HomeMy WebLinkAbout025-110-031N ART BARNES -31
ns/ of E. V99s Hwy, 700 t - W':
Dos Rios RE., E. Biggs
Permit#Al2-75B (awning, MH)
25-11-31
A. R.//arnes fw# $Wl 7
N/S,.4Biggs E. Hw"y,750'Wof D
E. Biggs os Rio Rd.,
Permit #2216-77B,E(new cabana MH)
Perml #,39,011-77B Ty
e
burning stove/MH
Permit # 25-11-31
MH 677 7/48B(Storage room /c
Vir- A /9
.025-11-0-031 93-513 MHI
PIERCE DUANE & DEBORAH--
583 E BIGGS HWY, BIGGS
CONTR: MH CENTER
MHI/EXISTING SITE
3- a s- 93
Al
N��� vmm
� Ta,iked iv wap&
Ie-� h��n �ou� forrnS
pIU l�x�cl ��C�eS
INSTRUCTIONS FOR RECORDING FORM
HCD 433A
1. Please review the HCD Form 433A before
recording at the Butte County Recorder's Office.
Verify that all information is correct. You will be
responsible to pay any fees if re-recording is
necessary to-orrect,any,.err ors on the farm.
2. _. Take the original and copy of. the 433A provided
.by. our office to the Butte County Recorder's O`ff ce
at 25 County Center Drive, Oroville (in the Butte
County Administration Center Building). Ask them
to record the original and to `Conform' the copy.
They will keep the original and give the copy back to
you to bring to our office. We will copy this copy
and give it back to you for your records.
CO TACT T BUTTE COUNTY
RECORDER'S OFFICE AT (530) 538-7691 FOR
OFFICE FOURS AND FEES FOR RECORDING
DOCUMENTS.
DO NOT RECORD THESE INSTRUCTIONS —
REMOVE PRIOR TO RECORDING
Rev'd 2-23-09
RECORDING REQUESTED BY:
AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE CA 95965
SPACE ABOVE THIS LINE FOR RECORDER USE ONLY
NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH,
INSTALLATION ON A FOUNDATION SYSTEM
Recording of this document at the request of the local agency indicated is in accordance with California Health and Safety Code
Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the
unit described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this
document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give
constructive notice as to its contents to all persons thereafter dealing with the real property.
PIERCE DUANE A & DEBORAH M
BUTTE COUNTY BUILDING DIVISION
REAL PROPERTY OWNER/LESSOR
LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY
583 BIGGS EAST HWY
7 COUNTY CENTER DRIVE
MAILING ADDRESS
MAILING ADDRESS
BIGGS BUTTE CA 95917
OROVILLE BUTTE CA 95965
CITY COUNTY STATE ZIP
CITY COUNTY STATE ZIP
583 BIGGS EAST HWY
B10-1707 (530) 538-7601
INSTALLATION MAILING ADDRESS, IF DIFFERENT
B PERMIT NO. TELEPHONE NUMBER
BIGGS BUTTE CA 95917
11/16/2010
CITY COUNTY STATE ZIP
S G AT 0 LOCAL AGENCY OFFICIAL DATE
SAME
NON
UNIT OWNER (if also property owner, write "SAME"
DEALER NAME (if not a dealer, write "NONE")
SAME
NONE
MAILING ADDRESS
DEALER LICENSE NO.
SAME
CH Y COUNTY STATE ZIP
UNIT DESCRIPTION .
GOLDEN WEST HM 1992 GV602S1
MANUFACTURER'S NAME -DATE OF MANUFACTURE MODEL NAME/NUMBER
GW6CALGV9505A/B 60'X 254" RAD638843/4
SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S)
REAL PROPERTY LEGAL DESCRIPTION: SEE ATTACHED
ASSESSOR'S PARCEL NUMBER: 025-110-031
HCD FORM 433(A) REV 8/91
WHITE— County Recorder CANARY — HCD PINK—Applicant GOLDENROD —Building Dept.
iµ`11/09/2010 11:09 FAX 5308776922 BIDWELLTITLE
urtle Vu. iJir4U
SCHEDULE G EXH I BIT A
86-4680,
The land referred to herein is described as follows.
1 All that certain real property situate in the County of Butte,
State of California, described as follows:
A part of Lots. 14 and 16 in Block 3 of Rio Bonito, Colony, accoriling
to the Official Map thereof, filed in the Office of the Recorder
of the County of Butte, State of California, on February 1, 1892
in Book 5 of Maps, at page 31, described as follows:
BEGINNING at a. point in the South line of said Lot 16, distant
208 feet West from the Southeast corner of Lot 16; thence at
right angles, North and parallel with the East line of said
Lot 16, a distance of 208 feet to a point; thence at right.
angles, West, a distance of 104 feet to a point; thence at
right angles, Suuth and parallel to the East line of said
Lot 16, a distance of 208 feet to the South linu of said Lor
14; thence East along the 'South line of said Lots 14 and 16,
a distance of 104 feet to the poisit of beginning.
I
CAT. N0. W.CCt:74
IC 21660 CA (1-431 4 sp{�
(Winless—IndividualIC O) ti�lt� R TITLE INSURANCE
STATE. OF CAUFORN1A
COUNTY OF _ Bit tte !t
December 26,1986
• On bcFure me, the undersigned, a Nosary Public In and for
I said Stare. perst tially appearid iquieired o
ipersonally knuwu (u me to Ire the person whose name is subsenled to the within Instrument, or proved to
�. be such by the oath of a crcd4)le witness who is personally known to me, as being she subscribing Witness
thereto, said subscribing Wines being by nit duty sworn, — '----'
deposes and says Vat this witness resides in
Butte
and that said witness was prescntand saw QaodonaaanoaaCssccuarhaancn4
n
t� • ^�� I.f•ist;. t•; Cid-^::; °°
personally known t0 soh wuness to he the some person w ,,
441:: n
�. deseribtd in and whose nnnhe is subserihed to the within a m_ •W..nall tt:.::•• ^,,... ,,..,,••.aA u
and annexed instrument as a parry thereto. erecute and o �; :;-••i •i
a ctrl lea Ai 4�tJJ41I: l,ln IY 1^
deliver the same, and that affiant subscrih4Yl his/her a ra
[Ionic to the tvithinhhstrumentosaWitness. BmouGmt:aaIca owasuo;(JUG ousioou¢i
WITNESS any hand rel ufl'leial seal.
l t%
Sigurd +'L „' `/ (Th,, urea for urnom onmrial seal)
Mina $ �eadis
5ND OF DuCUME.Igr
X1005/005
M
RECORDING REQUESTED BY:
AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE CA 95965
SPACE ABOVE THIS LINE FOR RECORDER USE ONLY
NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH,
INSTALLATION ON A FOUNDATION SYSTEM
Recording of this document at the request of the local agency indicated is in accordance with California Health and Safety Code
Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the
unit described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this
document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give
constructive notice as to its contents to all persons thereafter dealing with the real property.
PIERCE DUANE A & DEBORAH M
BUTTE COUNTY BUILDING DIVISION
REAL PROPERTY OWNER/LESSOR
LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY
583 BIGGS EAST HWY
7 COUNTY CENTER DRIVE
MAILING ADDRESS
MAILING ADDRESS
BIGGS BUTTE CA 95917
OROVILLE BUTTE CA 95965
CITY COUNTY STATE ZIP
CITY COUNTY STATE ZIP
583 BIGGS EAST HWY
B10-1707 530) 538-7601
INSTALLATION MAILING ADDRESS, IF DIFFERENT
-B PERMIT NO. TELEPHONE NUMBER
BIGGS BUTTE CA 95917
11/16/2010
CITY COUNTY STATE ZIP
S G AT O LOCAL AGENCY OFFICIAL DATE
SAME
NON
UNIT OWNER (if also property owner, write "SAME"
DEALER NAME (if not a dealer, write "NONE")
SAME
NONE
MAILING ADDRESS
DEALER LICENSE NO.
SAME
CITY - COUNTY STATE ZIP
UNIT DESCRIPTION
GOLDEN WEST HM 1992 GV602S1
MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER
GW6CALGV9505A/B 60'X 25'4" RAD638843/4
SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S)
REAL PROPERTY LEGAL DESCRIPTION: SEE ATTACHED
ASSESSOR'S PARCEL NUMBER: 025-110-031
HCD FORM 433(A) REV 8/91
11/09/<2010 11:09 FAX 5308776922
BIDWELLTITLE
Uude No.. ij/Mu A6—�68�r
SCHEbULE C
The land referred to herein is dehpr'ibod uv follows:
i A11 thatcertain: r.eal,'IDc ves:itiiestt; in. the County of Butte,
State.uf 'G`aLifornYa, .desci~i,r.ty' b6d as 16116ivlsj
A para o£ Lots.?14::ond 16 in b)lgck .3` o£ Rio. Bonito Colony, according
to �tho gf:£ce of the'Recotdnr
of tFie Comity ok Ltulte .S4ato';of Ca13£6rn' c'; on February 1, 1892
to kook 5; 0:fMaps;' at pdgt3crifit d ars 'fo:t.lowa
DEGIPININC a.t:.a. ,hair t xn th0 booth j: rie of: ,Uaid Lot. 16, diatant
700 foet west frorri' the southeast corher' Of,'Lot, 16; thurtee at
righ:tr angles, N4> tli a�d:.parall:el "wiCli, the;East-'.11ne of said
Lot.:TG, a'rdintapae:;o'f.:�08,`E_ee:t lo'.a.''point,. thence at• right.
angles, ,Wea.E a dl'st anco; of 10%i Ee'eC 'to t. thenau at.
right angles, South auil parallel to'the Cash. Eine of said
Lot• 16, s..distance of 606 Feels tu. tho .South lino of 3az.d t+ar
1.4.; then'eiaf Gast:_ akong;a.he $outti _1i•iie oG.'si'id Lots 14 and 16,
a i'stance .oP 104' feet to Lhe pcali't o[ begintri,ng.
i
4 •
.. �' CAT:.1JO. NRCCI
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(Wlnresi eiadi
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persu{laily
g
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depose an
Butte
and thats�
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AtIFORNIA
Matte �'�
ember 2fi� 19U6 befurr me, che'undcn)gned,.a Notary Public In and for
rsunaNyapkircd; �9gPi'iPdO :
uli
iiwu'ui nlcau IiC nc� Ircrum Gvliosc niiMe Is sstrikd r6;thc tvithin'Instrdmcnt, dr.provcd to
he uSih of u 4icJihlC wuncir hu Ii:Ixrsonally'I nuwn Come„es being dro.subscribing Witness
sulictiibing 1Vu5�css bclu� ly meJu1l iwpm ”` �""'�"'—""'"
ayc 711ar ula wlilws nsul�a uG
Wlin5ssGvasprcscntanJsl(0ti'tartan,ndrioaeocnaarracnlrs�uui.�
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f .. . o �� I ISG + r'l l.' +','•I J �
1n1vn Io fal WItltCat [n Ila tI7C ](AInC pc Y011 GI ^ p
and whus� n�mc a fol, crglcJ to thG
it 66 R d, r 1I/1+Ti •' • •+•+•+gin N
Instiumulr ac a'pany rhuttu �YCLUtI' t11J D 41+ +r,h CWlun ..44iw+: fnl+ a, nC•9 N
c+nlG':: and cher i . l iuhscrhed
nun(ctuihcivnhm:Instrunu.nnasas% aYunciu.',, ��'OtlHdriA.O�00Yg1tW000Y1aMOCrG/gtl
WITNESS uq banJ a pl ufllelal ccaf.
Signed r'tz .' !•r-`+� �_ ' ITIO. un•I tnr ormhi dmarial wall
Wo (W-00cUmme
Q005/005
FOUNDATION SYSTEM
CERTIFICATE OF OCCUPANCY
BUILDING PERMIT NUMBER: B10-1707
Address or location of unit: 583 BIGGS EAST HWY, BIGGS CA 95917
Legal Description of Real Property: 025-110-031
SEE ATTACHED
(x) Mobilehome/Manufactured Home
() Commercial Coach
Has been affixed to the real property above by installation on a foundation system
pursuant to Health and Safety Code Section 18551.
Owner's name: PIERCE DUANE A & DEBORAH M
Owner's address: 583 BIGGS EAST HWY, BIGGS CA 95917
INSIGNIA OR HUD NUMBER: RAD638843/4
SERIAL NUMBER OR V.I.N.: GW6CALGV9505AB
MANUFACTURER'S NAME: GOLDEN WEST HM YEAR: 1992
OFFICIAL APPROVING INSTALLATION:
DATE: 11/16/2010
PHONE: (530) 538-7541
H.C.D. 513
RESIDENTIAL -�
y 025-11-0-031 93-513 MH
PIERCE, DUANE & DEBORAH
583 E BIGGS HWY, BIGGS
CONTR: MH CENTER
r, MHI/EXISTING SITE .
y
. 1
1
OFFICE COPY
I .
r I Address
1 i GAS
Meter By
} ELECTRIC
Meter By \ ate
i
C
JOB FINALED (Date)
Signature r. '
,t
V=OK
O=Not OK`
- = Not Applicable
= Not Ready I MOBILE HOMES
Date/Initials MOBILE HOME UTILITIES (Plans) OK except #'a
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support Sketch
3. Sewer; Location -Test -Fall -C/O Concrete
4. Water; Location -Teat -Easement Needed (Sketch)
5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete
6. Gas; Location -Teat -Wrap: / /"L"ft.
/ /"Nat. or/ /"L"ft./ /"LPG
7. Well Clearance 8 Disconnect
8. Utility Clearance
Date/Initials MOBILE HOME INSTALLATION Plans OK except #'a
1. Zoning Requirements -Setbacks Easements
% Footings; Size -Spacing -Marriage Line
ricity: MH Test -Crossovers -Breakers -Clearances
Drain; MH Test -Fall -Flex Connector
star; MH Teat -Regulator -Connector
v Ter and Sewer Connected -C/O to Grade -HD Approval
�6�Gas and Electricitv Taaaed
MISCELLANEOUS
Date/Initial DEM COVERS CARPORTS GARAGES Plans OK exle, t #'a
i Zoning Requirements -Setbacks -Easements
Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks; Gridera and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-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/Initials 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-Enclosu res -Pane lboards- Ins. to Main in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
V=OK •,
O'= Not OK
- = Not Applicable
= Not Ready
RESIDENTIAL (Single & Duplex)
Date/Initials; ,VNDERFLOOR (Plans) OK except #'s
1. Zoning -Setbacks -Easements -Flood -Slope
2. Ftg., Main; Soils-Elec. Grnd.-/ /' Fig. Depth
3. Fig., Garage; Soils-Steel-Elec. Grnd.-/ /" Fig. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ /Fig. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped
6. Stemwalls, Garage; Steel-Blockouts-Wrepped
6a. Hold Downs and Special Anchors
7. Slab; Steel -Wrapped
S. Piers -Fireplace Ftg.-Steel
9. D.W.V.; Fell -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.
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
15. Access & Ventilation
16.. Insulation
Date/Initials PLUMBING (Permit) OK except #'s
16. Water Htr.; Vent -Access -Combustion Air -Baffle
17. Water Pipe; Test & Anchor -Nail Protection
18. D.W.V.; Test -Fittings & Anchor-Naii Protection
19. Shower Pan; Test, First Floor -Tub Access
20. Test Tub & Shower, Second Floor -Tub Access
21. Gas Pipe; Size & Anchors
Date/initials ELECTRICAL (Permit) OK except #'s
22. Fixture & Transformer Clearance -Ins. Protection
23. Elec. Receptacles Spacing -Lights & Switches at Doors
24. Size Boxes & No. of Conductors -Stapled
25. Romex Installed Close to Edge of Studs & C.J.
26. Equip. Ground made up w/Meth. Fastners-Bond Gas & Water
27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI
28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga.
Cu or Al
29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al.
Insulated Neutral ❑ Yes ❑ No
30. Service -Riser Conductors & Ground -Main Disconnect
31. Equip. Clearances Panels -Motors -Mach. Equip.
32. Clothes Closet Light -Shower Light -Spa Light
33. Smoke Detector
Date/Initials MECHANICAL (Permit) OK except #'s
34. A.C. Ducts Insulation & Support
35. Vent Fan; Exhaust above insulation
36. Condensate Drain & Overflow; Size & Grade
37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet
38. Attic Access & Platform if Furnance in Attic
Date/Initials FRAMING (Plans) OK except #'s
39. Sils, Proper Material & Anchors
40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound
41. Bearing Walls over Girders & Floor Nailing
42. Draft Stop in Wells (rat proof)
43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub
44. Headers & Beam -Size & Bearing
Date/Initials FRAMING (Continued)
45. Hangers -Post Caps -Anchors -Connectors
,46. Ong. Joist-Rftr. ties-Purlin=roof Brac-Trues-Shthng.-Rfng.
47. Fireplace Ties or Type A Flue -Fireplace Throat clearance
48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
50. Garage Fire Protection Framing
51. Property Line Firewall & Openings
52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits
53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
54. plywood on Roof Overhang -Attic Vents -Rafter Outriggere
55. Siding -Nailing Veneer
56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
57. Glazing Area -Glass Protection -Skylights -Plastic
58. Shear Wells; Nailing -Bolts
59. Insulation -Wells -Ceilings
60. Infiltration -Walls -Windows
Date/Initials FINAL (Plans) OK except #'a
61. Ext. Steps -Door & Sidelight Protection -Landings
62. Smoke Detector
63. Furnace; Vents -Clearance -Comb. Air -Connector -7
In Garage; Above Floor -Ducts -Mach. Protection
64. Bedroom Exiting
65. G.F.I. & Bath Fixtures & Tub Access -Spa
66.. Elec. Trim & Subpanel; Breaker Sizes & Labels
67. Stairs & Rails
68. Fireplace or Stove; Clearances -Hearth
69. Elec. Outlets at Wood Panel; Int. & Ext.
70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
71. Elec. Outlets & Receptacles at Kit. Counter
72. Garage Fire Door; Swing -Landing -Closer
73. A.C. Duct in Garage -Damper
74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.
In Garage; Above Floor -Meth. Protection
75. Plb., Elec. & Mech. Equip. Listed for Location
76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection
77. Insulation -Foam -Looked in Attic ❑ Yes
78. Guard Rails & Deck Construction -Post Caps
79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth
Clearance Looked under Floor ❑ Yes
80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No;
Planters ❑ Yes ❑ No
81. Stucco; Brown -Finish
82. A.C. Unit; Disconnect, Electrical, Plumbing
83. Vents Above Roof; Pibg.-Appliance-Fireplace.-Clearance to
Openings
84. Water Well; Disconnect, Electrical, Plumbing
85. Exterior Elec. Trim; G.F.I. Receptacle -Underground
86. Ventilation Throughout House
87. Glass Protection
88. Corrections from Previous Inspections
89. Gas Test -Meters Tagged; Gas -Electric
90. Water & Sewer Connected -C/O to Grade -HD Approval
91. Energy Compliance Certificate -Other Certificates
Comments at Final:
M-OBILEHOME INSTAiLATION'�ACCEPTANCE
" ` COUNTY'•`OF BUTTE
DEPARTMENT OF PUBLIC WORKS — )-COUNTY CENTERTDRIVE
ORO.VILLE, CALIFORNIA 95965-- TELEPHONE"(916) 538-7541
1.1',
.( s..,y c
''�
'
-PERMIT N0.V�
Address or locatio�n offmobilehome
Owner's name 1y� L)A YV % (2�
Owner's address Q //
Insignia or hud number -PA Q _& ��(J �Z • —
Manufacturer's name
Serial number f V.I.N. � _ Year of manufacture
kz�j
v (6ffc�ial Approving Insialretion) �— (Yate)
4Z
IF
s
f r
IF THE MOBILEHOME'IS,MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION
ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE
MOBILEHOME IS INSTALLED ON A,FOUKDATION SYSTEM.-
.5
YSTEM.-
�
• llJ}
( + w
5136, White - Owner, Yellow,- Pink
_ .._.,.. t l -
{i'3. _ .. ... _ ,' ;-.vim"•-�'�-Vie•.-.-� •� �Ts,-:'2'sJ'3°�:.v-ct�.�.y,
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
4 ,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.
j
CORRECTION NOTICE
lE & C - Sl 3
OWNS `' PERM TTNNO., 2
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,
please contact this -Ov�— mediately.
lPoCoU l�i�,Y
rnw,J � 1 It!''�r
• I; i
/ r - s'e I
Date Inspector
d
REV 10192
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 �
t�• APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
025-110-031
ZONING
A-5
BUILDING PERMIT
OWNER
Deborah Pierce
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
1113 s E. Hwy-, Bi s 95917
CONTRACTOR AMETELEPHONE
v" ter, Inc.
533-4403
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
LENDER'S MAILING ADDRESS .
Filing Fee
$ 15.00
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ 20. UU
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee
$
Penalty
$
BUILDING ADDRESS
Permit fee
$
PLUMBING PERMIT
Filing Fee 15.00
Each Trap
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 ❑ Duplex❑ Mobilehome;e Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home S I G I W
615.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installationy Other ❑
Describe work:
e s
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 200AORLESS
18.50
CONTRACTORS LICENSE LAW
I declare under penalty of
p y perjury y (Check One):
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full fo ce and effect.
License No.1, ��_ 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
Main service 200A TO 1 OOOA, .
37.50
NEW CONST. / DWELLING OC CUP"")
OR ADDNS. \ ACC. BLOGS. //
3.54sq.ft.
NEW CONST-- TI -OUTLET
NON.RESID BRANCH CIRCUITS
5.00
(POWER
(POWER APPARATUS e\
l SINGLE OUTLET CIR. I
EX. OR FIXTURES
20 76
Ex. OCCUp. OUTLETS (RESID IRE A.)
1 3.00
Temporary service
15.00
Mobile Home Facilities
15.00
Misc. Wiring
-15.00
Permit Fee
$
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
Cooling
Hood
6.50
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 to sav indemnify and keep harmless the County of Butte against
all liabilities, Ju ents, costs, EIDA expe ses which may in any way accrue
against said C t fin consequen th ranting of this permit.
X 5--3 �3
Signature of Applicant — 0 Contractor Agent ❑
An OSHA permit is required f r eacavotians over 5'0' deep and demolition or construct-
ion of structures over 3 storie In height.
Mobile Home Installation Fee $ 70,00
Energy Inspection Fee $
occ
CONST TYPE
TOTAL E $ 10 . 0
Es IMP FLO COF
PAR
P
HD Iss
This permit is hereby issued under the
sions of the Butte County Code and/or
work indicated above fpr which fees
I ' F PUBLIC
By
PERMIT E IBES Date
applicable provi-
resolutions to do
have been paid.
WORKS
Date
—
Receipt No. 135502
WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT
w«IYi.�-'.y`i.w^1�.Ai..Amy^.'YrYi',/•`/'R1.�r'[�.,��'�`'Y•r..`�l st r...'�1'"7Y'1'1r+�M%it,..:'rr.�YtrA�.__ 'y •7�. 1.
:
*,COUNTYOFBUTTE - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION
7COUNTY CENTER DRIVE - OROVILLE, CALIFORNkA55965 -TELEPHONE (916) 538-7541 -
PERMITAPPMbATION DATA SHEET
w
OWNER f/ A. P. No. 0 — Q 3 �
Proposed Building Use Building Inspector Date 3- 7-23
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECENED BY
1. All items have been submitted.............. .......................... .
ee 2. Plot plans, 3/4 sets, signed by preparer of plans . ..........................
3_ Complete plans, 3/4 sets, signed by preparer of plans . .......................
A. Engineered plans and calcs, 3/4 sets, with wet signature on plans. :........... .
5. Hazardous Material Form . ........................................... .
6. Energy Design Compliance and supporting documentation . ..................
7. Statement of Intent for Non -Heated and A/C Buildings . ......................
8. Engineered truss details and layout in duplicate (required prior to plan check). .
9. Mobilehome data and manufacturer's installation instructions, 2 sets. 3 �r
Fees of $ ..................................... .
Impact fees as shown on attached schedule. ............................. .
12. California Department of Forestry plan approval/fees. .
1 Flood elevation letter (100 year flood) by California Engineer ...................
1 Sanitation and plot plan approval Health Department . ............
15. City of Chico plumbing permit . .........................................
16. Plot plan and business license approval from City of Biggs/Gridley. .............
17. Planning approval for (A) Use: (B) Parking: . .........
18. Contact Land Development about (A) Improvements (B) Drainage. .......... .
19. Driveway permir (construction approval required prior to occupancy). . .
20. Pre -inspection for required. .. oB�ild 9 �specto
(Date)�
21. Contractor's license information. (No., Name Style, Classification) . .............. /
22Certificate of Workmans Compensation Insurance . ............................�_
wner-Builder Verification (Given to owner , Mail to owner _)............. ': ,
ecorded copy of Agricultural Acknowledgement Statement . ..................
4Ar�ou
etterof signature authorization.
g -......
26. Copy of recorded deed of parcel creation and 60 right of way to a public road. ..... '11,a - r'
27. Letter of intent on building use . ..........................................
28. Mobilehome uti•ity clearance . ..........................................
29. Documentation of legal access . ..................... :..................
30. Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning area and frontage requirements . ...............
31. Existing violations/expired permits . .......................................
32. Plan check list . .....................................................
33.
34.
Whe you issue the permit, process as follows: Mail to owner. Mail to contractor.
Telephone x'33 -yyn 3 and hold for pickup at dril ffice. Deliver with inspector.
Other
Parcel Creation
Acreage Applicant
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution D e
Copy of plans sent Health Dept. Fire Dept. Other Dat By
The following data must be submitted prior to permit issuance: (Circle new item not checked above).
1. Index permit for above items. No. //, /_Tq
2. Additional items required:
Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date
Contractor, designer, owner, was advised of above required data by _ phone _ mail �Cojinter by _ Date
Plans checked by Date Plans approved by Date
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Wo*s
TO: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
Owner Location
Plan Approved for: Sewage Disposal 4z Water Supply: I'ublic
Clearance for bedroom mobile; home. Other e3,P7., y
Hold final for:
Final clearance O.K. for:
NOTE: _
I
Environmell) Health Specialist
rr
8/92
Plot I'I:m AttaehcJ
Flour Phnt Awiched
Sent to B.U. /
0
AP//
Private Well_LG
Date
a� E;
1
1
COINTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BU=ING DIVISION
7 -COUNTY C=ZR DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916)5387541
do('479 f/ i lefCe- A.P. NO. 0-?
10POS D BTJ=IVG USE
DATE
REC. a - DATE_ R E C
time of permit aotl_cat_on, I was advised- t:.e above =ees are required to be paid = -
:3 issuance of cae aermit.
-= DT7-CA 1
DA'i
I.
School Distr_.c Fees
(pa=d at District Office) ................
.........
Z.
She---i.ff Fees
BausE.C
(paid. at -Building Department)
Residential .........
x
_
unit
amt.
Commerc=al( per sq. f t.)
x
=$
sq. ft.
amt.
3.
Urban Area Fees
(paid at Building Department
Residential (per unit)
x
=$
units
amt.
Commerical( per sq . f =.)
x
=
so .ft.
amt.
4.
Re— eatiou Dist_ pct Fees
(paid at Distr=c= 0===ce) ..........................
S.
;,,age Dist__c= Foos
(Contac: Land Development) .......................
.
6.
Other
7.
Other
time of permit aotl_cat_on, I was advised- t:.e above =ees are required to be paid = -
:3 issuance of cae aermit.
-= DT7-CA 1
DA'i
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC 4WOR ( -31' PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION ANO PERMIT
ASSESSOR PARCEL NUMBER
02�- /10-Q(
ZONING
BUILDING PERMIT
OWNER TELEPHONE
Al = r
OWNKRR'S A; ,i LA N.: AOORE:iS
4 4r %
SO. FT. OCC.1 BUILDING VALUATION
CONTRACTOR SN I
0
TELEP E
3-q
CONTRACTOR'S MAILING AODR SS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee $ 15,00
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee $
Penalty $
BUILDING ADDRESS
Permit fee $
PLUMBING PERMIT Filing Fee 15.00
Each Trap 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 ❑ Duplex[] Mobilehome)g] Other
SPECIFY
Gas -piping system 1 - 5 outlets 5.00
Building sewer 15.00
Mobile Home I S I G JW I @ 15.00
TYPE OF WORK
New ❑ Addition ❑ Remo el ❑ Utilities ❑ Installations Other ❑
Describe work: l -S � . e
Permit Fee $
Contractor
ELECTRICAL PERMIT Filing Fee 15.00
Main service 200AORLESS 18.50
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
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
Main service 200A To 1000AI 37.50
NEW CONST. / DWELLING OCCUP.k� 3.60sq.ft.
OR ADONS. 1 ACC. BLDGS.
NEWCONSTR "ULT' -OUTLET
NON.RESICIBRANCH CIRC ITS @ 5.00
POWER APPARATUS e
(SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES 20 76d
EX. Occup. OUTLETS ((RESID. IREA.� I 3.00
Temporary service 15.00
Mobile Home Facilities 15.00
Misc. Wiring
g 15.00
Permit Fee $
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
Cooling
Hood 6.50
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 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 over 39 stories in height. excavations over 5'0" deep and demolition or construct-
Mobile Home Installation Fee $GZ
Energy Inspection Fee $
OCC
CONST TYPE
TOTAL FEE $ /D S^
I
HAz
DFEES I
IMP
I FLOODCDF
PARCEL PO HO
ISSUE
This permit is hereby issued under the applicable provi-
sions of the Butte County Code and/or resolutions to do i
work indicated above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By DatePERMIT EXPIRES Date
-Receipt No. 13 d Z
WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
a
This set of plans and specifications MUST be
kept on the job at all times and it is unlawful tc
make any changes or alterations on same with.
. out written permission from the Department of
Public Works, County -of Butte.
19OTF�--.All . Materials & Workmanship Shall 09, in
Accordance with Recognized. Good Practices and
of a quality prescribed forthe SpeOfied wse In the
Uniform Building, Plumbing & Mechanical Codes and
$e National Electrical Code.
si3
BUTTE COUtaTY
13UILDI6dG DEPARTMENT
�mO�ED
Location of structures 6
equipment ShWI be a$ shown
& clear of all eaft lents.
5' SWDE AeAe- K
Sc� �Frza•1 � of 20�_
j =
8 P
500 SQ. FT. MINIMUM
FOR MOBILES
U4'
10
1, Owner's Name:
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS
7 County Center Drives Orovi le , CA
MOBILEHOME INSTALLATION -SHEET
CF
2. Installer's Name: _yyi C 6
3. Is the site currently under permit? Yes No
(If Yes, furnish permit number OR
Is'the site an existin.:, site? Yes No
(If yes, furnish two plot plans.)
4.. Willthe mobilehome be located'at least 5 ft, away from septic tankandleach'
fields and clear of i).l setbacks and casements? Yes No
(1f.no, clarify
5 What is the mobilehone electrical rating? --------------- ---- ZQ Amps
.6. What is the mobilehoi-0e site service r a L ins? -------------- Amps
7\. What is the mobilehome site circuit breaker.-r-at.ing.? ....... Amps
8. Is thereanyother electric load to be served by the
------------------------------- e
mobilehome site service - s, No
(If yes, identify the load and size: (Load) � (Amps)
9'. What is the mobilehome site gas.pipe size? -------------- - 31 --*1
.10., What is.:,th,etype of gas service? -------------------- Natural LPG
11. What is the gas pipe length from meter or tang to the
mobilehome? --------------------------------------------- -
12. What is the mobilehome.gas demand? ------------------------ (BTU)
*(This information not required if Pipe 1cr.&Lh less than 6 ft. on
natural -as or less than 50 it. on LPG.)
0
NM PAGE MUST BE COMPLETED TO PROCESS PERMIT APPINAUMCOUNTY
BUILDING DEPARTMENT.
APPROVED'.
If other than single wide,
Mobilehome Mfr.caly)�,t/ kJ6,ST furnish Setup Model No. �y 6�.2S'� Year -
::Width- (ft.) Box Length(ft.) Tagalong or Expando Size ft. x�,ft. .
On aft mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation
manual and structural.setup sheets (if not on file with the County of Butte).
FOOTINGS (check one) 1. Wood -pressure treated or foundation grade.2. Other (specify)
SUPPORTS (check one) L�_l , Concrete block,
El2. Other (specify)
Pier Footing Sizes and Locations
SINCLE•WIDE MULTI -WIDE
Line 1
Lina rine 2
Main Beams
L _ _ _
Lin
Line
ne 21
Line 2
— - _Malo Bcams�
y Line 7
L ine l
—.—Line
Tag or Triple
-- — — — -- — — — — . 1 1 n a 4
Line 1
Line 1 Piers; • Line 1 Openings:
Size -Min. ...............................
• Spacing -Max. Each -Side of Openings
..
From Ends -M........•
With Width Over -'-"'^'
Line 2 Piers; Line 7 Pierer (Under Bearing Wall Only)
Size -Min ........... ^ „x Size•Min...:...............
Spacing -Max.......... C Spoctng•Max................
From End• -Max ..... •- `J " P ...........
.__..__ ... From Ends -Mex, •
jun• 7 Root Loads: -Av>/1
Size -Min............. g—
Ir""— �tRM-TMANWAMWARWA®®
Location (Prom Front)
Line 4 Piers:
Size -Min. --- ••• •-
Spec ing-Max.......... ,
From Ends -Max ........
Size -Min . ..•... -
(ptation (Prom front)
ter ° - _' A CA r:
r Beating
Size -Min.------------------
,k
Spacing -Max ................
From Ends -Max .............. '_ "
Location (Prom Front)
Line 4 Piers:
Size -Min. --- ••• •-
Spec ing-Max.......... ,
From Ends -Max ........
Size -Min . ..•... -
(ptation (Prom front)
ter ° - _' A CA r:
r Beating
Size -Min.------------------
,k
Spacing -Max ................
From Ends -Max .............. '_ "
M -9
Ith
STATE OF CALIFORNIA Butte
COUNTY OF
March 10, 1993
before me, the undersigned, a Notary Public in and for
Diana Johnson personally
said State, personally appeared
known to me(6C)i�bHQffOCr1�i��C19Ct}@kt1tlLffl� 4 S 1 4 4 1 1 4 1 1 Y'+7 ' •vvv vv z ` 'p{
xatb>Ie�aes a�aDieceaoai�aogpQto bethe person whosename is subs:ribedtothe within instrument, as
:witness thereto,who being by me duly swore, deposed and said:
That tK/she resides i Crov i 11 e CA
that fie/she
was present and saw Duarte A. Pierce and
Deborah M. Pierce personally ,
known to *Whey to be the same person(s) described in and who
executed the within instrument, as a party(ies) thereto, sign, seal
and deliver the same and that said party(ies) duly acknowledged
in the presence of said affiant, that he/she/they executed the
same, and that said affiant, thereu®on at the partys(ies') request,
subscribed his/her name ag a witness thereto; 4
WITNEm n o I
Signature
OFFICIAL SEAL •
MICHELLE A. MILLER
NOTARY PUBL"ALIFORNIA
Ptinci Office in BUTTE Co.
NIXComm. Exp. OCT. 20,1995 •
(This area for official notarial seal)
.Return to DPW ACRICULTURAL STATI1ML;NT OF ACKNOWLEDGEMENT
FOR RESIDENTIAL DCVEI,OPMFNT
'Section 26-8.1 of the Butte County Code
requires this acknowledgement be recorded
prior to issuance of a building permit.
93-10636
,The. property described herein is adjacent
to land or included within an area zoned
— 1 I Rec Fee
5.00
ror agricultural purposes, and residents
_
_ I Check
5.00
of' this properly may be subject to incon-
Recorded
veniences or discomfort arising from the
Official Recorde���N rNOps�"1,B
use of agricultural chemicals, including,
County of I T
• but not limited to herbicides, pesticides,
Butte MAR 1 3 1993
.and .fertilizers; and from the pursuit
Candace J. Grubbs 1
of agricultural operations including,
- Recorder I
but not limited to cultivation, plowing,
2:28pm 17 -Mar -93 I PUBL
XX 1
spraying, pruning, and harvesting which
occasionally generate dust, smoke, noise, and odor. Butte County has establishcd
ngr•ic•ul-
tural zones which have as a priority use for
productive agricultural purposes, and
residoilis
within said zones and on adjacent property
should be prepared to accept such lnronvrri
i enc•o
".or disconform from normal, necessary farm operations.
All. Chat roal property situate in the County of Butt,,e, State of California, dosc•ribed n�
follows: '
All, that certain -real property situate in the County of Butte, State of Califonnia, ,
Described as Follows:
Apart of -Lots 14 and 16 in Block 3 of Rio Bonito Colony, according to the Official Map thereof,
.filed in the Office of the Recorder of the County of Butte, State of California, on February 1,
1892 in Book 5 of Maps, at page 31, described as follows:
BEGTNNING at a Point in the South line of said Lot 16, distant 208 feet West from the South-
east corner of Lot 16; thence at right angles, North and parallel with the East line of. said
.Lot'16, a distance of 208 feet to a point; thence at right-angles,-`4Jest,-a"distance-.6f'104
feet to a point; thence at-.right^angles; South7dna- parallel to theEast line of said Lot 16,
;a distance of 208 feet to the South line of said Lot 14; thence East along the South. line of
said .Lots 14 and 16, a distance of 104 feet to the point of beginning.
ASSESSORS PARCEL NO. 25- 11 - 31__;
..Date: PROPERTY OWNERS:
Duane' A. fierce
witnessed by:i
Diana Joon �n
State of.' )
County of )
,s
4
Deborah M. Pierce
On this the day of , 19--, iwroro inc-,
SS. the undersigned Notary Public, personally appeare
[] Personally known to me. 7 Proved to me on the basi..s
of satisfactory evidcnco,
to be the person(s) whose name(s)
subscribed to the within instrument and acknowledged Lh;it
executed the some for the purposes therein contained,, LN W1TN1`-SS,
WHEREOF, I hereunto set my hand and official seal, --
Present A.P. No, _ Notary Public
END OF DOCUMENT
•� r
Fr
• i
BUTTE COUNTY SCHOOLS IMPACT, FEE CERTIFICATION FORM
(One Form Per Building) Y
School District �r S 9 l Building Department No.
t ,,r
A.P. Number 0 //49-0 Jurisdiction [City County
Property Owner
Property Location/Address
Subdivison
r
Residential Development
• i , Commercial/Industrial
R,t- p /,4 CE- F
` Building DepartMent Rer
0
No. of Living
Units
Lot No.
0r 0 Sq. Footage /T` Z -o
MHI Addition (Group R)
0 Sq. Footage
New Addition (Including Exterior
Roofed Areas)
(Floor Plans reviewed by School District Personnel)
Date
District Identifcation
�No. l .�
School District certifies that
rf (Applica t)
'yr (Street Add
(State)
sW 7
(Zip Code)
has complied with the requirements of Resolution No.by payment of $
" representing square feet.
District Representative
Paid by Check Number
Bank Number
Paid by Cast:
3
Date
Remarks: %PD�.9C,�� /i'�o6� �e • (��m/l��
If, subsequent to the School District Representative signing this Butte County Schools Impact Fee
Certification Form, the School District is notified by the applicable Local Planning Agency that this project
is being reviewed under the California Environmental Quality Act (CEQA), this.project may be subject to
additional school fees to fully mitigate its impact on the school district's schools.
White (applicant), Yellow (building department), Pink (school district) feeform.wkl (4/92)
P
3901-77B
j�,g'ERMIT NO.
PERMIT EXPIRES
OWNER A. R. Banes
I
CONTR. owner X
r ,
LOCATION (A.P. 25-11-31 �. )
NIS Biggs E. Hwy,750'W.of Dos Rios Rd., E.Biggs
t
t
t
1 t
Temp. Power Pole
Called PG&E
Temp. Elec. Serv.
Called PG&E
emp. Gas Serv.
Called PG&E
JOB �aFINALED
(Date)
(Signature)
q _.
COUNTY OF BUTTE = DEPARTMENT OF PUBLICVORKS
BUILDING INSPECTION RECORD
BUILDING ; .
UILDING (Cont'd)
PLUMBING
Setback i
Firewall
Soil Piping
Forms
Parapets
1st Floor
Main Bldg.
Restroom Finish %
2nd Floor
Footings
Windows /
3rd Floor
Stemwall
Siding
To out
Slab '
Roof Sheathing %
Water PI in
Piers
Roofing {
Sewer
Garage ,
Fdn. Vents '
Fixtures
Footings
Stemwall j
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Carport
p
Footings
Prov. for physically
handica ed
Conformance of ex.
structure
Appliances f
Gas Pi in &Test
Temp. Gas
Slab
Final
Sanitation
Patio
FIREPLAC
Final
Footings j
Footing
ELECT KCAL
Relnf. Steel 1 1 I Final "l v _// '_ "l/h'1 I Flwhiran / 1
Motors
F
Mesh j
MSC NICAL
Gird. Fault Prot.
Scratch
Heating
Service
Brown
Cooling A
Temp.. Pole
Finish
Ducts
Underground
Interior Lath
Ventilation
Permanent
Door Closer
Final
Final
MOBILEHOMEUTILI ES ------- ----------
Elec. Service
Elec. Pedestal i
Water Piping
Sewer
Gas Piping
OBILEHOME INSTALLATION - - - - - - - - - - - - - -
Support
Elec. Continuity
Water Piping
Drainage
Gas Piping
DATE REMARKS OR CORRECTIONS
"/ > J6PV-X3
GvaG/ �'1,.� a �¢.,►� eon(, CV4X
pg
YeT��OI� �G1GL/^i+ (7 t�/tiJn7 D�1�jZ�if�
F✓G(� Y1 t"y (� �Gt.Q�17. Sof o. o/�r� 1' .3®
(NOTE: An entry must be made on this form each time you visit the job site.)
s
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
4,1 7 County Center Drive — UroviIle, California 95965
Telephone: 5134-4541
APPLICATION AND PERMIT
Signature of PermiteeNor Agent
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
By ate '7%
134kiding permit expires Date S-12— ZE
BUILDING
OwnerSQ.
r ,v c L
FT. OCC. BUILDING VALUATION
Mailing Address FT
f 66
Telephone No.
r( 45i/
Fireplace '%6p .p
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee $ .
Building Address W
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
' 0 p E. i (6
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. +— / f 3 /
Zoning &Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
F
Sa"+e*@n
I Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel'
Declaration
Parcel Ma P
60R/W
Improvements
Im P
Lawn sprinkler system 2.00
B c'd
Parcel Approval I
Plans Approval
Permit Fee $
$
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER 4
ELECTRICAL No.1 @ I FEE
PERMIT FILING FEE J$3.00
4 e_- %(le+pd, Ltr/JlX,(T
Main service 1000 AMP ORV OR LESS5.00
-W w..
r- 93 G
Main service EA. ADD -L 100 AMP 2.50
Single Family ❑ Duplex ❑ Mobil Home Others ❑
OVER Main service 00 AMP OR LESS 25.00
Main service EA. ADD'L 100 AMP 1.00
NEW LING O
OR ADDNST ( ACCLBL GS.CCUP. &� 22 sq ft
NEW CONITR. ( 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
st le of:
y
Ex. Occup(OUTLETS OR FIXTURES) @251tog
Ex. Occu FIXED APPLNS. OR
P• OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$
WORKMEN'S COMPENSATION INSURANCE
I am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑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.1 @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
authorize representatives of the County of Butte to enter upon the
ab ve-menti ed property for inspection purposes.
{��1
X ate -D'
TOTAL PERMIT FEE
$ Fy
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
Signature of PermiteeNor Agent
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
By ate '7%
134kiding permit expires Date S-12— ZE
.:i
I
41 �
PERMIT NO. 1512-75B
P
E ,.
M
MH UTIL.
PERMIT NO.
PERMIT EXPIRES
OWNER Art Barnes
1
CONTR.
LOCATION (A.P. 25-11-31 )
n/ s E. Biggs Hwy, 7001 W. of Dos Rios Rd.,
E. Bigg s
1
i
1
a
1
r ..
[i
S
F
Y
Temp. Power Pole
Called PG&E
Temp. Elec. Serv.
Called PG&E
Temp. Gas Serv.
Called PG&E
JJOB ......
FINALED
(Date)
(Signature)
COUNTY OF BUTTE — DEPARTMItNT• OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont'd) PLUMBING
Setback
Firewall
Soil Piping
Forms
Parapets
1st Floor
Main Bldg
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
Stemwall
Siding -
To out
Slab
Roof Sheathing
Water Piping
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Garage Vents
Water Htr.
Stemwall
Slab
Prov. for physically
handicapped
Heaters,
Appliances-,
Carport
Footings
Conformance of ex.
structure
Gas Piping &�T�est
Temp: Gas
Slab
Fina
Sanitation
Patio
FIREPLACE
Final ,
Footings
Footing
ELECTFhCA.L
Masonry Walls
Throat
Rou h
Reinf. Steel
Final
Fixtures
Bond Beam
FI SPRINKLERS
Motors
Framing
Test
Water Htr.
Stucco
Final
Sub ants
Mesh
MECHA ICAL
Grd. Fault Prot.
Scratch
Heating
Service
Brown
Cooling
Temp. Pole
Finish
Ducts
Underground
Interior Lath
Ventilation
Permanent
Door Closer
Final
Final
DATE
REMARKS OR CORRECTIONS
COUNTY OF BUTTE — DiFEPARTMENT OF PUBLIC R tS/,5
7.County Center Drive — Oroville, California 95965 `./
Tel ep4one: 5s4-4541
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes. I
X Date —L—�
Signature ofPermitee or Agent
/
Receipt No. 1171d d y 0
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 UBLIC WORKS
By Date 3 u._ 7J—
b
uilding permit expires Date ............................................
BUILDING
Owner Al— — h� ,,-�
SO. FT. OCC. BUILDING VALUATION
Mai I i ng Address
Telephone No.,
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee&/or Penalty
Telephone No.
Permit Fee
$
$ 3
Building A sA D d S �G�L
PLUMBING
No.
@ FEE
PERMIT FILING FEE $2.00
d d l%0S /
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.
Zoning & Planning
Gas piping system 1 - 5 outlets
1.50
Each additional outlet .30
F
f u ire Dept.
FireZone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
Declaration
Parcel Ma P
60' R/W
v
Im roments
P
Lawn sprinkler system 2.00
Bldg l; ons Recd
Parpprova1:::=P
I pprovol
Permit Fee
$
$
NEW ADDITION ❑ UTILITIES ❑ OTHER ❑
ELECTRICAL
No.
@ FEE
PERMIT FILING FEE $3.00
Main service incl. 1 meter
Additional meters, each
1.00
Sub -panel (12 or less) (more than 12)
Single Family ❑ Duplex ❑ Mobil Home N Others ❑
Range, Cook -top or Oven 1.00
Al/,�7 /,-7
Water Heater or Space Heater
1.00
21
Light fixtures bald io
Receps., switches & fix outlets 211 2,1
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
Hood, Ex. Fan or F. A. Furn. Motor
1.00
Evap. cooler, gar. disp. or D.W. 1.00
Air conditioner or heat pump
Water pump
Mobil Home Facilities 5.00
1
Temp. Power Pole 5.00
License No. Classification
Misc. wiring
— 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.
❑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
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
TOTAL PERMIT FEE
$ J�
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes. I
X Date —L—�
Signature ofPermitee or Agent
/
Receipt No. 1171d d y 0
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 UBLIC WORKS
By Date 3 u._ 7J—
b
uilding permit expires Date ............................................
• i
-�, hRMIT N0.
6776-78B
:> PERMIT EXPIRES
OWNER Art Barnes
owner '
CONTR.
LOCATION (A.P. 25-11-31
I NIS E. Biggs Hwy, app.700'W.of Dos.Rios
Rd., E.. Biggs
I
r
t
S •
E)�
Y,
Temp. Power Pole
Called PG&E
I Temp. Elec. Serv.
Called PG&E
Or
Tem$. Gas Serv.
Called PG&E
/Fol
-7
ALED
(Date)
(7
(Signature) .
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
UILDING
BUILDING (Cont'd)
PLUMBING
Setback 2
Firewall
Soil Piping
Forms
Parapets
1st Floor
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
Stemwall
Siding
To out
Slab
Roof Sheathing !
Water Piping
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Stemwa l l
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Carport
Footings
handicap forpehyslcally
Conformance of ex.
structure
Appliances
Gas Piping &Test
Temp. Gas
Slab
Final
Sanitation
Patio
7 FIR PLACE
Final
Footings
Footing
ELECTRICAL
KLERS
Stucco Final I I Sub aneis
Mesh MECHANICAL I Grd. Fault Prot.
Brown
Cooling
Temp. Pole
Finish
Ducts
Underground
Interior Lath
Ventilation
Permanent
Door Closer
Final
Final
MOBILEHOME UTILITIES - - - - - - - - - - - - - - - -
- - Elec_ Service
Elec. Pedestal
Water Piping
Sewer
Gas Piping
M0131LEHOME INSTALLATION - - - - - - - - - - - - - - Support
Elec. Continuity
Water Piping
Drainage
Gas Piping
DATE REMARKS OR CORRECTIONS
(NOTE: An entry must be made on this form each time you visit the job site.)
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
-'� 7 county Center DriVe — 70Oroville, California 95965
Teld�ihone: 534-4541 /_
APPLICATION AND PERMIT
Signature o Pe itpr Agent IC �-7�
/] 11-eoqBY Date `l L
�ceipt No. It�
te-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Building permit expires Date
BUILDING
Owner w-0es
SQ. FT. OCC. BUILDING V—XtfJATION
9(0 IT 00
Mailing Address ( 13 o 99 A
T3 K, G S CA 951 l
Tg4lnet715
Contractor OGt) IlJ
Mailing Address
Fireplace
Total Valuation pp
Telephone No.
Permit Fee p
Building Address,D� r IL�4 S,.WY
Plan Checking Fee&/or Penalty
Permit Fee $ T, 000
OC
700' PT W OF DOS '-LoS
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
Each TraD 1.50
Repair drainage or vent piping 1.50
A. P. No.
ZonFT & Planning
Water piping 1.50
Each gas water heater or vent 1.50
S io
Fire Dept.
Fire Zone
Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking
Plans
r Parcel
Declaration
Parcel Ma P
60' R/W
provements
Improvements
Each additional outlet .30
Building sewer 5.00
Bldg. P114ns Recd
Parcelroyal
Plans pprovol
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ UTILITIES ❑ qTHER ll
Permit Fee $
$
JT�/�rAG�E eoO 400012 Sii{+c
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service 600V OR LESS
10o AMP LESS 5.00
Sin
Single Family Duplex Mobil Home Others
9 Y ❑ P ❑ ❑
-L
Main service E4. ADD100 AMP 2.50
Main service OVER 600V
100 AMP OR LESS 25.00
Main service EA. ADD'L 100 AMP 1.00
NEW CONSDWELING OR ADDNST ( ACCLBLOGS.CCUP. S) 20 Sq ft
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:
NEW CONSTR MULBRANCH TI.OUT LET
NON-RESID CIRCUITS) 2.50ea
NEW CONSTR. POWER APPARATUS 8
NON-RESID. SINGLE OUTLET CIR.
Ex. OCCUD(OUTLETS OR FIXTIIRES 50e250
BAL@109
Ex. OCCU FIXED APPLNS. OR
P•�OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 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.
❑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
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
labove
X 1 Datel r �?
Land Development Fee
$
TOTAL PERMIT FEE
$ 9a:
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
for which fees have been aid.
DIRE TOq OF UBLIC WORKS
Signature o Pe itpr Agent IC �-7�
/] 11-eoqBY Date `l L
�ceipt No. It�
te-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Building permit expires Date
j
• PERMIT N0. 2216-77B� E
PERMIT EXPIRES
r=OWNER A. R. Barnes
CONTR. owner
LOCATION (A.P. 25-11-31
N/S Blggs E. Hwy,750::L' Dos Rios Rd., E.Bigg;
e
Temp. Power Pole
Called PG&E
Temp. Elec. Serv.
Ca I I-e#df' P G& E
Tem/Gas Serv.
/�F
alled PG&E
INALED
(Date)
(Signature) `
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILPI§IG BUILDING (Cont'd) PLUMBING
SetbackfzFirewall Soil Piping
Forms r Parapets 1st Floor
Main Bldg. „�" Restroom Finis 2nd Floor
Footings \ j' Windows 3rd Floor
StemwaI l i .% Sidina To out
Slab i Roof Sheathin ✓tom Water Piping
Piers ler Roofing Z /Sewer
Garage Fdn. Vents \ Fixtures
Footin st. Garage Vents _ Water Htr. f
Stemwall \ Insulation Heaters
Slab Prov. for ph slcally A liances
handicaped /
Carport �� Conformance of ex/ Gas Piping & Test
Footings structure , Temp. Gas
Slab A Final 7 Sanitation '
Patio FIREPLACE Final
Footings Footing ELE-CTRICAL.
Masonry Walls Throat Rough
Reinf. Steel Final Fixtures
Bond Beam FIRE PR NKLERS Motors
Framing Test Water Htr.
Stucco N, Final Subpanels
Mesh ME.6 , NICAL Grd. Fault Prot- -
Scratch Heating Service
Brown Cooling Temp. Pole
Finish Ducts Underground
Interior Lath Z11/ y Ventilation Permanent
Door Closer --� Final Final
MOBILEHOME UTILITIES Elec_ Service Elec. Pedestal
Water Piping Sewer Gas Piping
M913I6EHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity
Water Piping Drainage Gas Piping
DATE REMARKS OR CORRECTIONS
(NOTE: An entry must be made on this form each time you visit the job site.)
..COUNTY OF BUTTE' — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive Yroville, California 95965
Tel epfione: 534-4541
APPLICATION AND PERMIT
W .I
Signature of Permitee or Agent ^
Receipt No.
By — Date S—/ ?'!„-
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Bu ding permit expires Date 5 7E
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
,*-
Mai I i ng Address T f3 Qi c
A s
h ie
Tproy—'s wr,
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee $
Building Address �e
`s �V �
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
ow o, ®� _ �j p
Each Trap 1.50
of V`
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
Feb9fWAC. ani t n Fire Dept. Fire Zone Use Permit
EQA Parking I Parcel Parcel Ma 60' R/W Improvements_Lawn
Plans Declaration P
Building sewer 5.00
sprinkler system 2.00
Bldt'157'ans Recd
' cel Approval
PI Approval
Permit Fee $
$
NEW ADDITION ❑ UTILITIES ❑ OTHER ❑
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service 600v OR LESS 5.00
100 AMP OR LESS
Main service EA. ADD'L 100 AMP 2.50
Single ❑ Duplex ❑ Mobil Home Others ❑
Main service 100 AMP OVER oR LESS 25.00
Main service EA. ADD'L 100 AMP 1.00
,F�a`fmiilly
'� J��4
l r
NEW LING 0
OR ADDNST ( ACCLBLDGS.0 P(4a) 2¢sgft i 7V
NEW CONSTR. MULTI.OUT E
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:
Ex. Occup(OUTLETS OR FIXTURES) BAL0251
FIXED ALNS.
Ex. Occup. ( OUTLETS P(RESID.)REA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
MA I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$ 12, 7 v
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..
❑ I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
jj 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. @ FEEPERMIT
FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
(
XPPV(*W VIANIAO Date "
TOTAL PERMIT FEE
$S�
72
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 ?"UBLIC WORKS
Signature of Permitee or Agent ^
Receipt No.
By — Date S—/ ?'!„-
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Bu ding permit expires Date 5 7E