5U501 ` 51ON
UN 1 ?' 4 2
I
NOTE:—All Materials & Workman
The BI nized 'Goon
�g�Setbc�ck--sfial r r n�/,1t4V A L7. f ea ;q y..-0'es�_W, f :tom
.side p Foperfy I ne an 50 ft, fr m heUnIform 5WIdIri g & Mecha
centerline of the road, 3ermitting a maxi- the National Electrical Code.
mum of a 2 ft. eave'ov rhang but entirely
out of ;all easements.
I This set of plans and spec!
kept on the job at all times a
make a►�
$6a tics stem a �oocation of build y changes or alteratio:
p Y wrif� en permission from the D
tng drain stub- �1 to be as per, lic Works
06,tte County with Dept. R� t County of Butte.
k.
quirements.
i
i
I t
-
BUTTE
Sul pi c
hip Shall Be in
Practi es and
ifs! use in the
ucal Cordes and
;t�fions; MUST be
if !s ynlawful to
S on same without
partment of Pub-
'v�8 -77
COUNTY
TMLNI
E®
�. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS-
' 7 County Cerifer Drive - Oroville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
authorize representatives of the county of t3utte to enter upon the
above-mentioned property for inspection purposes.
X Date
Signature P/rrsiteeC/3 nt
Receipt No. l//j�/�)JIX�Jj' d`
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
This pe mit is hereby issued under the applicable provisions of
th utt County Code and/or resolutions to do work indicated
OL"ve f r wh' fee have been paid.
P0A OF PUBLIC WORKS •y
3 Date v
Building permit expires Date �a4�ohd
BUILDING
Owner JoRtJ DP -A415
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
q
Contractor G oeE is iiE L 1%IN 6,
Mailing Address R'I' 0, ✓& V
Fireplace
Total Valuation
"-
g5g7k
F, N
$'95-�n� `��i
Permit Fee
Building Address 3(�%jrj Jil�l�jGi2gER..I. �� '
ng Fee&/or Penalty
Planit
Permit Fee
Fee
PLUMBING
No.1
@
FEE
PERMIT FILING FEE
$3.00
r04D
Each Trap g 1.50
2.00
�3 - (!�j-i`i co
Repair drainage or vent piping 1.50
44•-QS3--73 P0�`r
A. P. No. lJV
Zoning 8 Planning
Water piping
1.50
a
Each gas water heater or vent 1.50
i,
Fbes
&.".tien
FireDept. iFireZone
Use Permit
Gas piping system 1 -5 outlets 1.50
,5-0
EQA
Parking
Plans
Parcel
Declaration
Parcel Map
60' R/W
Improvements
Each additional outlet .30
Building sewer 5.00
ns ec'd I
Parcel Approval
Plans Approval
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
Permit Fee $
�
$
Pwmb,
ELECTRICAL
No.
@
FEE
PERMIT FILING FEE
$3.00
600V OR LESS
Main service 100 AMP OR LESS 5.00
�/
Single Family L.� Duplex ❑ Mobil Home ❑ Others ❑
Main service EA. ADD•L 100 AMP 2.50
Main service OVER
OV AMPP OR LESS O
25,00
Main service EA. ADD•L 100 AMP 1.00
NEW CONSDWELING OOR ADDNST ( ACCLBL GS.CCUP. Y) rZPSgft
CONTRACTORS LICENSE LAW
1 am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
lit-r,J Lf�! �S
NEW CONSTR. (MULTI -OUTLET
NON-RESID BRANCH CIRCUITS)
2.50ea
NEW CONSTR. (POWER APPARATUS B
NON.RESID. SINGLE OUTLET CIR,
Ex. OCCUR{OUTLETS OR FIXTI]RES g @2j
FIXED APPLNS. OR
X.CCUp•OUTLETS (RESID.) EA) 2•00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. ��/9a20( 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 liability
for Workmen's Compensation.
I 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.
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 buildinq construction, and hereby
PERMIT FILING FEE
$3.00
Heating
Cooling
Ventilation
Hood 1 1 2.00
Permit Fee $
Land Development Fee
$
$
TOTAL PERMIT FEE
$
authorize representatives of the county of t3utte to enter upon the
above-mentioned property for inspection purposes.
X Date
Signature P/rrsiteeC/3 nt
Receipt No. l//j�/�)JIX�Jj' d`
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
This pe mit is hereby issued under the applicable provisions of
th utt County Code and/or resolutions to do work indicated
OL"ve f r wh' fee have been paid.
P0A OF PUBLIC WORKS •y
3 Date v
Building permit expires Date �a4�ohd
"Owner
Mailing Address
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Oroville, California 95965
Tel ep6orie: 534-4541
APPLICATION AND PERMIT
_ BUILDING
SQ. FT. I OCC. I BUILDING VAL
Code which requires every employer to be Insured against Il
Telephone No.
Contrac a,�
Mailing ddress ®
Fireplace
Total Valuation
Telephone No.
Permit Fee
Building Address
Plan Checking Fee&/or Penalty
Permit Fee
PLUMBING
/r p QUA
UU �J/ -/v /
PERMIT FILING FEE
Each Trap
Repair drainage or vent piping
'/ i
A. P. No. Y '0� J -7
Zoning & Planning
Water piping
Each gas water heater or vent
F
Fire Dept.
Fire Zone
Use Permit
Gas piping system 1 - 5 outlets
EOA
Parking
Plans
Parcel
on Declaration
Parcel Map
_--r.
60' R/W
Improvements
Each additional outlet
Building sewer
P . upproval
Plans Approval
Lawn sprinkler system
NE ADDITION ❑ UTILITIES ❑ OTHER
Permit Fee
Z ��
ELECTRICAL
PERMIT FILING FEE
Main service 600V OR LESS
100 AMP OR LESS
�-{
Single Family Duplex ❑ Mobil Home ❑ Others LJ
Main service EA. ADD -L 100 AMP
`
Main service OVER 600V
100 AMP OR LESS
Main service EA. ADD'L 100 AMP
NEW CONST. DWELLING OCCUP. S
OR AODNS. 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
sty
� IGC �I ,,- .
NEW RESID.CONSTR % BRANIMULTCH CII T
NON-RESID BRANCH CIRCUITS
NEW CONSTR. POWER APPARATUS 6
NON-RES,D. (SINGLE OUTLET CIR.
Ex. OCCUD(OUTLETS OR FIXTI1PE:
FIXED ALNS.
Ex. Occup.(OUTLETS P(RESID )REA
Temporary service
95—,7 -y
Mobile Home Facilities
/ ( �- -46Misc.
License No. 6�Ezs Classification
Wiring
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee
MECHANICAL
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
b'
PERMIT FILING FEE
Heating S�
a )Illy
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.
I certify that I have read this application and state that the above
information is correct. 1 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 -men 'oned property for inspection purposes.
X Date
-5/-2/;7,,2
Signature of Permiteee or Agent
Receipt No. t20 V-7
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
Cooling
$3.00
1.50
1.50
1.50
1.50
1.50
.30
5.00
2.00
$3.00
5.00
2.50
25.00
1.00
2.00
10.00
15.00
6.25
$3.00
FEE
FEE
Ventilation
Hood I J 2.00 . U
Permit Fee $ $ /3- t7
Land Development Fee $
TOTAL PERMIT FEE Is ( lj
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.
IREC 0 OF PUBLIC WORKS
Date "
-71
Building permit expires Date 16
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Oroville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
X090 79
authorize representatives of the County of Butte to enter upon the
above- entioned property for inspection purposes.
X Date
Signature of Perrrmi�je or Agent
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 r which fees have been paid.
DIRECVO,FR OF PUBLIC WORKS
permit expiresDate 2,6 a
BUILDING
Owner
r
SQ. FT. OCC. BUILDING VALUATION
Mailing Address C T
6 G
Telephone No
Contractor 4�
Mai I i ng Address /� j�'j -.4, t/ L
Fireplace
Total Valuation
elephone No.
Permit Fee
Building Address 0
Plan Checking Fee&/or Penalty
Permit Fee
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
Each Trao 1.50
-�—
Repair drainage or vent piping 1.50
. P. NO��_��� _
A. L�?Jt Zoning &Banning
Water piping 1.50
Each gas water heater or vent 1.50
�
s *I -K
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
Bldg. Plans Recd
Parcel A royal
Plans Approval
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
Permit Fee $
$
L
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00 G C.
00V 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 600V 100 100 AMP OR LESS
Main service EA. ADD•L 100 AMP 1.00
NEW CONST. DWELLING OC
OR ADDNS. ACC. BLDGS. 20 sq ft C
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: r--
�� �� �� tt77-- ��
�O X ELGG 722, C X.Mr
NEW CONSTR. MULTI.OUTL
NON-RESID BRANCH CIRCUITS 2.50ea
NEW CONSTR. (POWER APPARATUS 8
NON-RESID. SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTIIRES) 5 L25
EX. Occup.(OUTLETS FIXED TS (RESAPPLNS. OR ) 2.00
OUTLETS (RESID.) EA
Temporary service 10.00
Mobile Home Facilities 15.00
License No. 305-26 5 Classification Cf -10
Misc. Wiring 6.25
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $ Zo
$ ZC
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.
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 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 relatinq to buildinq construction, and hereby
Land Development Fee
is
TOTAL PERMIT FEE$
authorize representatives of the County of Butte to enter upon the
above- entioned property for inspection purposes.
X Date
Signature of Perrrmi�je or Agent
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 r which fees have been paid.
DIRECVO,FR OF PUBLIC WORKS
permit expiresDate 2,6 a