HomeMy WebLinkAbout007-350-022�John Drake
i ..._._
p 464 Cimarron Dr., lot 34, Joshua Tree#�2,
Chico li
�
�.��
,Permit #5717-78B(new si gle family) ,
Contr: Gore & White Plbg, Chico
Permit##351-79P(Plbg/5717-78)SF
Contr: McClelland AC
Perm t##1004 -79M Chico
(mech/5717-78)
+ Contr: FOR Electric
Ermit ##1317=79E�(ele
/5717-78)'SF'
o
i
t
'O���M Ll7,
5717-78B
PERMIT'NO.
PERMIT EXPIRES
'OWNER' John D. Drake
CONTR. owner
LOCATION (A.P. 44-053-73 port.
464 Cimarron Dr., lot 34, Joshua Tree#2,
Chico
T
Temp. Power Pole_
CalledPG&E
TsTW. Elec. Serv.—
Called PG&E
TVMP�-Gas Serv.
Called PG&E
JOB
FINALED
(Date)
(Signature)
F _COMPANY
® LICENDED CONTRACTOR
Phone: 342-4764
P. O. Box 3500 — Chico, California 95926
INSULATION (Batted or Blown)
Date 19 ,I
To
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 LOCATEDf AT:
Street Lot Number Tract No.
EXTERIOR WALLS I
Manufacturer �� Thickness/Type R Value //
CEILINGS
Batts: Manufacturer Thickness R Value
Blown: Manufacturer/Thickness No. Bags t Wt./Bag
Sq. Ft. Covered L R Value
FLOORS
Manufacturer Thickness/Type R Value
SLAB ON GRADE
Manufacturer Thickness/Type R Value
Width of Insulation Inches
FOUNDATION WALLS
Manufacturer i Thickness/Type R Value
G L C O ` �% LICENSE NUMBER
Y LAiT LE `+``— DATE
WS.U311ATION P NTRAC�. LICENSE E'.
/ r
LEO 16
DATE _�
SAVE ENERGY - INSULATE!
I DATE)
ACCEPTED SETH COMPANY
3N� aL��\
(Authorized Representative)
RES IDENT IAL
ENERGY CCNSERVATION STANDARDS4.'','
s
CONSTRUCTION COMPLIANCE CERTIFICATE
1., 4""3
THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN
•INST LIED IN CQNFOUTANCE -WITH CURRE NE•RGY CONSERVATION REGULATIQNS-Lcx
(location
BUILDING •PERMIT. N0. A.. P.. NO.'�T'�1�5
THE FOLLOWING HAVE BEEN INSTALLED AS PER.APPROVED PLANS:
(Check each i�cqi or write N/A if not applicable)
INSULATION: N
Slab Edge.
Fdn. Walls
Floors
Walls 01_
" Ceiling/Roof 6y_1
Ducts YES
Circulating Pipes t-.10
APPROVED HEATER -?IES
APPROVED WTR.HTR.-Mc-,_,
m"
GLAZ ING :
Single Glazed
'Special ( Insulated) til VA — f'
CERT. & LABELED WDS. S
& SLIDING DRS.
WEATHERSTRIPPED DRS. '-eES
BACK DAMPERED FANS TES
INTERMITTENT IGNITIQN DEVICFS�_,
CERT. APPLIANCES vE4-1)
I DECLARE THAT. ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED
IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREME(VT$' AND AGREE.,TQ;. { `�., ;'•
THE'COMPLETENB$S OF THIS CERTIFICATEA.$ SUBMITTED.
�\�
Insulation. App4cator Name
Signature of (please print) r=
Insulation Applicator ,
State Contractors "` E
License No.
/Owner* N _ �/N `� OU Ale,x
Signature of
/Owner
•' 'ti yt e , h
( se nt)
Ole Dates" 8-, t
e Contractors
;ensC NO. r
t , -
' '. t
f • . •
'THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO
REQUESTING FINAL INSPECTION AND SHALL 4E POSTED IN A CONSPICUOUS,, *AT ION
WITHIN THE DWELLING.
a
� •,F I ti
I DECLARE THAT. ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED
IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREME(VT$' AND AGREE.,TQ;. { `�., ;'•
THE'COMPLETENB$S OF THIS CERTIFICATEA.$ SUBMITTED.
�\�
Insulation. App4cator Name
Signature of (please print) r=
Insulation Applicator ,
State Contractors "` E
License No.
/Owner* N _ �/N `� OU Ale,x
Signature of
/Owner
•' 'ti yt e , h
( se nt)
Ole Dates" 8-, t
e Contractors
;ensC NO. r
t , -
' '. t
f • . •
'THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO
REQUESTING FINAL INSPECTION AND SHALL 4E POSTED IN A CONSPICUOUS,, *AT ION
WITHIN THE DWELLING.
a
COONTY OF BUTTE- D-6PARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
PLUMBING
BUILDING BUILDING nt'd)
Setback Firewall
Soil Piping
Forms Parapets
1st Floor / '?
Main Bldg. Restroom Finish
2nd Floor
Footings Windows I
3rd Floor
Stemwall Siding
To out ..
Slab —47, Roof Sheathing
Water Piping
Piers Roofing
Sewer
Garage Fdn. Vents -
Fixtures
Footings Garage Vents
Water Htr.
Stemwal Insulation z
Heaters
Slab — Prov.
Appliances ---------—�
Carport leandicappe
Conformance of ex.
Gas Piping &Test
Footings structure
Temp. Gas
Slab Final
Sanitation OCa"
Patio FIREPLACE
Final
Footings Footing L'A'G77
ELECTRICA
Masonr Walls Throat"7
Rough
Reinf. Steel Final
Fixtures
Bond Beam FIRE SPRIN LERS
Motors
Framing " Test
Water Htr. _
Stucco Final
Subpanels
Mesh MECHANICAL
Grd. Fault Prot.
Scratch Heating
Service
Brown Cooling
Temp. Pole
Finish Ducts ` Z Y &W
Underground -
Interior Lath Ventilation 4Permanen
Door Closer Final
Final --
MOBILEHOME UTILITIES ------------------ Elec. Service
Elec. Pedestal
Water Piping Sewer
Gas Piping
MOSILEHOME INSTALLATION - - - - - - - - - - - - - - Support
Elec. Continuity
Water Piping Drainage
Gas Piping
p'
DATE REM KS OR COR ECTIO
/
Of
� e
i
(NOTE: An entry must be made on this form each time you vislt the job site.)
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WO
.J 7 County Center Drive — Oroville, California 95965'
Telephone: 534.4541 // U
APPLICATION AND PERMIT
authorize representatives of the ounty of Butte to enter upon the
a -m Toned property for ' s ction purposes. �Q
XDate
Signature e oor' Agent
40
Receipt No. ZZ��
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/a PUBLIC WORKS
11
Iding permit expires Date
BUILDING
Owner Dill J)R'4E
SO. FT. OCC. BUILDING VALUATION
Mailing Address P D, 60x 14-Vl
1Vq1 T 2_&q(0
0,41co CR 9s9�a
T 'L� =e'7,s
53 4014 .2l�2_
Contractor .06V A) Eel
Mailing Address
Fireplace /OQO
Total Valuation .;L
Telephone No.
Permit Fee / ,.O 0
Building Address C��yg,Q�p DP,LIE
PI an Checki ng Fee &/or Penalty
Permit Fee %,DO
O % OG
c -
PLUMBING No. @ FEE
Ct ic4}LOAOn,
PERMIT FILING FEE $3.00
Each Trap 1.50
[�
J1 -Q % X 37 0JHV4 T456 eHICO
Repair drainage or vent piping 1.50
Z4LI—053 d%3`�
A. P. No.
Zoning 8 Planning
Water piping 1.50
Each gas water heater or vent 1.50
Fe
Sa
ire Dept.
Fire Zone
Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking
Plans
I Parcel
Declaration
Parcel Ma
II
60' R/W
Impro ements
Each additional outlet .30
Building sewer 5.00
//������ �
W6./t'� kilel'/db
Parc p royal
F
Plans Approval
Lawn sprinkler system 2.00
NEW ADDITION ❑ UTILITIES ❑ OTHER ❑
Permit Fee $
$
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
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 e O 25.00
100 AMP OR LESS
Main service EA. ADD•L 100 AMP 1.00
NEW
OR ADDNST ( ACCLBLDGS.LING CCUP. 4\ rZP 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
le of:
NEW CONSTR (MULTBRANCH CIR T `/
NON•RESID BRANCH CIRCUITS/ 2.50ea
NEW CONSTR. POWER APPARATUS &
NON.RESID. SINGLE OUTLET CIR. 4
Ex. Occup (OUTLETS OR FIXTI RES 'BA' 1
Ex. Occup. FIXED APPLNS. OR
p• OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Lic se No. Classification
Misc. Wiring 6.25
1 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
men's Compensation Insurance.
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
$ g S 08
TOTAL PERMIT FEE
$ /tea O�
authorize representatives of the ounty of Butte to enter upon the
a -m Toned property for ' s ction purposes. �Q
XDate
Signature e oor' Agent
40
Receipt No. ZZ��
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/a PUBLIC WORKS
11
Iding permit expires Date
We*
1 O,6,qu A TREE 5U5 D/ VI S J ON UIV l T 1' 2
NOTE:=-A(f Materials & Workmanship Shall Be in This "set of plans and specifications MUST be
Accordance with Recognized ,Good Practices and kept on the job at all times and in is 'unlawful to
of a quality prescribed for the Specified use in the make y changes or alterations on same without
Uniform Building, mbiag Ona wr'iftn-poemission--from the Depa tr mento �b-
the National Elect ical Code, lic Works Count
- y of Butte.
1 '
IC
. r ,
N �
The Bldcl. Setbac shall bf 5 +ft. from the i
side pr perty lin and 5 it. from the k
centerline of the ad, per itting a.maxi- I I
mum of 2 ft. ea a overh4 in§ but entirely.
out of A easem nts.
i 3 o PV E I
Septic systm and loc tion of build-
ing drain stub -out .be as per a Master Plan on : le for building
Butte County Heal Dept._ Re-
quirements I Ins,
BUTTE C UNTY
E
CTS. S CEA« FQEE. BUILDING D 'PARTMENI
J
V P D
Pla « 4
• COUNTY OF BUTTE .,n— DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Oroville, California 95965
Telephone: 5344541
APPLICATION AND PERMIT /
authorize representativesofthe County of Butte to enter upon the
above-mentioned property for inspection purposes.
XZZDate I —22—
Signature 4offermitee or Alert ?'
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
thea County Code and/or resolutions to do work indicated
a e fJr which fees have been paid.
Lh&RtTOZR OF/PUBLIC WORKS
gy "`� Date �3
Building permit expires Date 317f
BUILDING
Owner
C2 LA i^
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Contractor Go gF,w
Mailing Address
g I D 6
Fireplace
Total Valuation
Telephone No.
8 - 1J 2_
Permit Fee
Building Address �p ��/✓f �1
Planng Fee&/or Penalty
Permit t Fee
PLUMBING
No.
@
FEE
PERMIT FILING FEE
$3.00
g,,l0
Each Trap 1.50
i2 '00
II
O 4"2:14 O hk Tr ee 64,Lo
Repair drainage or vent piping 1.50
A. P. No. _0 —7
Zoning& Planning
Water piping
1.50
Each gas water heater or vent 1.50
p
FAWslVIR,
Fire Dept. Fire Zone
Use Permit
Gas piping system 1 - 5 outlets / 1.50
^p
EQA
Parking
Plans
I Parcel
Declaration
Parcel Map
60' R/W
Improvements
Each additional outlet .30
Building sewer 5.00
BId4_B4.�d I
Parcel Approval I
Plans Approval
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
Permit Fee $
L
l� To 5 17-78
ELECTRICAL
No.
@
FEE
PERMIT FILING FEE
$3.00
00V OR L
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 eoov
100 AMP OR LESS
25.00
Main service EA. AOD'L 100 AMP 1.00
NEW
OR ADDNST ( DWEACCL BLDGS.LING CCUP. S\ 2¢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:
�O� P l.1/✓t ��� / I �i Nr l�/fit /y C .
NEW CONSTR MULTI-OUTL T
NON -REBID ( BRANCH CIRCUITS
2.50ea
NEW CONSTR. POWER APPARATUS &,
NON.RESID, (SINGLE OUTLET CIR,
Ex. OCCUP(OUTLETS OR FIXTIIRES B L@;
FIXED ALNS
Ex. Occup. (OUTLETSP(RESID)REA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No.—V f" B� Classification G 3�0
Misc. Wiring 6.25
❑ I am exempt from the Contractors License Laws of the State of Califomia.
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.
n I have placed on file with the County of Butte a certificate of
y� Workmen's Compensation Insurance.
E)1 certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to 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 herebv
Land Development Fee
is
TOTAL PERMIT FEE
$ /f k5Z
authorize representativesofthe County of Butte to enter upon the
above-mentioned property for inspection purposes.
XZZDate I —22—
Signature 4offermitee or Alert ?'
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
thea County Code and/or resolutions to do work indicated
a e fJr which fees have been paid.
Lh&RtTOZR OF/PUBLIC WORKS
gy "`� Date �3
Building permit expires Date 317f
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Oroville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
/00
autho ' e representatives of the County of Butte to enter upon .the
abov - entioned property for inspection purposes. �J
X
Date
Signature of Permittees or
Agent
Receipt No. ( ° 6
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.
/19RECTOR Ol7PUBLIC WORKS
By Date a 9'
wilding permit expires Date 10" 3-71
e -i
BUILDING.
Owner
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Contractor c
Mailin Address s (.
Fireplace
Total Valuation
/
(rar
Tel phone No. 3
Permit Fee
Building Address
Plan Checking Fee &/or Penalty
Permit Fee
PLUMBING No. @ FEE
I�
PERMIT FILING FEE $3.00
Each TraD 1.50
Repair drainage or vent piping 1.50
L
A. P.No. 4 �' Q 9-3 _77 3 Zonin & Planning
Water piping 1.50
Each gas water heater or vent 1.50
F@es 1
w4clS
nl MnUITJ
Fire Dept.
Fire Zone Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking
Plans
I ParcelEach
I Declaration
I Parcel Map
60' R/W
I Improvements
additional outlet .30
Building sewer 5.00
Bldg. a�P `ns Re d
Parcel Approyal
Plans Approval
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
Permit Fee $
�b 7 — 7
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
Main service OVER 600V 25.00
100 AMP OR LESS
Main service EA. ADD'L 100 AMP 1.00
NEW CONST DWELING
OR ADDNS. (ACCLBLDGS.0cup- 't) 20sgft
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
tyle of• IOUTLETS
�'1 �/1/ ,l
NEW RESID, BRANCH CIR T
NON.CONS ( BRANCH CIRCUITS 2.50ea
NEWCONSTR.(POWER APPARATUS B
NON .RESID. SINGLE OUTLET CIR.
Ex. OCCUD(OUTLETS OR FIXTIIRES g @251'Ot
APP
Ex. Occup.(FIXED TS (RE S, OR
RESID•) EA 2•00
Temporary service 10.00
11�J /�� _ Q /� Z�
cma.
Mobile Home Facilities 15.00
License No.1Tys�n P
�—� Classification c
Misc. Wiring 6.25
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$
MECHANICAL N0.1 FEE
WORKMEN'S COMPENSATION INSURANCE
I am aware of the provisions of Section3700 of the California Labor
Code hich requires every employer to be insured against liability
for rkmen'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
PERMIT FILING FEE $3.00
Heating
Cooling
,
Ventilation
Hood t t 2.00 a26-
Permit Fee $
$ I
l certify t4at 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
$
TOTAL PERMIT FEE
$ 3 �'
autho ' e representatives of the County of Butte to enter upon .the
abov - entioned property for inspection purposes. �J
X
Date
Signature of Permittees or
Agent
Receipt No. ( ° 6
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.
/19RECTOR Ol7PUBLIC WORKS
By Date a 9'
wilding permit expires Date 10" 3-71
e -i
b��d�f������t+Zlf
Sr�ph1 Olzn�., ,,n .u�o
g+�fln jf,
9
t
J
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Oroville, California 95965
Tel ephgne: 534.4541
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned roperty for inspect' purpo es.
t
17
X Date f
Signature of Perm i o gent
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.
41RECTOR OF/PUBLIC WORKS
By Date
permit expires Date /D-3 — `I9
BUILDING
Owner J
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
I
Telephone No.
Contractor
Mailing AddressFireplace
uJ
Total Valuation
�—
Telephone No.
— IL7 xa
Permit Fee
Building Address �/
lO U�t-L G U
PI anCheckingFee &/or Penalty
Permit Fee
PLUMBING No.1 @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
`-0 JOS
Repair drainage or vent piping 1.50
A. P. No. 4 4 —o.� —4 —7 3 Zoning & Planning
Water piping 1.50
Each gas water heater or vent 1.50
!E
Ion
I Fire Dept.
FireZone Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking
Plans
ParcelEach
Declaration
I Parcel Map
1 60' R/W
I Improvements
additional outlet .30
Building sewer 5.00
I4Fddovd I
Parcel Approval
Plans Approval
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
Permit Fee $
$
I
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00 .0
Main service 600V OR LESS
100 AMP OR LESS 5.00
Single Family tR 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
NEW CONST.// DWELLING OCC�1P 22S
OR ADDNS. ( ACC. BLDGS. "1 qft
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:
A64,
NEW CONSTR BRANCH CIR T
NON.RESID (MULTI BRANCH CIRCUITS) 2.50ea
NEW CON ST R. (POWER APPARATUS 8
NON.RESID. SINGLE OUTLET CIR.
Ex. OCCUD(OUTLETS OR FIXTIIRES) g 02951'00
FIXED APPLNS. OR
Ex. Occup.(OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. iQJ_-36_ Classification e:/
Misc. Wiring 6.25
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$.140 1C
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.
Q5ave placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
E]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 $
$
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
$ 3
authorize representatives of the County of Butte to enter upon the
above-mentioned roperty for inspect' purpo es.
t
17
X Date f
Signature of Perm i o gent
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.
41RECTOR OF/PUBLIC WORKS
By Date
permit expires Date /D-3 — `I9