HomeMy WebLinkAbout021-190-06021-19-60
Benny Rivera
W/S Dewsnup Ave.,app.800'N.of Evans
I Reimer Rd., Gridley
contr: C. Elvin Fillmore, Yuba City
Permit #AAI,:5L
9-76B,P,E,M(newj in�,h .��
family)
21-19-60 92-686B,E,M
SALDANA, Lolita
871 Dewsnup AVe, Gridley
(addition/sf )S- 2-7 % 2-
U21 -Iota ---- C&O
RESIDENTIAL
21-19-60 92-686B,E,M
SALDANA, Lolita
871 Dewsnup AVe, Gridley
(addition/sf)
r.
JOB FINALE
Signature
4 O
O=Not OK
Not = Not Ready ble MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support Sketch
3. Sewer; Location -Test -Fall -C/O Concrete
4. Water; Location -Test -Easement Needed (Sketch)
5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap: / P11t.
/ /"Nat. or/ /"L"ft./ /"LPG
7. Well Clearance & Disconnect
8. Utility Clearance
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements -Setbacks Easements
2. Footings; Size -Spacing -Marriage Line
3. Gas; MH Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
5. Drain; MH Test -Fall -Flex Connector
6. Water; MH Test -Regulator -Connector 1
7. Water and Sewer Connected -C/O to Grade -HD Approval
8. Gas and Electricity Tagged
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK ekcgpt #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts- Bea ms- Rftrs.-Connectors
Shthg.-Rfg.-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distances-GFI
5. Elec.; Pool Lighting; 15 volts-GFI
6.Elec.;Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
_ Boxes -Enclosures -Panel boards -Ins. to Main in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Date Card 6-1 Date Card B-1
Date Card B-1 Date Card B-1
✓=OK
O=Not OK
= Not Applicable
Not Ready RESIDENTIAL (Sin le & Duplex)
=
Date IJNDE LOOR (Plans) OK except #'s
Date_FRAMING (Continued)
on Setbacks -Easements -Flood -Slope /
Hangers -Post Caps -Anchors -Connectors
tg., Main; Soils-Elec. &P,6.-/ " Ftg. Depth - -- -
__-L_Cing. Joist-Rftr, ties-Purlin-roof Brac-Truss-Shthng.-Rfng.
-e-FE'g., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth place Ties or Type A Flue -Fireplace Throat clearance
_-4_-Ft-g, Porches & Decks; Soils -Steel-/ /Ftg. Depth --F- - - - -
�.6�lcttiC-Access; Size &Romex Protection -Draft Stop -Ins. Baffles
emw IIs, Main; Steel-Blockouts-Wrapped
L-STe-irnwalls, Garage; Steel -Bloc Wrapped
6a. Hold Downs and Special Anchors
7. Slab; Steel -Wrapped
8. Piers -Fireplace Ftg.-Steel
9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test
11. Water Pipe; Test -Anchor -Regulator -Service Test
12. Electric; Underground
13. Pienums & Ducts; Clearance -Material -Support -Ins.
Girders -Sills -Anchor ts-Joists-Vents-Cri ples
�r
15. Access
16. Insulation _
Date Card B-1
Dateq �.`fMar�_�& / Date _Card B-1
Date PLUMBING (Permit).OK except P's
16. Water Htr.: Vent-Access-CombustionSkF Baffle
17. Water Pipe: Test & Anchor -N aii lAPtection
18. D.W.V.: Test -Fittings & Anch•"-Nail Protection
-------------------- ---- -----------------
19. Shower Pan: Test. First F r -Tub Access
20. Test Tub & Shoff. Seeond Floor -Tub Access
------21. Gas Pip ze & Ahors
-----------`------------- ----------------------------------------
Date Card B-1 Date Card B-1
---------------------- -------- Dat ------------ Card ---------------
Date. Card Date Card B-1
Date ELECT. AL (Permit) OK except 4's
22. izture & Transformer Clearance -Ins. Protection
---------------- - - -----------------------------------------
1-K Elec.
- --
Elec. Receptacles Spacing -Lights & Switches at Doors
Boxes & No. of_Conductors-Stapled
Romex Installed Close to Edge of Studs & C.J.
--------- -- --------------------------------------------------------------
26.- Equip. Ground made up w/Mech. Fasiners-Bond & Water
----------------------------------------------------------Gas-----------------
27. 2 Appliance_ Circuits in Kitchen & Conductor Size/GFI
- ---- -------------------------------------------
28. Subfeed Wire Size r r ga. Cu or AI-A.C. Wire Size ! / ga.
Cu or At
-------------- ----------------- ---- ----------------- ----------------------------
29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al.
Insulated Neutral O Yes ❑ No
- --------------------------------------------------
30. Service -Riser Conductors & Ground -Main Disconnect
-------------------- - -------------------------------
-------------------------
31. Equip. Clearances Panels-Motors-Mech. -Equip .
- - lothes Closet Light -Shower Light -Spa Light
-- --- -
---------------------------------------------
C('_,1'33.._ Smoke Detector
----------------------------------------------------------------------------------
Date Card B_1 Date Card B-1
----------- ------------------------------------ --
Date Card B-1 Date Card 11
Date MECHANICAL (Permit) OK except ft's
-------------
34. A.C.--Ducts Insulation & Support
---------------------------------------------------------------
- - - 35 Vent Fan_Exhaust above insulation - ------------ -& Overflow.Size & Grade -
Furnance Vent: Access Comb Air Return Air Vent 115 outlet
--------- ------t---------------- ------
.38. Attic Access & Platform if Furnance in Attic 1
------------------------------------------- -------------------------- -----------
Date Card -B-1 Date Card B_1
Date Card B-1 Date Card B-1
Date PAMING (Plans) OK except ft's
Is. Proper Material & Anchors
Walls Studs -Nailing. Spacing & Bracing -Plates -Sound
41. Bearing Walls over Girders & Floor Nailing
- -- - ---------------------------------------------------------
42. Draft Stop in Walls (rat proof)
-- ----- -----------
--- -------------------------- -----------------------
re Stops: Furred Ceilings -Stairs -Chases -Tub
44. Headers & Beam -Size & Bearing
1�
c
`YfStrrtn. Windows or Exiting Doors -Sill Hgt. & Dimensions
arage Fire Protection Framing
Property Line Firewall & Openings
-----Ext, Doors -One -T -Check Garage -3rd Story, 2 Exits
-- tairs; Width -Headroom -Rise -Run -Landing -Fire Protection
54 plywood on Roof Overhang -Attic Vents -Rafter Outriggers
55. Siding -Nailing Veneer_
-Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
ng Area -Glass Protection -Skylights -Plastic
>•" B.�S Its: Nailing -Bolts
---� �ulation-Walls-Ceilings�N-m
60. Infiltration -Walls -Windows
Date. and -B-- Date - Card B-1
B-1 - ate Card B-1
Date liiWL (Plans) O except N's
-- ------ 6 Ext. Ceps -Door & Sidelight Protection -Landings
Sm elector
Furnace: Vents -Clearance -Comb. Air -Connector -
In Gar e-Abov- -
e Floor-Ducts-Mech. Protection
--------- ----------- -
-� .Bedroom Exiting
------------ -
B'a(h'Fixtures & Tub Access -Spa
---------- - - ---- --- ----------
-��c-Trimo&-Subpanel: Breaker Sizes & Labels
------------------- ----------
rs &Rails
68. Fireplace or Stove: Clearances -Hearth
Fq FiA�--utlets at Wood Panel; Int. & Ext.
- --- --...5- ----------------
&
-------------& Appliance: Grnd.-Air Gap -Cooking Clearance
71. ec. Outlets & Receptacles at Kit. Counter
----- arage Fire Door; Swing -Landing -Closer -
--------------------------
--3-A-e--9uct in Garage -Damper
74. Wtr. Htr Vents -Clearance -Comb. Air-Connector-P.R.V.
-------tn-Garage: Above Floor-Mech. Protection
75. Plb. Elec. & Mech. Equip. Listed for Location
��,w
eptacles in Garage: (G.F.I.)-Rom Protection
-_____ __--_-_---- n -Foam -Looked in Attic Yes
-------------------------------------- -- --
rd'Rails & Deck Construction -Post Caps
79. Fdn Vents & Crawl Hole Door-Drai age Wood -Earth
l�arance Looked under Floor_ Yes -
Following instld. Dr vve_Q--, e`s No; Walks 0 Yes o;
Planters 0 Yes 1 --No
--Stucco Brown -Finish
-
..�-ii -A-C-Un Disconnect. Electrical, Plumbing
ents Above Roof: Plbg -Appliance-Fireplace.-Clearance to
Openings
.. - . - . --------------------
ater Well: Disconnect, Electrical, Plumbing
--r��^`----------------- ----
\ rior Elec. Trim, G.F.I. Receptacle- Underground --_
!i.,-86. Ve tilation Throughout House - - --- - -- - -
+ 87. Glass Protection __
'--itt-Ebrrt?ctions from Previous Inspections -----------
a est -Meters Tagged; Gas -Electric
- ------------------------------------ --PP---------
9 ater & Sewer Connected -C/O to Grade -HDA Approval
----------- -------------------------------------
91. nergy Complia e Certificate -Other Certificates
------ ----- ------ ---- ----
Date /� / B-1 ---- -- ate ----- Card B-1------_
--
Date and B-1 Date Card B-1
---s-_�------------------------ -- --
Dale Card B-1 Date Card B-1
Comments at Final:
-------------------------------------------- -- -
------------------------------------------ --
1�
COUNTY OF BUTTE '
DEPARTMENT OF PUBLIC WORKS
1469 Humboldt Road, Chico, CA - (916) 891-2751
7 County Center Drive, Groville, CA - (916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
OWNER PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please notify this office when correction of work
is completed. If you have any questions pertaining to this matter, or need additional explanation,
0
REV 11/91
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0
REV 11/91
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COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
1469 Humboldt Road, Chico, CA - (916) 891-2751
7 County Center Drive, Oroville, CA - (916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
4f,)A
OWNER PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please notify this office when correction of work
is completed. If youbdye any questions pertaining to this matter, or need additional explanation,
please conV11h' 'oice immediately.
t
all IUA I
L
COUNTY OF BUVTE
bEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico - Phone: 891-2751
7 County Center Drive, Oroville - Phone: 538-7541
747 Elliott Road -Paradise - Phone: 872-6307
CORRECTION NOTICE
--"�V44Z nAAJ,��
OWNE
T NO.
A routine inspection indicates that the following violationsof County Ordinance
exist at the above address and should be corrected. Please notify, t4is office
when correction of work is completed. If you have any question pertaining to 1his
matter, or need ad:di7tnal explanation, please contact this office immediately.
x2n /' . . /'I — - — 0 -. — -
-W,
Owner :L�.4�a.5 p�»� +�► Permit No.
ENERGY CERTIF ICAT ION
DESCRIPTION OF INSULATION
ROOF
Material
Thickness(inches)
EXTERIOR WALL
Materials
Thickness(inches)
CEILING
Batt or Blanket Type_
Thickness(inches)
Loose Fill Type
Minimum Thicknesj(Inch )+ +
Area covered(ft. ) ,
FLOOR, ELEVATED
Material i4
Thickness(inches) *�
FLOOR, SLAB a7�_
Material
Thickness(inches)
W idth(inches)
FOUNDATION WALL
Material
Thickness(inches)
is
A. P. No.
Brand Name
Thermal Resistance (R Value)
Brand Name nv# 0 1 r a t 6T
Thermal Resistance(R Value) JZ
Brand Name Ow eN ('d t 's
Thermal Resistance(R Value) _
Brand Name
Number of Bags Wt. per bag lb.
Thermal Resistance(R Value)
Brand Name �.,..•,�'ty'r. , far -V\ I t,
Thermal Resistance(R Value)—
Brand
alue)
Brand Name
Thermal Resistance(R Value)
Brand Name
Thermal Resistance(R Value)
I hereby certify that -the above insulation was installed in the above building
in conformance with the State of California Energy Requirements.
43
F
SIGNATURE OF INSTALLATION APPLICATOR
STATE CONTRACTOR'S LICENSE NO.
DATE
I hereby certify the above insulation and all required items as shown on the
Building Department approved plans and attachments have been installed as
required by the State of California Energy Requirements.
All equipment, devices and materials are of the quality prescribed or are
specifically approved by the State of California.
e )A
FIRM NAME/OWNER!( ease print) STATE CONTRACTOR'S LICENSE NO.
SIGATURE OF MERAL CONTRACTOR OWNIER DATE
THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL
INSPECTION APPROVAL AND A COPY SHALL BE POSTED WITHIN THE BUILDING.
January 1984
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
— P ERMI T N��
ASSESSOR PARCEL NUMBER
_n6n
ZONING
A-5
_
BUILDING PERMIT ter'
OWNER
TELEPHONE
SQ. FT. OCC. BUILDING VALUAT N
363 R 18,513.00
OWNER'S M LING ADDRESS
i -V9594,9
CONT N
TELEPHONE
OR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $18,513.00
Filing Fee
$ 15.00
LENDER'S MAILING ADDRESS
Permit Fee
$ 165.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ 82.50
Energy Plan Checking Fee
$ 20.00
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$ 282.50
PLUMBING PERMIT
Filing Fee 15.00
871 Dewsnup Ave.. Gridley
Each Trap
1 5.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
7.00
Each qas water heater or vent
7.00
USE OF STRUCTURE
SF ER Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home S I G I W 1 1@
15.00
TYPE OF WORK
New ❑ Addition L1t Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work: Add LivirigROOm _
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 600V OR LESS
200A OR LESS
18,50
Main service 200ATO1000A, 1
37.50
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
sale. (Sec. 7044)
I, as the owner, am exclusively contracting with licensed contract-
Zi,
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
DWELLING OCCUP.81
NEW OR ADDNS. CONST. ( ACC. BLDGS. /I
X 3.66sq.ft. 12.70
NEW CONSTR. MULTI -OUTLET
NON•RESID BRANCH CIRC ITS
@ 5 00
POWER APPARATUS &)
(SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES
75
A20P 46
FIXED APLNS.❑
Ex. Occup. OUTLETS PIRESID,IREA.)
I 3.00
Temporary service
15.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00
Permit Fee
$27.70
Contractor
—
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
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 15.00
Heating
Duct Ext,
1 9.00 9.00
Cooling
Hood
6.50
Ventilation
Permit Fee
$ 24.00
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
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, d expenses which may in any way acc
aga;6nsEid o in consequ a of the granting of this permit.KDate
Signature of App�nt — Owner ❑ Contractor Agent
1e
An OSHA permit is required For exc vations over ' deep nd d mol of Co struct-
on of structures over 3 stories in h ht. Qj
Mobile Home Installation Fee S
Energy Inspection Fee $.
occ
CONST TYPE
TOTAL FEES 74.20
DFEES
IMP
F
COF
PARCEL PD HD
ISSUE
This permit is hereby issued under the
sions of the Butte County Code and/or
work indicated abo a for which fees
DI R f PU LIC
By
PER IT EXPIR S Date
applicable provi-
resolutions to do
have been paid.
WORKS
DateL—Q
�,
Receipt No. 1104401156-7,9A20.
WHITE-O.P.W.. YELLOW -ASSESSOR, INK•IN sPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE-,- DEP,dARTMENTNF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVWL•LE}1FORNIA 95965 - TELEPHONE: 916/538-7541
PERMIT,APPLICATION DATA SHEET
/ m . Permit No.
OWNER
Proposed Building Use
A. P. No. �'-
i (ding Inspector-7LU Date
W
At time of permit application, I was advised the following data most be submitted prior to permit processing and/or issuance:
DATE RECEIVED APPROVED
1. All items have been submitted . ....................................
2. Plot plans in duplicate/triplicate, signed by preparer of plans ....... .
3. Complete plans in duplicate/triplicate, signed by preparer of plans ..
4. Complete engineered plans and calcs, with wet signature on plans ..
5. Hazardous Material Form ..........................................
6. Energy -Design Compliance and supporting documentation .........
7. Statement of Intent for Non -Heated and AC Buildings ..............
8. Engineered truss details and layout in duplicate (required prior to plan check)
9. Mobilehome installation data including manufacturer's installation
instructions.......................................................
10. Fees of $. ........................
11. Chico Urban Area fees paid .......................................
2. Park fees paid
13./l_r.! School District fees paid . 3 /z Z
2A 14. Sanitation approval from Health Department 1 4 2-
15. City of Chico plumbing permit .....................................
16. Plot plan and business license approval from City of
(see City for other requirements)
17. Planning approval for (A) 'Use:—(B) Parking: ......
18. Improvements may be required. Contact Land Development Section DPW
19. Driveway permit (construction approval required prior to occupancy)
20. Pre -Inspection for required Pre-inspec. request to
Building Inspector
21. Contractor's license information (No., Name Style, Classifications ...
22. Certificate of Workmans Compensation Insurance ..................
23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) .....
24. Recorded copy of Agricultural Acknowledgment Statement .........
25. Letter of si nature authorization ......................
27.
(Date)
When you Issue the permit, process as follows: -Mai l to owner. Mail to contractor.
_(Telephone `and -Hold for pickup at office. Deliver w/insp ctor.
Other I r
Applicant
Date
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submitted prior to permit issuance: (Circle new item not checked above).
1. Index permit for above items No. /JL4
2. Additional items required: _2D�,or,. E,3j %j Zg E,tn- _a4 /,e
Contractor, designer, owner, was advised of above required data by—
phone-mall-
Plans checked by
Copy—DPW
TORI Building Department
FROi: Environmental Health
SUBJECT: Sanitation Clearance
_
LA
Owner Location AP#
Plan Approved for:
Hold final for:
Sewaqe Disposal Water Supply
Water Supply
Final clearance O.R. for: Water Supply
lea nce r o e - Other ` k
NOTE
Sanitarian Date
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone: 916.'538-7541
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
a - C10— D&C>
ZONING
BUILDING PERMIT
OWNER/- 'A^„�
L- /
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
S 13
OWNER'S MAILING ADDRESS
N( -) l/ 1: 17A g59 41
CONTRACTOR'S NAME f TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
a
Total Valuation $
Filing Fee
$ 15,00
LENDER'S MAILING ADDRESS
Permit Fee
$ - OO
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
SZ -5a
Energy Plan Checking Fee
A$.
$ aQ- V+'
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS. �t,
et
Permit fee
$ a • SQ
PLUMBING PERMIT
FilingFee 15.00
i�
5 p
Each Trap
5.00
Solar or heat pump water heater
1 20.00
LOT NO.SUBDIVISION
NAME
PARCEL MAP
Water piping
7.00
Each qas water heater or vent
7.00
USE OF STRUCTURE
SO& Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home S I G I W
@ 15.00
TYPE OF WORK
New ❑ Addition Remodel ❑ Un/t�il-�it-�ies ❑ Installation❑ Other ❑
Describe work: 4W �% wyc,— /V OM _
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 600V OR LESS
200A OR LESS
18.50
Main service 200A TO 1000A)
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)
❑ 1 am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST.(DWELLING OCCUP
OR ADONS. .h ACC, SLOGS.
_37.50
3.6d ft.
sq.D
NEW CONSTR. ULTI-OUTLET
NON•RESID• BRANCH -CIRCUITS)
@ 500
POWER APPARATUS &)
(SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES
R20 76d
FIXED APLNS❑
EX. Occup. OUTLETS PRESIO IREA.)
I 3.00
Temporary service
1 15.00
Mobile Home Facilities
15.00
Misc. Wiring
g
15.00
Permit Fee
$ D
—
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 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.
Contractor
MECHANICAL PERMIT
Filing Fee 15.00
Heating
�v
Cooling
g
Hood
6.50
Ventilation
Perm it Fee
$ G '00
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
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 County in consequence of the granting of this permit.
X Date
Signature of Applicant — Owner❑ Contractor Agent ❑
❑
An OSHA
ion of structures toverr 3gstoriesoinehe excavations over S'0” deep and demolition or construct-
Mobile Home Installation Fee S
Energy Inspection Fee $
occ I
CONST TYPE
TOTAL FEES
I HAz
OFEES
IMP
F DOD
COF I PARCEL PO
HD
I ISSUE
This permit is hereby issued t nder
sions of the Butte County Code and/or
work indicated above for which fees
DIRECTOR OF PUBLIC
By
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
have been paid.
WORKS
Date
I
Receipt No. OWL/) '7y
NMIT!•O. P. W.. YELLOW -ASSESSOR, PINI( -INSPECTOR, (.OLDEN ROO-APPLICANT
cg�0 . />e�vs,,���,
Feb. 29, 1992
To whom it may concern,
I, LOLITA A. SALDANA a.k.a. LOLITA A. RIVERA,
give Bob Hayward to obtain a building permit to
build an additional room located at 871 Dewsnup Avenue,
Gridley, CA. 95948.
Sincerely Yours,°
COUWV s
quiLOWS Orr
MAR I �- 02,
"�'��n�:wv-.e4�.n::y�rt'.�i"`"v`w"s�t�M.`".`�;_ w: �`+�:.�!f�`�'�c _�l°I6. �.,,,'��.�'^�!r'�:•5►�s1!�y:,h*�.�'Rr'-i�::�:Ci+;Fi+ryCs.;�s�,^ej?Si�y:
1 � t
BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM
(One Form per Building)
A.P. Number] �Q -/�(o� Building Department No.
School District -6--r e d(e,
istricts r;d(e,City D County Jurisdiction
Property Owner O I/ l el lAhN4' i
Project Location/Address
Subdivision
Residential Development:
Commercial Industrial:
oa
# of Living MHI
Units
New
ing DepartmVn'e Representative
of Number
Sq. Footage 3(a3
Add tion (Group R)
OSq. Footage
Addition (Including Exterior
Roofed Area )
i r 92.--
Date
v
M,
(Floor Plans reviewed by School District Personnel)
District Id No. /S fi /&
zzi _,4� �� School District certifies that
� �%Li It/Cliff A v � �%-
(Ap icant Name) (Phone Number)
(Street Address),
4 / , A 1-1), s
City) // (State) (Zip Co
has complied with the requirements of Resolution No.
by the payment of $ representing 34 3 square feet.
School District Representative Date
PAID BY CHECK NO.
BANK NO
PAID BY CASH
i
white -applicant, yellow -building department, pink -school district
SCHOOL.FEE (8/88)
FORM 7
ADDITIONS TO RESIDENTIAL BUILDINGS ENERGY SHEET
PACKAGE "A" (Additions)
Owner Climate Zone
Permit #EJ��— Floor Area
The following data showing mandatory and required features of Package "A" shall
be installed for additions to dwellings. Additions to dwellings include room
additions, converting garages and patios to living areas, house moves that add
footage and attic conversions, and any space that is existing non -conditioned
space that is converted to conditioned space. Remodeling of existing conditioned
space is not included.
ZONE 11 IZONE(16
APPLIES TO NEW AREA
CEILING R-30
WALL
R-11 R149
FLOOR R-11 R,'-119
SLAB R-7 R -
GLAZING U-.65 (Dual) /U-.165 (Dual)
SHADING
SOUTH - OPTIMUM OVERHANG
or .36 Shading Coefficient
WEST .36 Shading Coefficient
LOOSE FILL INSULATION (Density)
INFILTRATION CONTROL (Weatherstrip.doors, certified windows, caulking)
/4�A��1�1_11* -
DUCTS PER UNIFORM MECHANICAL CODE - Ch. 10
LIGHTING KITCHEN & BATH NOT LESS THAN 25 LUMENS/WATT
MAXIMUM GLAZING 16% OF AREA PLUS REMOVED.GLAZING
NEW HEATING, VENTILATING, AIR CONDITIONING AND HOT WATER SYSTEMS IN
CONJUNCTION WITH AN ADDITION SHALL BE INSTALLED AS SHOWN ON BACK
OF THIS SHEET.
OTHER BUTTE COUNTY
BUILDING DEPARTMENT
O V E Q2/85
*1 HEATING, VENTILATING, AIR CONDITIONING SYSTEM
(A) Heating
❑ Central Gas Furnace
(brand and model number) SE
Btu/hr
(heating capacity)
❑ Heat Pump
(brand and model number) ACOP
Btu/hr
(heating capacity at 47°F)
❑ Active Solar
type (liquid or air) Collector brand and
ft2
model number solar fraction collector area collector
orientation collector tilt rated y -intercept
rated slope
❑ Other
(describe)
*1' (B) Cooling
❑ Electric Air Conditioner
(brand and model number) (seasonal EER)
Btu/hr
(cooling capacity at 95°F)
❑ Electric Heat Pump
EER
Btu/hr
(cooling capacity at 95°F)
❑ Other
(describe)
DOMESTIC WATER SYSTEM
❑ • (A) Gas Only Gallons
(brand and model number) (tank size)
❑ Heat Pump w/Electric Backup
(brand and model number)
Gallons
2 (tank size)
(3* Active Solar
(collector brand and model number)
(rated y -intercept) (rated slope) (solar fraction)
ft
(backup heater type, brand and model number) (collector area)
(collector orientation) (collector tilt)
❑ Location of Solar Panels
❑ Other
(Describe)
*1 Submit documentation of sizing heating and cooling equipment by Manual J, sizing
charts (form #4) or other approved methods, section 2-5352(8), and fill out the
following:
Heating: Winter design temperature elevation heating load BTU
elevation factor x heating load maximum outlet capacity gas furnace
BTU
Cooling: Summer design temperature ', cooling load BTU
*2 Submit T.I.P.S.E. chart or other approved system (form #5) to document sizing of
solar panels.
® DESIGN COMPLIANCE STATEMENT: The above building design meets the requirements of
Title 24, Part 2, Chapter 2-53 of the California Administration Code.
' +, y• SIGNATURE BUILDING DESIGNER OR APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive, Oroville, CA 95965 PHONE: 916-538-7541
• DATE 3-31-92
LOLITA SAIDANA RE: B.P. APP. #92-686
871 DEWSNUP AVE
GRIDLEY CA 95948 A.P. # 21-19-60
With reference to the above subject:
Attached is:
Application for permit Mobilehome Utilities Installation Sheet
Building Plans Mobilehome Installation Information Sheet
Engr. Calcs Typical Plan Sheet
Owner -Builder Verification Form List of Codes Enforced
OTHER
LL We need the following information:
Permit application signed and completed where indicated with all copies returned.
Fees of $ payable to Butte County Treasurer.
Certificate of Workmen's Compensation Insurance or check exemption statement.
Contractor's License Law information or check exemption statement.
Complete plans in , including plot plans.
Plot plans in
Structural details in
Complete plans and calcs in by registered engineer or architect.
Energy design including -
Street and drainage improvement plan approval from Land Development Section (DPW).
sets of plans in accordance with the changes marked in red.
Sanitation approval from Butte County Health Department at:
196 Memorial Way, Chico
7 County Center Dr., Oroville
Skyway & Elliott Rd., Paradise
Planning approval from Butte County Planning Department, 7 County Center Drive,
Oroville, for
Completed Owner -Builder Verification form.
Recorded copy of deed showing
Recorded copy of agricultural acknowledgement statement.
f OTHER SEE ATTACHED
Should you have any questions concerning the above, please contact D41.79 -
of this office.
Yours very truly,
JFG / a j
William Cheff
Director of Public Works
.F. Glander
Chief Building Inspector
f COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive, Oroville, CA 95965 PHO . 16-538-7541
DATE
RE :
A.P. #
With reference to the above subject:
Attached is:
Application for permit Mobilehome Utilities Installation Sheet
Building Plans Mobilehome Installation Information Sheet
Engr. Calcs Typical Plan Sheet
Owner -Builder Verification Form List of Codes Enforced
OTHER
LL We need the following information:
Permit application signed and completed where indicated with all copies returned.
Fees of $ payable to Butte County Treasurer.
Certificate of Workmen's Compensation Insurance or check exemption statement.
Contractor's License Law information or check exemption statement.
Complete plans in , including plot plans.
Plot plans in
Structural details in
Complete plans and calcs in by registered engineer or architect.
Energy design including
Street and drainage improvement plan approval from Land Development Section (DPW).
sets of plans in accordance with the changes marked in red.
Sanitation approval from Butte County Health Department at:
196 Memorial Way,' Chico
7 County Center Dr., Oroville
Skyway & Elliott Rd., Paradise
Planning approval from Butte County Planning Department, 7 County Center Drive,
Oroville, for
Completed Owner -Builder Verification form.
Recorded copy of deed showing
Recorded copy
of agricultural acknowledgement statement.
OTHER S�,
Shoul
of this ottice.
JFG / a j
Yours very truly,
William Cheff
Director of Public Works
F. Glander
Chief Building Inspector
r
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive, Oroville, CA 95965 PHONE: 916-538-7541
DATE 3-16-92
LOLITA SAIDANA RE: B.P. APP: -#92-686
871 DEWSNUP AVE
GRIDLEY CA 95948 A.P. # 21-19-60
With reference to the above subject:
X Attached is:
Application for permit Mobilehome Utilities Installation Sheet
_ X Building Plans Mobilehome Installation Information Sheet
Engr. Calcs Typical Plan Sheet
Owner -Builder Verification Form List of Codes Enforced
OTHER
L1 We need the following information:
Permit application signed and completed where indicated with all copies returned.
Fees of $ payable to Butte County Treasurer.
Certificate of Workmen's Compensation Insurance or check exemption statement.
Contractor's License Law information or check exemption statement.
Complete plans in including plot plans.
Plot plans in
Structural details in
Complete plans and calcs in by registered engineer or architect.
Energy design including
Street and drainage improvement plan approval from Land Development Section (DPW).
sets of plans in accordance with the changes marked in red.
Sanitation approval from Butte County Health Department at:
196 Memorial Way, Chico
7 County Center Dr., Oroville
Skyway & Elliott Rd., Paradise
Planning approval from Butte County Planning Department, 7 Co4nty Center Drive,
Oroville, for
..- Completed Owner -Builder Verification form.
Recorded copy of deed showing
Recorded copy of agricultural acknowledgement statement.
OTHER PLEASE REVIEW ATTACHED PLANS AND REDRAW/RESUBMIT THREE COPIES THAT COMPLY
WITH U.B.C.
Should you have any questions concerning the above, please contact
of this office.
JFG/a j
Yours very truly,
DAVE WASNEY
William Cheff
Director of Public Works
C.Glander
Chief Building Inspector
COUNTY OF BUTTE
7 COUNTY CENTER DRIVE
OROVILLE, CALIFORNIA 95965-3397
DEPARTMENT OF PUBLIC WORKS
' LOLITA SAIDANA
871 DEWSNUP AVE
GRIDLEY CA 95948
.; COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive, Oroville, CA 95965 PHONE: 916-538-7541
DATE 3
With reference to the above subject:
Attached is:
A ication for permit
Building Plans
Engr. Calcs
Owner -Builder Verification Form
OTHER
RE: IeAk. o 44Z --- ��v
A. P. # Z/- /7
Mobilehome Utilities Installation Sheet
Mobilehome Installation Information Sheet
Typical Plan Sheet
List of Codes Enforced
L1 We need the following information:
Permit application signed and completed where indicated with all copies returned.
Fees of $ payable to Butte County Treasurer.
Certificate of Workmen's Compensation Insurance or check exemption statement.
Contractor's License Law information or check exemption statement.
Complete plans in including plot plans.
Plot plans in
Structural details in
Complete plans and calcs in by registered engineer or architect.
Energy design including
Street and drainage improvement plan approval from Land Development Section (DPW).
sets of plans in accordance with the changes marked in red.
Sanitation approval from Butte County Health Department at:
196 Memorial Way,' Chico
7 County Center Dr., Oroville
Skyway & Elliott Rd., Paradise !
Planning approval from Butte County Planning Department, 7 County Center Drive,
Oroville, for
Completed Owner -Builder Verification form.
Recorded copy of deed showing
Recorded copy of agricultural acknowledgement statement.
MA`
Should you have any questions concerning the above, please contact
of this office.
JFG/a j
Yours very truly,
William Chaff
Director of Public Works
.F. Glander
Chief Building Inspector
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive, Oroville, CA 95965
LOLITA SAIDANA
871 DEWSNUP AVE
GRIDLEY CA 95948
With reference to the above subject:
Attached is:
OTHER
PHONE: 916-538-7541
DATE 4.=:8-92
RE: B.P. APP: # 92-686
A.P. # 21-19-60
Application for permit Mobilehome Utilities Installation Sheet
Building Plgns Mobilehome Installation Information Sheet
Engr. CaIcs Typical Plan Sheet
Owner -Builder Verification Form List of Codes Enforced
L.l We need the following information:
Permit application signed and completed where indicated with all copies returned.
Fees of $ payable to Butte County Treasurer.
Certificate of Workmen's Compensation Insurance or check exemption statement.
Contractor's License Law information or check exemption statement.
Complete plans in including plot plans.
Plot plans in -
Structural details in
Complete plans and talcs in by registered engineer or architect.
Energy design including
Street and drainage improvement plan approval from Land Development Section (DPW).
sets of plans in accordance with the changes marked in red.
Sanitation approval from Butte County Health Department at:
196 Memorial Way,' Chico
7 County Center Dr., Oroville
Skyway & Elliott Rd., Paradise
Planning approval from Butte County Planning Department, 7 Co4nty Center Drive,
Oroville, for
Completed Owner -Builder Verification form.
Recorded copy of deed showing
Recorded copy of agricultural acknowledgement statement.
0
TO ME AT 539 -
TO PLAN CHECK.
AST SUBMITTAL.
Should you have any questions concerning the above, please contact
of this office.
JFG/aj
Yours very truly,
DAVE WASNEY
William Cheff
Director of Public Works
F. Glander
Chief Building Inspector
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive, Oroville, CA 95965 P�7qZ_
16-538-7541
• DATE - 7
RE : 4, �A . % Z. e!
A.P. # Z/ /47,j5��
With reference to the above subject:
Attached is:
Application for permit Mobilehome Utilities Installation Sheet
Building Plans Mobilehome Installation Information Sheet
Engr. Calcs Typical Plan Sheet
Owner -Builder Verification Form List of Codes Enforced
OTHER
LL We need the following information:
Permit application signed and completed where indicated with all copies returned.
Fees of $ payable to Butte County Treasurer.
Certificate of Workmen's Compensation Insurance or check exemption statement.
Contractor's License Law information or check exemption statement.
Complete plans in , including plot plans.
Plot plans in
Structural details in
Complete plans and calcs in by registered engineer or architect.
Energy design including
Street and drainage improvement plan approval from Land Development Section (DPW).
sets of plans in accordance with the changes marked in red.
Sanitation approval from Butte County Health Department at:
196 Memorial Way,' Chico
7 County Center Dr., Oroville
Skyway & Elliott Rd., Paradise
Planning approval from Butte County Planning Department, 7 County Center Drive,
Oroville, for
Completed Owner -Builder Verification form.
Recorded copy of deed showing
Recorded copy of agricultural acknowledgement statement.
OTHE L %I
Shou]
of ti
JFG / a j
Yours very truly,
William Chaff
Director of Public Works
.F. Glander
Chief Building Inspector
PERMIT NO.
5739-76B,P;E,M
PERMIT EXPIRES
OWNER Beeny Rivera
CONTR. C. Elvin Fillmore, Yuba City
LOCATION (A.P. 21-19-60
W/S Dewsnup Ave„app.800'n.of Evans Reiner Rd.,
Gridley
l
Temp. Power Pole q/ e 49?1
Called PG&E
Temp. Elec. Serv. / Z `7 7 -7
Called PG&E
Temp. Gas Serv.
Called PG&E
JOB
FINALED
(Date)
(Signature)
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING I BUILDING (Cont'd) I PLUMBING
Setback O
Firewall
Soil Piping
Forms
Parapets
1st Floor
Main Bldg.
Restroom Finish 4n oe
2nd Floor
Footings
Windows 2
3rd Floor
StemwaII
C4 f
Siding
To outaznz
SlabRoof
oe Sheathing vZ
Water Piping
Piers
Roofing L11 Z ji. c
Sewer 1
Garage
Fdn. Vents %2 '
Fixtures %7
Footings 44
Stemwall
4Z4 AF/Garage Vent
C. Insulation F ZZ
Water Htr.
Heaters ----
Slab
Carport
Footings
Prov. for p sically .�_,
handica e
Conformance of a
structure xi6
A liances
Gas Piping & Test. 3 -
Temp. Gases >
Slab
Final
Sanitation
Patio
FIREPLACE
Final
Footings
Footing
ELECTRIQkL
Masonry Walls
Throat
Rough "
Reinf. Steel
Final
Fixtures off'
Bond Beam
-62 geFIR PRINKLERS
Motors
Framing o�'Z
i Test
Water
Stucco
Final
Subpanels
Mesh
MECHANICAL
Grd. Fault Prot.
Scratch
Heating
Service
Brown
Cooling
Temp. Pole
Finish
Ducts `
Underground
Interior Lath o2
% ? 7 Ventilation
Permanent
Door Closer 2,
Final
Final
DATE REMARKS OR CORRECTIONS
Cie
Hou sem to GKe2 60?-
27�i�y2e'.�'r'Lc a0e,�.���/AirV�' pC
NOTE: An entry must be rKade o this form each fime you visit the job site.)
THIS IS TO CERTIFY THAT INSULATION HAS BEEN, INSTALLED IN CONFORMANCE WITH THE CURRENT REGULA-
TIONS, CALIFORNIA ADMINISTRATIVE CODE, TITLE 25, STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT:
Street Lot Number Tract No.
EXTERIOR WALLS
Manufacturer ( Lv Thickness/Type L R Value
CEILINGS
Batts: Manufacturer Thickness R Value
Blown: Manufacturer / ��`( Thickness �� No. Bags Wt./Bag
Sq. Ft.'Covered R Value 1 y
FLOORS
Manufacturer Thickness/Type R Valu--
SLAB
alueSLAB ON GRADE'
Manufacturer Thickness/Type R Value
_ . Width of Insulation—_ --inches
FOUNDATION WALLS
Manufacturer Thickness/Type R Value
GENERAL CONTRACTOR LICENSE No.
BY TITLE — DATE
INSULT N CONTRACTOR: Fj WKINS INSULATION CO. LICENSE No. 215-925
BY ' - ( .TITLE �`G' `��-- DATE
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive-. — 0 oville, California 95965
Tel ephon2: 534-4541
APPLICATION AND PERMIT
BUILDING
Owner NAl V R v e—, -,q
SQ. FT. OCC. BUILDING VALUATION
G f 27 1 a • �
Mailing Address
o a n
Telephone No.
.+Fireplace
_
Contractor IJ/ A/ %' L L AA GI ✓
Total Valuation
Mailing Address' u�
Permit Fee
_
Plan Checking Fee&/or Penalty
U p
La I
Telephone No.
6
Permit Fee
$
,��
Q�
Building Addresss Deic�S,tJt., yvL
PLUMBING
No.
@
FEE
PERMIT FILING FEE $3.00
31An
A PP,-& ��' N 0 f _VA d S 'Pe j K r
Each Trap S 1.50
,
+
Repair drainage or vent piping
1.50
Water piping 1.50
, S
r _
44 9tig VerRicafion Onl
Each gas water heater or vent 1.50
t j
A P. 40 A - oning & PI
Gas piping system 1 - 5 outlets
1.50
Ea additional outlet .30
es S n R FireDept.
FireZon ee,
Building sewer 5.00
EQA
Parkl
Plans
Parcel
Declaration
Parcel Map
60' R/W
I Improvements
Lawn sprinkler system 2.00
Bldg. Plans Recd
I Parcel roval
Plan proval
Permit Fee
$
00
$--7 7J b�
NEW ADDITION ❑ UTILITIES ❑ OTHER ❑
ELECTRICAL
No.
@
FEE
PERMIT FILING FEE $3.00
00
Main service 100 AMP LE S
ORLESS 5.00
Main service EA. ADO'L too AMP
2.50
Main service 1OVEAMP OR LESS 25.00
Single Family 71 Duplex ❑ Mobil Home ❑ Others ❑
Main service EA. ADD•L too AMP 1.00
OR . &�20sgft
YADONS. ( ACCLBLDGSO
NEW CONSTR. MULTI.OUTLET
NON-RESID. ( BRANCH CIRCUITS) '2.50ea
NEW CONSTR. (POWER APPARATUS&
NON-RESID. SINGLE OUTLET CIR.
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of Californi B ness & Pydjessio Code under the name
style r /// (/
Y
Ex. Occup(OUTLETS OR FIXTURES) @L�'t
BA L P 1
FIXED APPLNS. OR
Ex. Occup. (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. �L J Classificationckl -I
Misc. Wiring 6.25_
❑ 1 am exempt from the Contractors License Laws of the State of California.
Permit Fee
3 S
33 —
WORKMEN'S COMPENSATION INSURANCE
I am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL
No•
@
FEE
PERMIT FILING FEE $3.00
;DO
Heating 1®o, 600 (B7--tL
Cooling T 41
,00
Ventilation
Hood I f 1 2.00
Z•ao
Permit Fee $
$ 3 R 2
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
TOTAL PERMIT FEE
$
authorize representatives of the ounty of Butte to enter upon the
above-mentioned property for in p ction purposes. /
X Date o
Signature of Permitee or Agent
Receipt No. / ,5_� F8 3
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF P BLIC WORKS
BY r Date
ding permit expires Date > �_ Z _�7
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