HomeMy WebLinkAbout021-070-104a:. P _ .� e•..^^ L."._=� -.. _. wr-r.C.''„ --.r+.rn "'.""'+"c•"+h.� . ,.�+.�_ Y�, ^.le�yi... 1a -+1 __ - \.
AP jr AP 21-07-W
JO �HINILE Steve Womack�� N/S e Ave., 500' W, of Fr enc n/s Little Ave.; 500' W/of French �Ave.r,'?' '
h Ave., ti' dd Gridley _
r Permit #4464-75B c �rn��&
(FIRE DAMAGE REPORT/SF - 8/81)
repair roof)
yacJ 21=07=W i
f ¢ ateuhen Womak
i ® N Little Ave.; app.500'W.of
French Ave., Gridley
contr: Quist COASt Gridley .
Per #302 82A%,P E M(repair ,
fire damage/SF) �5� 1lJTr4✓'
f NEW , Oil u=� 21-07-30 1
I�AVIS BUXTON Fe hA
590 Litt le,Avenuey:.Gridley
Pemit #3470-82'B,P,E,M(new S/F) Z
1. •l
•-•;. ' .,- .tib ',
1
/j
0
V = OK
0 = Not OK
Not Applicable
= Not ReadRESIDENTIAL (Single and Duplex) `
y
Date
UNDERFLOOR Plans OK exce t#'s
Date
FRAMING (Continued)
1. Zoning requirements -Setbacks -Easements
2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth
48.
49.
Property Line Firewall & Openings
Ext. Doors -One 3' -Check Garage -3rd story, 2 exits
3.
Ftg., Garage; Soils -Steel- / /" Ftg. Depth
50.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
4. Ftg., Porches & Decks; Soils -Steel-./ /" Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab
51.
52.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
Siding -Nailing -Veneer
6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab
53.
Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access
7. Piers -Fireplace Ftg.-Steel
8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test
54.
55.
Glazing Area -Glass Protection -Skylights -Plastic
Shear Walls; Nailing -Bolts
9.
Gas Pipe; Size -Anchors
10.
Water Pipe; Test -Anchors -Regulator -Service Test
11.
12.
Electric; Underground
Plenums & Ducts; Clearance -Material -Support -Ins.
13.
Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Card -BI
Date
Date Card -BI Date
Date Card -BI Date
PLUMBING (Permit) OK except N's
Card -BI
Date
Date Card -BI Date
FINAL (Plans) OK except q's
56. Ext. Steps -Door & Sidelight Protection -Landings
57. Smoke Detector
14.
Water Ht.; Vent -Access -Combustion Air
58.
Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
15. Water Pipe; Test & Anchors -Nail Protection
16.
D.W.V.; Test-Fttngs & Anchors -Nail Protection
59.
Bedroom Exiting
17.
Shower Pan; Test, First Floor -Tub Access
60.
G.F.I. & Bath Fixtures & Tub Access
18.
Test Tub & Shower, 2nd Floor -Tub Access '
61.
Elec. Trim & Subpanel; Breaker Sizes -Labels
19.
Gas Pipe; Size & Anchors
62.
Stairs & Rails
63.
Fireplace or Stove; Clearances -Hearth
64.
Elec. Outlets at Wood Panel; Int. & Ext.
Card -BI
Date Card -BI Date
65.
Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI
Date
Date Card -BI Date
ELECTRICAL Permit OK except q's
66.
Elec. Outlets & Receptacles at Kit. Counter
67.
Garage Fire Door; Swing -Landing -Closer
68.
69.
A.C. Duct in Garage -Damper
Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
20.
21.
Fixture & Transformer Clearance -Ins. Protection
Elec. Receptacles Spacing -Lights &Switches at Doors
70.
Plb., Elec. & Mech. Equip. Listed for Location
22.
Size Boxes & No. of Conductors -Stapled
71.
Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
23. Romex Installed Close to Edge of Studs & C.J.
24.
Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water
72.
Insulation -Foam -Looked in Attic ❑Yes73.
25.
2 Appliance Circuits in Kitchen & Conductor Size
Guard Rails &Deck Construction -Post Caps
-
26.
Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al
74.
Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance
Looked under Floor ❑ Yes
27.
Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al,
Insulated Neutral ❑Yes ❑No
75.
Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No;
Planters Dyes []No
28.
Service -Riser Conductors & Ground -Main Disconnect
76.
Stucco; Brown -Finish
29.
30.
Equip. Clearances; Panels-Motors-Mech. Equip.
Clothes Closet Light -Shower Light
77,
A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
78.
Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
79.
Water Well; Disconnect, Electrical, Plumbing
80.
Exterior Elec. Trim; G.F.I. Receptacle -Underground
Card B -I
Date Card -BI Date
81.
Ventilation throughout House
Card B-1
Date Card -BI Date
82.
Glass Protection
Date
MECHANICAL (Permit) OK except k's
83.
_
Corrections from Previous Inspections
84.
85.
Gas Test -Meters Tagged; Gas -Electric
Water & Sewer Connected -C/O to Grade -HD Approval
31. A.C. Ducts; Insulation & Support
_
32.
33.
Vent Fan; Exhaust above Insulation
Condensate Drain & Overflow; Size & Grade
86.
Energy Compliance Certificate -Other Certificates
34.
Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet
35.
Attic Access & Platform if Furnace in Attic
-
Card -BI
Date Card -BI Date
Card -BI
_Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Date
FRAMING(Plans) OK except q's
36. Sills; Proper Material & Anchors
Comments at Final:
37.
Walls; Studs-NaiIing, .Spacing & Bracing -Plates -Sound
_
38.
Bearing Walls over Girders & Floor Nailing
_
39.
Draft Stop in Walls (rat proof)
40.
Fire Stops; Furred Ceilings -Stairs -Chases -Tub
41.
Header & Beam -Size & Bearing
_
42.
43.
44.
Hangers -Post Caps -Anchors -Connectors
Cln_g. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shihnq.-Rfnq. _
Fireplace Ties or Type A Flue -Fireplace Throat
45.
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
_46.
Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
47.
Garage Fire Protection Framing
(NOTE: Anentry must be made each time you visit jobsite)
= OK
= Not OK y
= Not Applicable MOBILEHOMES
= Not Ready
MISCELLANEOUS
Date
MOBILEHOME UTILITIES (Plans) OK except k's
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support -Sketch
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's
1. Zoning Requirements -Setbacks -Easements
2. Footings; Size -Depth -Spacing -Connectors
3. Sewer; Location -Test -Fall -C/O -Concrete
3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Water; Location -Test -Easement Needed (Sketch)
4. Wood Awn.; Posts-Beams-Rftrs.-Con nec.-Shthg.-Rfg.-Bracing
5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG
6. Carports; Windows -Doors
7. Utility Clearance
7. Elec.
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date
Date Card -BI Date
MOBILEHOME INSTALLATION (Plans) OK except N's
1. Zoning Requirements -Setbacks -Easements
Card -BI
Date
Date Card -BI Date
POOLS (Plans) OK except N's
1. Setbacks -Easements
2. Footings; Size -Spacing -Marriage Line
2. Soils; Compaction -Structure Stability
3. Gas; MH Test -Demand -Valve -Connector
3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining
4. Electricity; MH Test -Crossovers -Breakers -Clearances
4. Elec.; Receptacles and Lighting; Distances-GFI
5. Drain; MH Test -Fall -Flex Connector
5. Elec.; Pool Lighting; 15 volts-GFI
6. Water; MH Test -Regulator -Connector
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Water and.Sewer Connected -C/O to Grade -HD Approval
7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater
8. Gas and Electricity Tagged
8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg.
Boxes -Enclosures -Panel boards -Ins. to Main in Conduit
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
9. Health Department Approval
10. Plumb; Cir. Test -Water Supply Test
Card B-1
Card B-1
Date Card -BI Date
Date Card -BI Date
Card -BI
Card -BI
Date Card -BI Date
Date Card -BI Date
i
r.
Y. PERMIT NO. 302-82B,P,E,M
PERMIT EXPIRES-/ vies
OWNER Stephen Womak
CONTR. Quist Const.,Gridley
ASSESSOR PARCEL 21=07-19
LOCATION N /S Tittle Ave..app.500'W.of
French Ave., Gridley
Temp. Power Pole_
Called PG&E _
Temp. Elec. Service
Called PG&E_
Temp. Gas Service _
Cal led PG&E
JOB FINALED (Date)
Signature
COUNTY OF BUTTE -'DEPARTMENT OF PUBLIC WORK PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone 916/5 -4541
APPLICATION AND PERMIT v
ASSESSOR_P�2C NUMB
ZO
BUILDING PERMI
OWN. iSryU
•--M
TELEPHONE
SQ. FT. OCC. BUILDING ALUATION
rN
OWNER'S AAIL1 G ADDRESS
IL ra
CO TRACTS •S NA E S ^� TELEPHONE
-
CON A TORS M I I D-R•jEU_S
1-
Fireplace
CONSTRUC7TION LENDER rim
UNKNOWN
Total Valuation Is
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ Q.
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ 2ba, W
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDIN ADD/RE (A)
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00 Z0.VV
Repair drainage or vent piping
5.00
f
Water piping
LOT NO.SUBDIVISION
NAME
PARCEL AP
Each qas water heater or vent
5.00 ;
Gas piping system 1 - 5 outlets
,D
USE OF STRUCTURE
SF Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer
Lawn sprinkler system
5.00
TYPE OF WORK
New ❑ Additi ❑ Remodel Utilities ❑ Installation Other
Describe work:9'�
4R.43 I
'r r —
Permit Fee
$ r
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V OR LESS
100 AMP OR LESS
00 0-0
Main service EA. ADD'L 100 AMP
2.50 J�
NEW CONST. / DWELLIN C &I 2 sq ft
OR ADDNS. \ ACC. BLD
CONTRACTORS LICENSE LAW
I declary under penalty of perjury (check one):
51 I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code my license is in full force and effect.
License No. a Classification �_'
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW NO R BRANCH CIRCTITS 2.50 ea
NEW CONSTR. / POWER APPARATUS e)
NON-RESID. SINGLE OUTLET CIR.
Ex. Occup OUTLETS OR FIXTURES gAL�
FIXED APPLNS. OR
EX. Occup.(OUTLETS. (RESID.) EA. 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 7.50
Permit Fee
$
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
The permit is for $100.00 (valuation) or less.
1 have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Cooling
Hood
3.00
Ventilation
Permit Fee
S Q-0
Contractor
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 authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
1 also ree to save, indemnify and keep harmless the County of Butte against
all li lities, judgments, cos , and expenses which may in any way accrue
again aid Co t i on nce oft a granting of this per it.
X ate
Signature of Applicont — wner ❑ Contractorg?oe Agent
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 storiesin height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE 01, 6;
OCCUP. GROUP
l`
TYPE OF CONST.
PARCEL
PD
ND
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DMEC7QR OF PUBLIC
By.
P IT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
a ��
Date—/
Receipt No.�fC
WNITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
.turn to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT 92"3-257
FOR RESIDENTIAL DEVELOPMENT
-- DFflC":J1.L RGGtiFt,...
. I
BlITTiE
Section 26-8.1 of the Butte County Code requires this acknowledgementa
R i th. -
be recorded prior to issuance of a building permit. -
The property described herein is adjacent to land or included
�o Pf'�9R?
within an area zoned for agricultural purposes, and residents of ELEANOR M.L+_CO3ER
this property may be subject to inconveniences or discomfort arising CLERK -RECORDER
frow the use of agricultural chemicals, including, but not limited to herbicides, FEE
pesticides, and fertilizers; and from the pursuit of agricultural operations including,
bot not limited to cultivation, plowing, spraying, pruning, and harvesting which occa-
sionally generate dust, smoke, noise, and odor. Butte County has established agricul-
tural zones which have as a priority use for productive agricultural purposes, and
residents within said zones and on adjacent property should be prepared to accept such
i: -,convenience or discomfort from normal, necessary farm op6rations.
!'•_ll that real property situate in the County of Butte, State of California,
described as follows:
The•South 125 feet of the.West 70 feet of Lot 7, according to that
certain Map entitled,: Map of Gridley Colony No. 9" which Map was filed
in the office of the Recorder of the County of Butte, State of California,
July 10, 1907 in Book 6 of Maps, at page 58.
Date: 11/26/82
•,p �" _ `.'�L- / �i_i�/cam
r
PROPERTY OWNERS:
John Buxton
Mavis Buxton
California )On this the 26th day of November , 19 82 ,
SS. before me, the undersigned Notary Public, personally
Butte ) appeared
***JOHN BUXTON AND MAVIS BUXTON*****
--------------
OFFIGAI SEAL
DONNA M. WiLMOT
NOTARY DUBLIC-CALIFORNIA known to me to be the person(s) whose name(s) are
BUTTE COUNTY subscribed to the within instrument and acknowledged
My Commission Expires MARCH 5, 1994 that they executed the same for the purposes
therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official
seal.
Notary Public
Present A.Y. NO. 21-07 %
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS `r
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Orovi Ile — Phone: 534-4541
Skyway and Elliott Road, Paradise— Phone: 872-2961, Ext. 57
CORRECTION NOTICE
��d L f7Lra- . �r2--
BUILDING OR PROPERTY ADDRESS
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
c�'��-/h'D� �
A? [ L-
J /
D . Px�)'h 4).Z C�rt�?.�.,y2.
l°i-fzAi�A����
Inspector ��"` Date
PERMIT NO. 3470=82B,P,E,M
PERMIT EXPIRES
�•�"S
OWNER JOHN & MAVIS BUXTON
CONTR. owner
ASSESSOR PARCEL 21-07-19
3
1.
LOCATION' 590 little Avenue, Gridley
w
;i
Temp. Power Pole
Called PG&E
�; Temp. Elec. Service
o'
"Called PG&E urs/
Temp. Gas Service _
' Called PG&E
y
JOB FINALED (Date)
t
Sig
natu
i
r ..
= OK
0 = Not OK — +
= Not Applicable MOBILEHOMES
* - Not Ready
• 6i� .y �r
f
MISCELLANEOUS
Date
MOBILEHOME UTILITIES (Plans) OK except H's
Date
'DECKS COVERS, RPORTS ETC. (P s) OK except N's"
1. Zoning Requirements—Setbacks—Easements
oning Requirements—Setbacks—Easements
2. Soils; Special MH Support—Sketch
Footings; Size—Depth—Spacing—Connectors
3. Sewer; Location—Test—Fall-C/0—Concrete
3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails
4. Water; Location—Test—Easement Needed (Sketch) '
4, Wood Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.-Rfg.—Bracing
5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete
J
5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures
6. Gas; Location—Test—Wrap:/ /"L"ft./ P'Nat.or/"/"L"f.L/ /"LPG
6. Carports; -Windows—Doors
7. Utility Clearance
7. Elec.
Card -BI
Date Card -BI Date
d -BI
Date Card -BI Date
Card -BI
Date
Date Card -BI Date
MOBILEHOME INSTALLATION (Plans) OK except N's
1. Zoning Requirements—Setbacks—Easements
Card -BI Date Card=B1 Date _
Date POOLS (Plans) OK except N's
! 1. "Selbacks—Easements.N
2. Footings; Size—Spacing—Marriage Line
2. Soils; Compaction—Structure Stability
3. Gas; MH Test—Demand—Valve—Connector
3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining
4. Electricity; MH Test—Crossovers—Breakers—Clearances
4. Elec.; Receptacles and Lighting; Distances—GFI
5. Drain; MH Test—Fall—Flex Connector
5. Elec.; Pool Lighting; 15 volts—GFI `
6. Water; MH Test—Regulator—Connector
6. Elec.; Enclosures; Conduit Entries—Terminals—Listed
7. Water and Sewer Connected—C/O to Grade—HD Approval
7• Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater
8. Gas'and Electricity Tagged - %
8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool..Lghtg.
Boxes—Enclosures—Panelboards—Ins. to Main in Conduit
9. Health Department Approval
10. Plumb; Cir. Test—Water Supply Test .
9. Exits; Insp.—Sketch _.�
10. Cert. of Occupancy i
_
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
Card B -I
Date Card -BI Date -
Card -BI
Date Card -BI Date
V = OK
0 = Not OK _
- = Not Applicable `A y
= Not Ready
RESIDENTIAL (Singre and Duplex)
Date UNDERFLOOR Pla OK except M's
Date FRAMING Continued
1 on' requirements -Setbacks -Easements
4 roperty Line Firewall &Openings
g., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth
4 xt. Doors -One 3' -Check story, 2 exits
g., Garage; Soils -Steel- / /" Ftg. Depth
Stairs; Widt - adroom-Rise-Run-Landing-Fire Protection
4., Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth
_—§,�&temwalls, Main; Steel-Blockouts-Wrapped-Slab
&+: -Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
52. Siding -Nailing -Veneer
Q. Xemwalls, Garage; Steel -B lockouts -Wrapped -S lab
t Fdn. Vents-Underflr. Access
_ ieys-Fireplace Ftg.-Steel
lazing__Ajea-Glass ction-Skylights-Plast ic
W.V.: Fall -Fittings -Test -2 way C/0 -Sewer Test
ear Walls; Nailing -Bolts
as Pipe; Size -Anchors
Ilft-Water Pipe; Test -Anchors -Regulator -Service Test
11.6-0-lectric; Underground'
t lenums & Ducts; Clearance -Material -Support -Ins.
1irders-Sills-Anchor Bolts -Joists -Vents -Cripples
Card -BI CX2 DateCard-BI Date
I
Card -BI Date Card -BI Date
C d -BI Date Card -BI Date
C d -BI Date C d -BI Dat -
Date FINAL (Plans) OK except k's
C2,PkB I Dat Card -BI Date
Date PLU ING (Permit) OK except N's
xt. Steps -Door & Sidelight Protection -Landings
a Detector
_ a er Ht.; Vent -Access -Combustion Air
_=�8. Furnace; Vents -Clearance -Comb. Air -Connector -
In rage; Above Floor-Ducts-Mech. Protection
ter Pipe; Test & Anchors -Nail Protection
fD�W.V.; Test-Fttngs & Anchors -Nail Protection
edroom Exiting -41
_ 1Test, First Floor -Tub Access
.F.I. & Bath Fixtures & Tub Access
ia'�es1'Y-& Shower, 2nd Floor -Tub Access
ec. Trim & Subpanel; Breaker Sizes ab
_-
1 Gas Pipe; Size & Anchors
62.
3. Firepla ea[Onces-Hearth
64. ane ; n . Ext.
Card -BI Date,S'% Card -BI Date
Ixt. & Appliance; Grnd.-Air Gap -Coo Clearance
Card -Bl Date Card -BI Date
�Elec. Outlets & Receptacles at Kit. Counter
Date ELECTRICAL Permit OK except q's
Garage Fire Door; Swing -Landing -Closer '
GR_-A-$"DLct in Garage -Damper
2 L4, -fixture & Transformer Clearance -Ins. Protection
6 tr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Gara bove Floor-Mech. Protection
--
2J/Elec. Receptacles Spacing -Lights & Switches at Doors
—
2. ize Boxes & No. of Conductors -Stapled
Location
a „ Elec. &Mech. Equip. Listed for Location
a
✓- Installed Close to Edge of Studs & C.J.
71 F.I.) Protec.
2. Insulation -Foam -Looked in Attic- s
7a. Guard Rails & Deck Construction -Post Caps
quip. Ground made up w/Mech. Fasteners -Bond Gas & Water
'---
2§L-2Appliance Circuits Kitchen & Conductor Size
- nin'
- 26. Subfeed Wire Size / -2. ga. Cu o A.C. Wire Size / / ga. Cu or AI
74. Fdn. Vents & Crawl Hole D or-Drai%na e.& Wood -Earth Clearance
Looked under Floor es
27. Range Circ. / lel ga. u or AI -Oven Circ. / / ga. Cu or AI,
I ulated Neutral _ es ��No_
!
- Service -Riser Conductors & Ground -Main Disconnect
75. Following g instl Drive es E] No; Walks es ❑ No;
Planters 2"Y es 1_JNo
7 Stucco; Brown -Finish
_— ip. Clearances; Panels-Motors-Mech. Equip.
77 C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
_ othes Closet Light -Shower Light _
nts Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
- -- --- - - - --- --- --
------Exterior
Card B -I _Dat __ _Card -BI Date -
Car I Datept-moi Card -BI Date
ater Well; Disconnect, Electrical, Plumbing
Elec. Trim; G.F.I. Receptacle -Underground
&4w-VERCTtion throughout House
-
8_2.- Glass 12=1e l4ap-
revious Inspections
Date MECHANICAL (Permit) OK except p's
s Test -Meters Tagged; Gas -Electric
_-_ _ D_u_cts: Insulation & Support _
Vent Fan_ Exhaust above Insulation _
33. Condensate Drain _& Overflow; Size & Grade
1%6e -Water &Sewer Connected -C/O to Grade -HD Approval
Energy Compliance Certificate -Other Certificates
_, 34. Furnace -Vent; -Access -Comb. Air -Return Air Vent -115V outlet
35. Attic Access & Platform if Furnace in Attic
Z -9 and -BI Date
Card- I Date f !� _3C 1
C BI Date Card -BI Date
1 ate Card -BI Date
Car I ate 2. Card BI Date
Card -BI Date Card -BI Date
Date FRAM-LNG(Plans) OK except q's
Comments at Final:
ills; -
Pro er Material & Anchors
S�� Walls: Studs -ailing, Spacing & Bracing -Plat -es -Sound
� Wa- — -N - - -
3 _
3jS/tlearing Its over Girders & Floor Nailing
3 ft Stop in Walls (rat proof)__
_ 4 ire Stops; Furred Ceilings -Stairs -Chases
'
—
. Header & Beam -Size & Bearing -
ers-Post Caps -Anchors -Connectors
Cing. Joist-Rfir. Ties -Purl of Brac.-Truss-Sht Rinq.
d4 Fireplace Ti o T Fireplace Throat
45. tic A s; Size & Rxnex Protection -Draft Stop -Ins. Baffles
4f Bdrm. Windows or Exiting Doors -Sill HgL_&- Dimensions
___ -
Garage Fire Protection Framing _
r
f
(NOTE:Anentrymust be made each time youvisit jobsite)
COUNTY OF BUTTE `
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751 .-'
7 County Center Drive, Oroville — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
s� ^tet 7'TL�_ ✓✓�-vh� :,e
BUILDING OR PROPERTY ADDRESS
'A routine inspection indicates that the following violations of County Ordinance
-exist at the above address and should be corrected.' Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
�. .
i � l J4
iyr" 1r�C1S% T7�s�../3ac-r
rats CClp S
.. A /
Inspector.//) -JW //�ir.A,. V Date 7;
COUNTY OF BUTTE
Z�_PARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico —Phone: 891-2751
7 County Center Drive, Orovi Ile — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
BUILDING OR PROPERTY ADDRESS
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter or nee additional explanation, please contact this office immediately.
Inspector Date "-�
RESIDENTIAL
ENERGY CONSERVATION STANDARDS
CONSTRUCTION COMPLIANCE CERTIFICATE
THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN
INSTALLED IN CONFORMANCE WITH CURRENT ENERGY CONSERVATION,REGULATIONS
AT Iry z- lTT'.t E li-ve.' i%moy - , C%,
(location) '
BU ILD ING PERMIT -NO. 3A- '70 — $�� , M A : P . NO. I 'Y>'7 . /
THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED.PLANS:.
(Check each item
or write N/A if not applicable)
INSULATION:
GLAZING:
Slab Edge Al 1A,
Single Glazed
& ° -
Fdn. Walls .r//.4
Special (Insulated)
Floors
CERT. & LABELED WDS.
Walls x.13
& SLIDING DRS.`..1�
Ceiling/Roof D•
WEATHERSTRIPPED DRS.
Ducts '4
BACK DAMPERED FANS
%
Circulating Pipes
INTERMITTENT IGNITION
DEVICES%"'•.
APPROVED HEATER ,4
CERT. APPLIANCES
'A11A
APPROVED WTR.HTR.
a
I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED
'IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO
THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED.
Insulation Applicator Name C/IAC-,�l CA
Signature of (ple se print)
Insulation Applicator `
State Contractors_
License No. 57 gu"�/
General Contractor/Owner Name j 1j V,41 '13W 7-0111.
Signature of
(please print)
/% ��� ryc�
General Contractor/Owner /�f Date
State Contractors
License No.
s THIS CERTIFICATE MUST BE ON FILE WITH THE BU ILD ING DEPARTMENT PRIOR . TO
REQUESTING FINAL_ INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION
WITHIN THE.DWELLING.,
•. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMtT-NO. j
7 County Center Drive - Oroville,*GaSoniia 95965 - Telephone 916/534-4541 a
APPLICATION AND PERMIT "
7NUMBER
ASSESSOR PARCEL
•_�/� /��
ZONQJG -
.BUILDING PERMIT
OW
7�ER
1. _ "AVISeWX7rY
%'�%,��/
8E4PZ
SQ. T. BUILDING/ 'V ION
_
5O�0U •!
�
OW
AVE✓�/ �U
_//MAI I%QRE �V4
V +�
�• 00
CONTRACTOR'S NAME- -
TELEPHONE
Ajt
�wV
7
(
CONTRACTOR'S MAILING ADDRESS - •,'
- 1,+
Fireplace A
1600. VO
CONSTRUCTION LENDS
UNKNOWN
Total Valuation $ -
552 vo
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ SHOD
ARCHILECT,OR ENGI ER
LICENSE No:.•
Plan Checking'Fee•$
%Z SC7
r
Penalty
$
ARCHITECT OR EN NEER'S MAILING .ADDRESS
Permit fee
$' 2•, 50:
I/ r�+y` �•
BUILDIy,(r�� ESS°!. LI LCC •' /gV (�/V' -
.-((//��
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
e& 2.00 120,bO
Solar Water. Heater
20.00
Water•piping
5.00 S-.00 ,
LOT NO.,
SUBDIVISION NAME
ARCEt MAP
Each qas Water heater or vent
5.00 -5ijjq
Gas piping system 1 - 5 outlets
5.00 57-tit?
USE OF STRUCTURE
�/
SF Duplex ❑ Mobi lehome ❑ Other
SPECIFY
Building sewer
5.00 ,aO
Mobile Home , S G W
10.00 e
-
TYPE OF WORK
New R' Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe work:
_
Permit Fee
$ .00
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service OOOV OR LESS
100 AMP OR LESS
10.00 /67.00
'
Maimservice EA. ADD'L 100 AMP
2.50 2,5-0
NEW CONST. ( DWELLING 0C�it7 )
OR ADDNS.. 1 ACC. BLDGS. /J
2��2QSQ ft 3'.�, ��
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (Check one):
F-1 I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my.license is in full force and effect.
License No. Classification
I, as the owner, or my employees with wages as their sole compen-'
sation, will do'.the work,and the structure is not intended or offered
for sale. (Sec. 7044) ' 1
❑ I, as 1.the owner, am exclusively contracting with licensed contract.
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONSTR MULTI-OUT LET 2,50 ea
NON.RESI D, BRANCH CIRC ITS
NEW CONSTR- / POWER APPARATUS•&1
NON-RESID. %SINGLE'OUTLET CIR. / -
Ex. Occup.(ouTLE7s OR FIXTURES 20@50 Q
FIXED APPLNS, OR
Ex. OCCUp.' OUTLETS (RESID,) EA.) 2.00
Temporary service 10.00 x.00,
Mobile Home Facilities 15.00
Misc. 6Viring 15.00
Permit Fee $ ,OD
Contractor
MECHANICAL',.PERMIT
Filing Fee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under/penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
I have placed on file with 'the County of Butte Building Department'
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self-Insure.
❑ I shall.hot employ any person. in any manner so as to become subject.
to the W. C. laws of California: I,
-Notice to Applicant: If after making this statement, should you become subject,
to the W. C. provisions of the Labor Code; you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Heating so.DOO
L,0
f)5
Cooling .57
(0 •Od
^Hood'3.00
'Ventilation
,Permit Fee
$ 2S.0
Contractor
1 certify that l• 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 Countydt
Butte to enter upon the above-mentioned property for inspection purposes..
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against id ounty 'n co sequence of the granting of this permit.
X Date //—�N—
Signa re of Applicant - Owner ❑ Contractor ❑ Agent ❑
An SHA permit is •required for excava ions over 5'0" deep and demolition o construct-'
ion o structures over 3 s ries in hei
Mobile Home Installation Fee
$'
TOTAL PERMIT FEE
OCCOP. GROUP
I TYPE OF CONST.
rii
]PARC;,J
PD
HD
ssu
This permit is hereby issued under
sions of the Butte County Code and/or"
work indicated above for hich
DIRECT R F UBLIC
By
'P IT XPIRES Date
the applicable provi-
resolutions to do
fees have .been paid.
WORKS
_.Date
J�
Receipt No.7 �575 0 ���8 7/,d0 ��3�0•!�b
WHITE-D.P.W.. YELLOW- SSE,S SO R, PI -INSPECTOR, OLDEN ROD PPLICANT .
77 COUNTY OF BUTTE
19 DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Orovi I le = Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
A e
BUILDING OR PROPERTY ADDRESS
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, 'please contact this office immediately.
Inspector \ ' Date 1 tom/ _ ) — W/
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS
SPECIAL INSPECTION REPORT
Owner:
Address:
A. P.
Date of Inspection
Inspector
Tenant.
Building Location: N s .L/TTLC AUC -N L.
S� �%, OF 6tl AVE
Type of Inspection requested:
1. Housing. f_[ 2. F ancing
3. Change of Occupancy to
Other (specify) `
Present use, of buildi /�''
' A Sanitation (Housing)
1. Water closet•.
2. L�tory:
o .
' 3. Bathtub or shower:
4. Kitchen sink:
14W 1r=
5. Hot and cold water to fixtures:
6. Heating' facilities:
X o
7. Natural light and. ventilation:
8. Room and space requirements:
9.. Bedroom window or door for second
exit: 777,
10. Infestation of insects, vermin, or
rodents:
11. Connectior. to sewage disposal:
12. Connection to water supply:
13. Rubbish and garbage facilities:
14. Comments:
B. Structural
1. Piers and footings: yoi�
2.. Floor construction:
3. Wall construction:
4. Ceiling arid'roof construction:
5. Fireplaces:
6. Comments:
C. Electrical.
1. Service rid ground: o
2. �Ve
3. .
4. Conm ent s :
D. Plumbing
1. Fixtures connected and vented: u
2. Gas water heater:
3. Gas heating vents: ork-4
4.. Comments :
E, Other
I. Maintenance and repair.:
2. Fire hazards:
3. Safety hazards
4. Weatl!er protection:
5. Tin.derfloor and attic ventilation:
6. Conme.nts:
F. Commercial Buildings
1. Rnof covering:
2. Distance to property lines:
3. Physically handicapped:
4. ^est"oom floors and ills:
5. Exits:
6. Improvements: —
I. Zoning:_ 4
8. Cam, eiit:.
G. Field Problems or Viola; ions
1. Problem or violation ;give complQtz description):
7.
Writ
act ion
taken i g:i.ve complete
descriptlon) :
3.
What
an. on
r. eccmnended :
77 A. ;:nfonaution only - fi ..
B. Hold for tea (10) days, then wri-e litter.
Wrl.if•_• letter.
% D. Other:
DO-RDER NUMBER
REO. R.U. INCIDENT N0. START MO. GATE YEAR COUNTY
FIRE NUMBER FIRE NAME:
REG. R.U. NO. 3 thru �
f',ORIGIN LOCATION
SEC. ITOWN^S�HIUN EE GQE
L / ❑SZ ❑W
P3.IN�CTYPE
7IDENT
FALSE ALARM
Q
MILES _
48
FROM ❑IN NATIONAL FOREST, FIRE DIST., CITY.& STREET NO.,
L[IRECTIO
_
ETC.
/i
4A RESPONSIBILITY (AT ORIGIN)
48
DIRECT PRAT RESP.('D.P.R•) STATUTORY
Ref. ✓ STATE ZONE
tO ❑ WILDLAND BURNED OR THREATENED
RESPONSIBILITY
0❑ SCHEDULE A D.P.R.
—]STATE
03 ❑ UNPROTECTED
.
I❑DISTRICT
40❑ OTHER AGENCY D.P.R.
El CITY
LOCAL ZONE
[_]COUNTY
OS .,SCHEDULE A D.P.R.
❑ U.S.F.S.
[:]OTHER AGENCY D.P.R. (Unlncorp)
B.L.M.
FEDERAL ZONE
❑ B.I.A.
D.P.R.
0 ❑
� N.P.S.
O8� SCHEDULE A O.P.R.
[]OTHER FEDERAL
MI C./OTHER (ZONE')
OTHER
❑
QCAUSE (STARTS IN 1002 V OW&NLY)
Did not start In 1 2 5 oro❑SMOKHJO p EQUIPMENT
❑ LIGHTNING ❑ DEBRIS ❑ PLAY W/FIRE
p CAMPFIRE %ARSON ❑ OTHER/MISC.
r AND USE(STARTS IN 10 2 OROONLY)
Did not start in t0 2 S oroC]FOREST h`1DUSTRY
DOMESTIC RECREATION
RANCH -FARM OTHERINDUSTRY-
CObR
C
L.
❑ DUMP ❑WILDLAND
ROAD
❑ NON-WILDLAND
❑ UTILITY. RAILROAD OTHER
❑ UTILITY, ELECTRIC
DA (UU 5 OR 8 ONLY)
7
NO DAMAGE IN Num of(Hoar BMAtA
4M&M& Veh/Dwlg 1 2 &/or
TIMBER VOR
YOUNG GROWTH
WILDLAND VEGETATION
(Other then T& YG)
AGRICULTURAL PROD
(Other than T & Y G)
DY/EL ING.
�� ENTS
OTHER STRUCTURES -
VOR ONTFN S
VEHICLES & CONTENTS
OTHER
TOTAL
ACRES OF VEGETATION
BURNED
8A
AGENCY
DIRECT
PROTECTION
ACRES BURNED
KZR00 10
CDF�sACRES
BURNED
VEG.
5
TYPE
1
5
OTHER
TIMBER
WOOD
TOTAL
LAND
.' .
BRUSH
88
GRASS
SIZE CLASS
PROD
CDF
A .25 ACRE OR LESS
TOTAL
B 2" ACRES
8D
�C 10-99 ACRES
STATUT.
RESPON.
0 ACRES BURNED
❑ D 100-299 ACRES
OF
❑ E 300-999 ACRES
STATE
❑ F 1000-4999 ACRES -
U.S.F.S.
�G 5000 ACRES OR MORE
B.L.M.
B.I.A.
:: W .P.R.S.
E-
x BOR)
>' OTHER
E
FED.
OTHER
E
1
TOTAL
s ON ARRIVAL
❑ 1 VEGETATION FIRE OTHER, GO TO 10
SIZE DISTANCE (Orlaln to head)
ACRES 'FEET
WEATHER (ESTIMATE AT SCENE)
WIND I DIRECTION FROM TEMPERATURE
M.P.H.
10
OVER PLEASE
OF
CDF 7540-130-0118
7a.•51-,156 1-10 1!QI 0�r
i,PERMIT NO. 44.64'-%5B
P
E
s
,-MH UTIL.
PERMIT NO.
<a, PERMIT EXPIRES/
,OWNER Mr. John Hinkle
,CONTR. owner
'LOCATION (A.P. 21-07-19
1
N/S Little Ave., 500' W of French Ave.,
y M1"
t j1
J2}3
..
r
77
r
Temp. Power Pole
Called PG&
i',
Temp. Elec. Serv.
Called PG&E
Temp. Gas Serv.
Called PG&E
B
JOB
V FIN�1
ALES
(Date)
(Signature)
r A•
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont'd)
PLUMBING
Setback
Firewall
Soil Piping
Forms
Parapets
1st Floor
Main Bldg.
Restroom Fin.§k
2nd Floor
Footings
Windows
3rd Floor
Stemwdlif
Siding
7opout
Sla
Roof Sheathing
Water Piping
Pi
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footin s
Garage Vents
Water Htr.
Stemwa I
Slab
Prov. for physically
handicapped
Heaters
A pliances
Carport
Footings
Conformance of ex.
struct
Gas Pipirig & Test
Temp. Gas
Slab
Fina
Sanitation
Patio
FIREPLACE
Final
Footings
Footing
ELECTRICAL
Masonry Walls
Throat
Rou h
Reinf. Steel
Final
Fixtures
Bond Beam
FIRE SPRINKLERS
Motors
Framing
d % `�—' Test
Water Htr.
Stucco
Final
Sub anels
Mesh
MECHANICAL
Grd. Fault Prot.
Scratch
Heating,Service
Brown
Cooling
Temp. Pole
Finish
- / 'Ducts
Underground
Interior Lath
Ventilation
Permanent
Door Clos
Final
,Final
DATE
REMARKS OR CORRECTIONS
COUNTY OF BUTTE — DEPAR-MENT OF PUBLIC WORKS
.7 County Center„Dri%A& broville, California 95965
Telephone; 534-4541
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
ly 1
X Date
Signature of Permiteeror Agent
Receipt No.
White-D.RW. — Yellow -Assessor = Pink-Insp'ecior —'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 PUB.LIC WORKS
By o/7r1. Date.
Building permit expires Date _x/76
BUILDING
Owner Oh//y �1/�L
SQ. FT. = .00C. BUILDING VALl1ATION
Mai I ing Address
Telephone No,
�3
Firepla'
Contractor
Total Valuation
Mailing Address .,
Permit Fee,
Plan Checking Fee &/or Penalty,
Telephone No.
Permit Fee ^-
i
Building Addressjy
PLUMBING No. @ FEE
PERMIT•FILING FEE J$3.00
0 F"12 en C/ U Lt-`
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping . 1.50
Each gas water heater or vent 1.50
A. P. No, — Q •---
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
F
�SeRitetron
I Fire Dept.
Fire Zone
Use Permit '
Building sewer 5.00
EQA
ParkingParcel
Plans
Declaration
Parcel Map
60' R/W
Improvements
Lawn sprinkler system 2.00'
Parcel Approval 7
Plans Approval
Permit Fee $
$
NEWE] ADDITIONE] UTILITIES ❑ . OTHER
ELECTRICAL No. " @ .- FEE .
PERMIT FILING FEE; " . $3.00
nt eoo e 00 —
Main service•incl. 1 meter
Additional meters, each 1.00
Sub -panel (12 or.;less) (morethonl2)
Single Family Duplex Mobil Home ❑ Others ❑
Range, Cook -top or Oven 1.00
Water Heater or Space Heater 1.00
Light,fixtures YU (dbgl �2
t°
Jp
Recaps„ switches & 'fiz outlets
- CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions .,Code under the name
style of:
Hood, Ex. Fan or F;A:'Furn. Motor 1:00
Evap:"cooler, gar. disp. orD.W. 1.00
Air conditioner or heat pump
Water pump
Mobil Home Facilities 5.00
Temp. Power Pole 5.00 ."
License No. Classification
Misc. wiring
r� 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.
1 have placed on filewith 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 buildina construction. and herebv
TOTAL PERMIT FEE"
$
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
ly 1
X Date
Signature of Permiteeror Agent
Receipt No.
White-D.RW. — Yellow -Assessor = Pink-Insp'ecior —'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 PUB.LIC WORKS
By o/7r1. Date.
Building permit expires Date _x/76
x
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har4trippe
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s6f pf*plams-ana 5
Accordance with Recognized Good Practices cnJ:
of a quality prescribed for the Specified use in the
Wan, c
Uniform Widing, Plumbing'& Mechanical Codes Ahil It
%?I 61`1100=141.tOM, r
W -b
the Nor iccd Code. ional Bectri