HomeMy WebLinkAbout025-130-004`
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' - -Donald L. Hodge.NIS Almond-Ave.,app.s�2p"24�C 'OE. of larkinRd., Biggs
~ ' ^Permit #738-79P,E(util.,MH)GASSUPPORT STRUCTURE REQ.--L,_,�,COMPACTION TEST REQ.25-13-401Tcon r: Hil on's MH Ser, �Mag'aliaPermit #2999-79MHIIssued25-13-4Perm 79B(new open deck/MH)
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�A-PE�iMIT N0. 7540-79B ,
PERMIT EXPIRES Jai?
OWNER Donald L. Hodges
owner
CONTR.
LOCATION (A.P. 25-13-4
1
NIS Almond Ave., app.2400'E.of Larkin Rd.
Biggs
t '
kk
t
i
Temp. Power Pole
Called PG&E
Temp. ElecServ..
Called PG&E
Temp. Gas Serv.
Called PG&E
FINA ED
(Da i
gnature)
i�
tl
I
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING
BUILDING (Cont'd)
PLUMBING
Setback,,*— 3
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
Insulation
Heaters
Slab
Carport
Footings
Slab
Prov. for phsically Z
handicapped
Conformance of ex.
structure
Final �—
Appliances
Gas Piping & test
Temp. Gas .
Sanitation
Patio
FIREPLACE
Final
Footin s 'r
Footing
ELkCTRICAL'-
Masonry Walls
Throat
Rou h
Reinf. Steel
Final
Fixtures'
Bond Beam
FIRE SPYdNKLERS
Motors
Framing r C
Test
Water Htr.
Stucco
Final
Subpanels
Mesh
MECHANICAL
Grd. Fault Prot.
Scratch
Heating
Service
Brown
Cooling
Temp. Pole
Finish
Underground
Interior Lath
4Ducts
Ventilation
Permanent
Door Closer
Final
Final
MOBILEHOMEUTILITIES ---------•-------- Elec. Service
Elec. Pedestal
Water Piping
Sewer
Gas Piping
BI E OME 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 - Oroville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
7
AA 12P
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
XDate
Signature of Pe mi[te�']r gent
Receipt No. ` u
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.
DIRECT -OR OF PUBLIC WORKS
By Date I2'1?- 719
wilding permit expires Date /2—/P,Fo
BUILDING it 164
Owner N000AAO L, P406M
SQ. FT. OCC. BUILDING VALUA 10
o
27x) 500 90
f
Mailing Address T & X VS
' 6(SS �
Te,3pho�S�Z
Contractor O w AJ (mf—
Mailing Address
Fireplace
Total Valuation
Telephone No.
Permit Fee % roo
Building Address R_froNJ)AVE ArPP. 2L(DJ
Plan Checking Fee&/or Penalty 10.00
Permit Fee t 1C)o
L&RICt1J 2p
PLUMBING No.1 @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
�(&a
Repair drainage or vent piping 1.50
A. P. N0. � ~ )� C)�
5
��/
Zoning 8 Planning
Water piping 1.50
Each gas water heater or vent 1.50
F s
Sa on Fire Dept.
FireZone
Use Permit
Gas piping system 1 -5 outlets 1.50
EQA
Parking
P ans
P reel
Declaration
Parcel Map
60' R/W
Improvements
Each additional outlet .30
B 'Iding sewer 5.00
Bldg. Ions Recd
Parcel Approval Plans Approv
Lawn sprinkler system 2.00
NEW ADDITION ❑ UTILITIES ❑ OTHER ❑
Permit Fee $
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service 600V OR LESS
100 AMP OR LESS 5.00
Single Family ❑ Duplex ❑ Mobil Home
Others
Main service EA. ADD'L 100 AMP 2.50
O(?,-Q OC�
r G �
100 AMP Main service OVER soovOR LESS 25.00
Main service EA. ADD'L 100 AMP 1.00
NEW CONST.( OR ADDNS. ACCLLING BLDGS.CCUP. S� 20sgft.
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:
T
NEW RESID, BRANCH
NON.RESID, ` BRANCH CIRCUITS 2.50ea
NEW CONSTR.//POWER APPARATUS 11
NON .RESID. (SINGLE OUTLET CIR.
Ex. OCcuD{OUTLETS OR FIXTIIRES BAL@251't
FIXED APPLNS, OR
Ex. Occup. 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 $
$
MECHANICAL No. @ FEE
WORKMEN'S COMPENSATION INSURANCE
t 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.
RI 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.
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
+2.00
Hood
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
Land Development Fee
$
TOTAL PERMIT FEE
$ CJC
I
2 '
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
XDate
Signature of Pe mi[te�']r gent
Receipt No. ` u
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.
DIRECT -OR OF PUBLIC WORKS
By Date I2'1?- 719
wilding permit expires Date /2—/P,Fo
2060-7V
PERMIT NO. 738-79P,E
m�PERMIT EXPIRES
'OWNER Donald L.Hodges
owner
CONTR.
25-13-84
LOCATION (A.P.• }
N/A Almond Ave. app. .of Larkin Rd.,
Boggs
,c
t•:
iC
d _
t Temp. Power Pole
Called PG&E
Asmp!-Elec. Serv.
Called PG&E^�
Temp. Gas Serv. `
JB
alled PG&E
-
�9
FINALED
(Date
(Signa ure)
c
h
I
y .Y .. � .
_ - � r � r
� �
- _
_ — _.. , , , - . _ � s I f . � _- . _ _ . _ ..-
1-„
� � ` '
_ .' ,
COUNTY OF BUTTE — DEPARTMENT 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
StemwaII
Siding
To out
Slab
Roof Sheathing
Water Piping
Piers
Roofing
Sewer
Garage-
Fdn. Vents
Fixtures
Footings
Stemwal I
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Carport
Footings
Prov, for ph sically
handica ed
Conformance of ex.
structure
Appliances
Gas Piping & Test
Temp. Gas
Slab
Final
Sanitation '
Patio
FIREPLACE
Final
Footings
Footing
ELECTRICAL
Masonry Walls
Throat
Rough
Reinf. Steel
Final
Fixtures
Bond Beam
FIRE SPRINKLERS
Motors
Framing
Test
Water Htr.
Stucco
Final
Subpanels
Mesh
MECHANICAL
Grd. Fault Prot.
Scratch
Heating
Service
Brown
Cooling
Temp. Pole
Finish
Ducts
Underground
Interior Lath
Ventilation
Permanent
Door Closer
Final
Final
MOBILEHOME UTILITIES ------------------
Elec. Service M -,
Elec. Pedestal .5?7
Water Piping
Sewer —`7
Gas Piping
70BILEHOME INSTALLATION - - - - - - - - - = - - -
Support
Elec. Continuity =
Water Piping —
Drainage
DATE
REMARKS OR CORRECTIONS
moty w� 1, ti! de.�
V Q
zea s�
(NOTE: An entry must be made on this form each time you visit the job site.)
COUNTY OF BUTTE
r)EPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE
OROVILLE, CALIF. - 534-4541
CERTIFICATE OF OCCUPANCY
This mobilehome has been installed in accordance with the requirements
of the California Administrative Code, Title 25, Chapter 5, under permit
number '711, 37) - -7 `% for the.following location:I Al
Owner
Owner's Address
Mobilehome Mfg.--Ir
Mfg. ---II j�' 't N Model '?` 1 Year 7
Insignia No. Serial NoA ,-� �� 3 --� 2A
It is hereby certified for occupancy at the above described location and
may be occupied.
Director -of Public Works
Date / By-
THIS
y THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED
White - Owner, Yellow - Installer, Pink - D.P.W.
- MOBILEHOME INSTALLATION INSPECTION CHECK LIST
1. Is the mobilehome located w'th equired separation from lot lines and buildings andgenerally
conform to plot plan? Yes_ No
2. Does the mobilehome have required clearances above ground? (Sec.5085) Yes i,�No
3. Are footings and supports properly sized, spaced, and braced'as per approved plans? (Note
possible variation at spring shackles.) (Sec..5082 & 5083) Yes No
4. Is the mobilehome level? (Sec. 5088) Yes C" No
5. If more an a single unit, are crossover connections properly installed?:(Seca 5088)
Yes No_
6. Water
A. Is flex' le connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566)
Yes 1/ No
B. Test - Does water piping withstand working pressure or 50 lbs. air test? Yesi, No
C. Backflow - If coach is not St t California approved,. does station have backflow device
and pressure -relief valve? Y o
7. Wastes and Drains
A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes
B. Does it have minimum" per foot slope and is it properly supported? Yes_ k--No—
C.
o
C. Are any leaks detected in drainage system after running 3- llons of water through each
fixture including washing machine standpipe?,.Yes No
D. If coahr' not State of California approved, does station have required trap and vent?
Ye s / IO
8. Gas Piping and
and Gas Vents
A. Connector - Is mo ilehome connected to the gas supply with pproved 3/4" minimum
mobilehome connect r not more than 6 ft. long? Note: piping is to be at least as
large as the mobile me gas line inlet without redu ons other than the mobilehome
connector. Yes No
B. Test OK as per.following rocedure? Yes No
1. Open all appliance con ectoZ__ 2. Shut off appliance burner valves.
3. Air test with manometer o 1 '-14" water column, or test with slope gauge (minimum
6oz.-maximum 8 oz.) c ibrated 'n tenth pound increments. Test for 10 min. without
drop.
4. Connect gas nietaf to mobilehome with\ nnector, turn on gas, test connections with
soapy water.
C. Are all appliance vents properly installed? es No.
9. Electrical
.A. Is service large enough 'to provide",'ad'equate amperage. to mobilehome (must equal"ratitg orr
mobilehome with a minimum of 1 'amp).and other facilities•on.lot, i.e., water pumps,
.garage, cabana, etc.? Yes No_
B. Is there proper clearances around panels? Yes 11 No
C. Is power supply cord or feeder assembly properly fused? Yes No
D. Is continuity test satisfactory as per the following. procedure? Yes_L/.No.
1. De -energize electrical wiring system of the.mobilehome at the pedestal.
2.. Make sure that the power supply cord or feeder assembly conductors, including neutral
conductor, have been disconnected.
3. Switch all breakers and switches in the mobilehome to the "on" position.
4. Connect one lead of a test instrument to the mobilehome grounding conductor.and..
apply the other lead to each mobilehome supply conductor, including neutral.
5. All non-current, carrying metal parts of the mobilehome (aluminum siding, -,gas line,
water line), including fixtures and appliances, shall be tested for continuity from
such equipment'arid-the grounding conductor.,`
6. Upon completion of the above procedure, the power supply cord or feeder assembly
conductors shall be connected to the site service equipment. A further continuity
test shall then4•be'made between the grounding electrode and the chassis.of the
mobilehome. Upon satisfactory completion of.the electrical tests, the lot or site._
service equipment may be -approved for energizing.
10. 'Is job card signed by'Health Department for water and sanitation?
t
ll..If everything okay, sign off card and tag services.
MOBILEHOME DATA
Manufacturer and/or Namestyle
Length,__,_ Width W- )a Z
Vehicle Serial No.
State Identification No.
Additional Information or Comments:
i
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965
` Telephone: 534-4541
APPLICATION AND PERMIT
aurnonze represeniaiives oT me county or tsuiie io enier upon me
above-mentioned property for inspection purposes.
X- 4 Date
Sign ure of Permitee or Agent
Receipt No. )
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
abovej"which fees have been pa(d
EC70V OF PUZLIC WORKS
Tuilding permit
expires Date ;Am
BUILDING
Owner 440111,4GO //6 zj LeS
SQ. FT. OCC. BUILDING VAL ATION
Mailing Address 7` &CY 6S! 6
�j
Telephone No.
Contractor /LT�lU;$ O /G�/��' Se&U/Pe-
Mailing Address QQ„BQ ,7
Fireplace
Total Valuation
e-14
Tel No. �
Permit Fee
Building Address K7% ;g�S" � ��
Plan Checking Fee&/or Penalty
Permit Fee
L -
PLUMBING No.1 @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
Repair drainage or vent piping 1.50
A. P. N0. S — 1 -- y
Zoning 8 Planning
Water piping 1.50
Each gas water heater or vent 1.50
F
men
Fire Dept.
FireZone
Use Permit
Gas piping system 1 - 5 outlets 1.50
EQ A
Parking
Plans
ParcelEach
Declaration
Parcel Map
60' R/W
Improvements
additional outlet .30
Building sewer 5.00
Parcel royal
Plan Prov,,
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
Permit Fee $
$
ELECTRICAL No. @ FEE
PERMI T' FI LI NG FEE $3.00
Main service 100v OR LESS 5.00
100 AMP OR LESS
Single Family ❑ Duplex ❑ Mobil Home Others ❑
Main service EA. ADD'L 100 AMP 2.50
Main service OVER 600V 25.00
100 AMP OR LESS
Main service EA. ADO'L 100 AMP 1.00
NEW CONST DWELING
OR ADDNS. ACCLBLDGS.CCUP. 51 2¢sgft
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: ^^ ss
#L6TO/V �vl��<«�d/YJ�SC�/7/�"-
NEW RESID, BRANCH CIRCUITS T
NON.CONST BRANCH CIRCUITS/ 2.50ea
NEW CONSTR. (POWER APPARATUS B
NON.RESID. SINGLE OUTLET CIR.
Ex. OCCUP(OUTLETs OR FIXTIiRES)BAL@100
Ex. OCCUp. OUTLETS FIXED PL SID )RE A) 2•00
Temporary service 10.00
Mobile Home Facilities 15.00
License No:�a9/ Classification _46
Misc. Wiring 6.25
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
MECHANICAL No. @ 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
Cal i forni a.
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
ee M
$
TOTAL PERMIT F E
$
aurnonze represeniaiives oT me county or tsuiie io enier upon me
above-mentioned property for inspection purposes.
X- 4 Date
Sign ure of Permitee or Agent
Receipt No. )
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
abovej"which fees have been pa(d
EC70V OF PUZLIC WORKS
Tuilding permit
expires Date ;Am
BUTTE COUNTY DEPARTMENT OF'-PUBLIC•WORKS
7 County Center Drive, Oroville, CA•.
PHONE: 534-4541
• 0 '
MOBILEHOME INSTALLATION SHEET
.1. Owner's name :.Do"Ac p
2. Installer's name:
3.`. Is the site currently under permit? Yes hl No
two
(If yes, furnish Permit number13.6 — 77 P" f) OR
Is the site an existing site? Yes / / No
(If yes,.furnish two (2) plot plans.)
4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields -and
clear of all setbacks and easements? Yes No
(If no, clarify
5.
What
is the mobilehome electrical rating? -----------------------
Amps
6.
What
is the mobilehome site service rating? ----------------.-----
02 00
Amps
7.
What
is the mobilehome site circuit breaker rating? -------------
/j0
Amps
8.
Is there any other electric load to be served by the mob-ilehome
site
service? ---------------------------------------------------
Yes / / No
/!/J
(If yes, identify the load and size: (Load)
(Amps)
.9.
What
is the mobilehome site gas pipe size? ----------------------
(in.),.
10.
What
is the type of gas service? ----------------------------- Natural LPG
11.
What
is the gas pipe length from meter or tank to the mobilehome?
(ft.)
12.
What
is the mobilehome gas demand? ------------------------------
BTU)
(This information not required if pipe length less than 6 ft.
on natural gas
or less than 50 ft. on LPG.)
MOBILEHOME SUPPORT DATA
nn If other than single w' e
Mob�ilehome Mfr. gle-u&,ec��"S�`. furnish Setup Model No � Year /
Width -34 (ft.) Box�Length l (ft.) Tagalong or Expando Size /6 ft. x 3 2- ft.
(SHOW SUPPORT DETAILS BE)LOW)
On,all mobilehomes manufactured after October 7, 1973; furnish manufacturer's ins'tallat,—
manual and structural setup sheets (if not on file with the County of Butte).
All center supports measured from - of
mobil,ehome unless otherwise specified.
Footings (check one)
Single �' 1. Wood either
pressure treated or
A" A i
foundation grade.
�uTTE COUNTI
BUILDING DEPARTMENT
APPROVED..
*If center piers are other than drawn above,
'draw in locations, spacing, and dimensions.
(in.) (in.)
_�X3o o 2. Other (specify)
- ❑
�._..c
Center support
Center support
� Supports (check one)
locations*
footing sizes
,
(in.)
1. Concrete block.
`�❑'"
j�,. ��.
,, !o
X_ .
�' A P' 1' il: 2. Other (specify)
y
(ft:)(in.)
(in.). (in.)
gyp
It < -Tagalong or Expando,
show support details.
(in.) (in.)
Typical_ Support
(in.) (in.) 'Footing.Size
(ft.)(in.)
(in.) (in.)
Max. Pier Spacing
/a-
-- Max. Overhang
ae-)I (in.)
t
(in.) (in.)
(ft.) (in.)
�uTTE COUNTI
BUILDING DEPARTMENT
APPROVED..
*If center piers are other than drawn above,
'draw in locations, spacing, and dimensions.
COUNTY OF BUTTE - DEFARTMENT OF PUBLIC WORKS
�r 7 County Center Drive - Orov,ille, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
auuw,lcc lcNlcac)nau Vca UI UIc I'UmIly ul OUIIC N CALCI upon lne
above-mentioned property for inspection purposes.
X Date
Signature of Per'itee or Agent
er
Receipt No. 1 D 85 o
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_QF PUBLIC WORKS
By ate 2- '1. -3 - 7 y
wilding permit expires Date -Z ` ZJ ` ?U
9
BUILDING
Owner
SQ. FT. OCC. BUILDING VALVA ON
Mailing Address a
Telep one Ng.
Contractor Oyu
Mailing Address
Fireplace
Total Valuation
Telephone No.
Permit Fee
Building Address f� Z ✓�
Plan Checking Fee&/or Penalty
Permit Fee
Uv "
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
Repair drainage or vent piping 1.50
A. P. No. S —' ..
�ning a P n
_Ww6r piping 1.50
Each gas water heater or vent 1.50
F&f
&,C. S on FireDept.
FireZone
Use ennit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking
Pians
Parcel
Declaration
Parcel p
60R/W
'
Improvemen
Each additional outlet .30
Building sewer 5.00
Bldg. P6�e<'d
ParcelL,Aopproval
Plans A oval
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ UTILITIESM OTHER ❑
Permit Fee $
$ (
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00 ,CSD
Main service 600V OR LESS C1i
10o AMP LESS 5.00 �V
Single Family Duplex Mobil Home Others
❑ P ❑ ❑
L
Main service EA. ADD - 100 AMP 2.50
Main service OVER 600V 100 100 AMP OR LESS
Main service EA. ADD'L 100 AMP 1.00
NEW CONSDWELING O
OR ADDNST ( ACCL BLDGS.CC UP. N1 20sq 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 RE. MULTI-OUTL T
NON.RESID BRANCH CIRCUITS/ 2.50ea
NEW CONSTR. (POWER APPARATUS .&
NON-RESID. (SINGLE OUTLET CIR.
Ex. Occup{OUTLETS OR FIXTURES 5 L�
Ex. QCCU p'FIXED APPLNS. OR
(OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
(-C_3 V A6 0
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. FEEPERMIT
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
Land Development Fee
$
TOTAL PERMIT FEE
$ t
auuw,lcc lcNlcac)nau Vca UI UIc I'UmIly ul OUIIC N CALCI upon lne
above-mentioned property for inspection purposes.
X Date
Signature of Per'itee or Agent
er
Receipt No. 1 D 85 o
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_QF PUBLIC WORKS
By ate 2- '1. -3 - 7 y
wilding permit expires Date -Z ` ZJ ` ?U
9
NO,TE:=--AII Materials & Workmanship Shall Be in
Accordance with Recognized Good Practices and
Opo -qualify prescribed for the Specified use -in the
Qn' 4otm Building, Plur6ing &C Mechanical Codes and
A6 National Eoectrical Codg,
407
This set of plans and specifications MUST bt
kept on the job at a!l times and iit is unlawful to
ma! a eny change, or alterations on same without .
writiicn permissic., from the Department of Pub.
lic Works, County of Butte.
M/l+
The 81OPg. Setback shall be 5 ft. from the
side property line and 50 ft. from the
centerline of the road, permitting a maxi-
. um of a 2 ft. eave overhang but er`irely
out of all easements. s
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All utility connections shall be
located within 4 ft. outsid6 the reov me' "%-1 f Septic system and
third section of the moble homle4 n i
onthehome. left (road) side of the mob Butte County H
quirements.
2
A permit will be required for the f
installation of the mobilehome. 4 j
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`' e
ration Aiiwiiiil-
to be as per
th Dept. Re.
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BUTTE COU. NTY
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ILDING DEPART
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