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021-190-029
21-19-29 R. L. Brown 935 De pup Ave., Gridley contr: Ma sh Const., Oroville Permit �k298-8Q',E(util . ,MH) ELEC. GAS SUPPORT STRUCTURE Q. COMPACTION TEST R12 2 9- Contr: Adams Permit#36-80MHI` Issu O ��� 21-19-29 Male E�Wa 935 Dewsnup Ave., Gridley Permit #4886-80p(d`eck & a ning/ ) 21-19-29 935 Dewsnup Ave., Gridley Permit #,549-81B(add screen room/MH) COLE, Shelby L. 287-67B 21-19-29 w/s Dewsnup so. of W. Liberty Rd., ri ey' (trailer cover) i 1 1 3:16i3 -1e-0 PERMIT NO. PERMIT EXPIRES OWNER R. L. Brown Marsh Const,; Oroville CONTR. 21-196-29 LOCATION (A.P. ) 935 Dewsnup Ave., Gridley 'Oak C r CQ 3/ C6. Temp. Power Pole Called PG&E Temp. Elea, Serv. Called PG&E Temp.. Gas Serv. 21.2 Called PG&E JOB _ FINALED (Date Pr (Si nature) Bond Be;fm \ I /FIRE SPRINKLE'VIS I Motors / Stucco mesw MECHANICAL X I Grd. Fabit Prot. Sc r tch Heati Servi B wn Cooing I TAMP. Pole finish X Dults X I Anderaround oor Closer anal inal MOBILEHOME UTILITIES ------- - Elec_ Service 4 Elec. PedestaJ-----------,. Water Piping Sewer Gas Piping MOBILEHOME INSTALLATION - - - - - - - - - - - - - Support Elec. Continuity Water Piping 7 Drainage Gas Piping DATE �RMAeRIKS OR CORRECTIONS (.? t1i (NOTE: An entry must be made on this form each time you visit the job site.) /4, COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD ' BUILDING BUILDING (Cont'd) PLUMBING Se ack FI wall Ski Piping For Parllpets 1N Floor Mai .Bldg. Rest om Finish 2n loor Fo ins Windo 3rd F or Stem all Siding To out Slab Roof Sheaking Water PI in Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Stemwa l l Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for physics y handica ed Conformance of ex. structure Appliances Gas Piping & Test Temp. Gas Slab Final A Sanitation Patio R LACE Final Footings I Footing x SLECTRICAN Bond Be;fm \ I /FIRE SPRINKLE'VIS I Motors / Stucco mesw MECHANICAL X I Grd. Fabit Prot. Sc r tch Heati Servi B wn Cooing I TAMP. Pole finish X Dults X I Anderaround oor Closer anal inal MOBILEHOME UTILITIES ------- - Elec_ Service 4 Elec. PedestaJ-----------,. Water Piping Sewer Gas Piping MOBILEHOME INSTALLATION - - - - - - - - - - - - - Support Elec. Continuity Water Piping 7 Drainage Gas Piping DATE �RMAeRIKS OR CORRECTIONS (.? t1i (NOTE: An entry must be made on this form each time you visit the job site.) /4, 9. Electrical A. Is service large enough to provide adequate amperage -to mobile�iome (must equal rating of mobilehome with a minimum of 10 amp) and other facilities on lot, i.e., water pumps, garage, cabana, etc.? Yes_ o_ B. Is there proper clearances around panels? Yes 1e__ _ C. Is power supply cord or feeder assembly properly fused? Yes %--Qo D. Is continuity test satisfactory as per the following procedure? Yes v No 1. De -energize electrical wiring system of the mobilehome at the pedestal. 2. Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected. 3. Switch all breakers and switches in the mobilehome to the "on" position. 4. Connect one lead.of a test instrument to the mobilehome grounding conductor and apply the other lead to each mobilehome supply conductor, including neutral. 5. All non-current, carrying metal parts of the mobilehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor.. 6. Upon completion of the above procedure, the power supply cord or feeder assembly conductors shall be connected to the site service equipment. A further continuity test shall then be made between the grounding electrode and the chassis of the mobilehome. Upon satisfactory completion of theelectrical tests, the lot or site service equipment may be approved for energizing. 10. Is job card signed by Health Department for water and sanitation? 11. If everything okay, sign off card and tag services. MOBILEHOME DATA Manufacturer and/or Namestyle , LeAc Length Width ��� 1.2x7� ouf' Vehicle Serial No. State Identification No. Additional Information or Comments: r I r MOBILEHOME INSTALLATION INSPECTION CHECK LIST 1.- Is-khe mobilehome located with required separation from lot lines and buildings and generally conform to plot plan? Yes_Le-4Qo_ 2. Does the mobilehome have required clearances above ground? (Sec.5085) Yes/-- No 3. Are footings and supports properly sized, spaced, and braced as per approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes I/ No 4. Is the mobilehome level? (Sec. 5088) Yes VNo_ 5. If more than a single unit, are crossover connections properly installed? (Sec. 5088) Yes—vIvo_ 6. Water A. Is flexible connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes e' No B. Test - Does water piping withstand working pressure or 50 lbs, air test? Yes_ No C. Backflow - If coach is not State of California approved, does station have backflow device and pressure -relief valve? Yes_ No_N 7. Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes_ B. Does it have minimum 4" per foot slope and is it properly supported? YesL,-No_ C. Are any leaks detected in drainage system after running 3 -gallons of water through each fixture including washing machine standpipe? Yes_ No D. If coach is not State of California approved, does station have required trap and vent? Yes_ No /V 4- 8. Gas Piping and Gas Vents A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum mobilehome connector not more than 6 ft. long? Note: All piping is to be at least as large as the mobilehome gas line inlet without reductions other than the mobilehome connector. Yes_4�No_ .B. Test OK as per following procedure? Yes_ No 1. Open all appliance connector valves. 2. Shut off appliance burner and pilot valves. 3. Air test with manometer to 10"--14" water column, or test with slope gauge (minimum 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without drop. 4. Connect gas meter to mobilehome with connector, turn on gas, test connections with soapy water. C. Are all appliance vents properly installed? Yes ZNo — ' COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER (� lcl-a ZONING -x BUILDING PER OWNER ou)t) TELEPHONE ��SO p SO. FT. OCC. BUILDING V UATION az OW ER'S MAILING ADDRESS G CONTRACTOR'S NAME TELEPHONE DA /W M CONTRACTOR'S MAILING ADDRESS. - CONS RUCTION LENDER UNKNOWN Fireplaces Total Valuation $ LENDER'S MAILING ADDRESS , Permit Fee $ ARCHITECT OR ENGIN ER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS 10 �V , /� �js �_ PLUMBING PERMIT Filing Fee 3.00 Each Trap 2.00 Repair drainage or vent piping 2.00 G91Z)LC—Y Water piping LOT NO.SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 2.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex ❑ Mobi lehome Other SPECIFY Building sewer Lawn sprinkler system 2.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ UUti lities ❑ Installation Other ❑ Describe work: r-O!L UTI - / C�• 90 _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 3.00 Main service 100 AMP OR0V OR LESS5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUR.& OR ADDNS. ACC. SLOGS. 20 sq ft CONTRACTORS LICENSE LAIN I declare un r penalty of perjury (Check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code a d my license is in full force and effect. License No. �9� 7 2- Classification V ��1 ❑ 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 ❑ 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 CONSTR ULTI.OUTLET 2,50 ea NON.RESID. BRANCH CIRC ITS NEWCONSTR POWER APPARATUS & NON •RES I D. (SINGLE OUTLET CIR. Ex. OCCup(OUTLETS OR FIXTURES 50@� BAL@1D¢ APPLNS. OR OUTLETS (RESID.) EA.� 2.00 EX. OCCU Occup. Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ve 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 3.00 Heating Cooling Hood 2.00 Ventilation Permit Fee $ Contractor I certify that I have r ad this application and state that the above information is correct. I agree ,o I mply to all County Ordinances and State Laws relating to building constru Io and hereby authorize representatives of the County of Butte to enter upon a Bove -mentioned property for inspection purposes. 1 also agree to save, i emnify and keep harmless the County of Butte against all Iia " ' 'e g e s, costs, and expenses which may in any way accrue a s ai n nseq nce of the granting of this permit. X Date ,56-0 Signature of Applican� Owner ❑ Contractor &/ent ❑ An OSHA permit is r uired for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories ip height. Mobile Home Installation Fee $ Land Development Fee $ TOTAL PERMIT FEE OCCUP. GROUP TYPE OF CONST. PARCEL PD HD ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTO F PUBLIC BY P T EXPIRES Date__. the applicable provi- resolutions to do fees have been paid. WORKS Date 77—/6'�ry�`� / /��Q Receipt No. ' WHITE-D.P.W., YELLOW-ASSE5SOR. PINK -INSPECTOR. GOLDENROD -APPLICANT BUTTE COUNTY DEPARTMENT OF.PUBLIC WORKS 7 County Center Drive, Oroville,-CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name: &-WWA) 2Al-00 2. Installer's name: ADAMS 421-5-h. fes, 6L 3. Is the site currently under permit? Yes /c.% No (If yes, furnish permit number ) OR Is the site an existing site? Yes No i t (If yes, furnish two (2) plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes / L/ -- No (If no, clarify L7 ) 5.- What is the mobilehome electrical rating? ------------------ 6. What is the mobilehome site service rating? --------------------- 7. What is the mobilehome site circuit breaker rating? ------------- 8. Is there any other electric load to be served by the mobilehome site service? --------------------------------------------------- (If yes, identify the load and size: (Load) /00 Amp s Amp s �ey Amps Yes / / No / (Amps) (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) BUTTE COUN I Y BUILDING DEPARTMENT APPROVED 4-- 9. What is the mobilehome site gas pipe size? -------------------,--- 'Jin.) 10. What is the type of gas service? ----------------------------- Natural / / LPG /L� 11. What is the gas pipe length from meter or tank to the mobilehome? 12. What is the mobilehome gas demand? ------------------------------ (BTU) (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) BUTTE COUN I Y BUILDING DEPARTMENT APPROVED 4-- MOBILEHOME SUPPORT DATA s1:7\1 U 40 L' C(AZj5' If other than single wide, Mobilehome Mfr.0/ e ri-C furnish Setup Model No. ' Year % 7 Width- t.) Box Length 6714 Tagalong or Expando Size / o� ft. xft. (SHOW SUPPORT DETAILS BELOW) On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of Butte). All center supports measured from front of mobilehome unless otherwise specified. *If center piers are other than drawn above, draw in locations, spacing, and dimensions. Footings (check one) Single a -,--.-Wood either AA pressure treated or foundation grade. ( t.)(in;) x (in.) (in. /� 2. Other (specify) Center s pport Center su port �� j locatio s^' footing .izes t Supports (check one) �, , Concrete block. i 2. Other (specify) (ft.)(in.) (in.) (in.) c. jZ-430 ' 4 ---Tagalong or Expando, show support details. (ft.)(in.) in.) (in.) x30 -- Typical Support (in.) (in.) Footing Size x (ft.)(in. (in.) (i .) S - -- Max. Pier Spacing (ft.)(in.) L_ x J -- Max. Overhang � (ft.) (in.) (in.) (in.) (ft.)(in.) *If center piers are other than drawn above, draw in locations, spacing, and dimensions. COUNTY OF BUTTE - DEPARTMENT OF,PUBLJC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 ' • APPLICATION AND PERMIT MEN"Mim'Silwal ASSESSORP RCEL NUMBE , ZO ING BUILDING PERMI OWNER /j TELEPHONE SO. FT. OCC. BUILDING V ATION OWNER'S MAILING ADDRESS CONTRACTOR'S NAME /-/ 5. �.— --- 7 . TELEPHONE /J CONTRACTOR'S MAILING ADDRESS ) /c CONSTRUCTION LENDER UNKNOWN Fireplace Total Valuation $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGIN ER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS PLUMBING PERMIT Filing Fee 3.00 Each Trap 2.00 Repair drainage or vent piping 2.00 Water piping [j, LOT NO. SUBDIVISION NAME !�t CE MAP Each qas water heater or vent 2.00 Gas piping system 1 -5 outlets10.00 USE OF STRUCTURE SF ❑ Duplex❑ MobilehomeD§ Other SPECIFY Building sewer ,©p Lawn sprinkler system2.00 TYPE OF WORK New❑ Addition❑ Remodel❑ Utilities Installation❑ Other El Describe work: — Permit Fee $ :F11 00 Contractor ELECTRICAL PERMIT Filing Fee 3.00 Main service 100 AMP ORV OR LESS5.00 Main service EA. ADD'L too AMP 2.50 NEW CONST. (DWELLING OCCUR.&\ OR ACDNS. ACC. SLOGS. / 2¢sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): 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 Nab % 3 3%5 Classification - 1119, 23, ❑ 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) ❑ orsa the owner, am exclusively contracting with licensed contract- ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR MULTI -OUTLET 2,50 ea NON-RES'.,BRANCH CIRCUITS) NEW CONSTR. (POWER APPARATUS & NO-RESID, SINGLE OUTLET CIR. N � Ex. Occup(OUTLETS OR FIXTURES 500" BAL@10q Ex. Occup.(OUTLETS FIXED P(RESID )LNS REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 L. Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE 1 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 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 FiIingFee 3.00 Heating Cooling Hood 2.00 Ventilation permit Fee $ 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. 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 sasid County in consequence of the granting of this permit. %��r�� Date l//—/e;, "Z%L) Signature of Applicant — Owner❑ Contractor Q Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Land Development Fee $ L TOTAL PERMIT FEE $ J occUP. GROUP I TYPE OF CONST. JPARCE,LJ PD M ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTO F PUBLIC By PER EXPIRES Date_ the applicable provi- resolutions to do fees have been paid. WORKS Date / J �/ /—� Receipt No. oZ 62— IS7_ WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT This set of plans and specifications MUST be kept on the iob at all times and it is unlawful to make any changes or altera+ions on same without written permission from the Department of Public Works, County of Butte. NOTE:—All Materials & Workmanship Sholl Be th Accordance with Recoani-,34 Good Pror"Nees and of a quality prescribed for -+e Snesifiod F+so in the Uniform Building, Plumbing & Machanical Codes and the National Electrical Code. b° et t c°�� t�`°p o� lel \�`�I e�`t�� d5`d i i - •. A � a\iec �` °fie, a ° \N r l E rc1aQ.\ ! _.. A. permit will be requir�d for the ` installation of the mobil home. A setback of 5 ft. fritim the property lines and a setback of 50ft. front► the roan centerline shell be clear of _ structures or equlpmW except for a 2 ft. eeve *v@rheR@: J 7 Z 794 -NO BUTTE COUNTY IlUILDING DEPARTMSNr Y/ DECLARATION REGARDING ACCESS applicant for al;7/�O�.e,�lr'��., permit from the County of Butte for the parcel -of land identified as Assessor's Parcel �No. V H ga `j , declare that said parcel was created on �.� , 19_4:L, by deed recorded in Book of Official Records at Page ( in the office of the County Recorder of the County of Butte, and that I first purchased an interest in said parcel on or about e 190, and that at that time I was not aware of any facts that would cause me to suspect that said parcel may have been created without the access thereto required by law. I declare under penalty of -perjury that the foregoing is true and correct. Executed this +% day of , 19 Q , at �j�y-7 31California. f t� i ~ � PERMIT NO. 549-815=' PERMIT EXPIRES1 OWNER Maile E. Walsh CONTR. owner r ASSESSOR PARCEL 21-19-29 I LOCATION 935 Dewsnup Ave., Gridley 4 Temp. Power Pole / Called PG&E Temp. Elec. Service/ Called PG&E Temp. Gas ervice Caj, ed PG&E FINALE[ Signature V = OK O = Not OK , – = NotApplicaWe MOBILEHOMES MISCELLANEOUS * = Not Ready i Date MOBILEHOME UTILITIES (Plans) OK except #'s Date DECKS COVERS, CARPORTS, ETC. (Plans) OK except #'s 1. Zoning Requirements–Setbacks–Easements . Zoning Requirements–Setbacks–Easements 2. Soils; Special MH Support–Sketch ootings; Size–Depth–Spacing–Connectors 3. Sewer; Location–Test–Fall-C/O–Concrete 4. Water; Location–Test–Easement Needed (Sketch) Z—geeksfairders and/or Joists–Decking–Bracing–Stairs–Rails – king 5. Electricity; Location–Clearances–Grnd.–/ / Amp–Concrete m. Awn.; Columns–Connections–Splice–Decal–Enclosures 6. Gas; Location–Test–Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG �f�rpnrtc Windova–Dnnrc 7. Utility Clearance 7. Card -BI Date Card - BI Date Card -By" Date �- — and -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements–Setbacks–Easements Card -BI Date Date f Card -BI Date POOLS (Plans) OK except #'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–GF] 6. Water; MH Test–Regulator–Connector 6. Elect; 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–Enc losures– Pane lboards–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 -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date = OK = Not OK = Not Applicable = Not Ready RESIDENTIAL (Single and Duplex) Date UNDERFLOOR Plans OK except #'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Fig., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Fig., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers ti 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. 55. Glazing Area -Glass Protection -Skylights -Plastic Shear Walls; Nailing -Bolts 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Card -BI Date Card -BI Date Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FINAL (Plans) OK except H's 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date Date Card -BI Date PLUMBING (Permit) OK except N's 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, 65. Elec. Outlets at Wood Panel; Int. & Ext. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Card -BI Date Card -BI Date Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except #'s 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. 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 C] Yes 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 El No 75, Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑Yes 0 N 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77, A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light 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 -I Date Card -BI Date 82. Glass Protection Date MECHANICAL (Pertnit) OK except N's 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric _ 31. 32. 33. 34. A.C. Ducts; Insulation & Support Vent Fan; Exhaust above Insulation Condensate Drain & Overflow; Size & Grade Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 85. Water & Sewer Connected -C/O to Grade -HD Approval 86, Energy Compliance Certificate -Other Certificates 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 Comments at Final: 36. Sills; Proper Material & Anchors 37. _ Walls; Studs -Nailing, 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 Cing. Joist-Rftr._Ties-Purlin-Roof Brac.-Truss-Shthnp.-Rfnp. 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:Anentrymust be made each time youvisit jobsite) J COUNTY OF BUTTE DEPARTMENT OF PUBLIC`'NORKS 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 need additional explanation, 'please contact this office immediately. A -S TAM L) I ! / S CP PAll •els P ��� 7�` 601774 Alol,11AIL P4 0 Inspector C6UNTY OF BUTTE - DEPAR.TMEN-17 OF PUBLIC WORKS 1.7 County Center Drive - Oroville, Californifi 95965 c Telephone 916/534-4541 —APPLICATION AND PERMIT `PE MI NO ,J ten, ASSESSOR PARC9 NUMBSZO INGq • BUILDING PERMIT OWN E EPHONE SQ. FT. OCC. BUILDING VArUATION O 'S ING ADDRESS , D 1573 CONTRACTOR'S AME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ alf op Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit F('e $ c.1 il-11 Do ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 0, 00 Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ , BUILDING ADD ESS S PLUMBING PERMIT FilingFee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO. SUBDIVISION NAMEPARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex❑ Mob ilehomeVa"'Other SPECIFY Building sewer Lawn sprinkler system 5.00 / TYPE OF WORK - 2--' New ❑ Addition t� Remodel ❑Iities ❑ Installation ❑ Other ❑ Describe work: —�Yi S�ey�81 i - 2 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service sODv OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.y\ OR ADONS. ACC, BLDGS. 2d sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check One): El I am licensed under provisions of Chapt. 9, Div. 3 of the Business�@2sa and Professions Code and m license is in full force and effect. %� License No. Classification ET111, 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 CONSTR I.OUTLET 2,50 ea IRC TS NON.RESID BRANCH CIRCUIT ' NEW CONSTR \ POWER APPARATUS 6� NON .RESID. SINGLE OUTLET CIR, Ex. Occup(OUTLETS OR FIXTURES SAL ®1 IXED APPLNS, OR EX. Occup. OUT LETS (RESID,) EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ 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 );i,f Consent to Self -Insure. Ctd ' 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. Heating Cooling Hood 3.00 Ventilation permit Fee S 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 agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, co and a nses which may in an way accrue against County-i�s u/ of a gr nting of this permit '/1�- Date Signature of Applicant - Owner Contractor E]AgentElwork An OSHA permit is required for excav do s over 5'0" p and demolition or construct- ion of structures over 3 stories in heig t. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP I TYPE OF CONST. L/Alv PARCEL D ND 1550E This permit is hereby issued under sions of the Butte County Code and/or indicated above for which DtREC R OF PUBLIC BY PE T XPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date -2-2-7-R/ Z— Z 3 —" :3== Receipt No. `7 WNITE-D.P.W., YELLOW -ASSESSOR. PI K -INSPECTOR •GOtDENROD-APPLICANT V' v s� m X N z n N r D D :` i N? P j P. ° J1 m .4 C. to 00 S 77a D p 0 .0 4 i to xA D ° JE 13� a 'o f i u $3 is N? P j P. ° J1 m .4 C. to 00 S 77a D p 0 .0 4 i to xA D ° T v � 0 m m nm�fid 'o a3 zs 33 R z. aaD £ p p U PJ G Vis^ ^,pn No'o Ij�jl 3; P i% Pa i 1 N^P,� zz fa'cDo �l0`- P a nP v 0 c 4p 51ssr fi a 3 I 1 ow "I X N S. 0.0 3, i .. u $3 is :3 z C � N? P j P. ° J1 m .4 C. w �& x S 77a D p 0 .0 4 i to vL^ ➢ J nP 0- a 0 ;7.J 0 T v � 0 m m or � a [ aaD £ p p U PJ G Vis^ ^,pn No'o Ij�jl 3; P i% i i 1 N^P,� zz z C � GI V A N 0 N O o J1 m .4 C. 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Z Lvr 1 P .r� /` °. 63 OaPS PS a,'1? // J > L•'li Fr jn P°nr/�3 p ^ r •,'¢ � I rrPPv L t rP ss !:1° do° cr 3i:a3^s . :F - •°: LF' Odi<1 rin > '° p„OYLin �>P P- .c ,r.d) i '6' r I ..t ro �” AY ss S rS.iC:rtr t^ i^ .pq'�e o 0 r� >♦ d .1 d P•.� p,,n�F OD • n Jyi^ y9G "oeij19� c .I O iiu Ps?. � '•s L ''[i: P iPo r ° Pa o �?a°^° o1zsl.,+e .e� �'t° P .rp `a ° %r•I�i n ' ro31 .oPt �J (9•a )k - wI UON °ewueia � ^i a s P o .' o s' c m ,y. .y°..y.'s�o�oo a_ r- n om r >J J �J!A s o o c Q c o 'y i 'r i .i ti.. .._ PERMIT NO. 4886-80B PERMIT EXPIRES_ OWNER M e E Walsh owner CONTR. ASSESSOR PARCEL 21 LOCATION 935 Dewsnup Ave., Gridley Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E Temp. Gas Service Called PG&E JOB FIN Signature J = OK O = Not OK - = Not Applicable RESIDENTIAL (Single and Duplex) * = Not Ready Date UNDERFLOOR Plans OK exce t#'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. 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 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10.Water Pipe; Test -Anchors -Regulator -Service Test 11.Electric; Underground 12. 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 Date Card -BI Date Card -BI Date Card -BI Date Date FINAL (Plans) OK except #'s 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date Date Card -BI Date PLUMBING (Permit) OK except #'s 14. Water Ht.; Vent -Access -Combustion Air 57. 58. Smoke Detector 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 Card -BI Card -BI Date Card -BI Date Date Card -BI Date 64. Elec. Outlets at Wood Panel; Int. & Ext. 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except #'s 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. 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 ❑Yes 73. Guard Rails & Deck Construction -Post Caps 25. 2 Appliance Circuits in Kitchen &Conductor Size --. 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 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 At, Insulated Neutral ❑Yes 0 N 75. Followinginstld.: Drive ❑Yes ❑ No; Walks C3 Yes ❑ No; Planters ❑Yes ❑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. Card B -I ---- -- -- __Date _ Card -BI Date 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground 81. Ventilation throughout House Card B -I Date Card -BI Date 82. Glass Protection Date MECHANICAL (Permit) OK except #'s 31_ A.C. Ducts: Insulation & Support - 83. _ Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 85. Water & Sewer Connected -C/O to Grade -HD Approval _ - Card -BI Card -BI 32. 33. 34. 35. - Vent Fan; Exhaust above Insulation Condensate Drain & Overflow; Size & Grade Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet Attic Access & Platform if Furnace in Attic - - -- - - - -�- Date Card -BI Date Date Card -BI Date 86, Energy Compliance Certificate -Other Certificates Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Comments at Final: Date FRAMING(Plans) 36. 37. 38. 39. 40. OK except #'s Sills; Proper Material & Anchors__ Walls: Studs -Nailing, Spacing & Bracing-_Pla_te_s_-Sound Bearing Walls over Girders &_F_loo_r_Nailing_ _ Draft Stop in Walls (rat proof) _ Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. 42. 43. 44. 45. 46. 47. Header & Beam -Size & Bearing Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof erac.-Truss-Shthng.-Rfng. Fireplace Ties or Type A Flue -Fireplace Throat Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles Bdrm Windows or Exiting Doors -Sill Hgt._&_Dimensions Garage Fire Protection Framing _ (NOTE:Anentrymust be made each time youvisit jobsite) = OK = Not OK = Not Applicable MOBILEHOMES = Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except k's Date DEC COVERS, CARPORTS, ETC. (Plans) OK except N's 1. Zoning Requirements—Setbacks—Easements AK Zoning Requirements—Setbacks—Easements 2. Soils; Special MH Support—Sketch Fo ; Size—Depth—Spacing—Connectors 3. Sewer; Location—Test—Fall-C/O—Concrete I VVVM�Pfecks; Girders and/or Joists—Decking—Bracing—Stair 4. Water; Location—Test—Easement Needed (Sketch) 4. W n.; Posts— Beams—Rftrs.—Connec.—Shthg.—Rfg.—Bracing 5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures 6. Gas; Location—Test—Wrap:/ /"L"ft./ P'Nat. or/ /"L"fl./ /"LPG r&.—Carports; Windows—Doors 7. Utility Clearance _ 7. Elec. Card -BI Date Card - BI Date Card-Ba-5—h,Date CyT 2- Card -BI Date Card -BI Date Card -BI Date Card -B Card -BI Date Date MOBILEHOME INSTALLATION (Plans) OK except N's 1. Zoning Requirements—Setbacks—Easements Date POOLS (Plans) OK exce t #,s 1. Setbacks—Easements 2. Footings; Size—Spacing—Marriage Line 3. Gas; MH Test—Demand—Valve—Connector 2. Soils; Compaction—Structure Stability 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/0 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 -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date —• COUNTY OF BUTTE - DEPXRTMENT OF, PUBLIC WORKS ,7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 - - APPLICATION AND PERMIT I4Q,' 'I / l ASSESSOR PAICEZL N MBE rJ ZONIN-?,, uN BUILDING PER l0°%' E�Z�� /, S �I �yILE ��j � ® / SO. FT. OCC. BUILDING VALUATION +�RL �/ /� �! �Lg 6 R1 -2r 06V 0,00 CONTRACTOR'S NAME f ki EZ TELEPHONE CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LE DER UNKNOWN Fireplace Total Valuation $ /76 O LENDER'S MAILING -ADDRESS Permit Fee $ arp ARCHITECT OR ENGEER LICENSE NO. Plan Checking Fee $ •0 Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ �d0 BUIORESS �J /S Up ` (N PLUMBING PERMIT Filing Fee 3.00 Each Trap 2.00 Repair drainage or vent piping 2.00 PID&EY Water piping LOT NO.SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 2.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other �U/��y SPECIFY Building sewer Lawn sprinkler system 2.00 TYPE OF WORK New ❑ Addition ❑ Re odel ❑ Uti lities 4 Installation ❑ Other Describe work:�STA�-/I/�/(lGi _ Permit Fee $ ontractor ELECTRICAL PERMIT Filing Fee 3.00 Main service 1000 AMP ORLESS5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP,& OR ADDNS. ACC, BLTGS. . 20sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ 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) ❑ 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 NON -RESIT R.BRANCH CTLETITS 2.50 ea NEW CONSTR. ( POWER APPARATUS & NON.RESID. SINGLE OUTLET CIR. / Ex. Occup(OUTLETS OR FIXTURES s @ , FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE 1 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 not employ any person in any manner so as to become subject to the W. C. laws of California. Noti.ce 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 FiIingFee 3.00 Heating Cooling Hood 2.00 Ventilation permit Fee $ 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 Countyof 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 said Counly in cc quence the granting of this per 't. Date B Signature of Applicant — Owner7 Contractor ❑ Agent n An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Land Development Fee $ TOTAL PERMIT FEE $ rvv ,�7n OCCUP. GROUP o//�/ vv� I TYPE OF CONST. PARCEL v PD v HD SSUE J This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIREC OF PUBLIC By P IT EXPIRES Date_ the applicable provi- resolutions to do fees have been paid. WORKS Date %26O F-76 Receipt No. WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT 11, � S . . _ J- �.M .. .. , .ol !d � S . ,. •,. f .. i _ i i 1 L � l 1 � , , � ? ... 1, 1 . s I + - --- CA r �. 03 z .. =P- I JN, �l�Jin J' 1;3 j do --4 co Ar— :Iro - - — _._. - - -�-' - - - -- - - - - - ---E9�sf� � ..__�.__ --- __ ____._ �-•_--•----- - � a �4- T1s 3 moi'- - - _._ __ _ - l } Noll;-Kigi 1 f �1%�-�- •� t �1 • . _ { � � =, � .ter r _i i j .' ._ .. ..,. � �• � ._ r�..rr ' ,�' __ .— _.yam- , �...._. .d �_• �._ _ _ 1_ .._ �.. _ _ _ � _ a � - -- - - - . _ � --„ . y ~