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HomeMy WebLinkAbout025-110-0187 J. COs- 67 IALPH MARONEY 25-1 =18 E./S OF Dos Rios RD! S T .�FE+,tyWj45-5;- �-RMOAST 13IG-G--S-'-H'w--- --J'A I_ S G G PERMIT E I T Y . #6421-75E(SERV CE CHANGE) /F, CONTR: NORTH VALLEY ELECT. N%. .25r11718 NEW OWNER - DAN 'NAVA!&.(), 3072 Dos ermi#3000. A'ioh- Rd; East Biggs 0 *K t 6ABK(addition/SF ISD 215-11-18 Per 3-t#340-8-8'3P(`gas line/3660-83) N I cm i X3/2- 06�Z U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATEOMB No. 1660-0008 Federal Emergency Management Agency Expires March 31, 2012 National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A - PROPERTY INFORMATION For Insurance Company Use: Al. Building Owner's Name Dan and Mary Navarro Policy Number. A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company.NAIC Number P.O. Box 64 (Dos Rios Road) City Biggs State CA ZIP Code 95917 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) APN 025-110-018-000 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Non -Residential A5. Latitude/Longitude: Lat. 39°25'04" Long. -121°39'27" Horizontal Datum: ❑ NAD 1927 ❑ NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 1 A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) N/A sq ft a) Square footage of attached garage N/A sq ft b) No. of permanent flood openings in the crawlspace or b) No. of permanent flood openings in the attached garage enclosure(s) within 1.0 foot above adjacent grade N/A within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? ❑ Yes ® No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State Butte County 060017 Butte CA B4. Map/Panel Number B5. Suffix 66. FIRM Index B7. FIRM Panel B8. Flood 69. Base Flood Elevation(s) (Zone 06007CO975 E Date Effective/Revised Date Zone(s) AO, use base flood depth) 1-6-11 1-6-11 A 107.9 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile ® FIRM ❑ Community Determined ® Other (Describe) See attached plat 811. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 ® NAVD 1988 ❑ Other (Describe) B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No Designation Date ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations -Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a-h below according to the building diagram specified in Item A7. Use the same datum as the BFE. �/ Benchmark Utilized AH9375Vertical Datum NAVD 88 BUTTE COUN 1 1 Conversion/Comments N/A ('II (n'�1n' Q DIVISION Check the me��Pra�e+�4�1�. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 116.87 ® feet ❑ meters J13OVED b) Top of the next higher floor N/A. ❑feet ❑meters u o R o pp c) Bottom of the lowest horizontal structural member (V Zones only) N/A. ❑ feet ❑ meters (Puerto Rico only) d) Attached garage (top of slab) N/A. ❑ feet ❑ meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building N/A. ❑ feet ❑ meters (Puerto Rico only) (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 115.8 ® feet ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade next to building (HAG) 116.2 ® feet ❑ meters (Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/A. ❑ feet ❑ meters (Puerto Rico only) structural support SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the information on this Certificate represents my best efforts to interpret the data available.1 QQpFESS/p understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.0 c� Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a licensed land surveyor? ® Yes ❑ No °~ �'LACE AL SE� Certifier's Name Michael S. Byrd License Number 28998 i = E 0 Title Principal Engineer Company Name Rolls, Anderson & Rolls Address 115 Yellow rive City Chico State CA ZIP Code 95973 Signat Date 07-10-12 Telephone (530) 895-1422 FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use: Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number PO Box 64 (Dos Rios Road) City BiggsState CA ZIP Code 95917 Y Company NAIC Number SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments As shown on the attached plat, the existing levee located at 4444 feet west of the shop building is the boundary between Zone A and Zone X on the referenceq,�.Iqd Insurance Rate Map. Jae field determined top of levee elevation of 107.9 was used as the base,flood elevation. ru l Date 07-10-12 ,l/ ®Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1 -E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. For Items E1 -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG.- E4. AG:E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA -issued or community -issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8 and G9. - G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued BFE) or Zone AO. G3. ❑ The following information (Items G4 -G9) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters (PR) Datum G10. Community's design flood elevation ❑ feet ❑ meters (PR) Datum Local Official's Name Title Community Name Telephone Signature Date Comments ❑ Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions --------------------- ZONE X - — — — — — — — — — — — — — — — — — — — — — — — � — — — — — — — — — — — — — - 688.8' _I W a G) 840't N m D DOS U) 2 _. D 4 41 P, I+ ' RIOS ROAD Z1-1 <OCD M O m co 0 I m OD Q i = x M O y m� f'n I � .. (nZ <Z i m0 C7rn i II m n rn I MOx DAN I N I =1:U= I OD I i Omz rl 0 / N rn m/ ao 40 t N m / M....................)t x m � m <Z (nC 'W <Z DO N2 :O DO O o p� -VA µ OA m N o X....................X / o OD w zm= CDW Gc)D DM Oul)�N w r-0 m ry FF m I <DOr II = 'D OJD oN� m Ln _0-V ZOO 2 rZ � 020 ;o X N O O O z Z n �NF 1 NO SCALE N O tD O 115'9 SUTTER BUTTE CANAL 75.9' --mM ------ --m m— -- r -m ---- m --- mm------- � �- N ZONE A �m=1 N z o z o z z <o - <o <o <o u v u u v u 0 0 0 J 0 J o J O (D 4 W a G) 840't N m D DOS U) 2 _. D 4 41 P, I+ ' RIOS ROAD Z1-1 <OCD M O m co 0 I m OD Q i = x M O y m� f'n I � .. (nZ <Z i m0 C7rn i II m n rn I MOx DAN I N I =1:U= I OD I i Omz rl 0 / N rn m/ ao 40 t N m / M....................)t x m � m <Z (nC 'W <Z DO N2 :O DO O o p� -VA µ OA m N o X....................X / o OD w zm= CDW Gc)D DM Oul)�N w r-0 m ry FF m I <DOr II = 'D OJD oN� m Ln _0-V ZOO 2 rZ � 020 ;o X N O O O z Z n �NF 1 NO SCALE N O tD O 1 3000-83B,E PER NO. �1 PERMIT EXPIRES ��� 8,-T DAN NAVARRO ' OWNER CONTR. owner' 25-11-18 ASSESSOR PARCEL r LOCATION 3072 Dos Rios Rd, East Biggs _ PE t i �c .h 1 1 Temp. Power Pole 1 t Called PG&E s. Temp. Elec. Service t Called PG&E _ 1 Temp. Gas Service ' r i Called PG&E JOB FINALED (Date) 3 4 Signature t i J OK 0 = Not OK - = Not Applicable * = Not Ready MOBILEHOMES MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except k's 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 2. Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/0 -Concrete _ 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rfirs.-Connec.-Shthg.-Rfg.-Bracing_ 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete _ 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 7. Utility Clearance ------ 6. Carports; Windows -Doors' 7. Elec. 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 MOBILEHOME INSTALLATION (Plans) OK except it's 1, Zoning Requirements -Setbacks -Easements 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 4. Electricity; MH Test -Crossovers -Breakers -Clearances 3. Pool Structure: Steel -Connections -Thickness -Dead Men -Lining 4. Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/O to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged. 9. Exits; Insp.-Sketch -Pool Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghig. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 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-1 Date Card -BI Date Card -BI Date Card -BI Date 0 V = OK JP 4b-. 0 = Not OK - = Not Applicable * = Not Ready U RESIDENTIAL (Single and Duplex) Date UNDE LOOK P s OK except#'s Date FRAMING Continued oning requirements -Se cks-Easements 48. Property Lie Firewall & Openings g., Main; Soils-S-Elec.�Grnd.- f.81" Ftg. Depth Q9 Boors -one 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils-Steei- / /" Ftg. Depth 50. _ - room -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 5 ywood on Roof Overhang -Attic Vents -Rafter Outriggers temwalls, Main; Steel-Blockouts-Wrapped-Slab 52-_S:i ing-Nailing-Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53._.S1ueeo Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ft .-Steelazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 5 :.heaYWatfs T -failing -Bolts s Pipe; Size -Anchors fjSG�(_�QTf' 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground i & Ducts; Clearance -Material -Support -Ins. _ 16o -Sills -Anchor Bolts -Joists -Vents -Cripples M52 BgteL Card -BI Date d- - _-Date - Card -BI Date Card -BI Date Card -BI Date I Date Card -BI Date Date FINAL (PlK) OK except q's d -BI Date O Card -BI Date Date PLUMBING (Permit) OK exce s 51 Ext.,Steps-Door & Sidelight Protection -Landings yoke Detector - 14. Water Ht.: Vent -Act s -Combust ion Air 58.�Furnace; Vents -Clearance -Comb. Air -Connector - 1n�arage; Above Floor-Ducts-Mech. Protection 15. Water Pipe; Tes Anchors -Nail Protection 16. D.W.V.; TesjoeFttngs & Anchors -Nail Protection % edroom Exiting 17. Shower n; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access _ 18. Te5Vfub & Shower, 2nd Floor -Tub Access 6 c. Trim & Subpanel; Breaker Sizes -Labels 19. as Pipe; Size & Anchors 62. Stairs & Rails _ 63. Fireplace or Stove; Clearances -Hearth r�44 lec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65.1 Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. JElec. Outlets & Receptacles at Kit. Counter Date ELEC L Permit OK except q's 67. Garage Fire Door; Swing -Landing -Closer 68. IA.C. Duct in Garage -Damper _- Fi&Uue-&r Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection lec. Baaeptacles Spacing -Lights & Switches at Doors 7ar.plb., Elec. & Mech. Equip. Listed for Location _ 2 ze No. of Conductors -Stapled 71.1 Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 2 ex Installed Close to Edge of Studs & C.J. quip. Ground made up w/Mech. Fasteners -Bond Gas &Water 72.1 Insulation -Foam -Looked in Attic 73.1 Guard Rails & Deck Construction -Post Caps its in Kitchen & Conductor Size - 26. 6_, tri ireSize / 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 R�Y-es 27. Range Cir / g^. Cu or AI -Oven Circ. / / ga. Cu or Al, la ted Neutral L Yes ❑No 75. Following ins_- .: Drive �E� ❑ No; Walks r Yes ❑ No; Planters Yes ❑No --- 2&--e.w 4ee--Rtser-Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29..Fga+p�iFear es: Panels-Motors-Mech. Equip. 77, A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet _ 30. • - -Shower Light _ 7 nts Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. --------------------------------- Card -BI Date -- -- Card B-1 Date Card -BI Date 79.1 Water Well; Disconnect, Electrical, Plumbing &Q. -Exterior Elec. Trim; G.F.I. Receptacle -Underground entilation throughout House B -Gass Protection Date MECHANICAL (Permit) OK exce 's _ Corrections from Previous Inspections da•� st-Meters Tagged; Gas -Electric 31_ A_C. Duc[s: Insulation upport /� f 85. gg Water & Sewer Connected -C/O to Grade -HD Approval Energy Compliance Certificate -Other Certificates _ 32. Venl-Fan_Exh above Insulation _ _ 33. Condens rain_& Overilow; Size & Grade 34. F _ ce-Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. flit Access & Platform if Furnace in Attic -- --- --- - -- -- --------- Card -BI - Date _ Card -BI Date Card -BI Date Card -BI Date Card -BI Date e- rd -BI Date Card -BI Date and -BI Date Card -BI Date Card -BI Date Date FRAMI lans) OK except N's Comments at Final: - _ _ ills; Pr_ _Material & Anchors 37 s; St s -Nailing, Spacing & Bracing -Plates -Sound 3 r g Walls over Girders & Floor Nailing-_ - ---------------- - raft Stop in Walls (rat proof) - urred Ceilings-Stairhases-Tub -_40 s -C - eader & Beam -Size & Bearing angers -Post Caps -Anchors -Connectors - - - ng. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. 44r-fep+ese-Lips or Type A Flue -Fireplace Throat cc-eS Size & Rom ex Prote Draft Stop -Ins. Baffles _ Bdrm._Windows or Exiting Doors _' L H - Dimensions -` arage ire iotection Framing - - (NOTE: An entry must be made each time you visit job site) 1, n COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS, 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: `344541 Skyway and Elliott Road, Paradise -- Phone: 87'-2961, Ext. 57 CORRECTION NOTICE A routine inspection indicates that the following violatiois 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. II au,c4,>\ .Set -C' Inspector_ r%t2`�i"! c 'r-r�-t fi'�► Date b COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville - Phcne: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE 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. /'f 151i7 -? Inspector Date Date THIS IS. TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE' BEEN INSTALLED IN COQ RMANCE WITH. CURRENT ENERGY CONSERVATION REGULATIONS AT 4 (location) BUILDING PERMIT NOA.P. N0. THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS: (Check each item or write N/A. if not applicable). INSULATION: .Slab Edge. Fdn. Walls Floors ✓ Walls Ceiling/Roof Ducts Circulating.Pipes APPROVED HEATER 77n APPROVED WTR:HTR.* GLAZING: Single Glazed �. Special (Insulated) y/�9 CERT. & LABELED WDS. & SLIDING DRS. . WEATHERSTRIPPED DRS._ BACK DAMPERED FANS INTERMITTENT IGNITION DEVICES t9 CERT. APPLIANCES I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED IN ACCORDANCE WITH THE ENERGY -.CONSERVATION REQUIREMENTS' AND AGREE TO THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED.. Insulation Applicator Name 9w As9,VPv Signature of (' lease print) Insulation Applicator Q� State Contractors License No. General Contractor/Owner Name /)oqn- ^� (please print) Signature of & General Contractor/Owner - - Date State Contractors License No. THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING" DEPARTMENT PRIOR TO REQUESTING FINAL INSPECTION AND SHALL. BE POSTED IN A CONSPICUOUS LOCATION WITHIN THE DWELLING. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION "ANDPERMIT L ASSESSOR PARCEL NUMBER ,-11K_X-1 ZON G BUILDING PERMIT OWN 1 TE EPHO E r S0. FT. OCC- BUILDING VAL TION DO 0 O ,` R' MAI G ADD ESS IF, 0a L .— S CONTRACTOR'S NAM TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNO Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $,(� ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ S^ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS e PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 -y S Water piping 5.00 LOT NO. SUBDIVISION NAME PARC AP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Building sewer 5.00 Mobile Home FsFG] W 10.00 e TYPE OF WORK New ❑ Addition p -*,R m del Util'ties ❑ Installation❑ Other ❑ Describe work: 1` Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10:00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2:50 NEW CONS. ( DWELINGOR ADDNST ACCLBLDGO U 21�20sgft .Sr 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 NNEW ON•RESID R. BRANCH CIRCTITS 2.50 ea NEW CONSTR. /POWER APPARATUS &'1 NON-RESID. (SINGLE OUTLET CIR. 20®50C Ex. Occup(O TS OR FIXTURES BAL®30 FIXED FIXED APPLNS, OR Ex. Occup. OUTLETS (RESID•) EAJ 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): vQ 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. IM 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 10.00 Heating S Cooling Hood 3.00 Ventilation permit 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 building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree save, indemnify and keep harmless the County of Butte against all liabili eS, judgments, costs, and expenses which may in any way accrue against Mgidbiunty in c equence of the granting of this permit. X 0-44fo Date Signature of Applicant — Owner ® Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in heigh . Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP TYPE OF CONST. PARCEL PD ND ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which D TOFi O PUBLIC /^ 0 By. `� a PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Dat "A Receipt No. WNITE-D.P.W., Y O PIN INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - 7 County Center Drive - Oroville, California�95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMITNO. ASSESSOR PARCEL NUMB ZO ING '--// f BUILDING PERMIT OWNER ELAEE��PHON D V` SQ. FT. OCC. BUILDING VALUATION OW E MAILING A DRES �% ° I& CO'NTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 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 ® � • DS QS PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO.SUBDI VISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 60 USE OF STRUCTURE SF Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home S G W 10.00 e TYPE OF WORK New ❑ Addition Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe work:AI aqQ, IJA)F_ �4_ Wq _'WW -9t,- Permit Fee $ 1,5006 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service eODV OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.&` OR ADONS. ( ACC. BLDGS. / 2h¢sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): F-1NON.RESID, 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 NEW CONSTR ULTI.OUTLET 2,50 ea NON.RESID BRANCH CIRCUITS) NEW CONSTR.. J POWER APPARATUS &'\ %SINGLE OUTLET CIR. / zo-030 Ex. Occup(o OR FIXTURES 9AL®ao FIXED A FIXED APP LNS, OR EX. Occup. OUTLETS (RESID.) EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall 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 $ 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 Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agr save, indemnify and keep harmless the County of Butte against all liabi ies, udgments, costs, and expenses which may in any way accrue against/saio C my in con uence of the granting of this permit. %� �� �Lt�'I Date /0,' `l 'W3 Signature of Applicant — Ownert, Contractor ❑ Agent ❑ AnOSHA 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 $ TOTAL PERMIT FEE r— OCCUP. GROUP I TYPE OF CONST. PARCEL PD HD IesuE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which CTO OF PUBLIC BY PERMIT EXPIRES D to the applicable provi- resolutions to do fees have been paid. WORKS Date - !_ Receipt No. 0���/ WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT i INSTALLED ENERGY SHEET FOR ADDITIONS TO RESIDENTIAL BUILDINGS PERMIT NO. -��_ PACKAGE ItA" (Additions) NAME JOB ADDRESS 6 TYPE OF WORK __Fe,_��i��.— FORM 7 SQUARE FOOTAGE Existing Residence, New Addition a New Total o9tld d The following information sheet,,showing mandatory features and required features of Package "A" must be completed and attached to all plans for additions. to dwellings. Additions, to dwellings include room aidditions,.converting garages and patios to living -areas, house moves that add footage and attic conversions, and any space that is ex- isting non -conditioned space that is converted to conditioned space. Remodeling of existing conditioned space is not included. ZONE 11 ZONE 12 ZONE 16 APPLIES TO NEW AREA CEILING R-30 R-30 R-38 WALL R-11 R-11 R-19 FLOOR R-11 R-11 R-19 ..SLAB R- 7 R-11 R- 7 GLAZING ,65 .65 ,65 SHADING SOUTH -OPTIMUM OVERHANG or .36 S.C. WEST - .36 S.C. LOOSE FILL INSULATION (Density) INFILTRATION CONTROL (Weatherstrip doors, certified windows, caulking) &&- VAPOR BARRIER (Zone 16) DUCTS PER UMC - Ch. 10 Y_A LIGHTING KITCHEN & BATH NOT LESS THAN 25 LUMENS/WATT MAXIMUM GLAZING 16% OF AREA PLUS REMOVED GLAZING _A/A NEW HVAC AND HOT WATER IN CONJUNCTION WITH AN ADDITION SHALL COMPLY AND FILL OUT DATA ON BACK OF THIS SHEET 7/83 -' *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 ❑ 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 (tank size) ❑ *2 Active Solar (collector brand and model number) (rated y -intercept) (rated slope) (solar fraction) ft 2 (backup heater type, brand and model number) (collector area) (collector orientation) Location of Solar Panel other (collector tilt) (Describe) *1 Submit documentation of sizing heating and cooling equipment by Manual J, sizing charts (form X64) or other approved methods, section 2-5352(g), 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 i- *2 Submit T.I.P.S.E. chart or other approved system (form 4)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 Califo i Administration Code. SIGNATUBUILDING DESIGNER�LICANT 'Z_j T_.. �t__t�I— ! .. �--I r � � � _ (� ! z I __� s , '-�- ,.� ► }- � i � _ ..E .__,��,.� ....�_ �.. I!�._ - - �-- - I ,— }--r '�--� �-' -�"_r i I r- *rV �. "` I !! -'� i I 1 r • ., I' t - flVA+ .� � .r9' � _ �-� � �T %� Gt I I t _ --r I _ T , ,, t - �- ;j ! ► .; � h- .� _ tZ. r -- --j-- _ i— i I r ! F r t 1 ttt r. ( ( _!- ( -J� �» i -�• j`` , �tsc,k, _ �^{ _ I ' — -- r �-- — JJ -T - I -+-(- i -! = •T4_� iQ ' I t C 1 ` ii -4 1 i I �' 1 /M f t �- � I -' •- T-1- - 1-7 -f , I ' ' f ' - f !- -� e SS ; . , { N . F , f sutbLjck Of S ft. from he ` OupeCty Imes and-a set )ack' I Of Wt, from the road eCtnturlinq� shall be clear f ` stFuctums or e } r gvipment • xcQgt ! O� fora 2 ft. ea" overhan , ' '_ Se�T G t 2 S =--1 This set oflans and specificat ons MUST b3 kept on the jo at all times and i- is unlawful to NOYE: :-til ���«�e,ja,y ! : 'h; make an chap es or alterations n same wifhoui a Yi7 :j y � ACCfr.. �.�yr� Nfe;'i'1 ^ry,...7�,., �; �,_,-„„'! H� •-s �.. written ermiss on from the De altment of Public te; and P P of a � - !'' - . Works, ' Counr of Butte. t �nifnrm Bu'' r • ~ r ` F t ' r ._��:.^� t" " the Nati OhCI �Y,.cri lcal L:t; _ i ! �N e t 10 '11 Jam_ t ILN 41t: Nil, . r - - - r - - '--- = - - - - -- • - - - - -• -'__y______-_•-_-I-! __.i--- -�-'•- � � � ' tet. jay �Aftt- 41Amin ZI _ '. _ X11 � F - • -. - �' ' -f "-�` �_..�....�- � i`1 Nk <,7 - - - C, - .� ---• . _ _ :.��.�„:� of .�--,�:.;{�.� _�. IZZ Ft-tHi t--� -T- �--� _tom.___•--•� _ l._e_i.>,�.t T. } �. -.i I .,. ..q' ..i .{. t *-'- .>i. ,.' i, - f, r.. _� i. �y I..•,1._ i I9: ' { : d_ _ jI ..t.... — i ._ t.-,.:t.: i i..:.{- .'•.�—.;+%' ,I�,,,,}.,— .+c --� kr". •a^+�.' 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'}._.• �..� - .r� -1 —j �': I I � i I, i t i � j j i• j I ,� i r 1 -I Y - --�- �--!-'�'--'-F - --}' - f - - --i.•-- �._-�' -- i'_ r- �- _-�. �, i I _, t_.. j �. � -j --�_ � �. I- t J i j¢=}- , i' .r - f X2' 7 f, rm oim ` home. �' IM�1 tarn QW&W -mo-m AM Low lmmw� I ow-wasmage— -,.W; ,,,_,gyp t t . ' _ i e �C... . ' . 1, L 14- 4. 4- wl AL T C' C4 L J J �. _ ; f ` � .;.. r _ ._. _ �_ �_ _. l � _ � � � � t'M � �'/l�1 S a M-�.- t r � ; i a. _ T +- -� �- t- � I , 4 low=. tt^'7_ � — � .-�-•- --{----!- � 1 _ � _�___+--'' _�._ �'• •'�,�,. -- .�6. (f i TL E O -4 t 11 - - 7-j -r -1 4 1 i i ' _ _�• 1 � - ' ,--f.._..�.. _..�... _ T_. -__ r .�'...a. ' —t t ' t _d V.re-. .�.. .r _..� 1._.�-',y..-��.+_.A._ _.1 �1_t....� t- -a. Vii._ .r I _.y,. _... -��� �.� i . 1 .I ~ � �- j 1 ' -4. r � ��� � • -1 _.� -1 y '� ( I _�. _��.Y �. ( .-+• ��-� I .: ,� t��nr. �� ..� �._ � `_�.- �� ' _ -� !--/t(LT--,�� �"� _�--� - _i-- - _ � e � f r � L�-• � '' -.:—:--t=�-- � � f : - "'"vr-•�I '-? ��--y - — 1 l_. _L� _ 1 ,.� _}.r, � 'el � I: 1 • i i ' � I' � {���Q � __ � - � t. 1 � r � ""<�:• `- � 5 ,:., 1 _ � � i � .�. ' � � : 1.. - I —� � �i� 1 Y (i ti;, _ — -- — ot i+-- 1 PAi (• i-- h r' •+—f �_ _'�.. ."j --i---.1-.. --r y .� - ....1 t' _ —�. _ _ ._�-. .T Y.fM� 4_Y Tj 10I t I • t , � rS7vdS . , I - � Fd 6,0 j � i , 7e -- i w"/eolzxy - /J i/L / !, ✓Ll uoi/ sli - i 4eveZ T ib 1257Z,o40,4T. X 'N3YGdV d3G NIGlintf ��/O 4t�C/ior 60/5 9 mom, ✓O�if �S , Boor Sy Sfel, Pressvz� Tred'fed Mia G'�MiN ,✓afdro /� !i�►e�;ILI'-6 oa/ %01001 S5 -y /e~ V L ,,- , ,.P �8 nn, H est M Re dcdmo el or ,�essv�r Ti•eol�eo� block ("Mip Areo011 %tier s� Into we/ .1w -t4 "Ms H k_!4 /-f -- fr�o�'.a9 DA7Z- o OC/79' rr.r.'�ti4^'4'+�.nar,.�Y:7?Fi,i$'i�'ii;�Fa�,FBF:d"'"►ti-l+•;�.-.�-,�►+.Y.��a:1 .....,.-.� ,�,�*...�*.�y,..�.�ri;•.r-'t.. iR �i �` �Y ii �, i .. ��. a 1 f _ �"` �.�a . - . .:l✓tom `. I �- COUMTY OF BUTTE DEPARTMENT OF PUBLIC WORKS • „ 7 County Center Drive — Uroville, California 95965 Telephone: 531-4541 APPLICATION AND PERMIT w i.. V....+a.n wuvc..� , .nc VVul. Y UI ouiic W QIIICI UPUII IIIc above-mentioned property for inspection purposes. DX--' �. / Date Signature of Permiteeeor Agent 1' t^ Receipt No. l J Q I i 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 PUBLIC WORKS � J _ By . r / ` �- - x Date Building -permit expires Date BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mai I i ng Address Telephone No. Fireplace Contractor Total Valuation Mailing Address, Permit Fee Plan Checking Fee &/orPenalty Telephone No. _ Permit Fee $ Building Address _. PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 I Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. ) _ 1 Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fees me Sanitatico Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA ParkinDeclaration Plans IBIdg.—PlansRecL Parcel Map 60' R/W Improvements Lawn sprinkler system 2.00 Parcel Approval Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER 0 ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.000V OR L Main service 100 AMP ORSLESS 5.00 " ( r y Main service EA. ADD'L 100 AMP 2,50 Single Family ❑ Duplex ❑ Mobil Home ❑ Others ❑ Main service 1100EAMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW OR ADDNS. ( DACCLBLDGS.LING CCUP, &) 2¢Sgft 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 California Business & Professions Code under the name style of: ! �` ► l�,-; I:' ' 'I Ex. Occup(OUTLETS OR FIXTURES) *L0 BAL@1 Ex. Occu p•(FIXED APPI OR OUTLETS (RESID,) EA) 2.00 Temporary service 10.00 - Mobile Home Facilities 15.00 License No. + ^.Misc. Classification i�. ' Wiring 4 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. 1 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 Cal i forn i a. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT FEE $ /�/ w i.. V....+a.n wuvc..� , .nc VVul. Y UI ouiic W QIIICI UPUII IIIc above-mentioned property for inspection purposes. DX--' �. / Date Signature of Permiteeeor Agent 1' t^ Receipt No. l J Q I i 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 PUBLIC WORKS � J _ By . r / ` �- - x Date Building -permit expires Date 0 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — UroviUe, C 4ornia 95965 Telephone: 534-4541 APPLICATION AND PERMIT I+, cii.oaivuo 0� t e %.Gun.y VI putte w enier upon me above-mentioned property for inspection purposes. Date 12' &-L— Signature of Permitee or Agent Receipt No. 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. X, DIRENT6� OF PUBLIC WORKS ............ BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address -- Telephone No. Fireplace Contractor /� Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. �_� Permit Fee Building Address PLUMBING No. @ FEE PERMIT FILING FEE $3.00 40 Each Trap 1.50 _ Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No./� _ r Zoning 8 Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 , Wrc/ atierr Senit Fire Dept. FireZone Use Permit Building sewer 5.00 EQA Parkin Pa Declaration I Parcel Map 60' R/W I Improvements Lawn sprinkler system 2.00 Parcel Approval Plans Approval Permit Fee $ NEW,0 ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 spp Main service 600V OR LESS 100 AMP OR LESS 5.00 LS.0 Main service EA. ADD'L 100 AMP 2.50 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Main service OVER 600V 00 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW OR ADDNST ( ACCLBL GS.LING CCUP. &) 20 sq tt NEW CONST R. (MULTI -OUTLET NON-RESID. BRANCH CIRCUITS) 2.50ea NEW CONSTR. POWER APPARATUS & NON.RESI D. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: ",a 1 �F�r�F� Ex. Occup(OUTLETS OR FIXTURES)@29C BAL@1 Ex. Occup. (OU LETS PRESID )REA) 200 Temporary service 10.00 Mobile Home Facilities 15.00 License No. 62%T :3 - Classification Ca /d Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ /44 2-3- $ Z WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. �jA I have placed on file with the County of Butte a certificate of VJ� Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued 1 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 J$3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. 1 agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT FEE f -S I+, cii.oaivuo 0� t e %.Gun.y VI putte w enier upon me above-mentioned property for inspection purposes. Date 12' &-L— Signature of Permitee or Agent Receipt No. 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. X, DIRENT6� OF PUBLIC WORKS ............ pl, SZ61 6 311,nd -0 _j!ns Al 'ld3C7 :;0 lmnoo