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Home My WebLink About024-080-07324-09-73 GEORGE WHITAKER 1387 Larkin Rd, Gridley Contr:-Waibel Inc, Oroville Permit#2641-80P,,Ei,M(inst.-gas- pack/Ac & furnace)SF Tt"M 4 24-o8-73 1185-�W WHITTAKER, George 1387 Larkin --Rd,"-'Gridley Contr:. (reroo Cal e Pac Roofing Inc SF . .............. t � 24-08-73 1185-89B WHITTAKER, George 1387 Larkin Rd, Gridley Contr: Cal-Pac Roofing Inc (reroof/tile)SF 16.--. 7' C,OUNTYIOF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 1' 7 C. �nia 95965 - Telephone: 916/538-7641, o6nty Center Drive, Oroville. Califo APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ,_xi IZONING BUILDINd PERMIT OWNFR� (,4 )Ad, TELEPHONE SQ. FT., OCC. BUILDING VALUATION i�� 4 V n" _7W OWNE R'S MAILING ADDRESS ;,_7 , bul �C�aNTIRACTO'R'S NAME,e J TEL.? aA/ �-C'ONTRACTOR'S MAILING Sv . J::� n In V_ A '0 ;2"17 '01', Firepii�e CONSTRUCTION L91NDER UNKNOWNf Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS — I Permit Fee ARCHITECT OR ENGINEER LICEN SE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ V4 SO PLUMBING PERMIT FilingFee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. 'I SUBDIVISION NAME /PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF [Z DuplexF] Mobilehomef_� Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00 ea. TYPE OF WORK I New El Add i t i on [:1 Remodelo Utilities[:] InstallationE] Other [Z Describe work: 0 0, I I Permit Fee $ Contractor ELECTRICAL PERMIT Fi ling Fee 10.00. — 600V OR LESS main service 100 AMP OR LESS 10.00 Main service EA. ADD -L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): F� I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions C de a d my license is in f force and effect. License No Classification 4WO(5- 11:1 1, 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, as the owner, am exclusively contracting with licensed conhaut- ors. (Sec. 7044) -IF] I am exempt under Sec.—, Business and Profess ions Code for this reason NEW CONST DWELLING OCCUPM OR AODNS. ACC.BLDGS. 21/20sqft NEW C NSTR. MULT'_OUTLET N ..R2S,D. BRANCH CIRC.ITS) 2.50 Be POWER APPARATUS IN) (SINGLE OUTLET CIR. Ex. OCCUP(OUTLETS OR FIXTURES 20050t .5AL@ 30C FIXED APPLNS'. OR I Ex. -Occup. OUTLETS (RESID.) EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15-00 Misc. Wiring 15 00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): The permit is for $100.00 (valuation) or less. r 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 subjwut X�of 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 Fi I ing Fee 10.00 Heating Cooling Hood 3.00 Venti lation p ennit Fee $ Contractor 1 certify that I have read this a0plication and stite'Ahat the above information I s correct. I agree to comply to all, County Ordinances and State Laws relating to building construction, and hereby abthoriz6-rekres�bntatives of the County ot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, inNinnify and keep harmless the County of Butt against all IiabiIities,,�4..udgA-Mfts, o0sts, and expenses which may irl any wrly accrue t it -sai y 'I .. /ah'at s Zdount I ;on ecquen6e of the grAnting o this perp X Date -4 Vz� [1 gnature of Applicant 0 wife- r Lit Contractor El 'Agent t is requi,�6'6<oi, xc.,,. .an, ..r 5'0" deep and demolition or construct- An OSHA permi I ) -- ion of structures over 3 stoii-as in height. Mobile Home Instal lation, Fee $ Energy, Inspection Fee` $ - I " q TOTAL PERMIT FEE $ 1� - occup. I CONST.T;;77SCHOOLI , . FL0061 - -1 PARCEL PV This p6rmit is hereby issued under sions of the Butte County Code and/or work indicated above forrhich fees By PERMI-T EXPI' the applicable provi- resolutions to do have been paid. WORKS Date ?7 -�/ Receipt No. WHITE-C.P.W.. TZL'L0W-_AS8E'390R_, P`iNKiw9PrcT0R. GOLDENROD-APPL I CANT ff�__ N 0 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville;California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERh T NO. 0 ASSESSO )WARI 6?MBER ZONING BUILDING PERMIT OWNE%F TELEPHONE SQ.FT. OCC. BUILDING VALUATION a,971^ A,0 Z ZF4�Z4 OWUgR'S MA(ULING A sps AC 'S NAME T,9L_EP 0 //2 — — "RAC;.R'S MAIL Sv Fireplace CONSTRUCTION LEINDER UNKNOWNIF Total Valuation 1$ LENDIER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. ARCHITECT OR ENGINEER'S MAILING ADDRESS Plan Checking Fee $ Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS Permit fee s 944. SO PLUMBING PERMIT Fi ing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP 1 T Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SFK Duplex[] MobilehomeR Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00 ea. TYPE OF WORK NewF] AdditionEj Remodel[:] UtilitiesO Installation[] Other Describe work: A 0 I Permit Fee $ Contractor ELECTRICAL PERMIT FilingFee 10.00 main service 6001 OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 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 Professio my license is in f" force -end� effect. License No Classification 1, 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, 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.ai) —OR ADDNS.* ACC.BLDGS. 21/2(tsqft N I- W CO NSTR. MULTI -OUTLET .0 N -RIE S'.. BRANCH CIRCUITS) 2.50 ea I POWER APPARATUS &I (SINGLE OUTLET CIR. I Ex. Occup(OUTLETS OR FIXTURES 20050t DAL@ 30C FIXED APPLNS. OR 111 Ex. Occup. OUTLETS (RESID.) EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee WORKMEN'S COMPENSATION INSURANCE I dqcl re under penalty of perjury (check one): The permit is for $100.00 (valuation) or less. J1rI have placed on tile 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 t, to the W. C. provisions of the Labor Code, you must forthwith comply with such p p rovisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Fi I ing Fee 10.00 Heating Cooling Hood 3.00 Venti lation rpermit Fee $ 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 bu i Iding construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. - _mnify and keep harmless the County of But a against I also agree to save, i a I s9 ii a agree to ave, i rn�i( SLL,liabilitie o;ps s, an expenses which ay I a Wny w accrue r9 it� w y Coun on equen e of the nting of this p it. X X Da g ,u r. pplic 9 nature Applicant r Contractor El Agent of VZ:7_ �0 V, An OSHA permit i a c9 t ions over 5'0" deep and demolition or construct- s ryuir� >fo., nxr.,, ion of structures over stories in heigh Mobile Home Installation Fee $ Energy Inspection Fee TOTAL PERMIT FEE s 0 74 oCCUP-1 CONST.TYPEJ ISCHOOLI FLOODIPARCrL[ P11 I NO 1133 This permit is hereby issued under sions of the Butte County Code and/or work indicat above, forl',which UB IR c �Tl�� By 7- 1$ PERMK EXPQEr S Date the applicable provi- resolutions to do fees have been paid. WORKS —Date 44 -Al Receipt No. WHITZ-O.P.W., TELZ'OW�TSSE3301111. PINK -INSPECTOR. GOLDENROD-APPLI CANT COUNTY OF BUTTE - DEPAR.TMENT-OP PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET Permit No. OWNER 0 - Proposed Building Use Building Inspector -Q INI Date �IZ2Q Attimeof permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: 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. Energy Design Compliance and supporting documentation. 6. Statement of Intent for Non -Heated and AC Buildings. 7. Engineered truss details and layout in duplicate (required prior to plan check). 8. Mobilehome installation data including manufacturer's installation instructions. 9. Fees of $ 10. Chico Urban Area fees paid. 11. Park fees paid. 12. School District fees paid. 13. Sanitation approval from Health Department. 14. City of Chico plumbing permit. 15. Plot plan and business license approval from City of (see City for other requirements) 16. Planning approval for (A) Use:—(B) Parking: 17. Improvements may be required. Contact Land Development Section of DPW. 18. Driveway permit (construction approval required prior to occupancy). 19. Pre -Inspection for required. 20. Contractor's license information (No., Name Style, Classification). 21. Certificate of Workmans Compensation Insurance. 22./Owner-Builder Verification (Given to owner 0, Mail to owner 0). X- Recorded copy of Agricultural Acknowledgment Statement. 24. Letter—of sicinature aulbDrization. A 26. When you issue the permit, process as follows: —Mail to owner. —Mail to contractor. Telephone and hold for pickup at —office. —Deliver w/inspector. Other Applicant Date GENERAL INFORMATION BUILDING DEPARTMENT OFFICES HEALTH DEFARTMENT OFFICES Chico . . . . 196 Memorial Way Chico . . . . 196 Memorial Way Phone: 891-2751 Phone: 891-2727 Hours: 8:00 a.m. - 10:00 a.m. Hours: 8:00 a.m. - 9:00 a.m. Orovi I le . . . 7 County Center Drive Phone: 538-7541 Hours: 8:00 a.m. - 5:00 p.m. Oroville . . . 7 County Center Drive Phone: 538-7281 Hours: 8:00 a.m. - 10:00 a.m. Paradise . . . 747 Elliott Road Paradise . . . 747 Elliott Road Phone: 872-6307 Phone: 872-6308 Hours: 8:00 a.m. - 9:00 a.m. Hours: 8:00 a.m. - 9:00 a.m. PLANNING DEPARTMENT — 7 County Center Drive, Oroville — Phone: 538-7601 — Hours: 10:00 a.m. - 3:00 p.m. Original — Applicant t� -4., 01 1411MMU COUNTY OF BUTTE - DEPARTMEW6t_15UBLIC WORKS - BUILDING DIVISION Proposed Building Use 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICAT.10N DATA SHEET Permit No. A P. No. OW — '7 _jg� 411,-;0 Building Inspector -O Date Attimeof permit application, I was advised the following data must be subm itted prior to Oermit 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. Energy Design Compliance and supporting documentation ......... 6. 'Statement of Intent for Non -Heated and AC Buildings .............. 7. Engineered truss details and layout in duplicate (required prior to plan check) 8. Mobilehome installation data including manufacturer's installation instructions....................................................... 9. Fees of $ .......................... 10. Chico Urban Area fees paid ........................................ 11. Park fees paid ..................................................... 12. School District fees paid ................. 13. Sanitation approval from Health Department ... 14. City of Chico plumbing permit ...................................... 15. Plot plan and business license approval from City of (see City for other requirements) 16. Planning approval for (A) Use:—(B) Parking: . ......... 17. Improvements may be required. 18. Driveway permit (construction approval required prior to occupancy) ... 19. Pre -Inspection for required ...... Pre-Inspec. request to Building inspector (Date) 20. Contractor's license information (No., Name Style, Classification) ........ 21. Certificate of Workmans Compensation Insurance .................... 99 B, wner- uilder Verification (Given to owner 0, Mail to owner 0) ........ ., Record d copy of Agricultural Acknowledgment Statement ............ . Lett - f signature authorization ........... .... RR -07M At S A . � -7-) - - n11**---********* When you issue the permit, process as follows: — Mail to owner. —Mail to contractor. Telephone and hold for pickup at —office. —Deliver w/inspector. Other Applicant Date Copy of plans sent — Health Dept., —Fire Dept., — Other— Date The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by —phone ---mal I —counter by— date Contractor, designer, owner, was advised of above required data by —phone —ma I I —counter by— date Plans checked by Sets of plans on hold in Copy—DPW Date Plans approved by File cabinet _AP folder Date a COUNTY OF BUTTE - 0EPA9TMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Orovilte, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ZONIN ? - 7 - BUILDING PERMIT OWNER �'_L �114 TELEPHONE SO. �T. OCC. BUILDING VALUATION 0 W N E Rl�'Sf M A G ADDRES'S CONTRACTOR'S NAME TELEPHONE CO'i�T48TOR'S MAILING ADDRESS CONSTRUCTION LENDER 6&ESS UNKNOWN Fireplace Total Valuation $ LENDER'S MAILING Permit Fee $ ARCHITECT OR ENGINEER _�- "k - LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS PLUMBING PERMIT FilingFee 3.00 Each Trap 2.00 Repair dra�nage or vent piping 2.00 Water piping LOT NO. SUBDIVISION NAME ARCEL MAP 1P Each qas water heater or vent 2.00 Gas piping system I - 5 ouVets USE OF STRUCTURE S17[g-'Duple,FJ MobilehomeF-1 Other SPECIFY Building sewer Lawn sprinkler system 2.00 TYPE OF WORK New r_1 Addition 0 RemodeiEj Uti lities [:1 Installation F_ Other EJ Describe work: ty i< Permit Fee $ contractor ELECTRICAL PERMIT FilingFee 3.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. 20 sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): 0 1 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 ej 0 1, 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) F] 1, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) F] I am exempt under Sec.—, Business and Professions Code for this reason NEW CONST MULTI -OUT LET 2.50 ea NO N.RES'D,� BRA NCH C:, RCIITS) NEW.CONSTR. (POWER APPARA—US.&) NON RESID. SINGLE OUTLET CIR Ex. OCCUP(OUTLETS OR FIX T URES 50 @ 25e BAL@10a OCCUP.(IIIEI'APPLNS. OR Ex. 2.00 OUTLETS (RESiD.) EA.) Temporary service 10.00 Mobile Home Facilities 15. 0 Misc. Wiring 6.25 1 Permit Fee $ J— Contractor MECHANICAL PERMIT FilingFee 3.00 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 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 2.00 Ventilation Permit Fee $ t. 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 ot 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 ate Signature of Applicant Ow , ner Contractor 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 $ TOTAL PERMIT FEE $ OCCUP. GROUP I TYPE OF CONST. IPARCELI PD This permit is hereby issued under the applicable provi- sions of the Butte Qbunty Code and/or resolutions to do work / indicated ab�ve_for which fees have been paid. , �Jf 1341 R 'TOR OF PUBLIC WORKS 4 Date PERMIT EXPIRES Date -5 2- A Z Receipt NO. 3 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDEN ROD-APPL I CANT C- C; (Z-(. C - w NEW ELECTRICAL 1 DRAWING 2..'Existing S e ry i c e <!::!ETJ:S DH, SURFACE 1. Type 2. Size RECOMMENDATION 3. Location (picture)', 'Equipment location '/2- Th�J YZ- 4.:',List of appliances 1. Water heater Watt or amp A TV RA L 2. Range Watt'or amp �4 S -Z 0 3. Oven Watt or amp L( c, --D 0 4. Dryer Watt or amp 4 S-6 0 .5. Garbage disposal Watt or amp N 6. Dishwasher Watt or amp 0 0 Water pipe location 6. Type of roof 1. Kind 21. Type 7. GFI's LOAD CALCULATIONS Square foot X 3 14o2 -o Water heater Watts �4 S --b Dryer Amps X Volts Watts Cooktup (4500) 100 0 Oven (4500) 1000 Range 0�,b6o) - 14 <Z -O n Dishwasher 0000) 4 �-010 Kitchen Circuits (1500 -watts per circuit) 2 required Laundry (Washing ma'cha:—ne) 1000 watts Total Z, C 2 1st 1OKW at 10011, I b oOQ 2nd XKW a o t�/ 40� —::�, S7-0 Og Total 4 2-1;S X 230V or H/P draw S, 4 A COUNTY OF BUTTE - DEPABTMENT OF PUBLIC WORKS 7 County Center Drive - Or6ill.e, California 9'5965 - Telephone 916/534-4541 J , I � APPLICATION -AND PERMIT ASSESSOR PARCEL NUMBER ZONI 'A-L�-- BUILDING PERMIT TELEPHONE SQ.FT. OCC. BUILDIN�,�ALUATION OWNER'S MAALING ADDRESS A k, 1726, 4 d' 6,- dlele c"W/ CONTRACTOR'S NAME L14 -44d A41C !�[_EPHONE J J f CONTRACTOR'S MAILING ADDRESS Z e,- & CONSTRU N LENDER 'ef!!% & 4'�WN Fireplace Total Valuation $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS I-TY7 IA.&&" PLUMBING PERMIT FilingFee 3.00 !�/Zs I'ARY-W P-0.4 R PP. Zoo., S, Each Trap 2.00 Repair drainage or vent piping 2.00 Water piping LOT NO. SUBDIVISION NAME 1 CEL MAP Eac ater or vent h qas water he 2.00 Gas Piping System 1 - 5 outlets USE OF STRUCTURE SFE9`�Duplex[] Mobilehomen Other SPECIFY Building sewer Lawn sprinkler system —W.00 TYPE OF WORK New R Addition Ej RemodelE] UtilitiesD InstallationD Other Describe work: LAI Dq-U, 6 IES Ed 61e-' Permit Fee $ 57. 0 C) Contractor ELECTRICAL PERMIT FilingFee 3.00 Main service 600V OR LESS 100 AMR OR LESS 5.00 Main service EA. AOD'L 100,.AMP 2.50 NEW CONST. ( DWELLING 0 CCUP.&) OR ADONS. ACC.BLDGS. 120sqft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 *of the bus ness I and Profess ri$ Code and my license is in full force and effect. License Nnl�./ 7,74�J Classification /0-26 EJ 1, 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, 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. ( MUL.TI*CUTRLET --h! ON.RES,., BRANC C CU, TS) 12.50 ea, NEW.CONSTF;L (POWER APPARATUS.&) NON RESID. SINGLE OUTLET CIR Ex. Occup(ouTLETS OR FIXTURES 50 0 25�t IBALOICC FIXED APPLNS OR Ex. Occup.(OUTLETS (RESI'D.) EA.) 2.00 9.0 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 1 Permit Fee $ 6. 0 Contractor WORKMEN'S COMPENSATION INSURANCE I dec I are under penalty of perjury (check one): F-] 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. F-] 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 shal I be deemed revoked. MECHANICAL PERMIT Filing Fee �.00 Heating C� 47 11 00 6AS VA Ilk - Cooling .2,L,7, -Al 00 Hood 2.00 Ventilation Permit Fee $ 6 _0 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 a ee t 0 save, indemnify and keep harmless the County of Butte against :I i a7li 1, ju%ments, costs, and expenses which may in any way accrue 91ailn . i in consequence of the granting of this permit. Ir/? — X -/Date -3 97'0 Si n ure ' Applicant Owner Contractor GK Agent El n OSHA6mit is required for excavations over 5'0" deep and demolition or construct- ion of Stru ctu res over 3 stories in height. Mobile Home Installation Fee $ Land Development Fee $ — TOTAL PERMIT FEE $ V.00 occ UP. GROUP I TYPE OF CONST. IPARCELI PD UE hJ pe mit is hereby issued under the applicable provi- Ts - Xn�s the tte gounfity Code and/or resolutions to'do ork i te ab va— or which fees have been paid. TOR OF PUBLIC WORKS PERMIT EXPIRES Date 9 - 2_0 Jr= Re ceipt No. 3 WHITE-D.P.W., YELLOW -ASSESSOR, I PINK -INSPECTOR, GOLDENROD-APPL I CANT I.