HomeMy WebLinkAbout025-240-044i
i
25-24-44
Shirley Dow -� to -7i
W/S Access Rl ,800'N.of Palermo Rd;,
:
1000'E.of Powerhouse Hill Rd., Palaermo
Permit #6474-76P,E(util MH-exis.site)
E Imo. -- ---------.
GAS _�"�
SUPPORT STRUCTURE REQ. 40
COMPACTION TEST REQ. y,p
25-24-44�'�,,
4-76P as i
Permit #683 (g p p ing
6474-76
25-24-44
> ontr: McCart's Mobile �Home
Serv. ,Rose-'
ville
Permit. #9-77M1v ����
Issued /
n
� �f
Ln
{k, COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE
.5 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 51 under permit
number: A— 7 7 for the following location:
Owner /Z,
Owner's Address
Mobilehome Mfg. Model Year
Insignia No. 64Z /'I SSS- Serial No.
It is hereby certified for occupancy at the above described location and
may be occupied.
Directory of Public Works
Date—/ By
THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED
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
Stemwall
Sidina
To out
Slab
Roof Sheathing
Water Piping
Piers
Roofing
Sewer - /..-- z
Garage
Fdn. Vents
Fixtures
Footings
StemwaI I
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Carport
p
Footings
Slab
Prov. for physically
handica ed
Conformance of ex.
structure
Final
Appliances
Gas Piping &Test
Temp. Gas
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. Ao1e- j
Finish
Ducts
Underground
Interior Lath
Ventilation
Permanent
Door Closer
Final
Final
DATE REMARKS OR CORRECTIONS
i
10
eW41
t r• r P
I
(NOTE: An entry must be made on this form each time you visit the job site.)
t
PERMIT NO..,. R 6474-76P,E
PERMIT EXPIRESWF
OWNER Shirley Dow
CONTR. owner
SLOCATION (A.P. .25-24-44
W/S of Access Rd.,800'N.of Palermo Rd., 1000'E.
e
Power House Hill Hd.&M Palermo
t
,
I:
Temp. Power Pole
Called PG&E
! Temp. Elea Serv.
Called PG&E
T mp. Gas Serv.
Called
,los
• ► FINALED
f (Date
(Signature)
i
f !
9. Electrical
A. Is service large er..ollgl. to provide ::idcqu:rt_e amperage to mobilehome (must equal rating of
Mobi.leliome with J-E!iiniwlJlll of 100 amp) and other faciliti.E!s on lot, i.e., water pumps,
.ara ,e, cabana, ctc.:. Ye sX No�
1;. is thea'. proper clearances around panels? Yes No
C. Is power supply cord or feeder assembly properly fused': YesX,
Nc,_
D. Is continuity, test satisfactory as per the following procedure? Yes No
1. De -energize electrical wiring, system of the mobilehome at the pefestal.
2. Make sure that the power supply cord or feeder assembly conductors, including neutral
co'iid,,ctor, have+ been disconnected,
3. Switch all breakers and switches in`the mobilehome to the "on" position.
4. Connect one ls,.ad of a test instrument to the mobilehome grounding conductor and
the outer le ail to eacin riiob'11—len uLe siip�,ly CGfi.iuCtGr , llli liiiilklg YLC�1lYal.
apply
5. All nor. -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 and 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
te::;t shall then be made between the grounding electrode and the chassis of the
i'l.obilehome.. Upon sat'i_Isfactory completion of the electrical tests, the lot or site
service equi:pinent- may be approved for energizing.
;ob card signed by Health Departmeat for water. and sanitation?
:.1.. If everything okay, sign off card and t.a; services.
'MOBTLEMt4E DATA
Manufacturer and/or Namest:yle
Length Width
A
Vehicle Serial No. –6Ak—Q/7-5-
State Identif. icat i..on No.
Adel,t t Tonal Inf orma t: i on or C orrnrent s :
J
11, iii.
D4S'.1'ALLA;F10H INSPECTION 'CRECK LIST
1. Is the. mobilehome located wi.i.h required separation from lot lines and buildings and generally
conform to plot plan? Yec� No�
2. Doe;; thE! mobilehome have required clearances above ground? (Sec.5085) Yes/1/ No
3. Are foot n,;s 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) Yes4 No
5. Ifras vs� e onnections properly installed? (Sec. 5088)
Yes No
5. Water
A. Is flexible connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566)
Yes No
B. Test - Does water piping withstand working pressure or 50 lbs. air test?,Yes No
C. Bac�f---�f—c��C1"i is not State of California approved, does station have backflow device
and pressure -relief valve? Yes No
7. Wastes and Drains
A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes No
B. Does it have minimum 1;" per foot slope and is it properly supported? Yes No
C. Are anv leaks detected in drainage system after running, -gallons of water through each
fixture including washing machine standpipe? Yes_ No &
D. If roach ; a49t �-� artfornix a rove 7�
pp s station have required trap and vent.
Yes No
8. Gas Piping and Gas Vents
A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum
mobilehome connector not more than 6 ft. long? Note: All piping is to be at least as
large as the mol:Q,ehome gas line inlet without reductions other than the mobilehome
connector. Yes No
B. Test OK as per following procedure? YesNo
1. Open all appliance connector valves.
2. Shut off appliance burner and pilot valves.
3. Air test with manometer to 10"-14" water column, or test with slope gauge (minimum
6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without
drop. '
4. •Connect: gas meter to mobilehome with connector, turn on gas, test connections with
soapy water.
C. Are all appliance vents properly installed? Yes N oK %
COUNTY OF BUTTE — DER`!JRTMENT OF PUBLIC WORKS
7 County Center Drive — Oroville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT4.
t`Y
� Fig 9vTt� /�T%ycfic /�
` Date ✓� a /,�
5' ature of Peermite/eee or Agent
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRE OF PUBLIC WORKS
ByDate z-- 5
Building permit expires Date
BUILDING
Owner C3'L�
SQ. FT. OCC. BUILDING VALUATION
Mailing Address S.1" S S
"
T�ep�lon N�
s`+C�
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee&/or Penalty
Telephone No.
`
Permit Fee `p"
Building Address 0
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00 3, d
��,
Each Trap 1.50
v
Repair drainage or vent piping 1.50
yr4nl S-
U /�
Water piping 1.50
Each gas water heater or vent 1.50
2Lb
A. P. No.7-VI
1 Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
s
W. C.
ti Fire Dept.
Fire Zone
Use Permit
Building sewer -586 %OrOO
EQA Parking Parcel
Pllans// Declaration
Parcel Ma P
60' R/W
Imp
Provements
Lawn sprinkler system 2.00
BI �ladk'f�&OQ�
Parcel Ap val
Plans royal
Permit Fee $ �V
$ 0d
NEW ❑ ADDITION ❑ UTILITIES® OTHER ❑
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.0 3,00
-aAe
Main service 600v ORLESSESS 5•Q0 dd
100 AMP OR L
TT
Main service EA. ADD'L 100 AMP 2.50 V
Single Family ❑ Duplex ❑ Mobil Home ® Others ❑
OVR
Main service 10 EAMP oR LESS 25.00
Main service EA. ADD'L 100 AMP 1.00
NEW CON S T. DWELING OR ADDNS. ( ACCLBLDGSCCUP. &) 2�sgft
NEW CONSTR. (MULTI -OUTLET
NON.RESID. l BRANCH CIRCUITS) 2.50ea
NEW CONSTPOWER APPARATUS &
NON.RESI R. 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)@ -C
101
Ex. Occup. (OUTLETS ((RESID )REA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
EAI am exempt from the Contractors License Laws of the State of California.
Permit Fee $C1$
�Z5_ sC
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.1 @ 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. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby I
authorize representatives of the County of Butte to enter upon the
above-mentionefl nrnnprty fnr incnontinn n—none
Q Q 10, L
0G
TOTAL PERMIk FEE
$ C
This permit is hereby issued under the applicable provisions
of
� Fig 9vTt� /�T%ycfic /�
` Date ✓� a /,�
5' ature of Peermite/eee or Agent
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRE OF PUBLIC WORKS
ByDate z-- 5
Building permit expires Date
ti
�AeOwner• '1Z
Address:
Tenant:
Building Location: cS
Type of Inspection requested:
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS
SPECIAL INSPECTION REPORT
1. Housing / / 2. Financing
/ 4. Other (specify)_
Present use of building:
A. P. #
Date of Inspeeection al9 7
Inspector
3. Change of Occupancy to
040 �1�
A. Sanitation (Housing)
1. Water closet:
2. Lavatory:
3. Bathtub or shower:
4. Kitchen sink:
5. Hot and cold water to fixtures:
6. Heating facilities:
7. Natural light and. ventilation:
8. Room and space requirements:
9. Bedroom window or door for second exit:
10. Infestation of insects, vermin, r rodents:
11. Connection to sewage disposal: •
12. Connection to water supply:
13. Rubbish and garbage facilities:
14. Con ents:
B. Structural
1. Piers and footings:
2. Floor construction:
3. Wall construction:
4. Ceiling and roof construction:
5. Fireplaces:
6. Comments:
C. Electrical
1. Service and ground:
2. Receptacles:
.3. Fusing:
4. Count ents•
D. Plumb in
1. Fixtures connected and vented:
2. Gas water heater:
3. Gas heating vents:
4. Comments:�O
�� ��
(continued on back)
E. Other
1. Maintenance and repair:
2. Fire hazards:
3. Safety hazards:
4. Weather protection:
5. Underfloor and attic ventilation:
6. Comments•
F. Commercial Buildings
1. Roof covering:
2. Distance to property lines: _
3. Physically handicapped:
4. Restroom floors and walls:
5. Exits:
6. Improvements:
7. Zoning:
8. Comments:
G. Field Problems or Violations
1. Problem or violation (give complete description):
2. What action taken (give comple a description):
3. What action recommended:
/ / A. Information only - file.
B. Hold *for ten (10) days, then write letter.
C. Write letter.
/ / D. Other:
fhis set of plans and specifications MUST bt
kept on the job at all timxs and it is unlawful to
make any changes or alterations on same without
written permisson from the Department of Publirrn
Works, County of Butte.
c{�
The INvy. Setback shall be 5 ft, from the
side property line and 50 ft, from the
centerline of the road, permifiing a maxi-
n;u;., of a ? i,. ec;�-e overhang but entirely
cut of ull easements.
R-
All utility connections shall be
located within 4 ft. outside the rea
third section of the mobile home
A` on the left (road) side of the mbbilAtj
ome, z -
Septic system and
Fe44�to be as pe
Butte COUn y H --)K, f) -rt
001
11
5)-
NOTE:—All
Materials & Workmanship Shall Be in
Accerda;ice wiih Recovni_ed Good Practices and
of a cu':d:;,, " rES'f1 :7 for t;.e Spoz;ified use in the
Un'sfc I':u:.i'_.in,- & Mechanical Codes and
BUTTE M7NTY
BUILDING DEPARTPI
OPROVEV
-2-
�Y.
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
r 7 County Center Drive — UroviIle, California 95965
Tetephone:.534-4541
APPLICATION AND PERMIT
BUILDING
Owner Q zLo Q
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Fireplace
Contractor C 14-9-2 A41d 5:�L S
Total Valuation
Mailing Address I It
1
d C�
Permit Fee
Plan Checking Fee&/or Penalty
— �s�j
Tee hone No.
_ Q
Permit Fee $
Building Address CCE'S,$ • O
O��
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
e LZ Q .p U�U
Each Trap 1.50
_
S
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No.�j —�
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
F eksiW.
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
Declaration
Parcel Ma P
60' R/W
Improvements
provements
Lawn sprinkler system 2.00
Bldg. Plans Recd Parcel Aroval
Plan praval
Permit Fee $
$
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER R 1
ELECTRICAL No.1 @ I FEE
PERMIT FILING FEE J$3.00
III ;IksCom/ x Y
Main service 10O00 S
AMP OR LESS 5.00
Main service EA. ADD'L 100 AMP 2.50
Single Family Duplex Mobil Home Others
g Y ❑ P ❑ ❑
Main service OVER 600V
100 AMP OR LESS 25.00
Main service EA. ADD'L 100 AMP 1.00
NEW CONST DWELING
OR A.D.S. ( ACCLBLDGS.CCUP. &) 21tsgft
NEW CONSTR. MULTI -OUTLET
NON-RESID. (BRANCH CIRCUITS) 2.50ea
NEW CONSTR. POWER APPARATUS Ik
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:
A'14 ic � Al., /� N�' .P
-c
Ex. Occup(OUTLETS OR FIXTURES)@L29C
BAL�1
Ex. Occu FIXED APPLNS. OR
P•(OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. x�'-7 tol Classificatio( �( - %/
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
z)rkmen's Compensation Insurance.
certify that in the performance of the work for which thisVentilation
mit 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
12.00
Hood
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
$ �Jd
u IcNIcaol fl QU VVQ UI UIQ I�UUIILY UI OULLU tU UrItUl UNUn Ine
above-mentioned property for inspection purposes.
t/ a, , ,I, l'. J Date
Signature of Per/ermitee 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
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
g permit expires DateT�,Z
MOBILEHOME SUPPORT DATA
Mobilehome Mfr. ,5 (r/ c,, i n/ w Setup Model No. Year i C
Width (ft.) Length 10 (ft.) ' Expando Size ft.x 6,, ft. -
(Draw support details below)
On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation
manual and structural setup sheets (if not on file with the County of Butte).
Center Support
Footing Sizes
(in.)/
X I
in.) (in./
a
�. X
(In. )(in.)
t.�jt�n. in..
L
S
*If center piers are other than drawn above,
draw in locations, spacing, and dimensions.
Footings (check one)
1. Wood either
R \;� pressure treated or
Q fdn. grade.
2. Concrete pad.
3. Other, specify
Supports (check one)
1 1. Concrete block -
% / 2. Concrete piers
3. Steel piers
i
4. Other, specify
i ----- -Typical Support
Footing Size
3.n.) (lIl.)
i
i
Max. Pier
(' Spacing
A'-
_.. ` Max.
Over
hang
�ft (iri.)
.e.
BUTTE COUNTY DEPARTMENT OF PUBI C WORKS
7 County Center Drive, Orovil1%.,;., CA.
PHONE: 534-4541
MOBILEHOME INSTALLATION SHEET
1. Owner's name:
2. Installer's name: In 7:t /L, „ L, ; ll A/0 e
3. Is the site currently under permit? Yes No
( If yes, furnish permit number OR
Is the site an existing site? Yes,./ / No 777
(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? ----------------------- /p 0 Amps
6. What is the mobilehome site service rating? --------------------- Amps
7. What is the mobilehome site circuit breaker rating? ------------- /p O Amps
8. Is there any other electric load to be served by the mobilehome
site
service? ---------------------------------------------------
Yes /y /
No
(If yes, identify the load and size: t_l ,p �/
(Load) J p
(Amps)
9.
What
is the mobilehome site gas pipe size? ------------=---------
(in.)
10.
What
is the type of gas service? -----------------------------
Natural / /
LPG / K/
11.
What
is the gas pipe length from meter or tank to
the mobilehome?
12.
What
is the mobilehome gas demand? ------------------------------
....
(BTU)
(This information not required if pipe length
less than b ft. on natural
gas
or less than''S0 ft. on LPG.)
�� ���
�..�. m,�.� -ze.�.
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — 5 le, California 95965
Telephone: 534-434-4541
APPLICATION AND PERMIT f
Date e�/'�
N44gff
of Permiitee or Agent
/
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
the butte county uoae anaior resolutions to do work indicated
above for which fees have been paid.
DIRr R OF ELIC WORKS
By Date
permit expires Date —
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
(
Tel epho=e
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee
Telephone No.
&/orPenalty
Permit Fee
Building Address �jY�
PLUMBING No.1 @ I FEE
PERMIT FILING FEE $3.00'.Be47
Q
Each Trap 1.50
Repair drainage or vent piping 1.50
11 �2121-d! 4Ey
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No. --
Zoning 8 Planning
Gas piping system 1 - 5 outlets 610
Each additional outlet .30
FA -s-
smtt4lFireDept.
Fire Zone
Use Permit
Building sewer 5,00
EQA
PPlans arkin
Declaration
Parcel Map
60' R/W
Improvements
Lawn sprinkler system 2.00
Btd . ans ec'd
Parc 4Approval
Plans Approval
Permit Fee $
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
ELECTRICAL No.1 @ FEE
PERMIT FILING FEE J$3.00
wee
00V OR
Main service 600 AMP LOR ESSLESS 5.00
�7
Main service EA. ADD'L 100 AMP 2.50
Single Family ❑ Duplex ❑ Mobil Home JZ Others ❑
Main service 00 AMR OR LESS 25.00
Main service EA. ADD•L 100 AMP 1.00
NEW CONST. ING
OR ADONS. ( DWELL -ACC. BLDGS.CCUP. &) 22sgft
NEW CONSTR MULTLOUT LEI'
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:
Ex. Occup(OUTLETS OR FIXTURES)P2-
BAL01
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
kh 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 Section 3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
'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 $3.00Heating
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
abnve-tnPntannari nrnnarty fnr inenanrinn n..r.,n
TOTAL PERMIT FEE
$ dG
This permit is hereby issued under the applicable provisions
of
Date e�/'�
N44gff
of Permiitee or Agent
/
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
the butte county uoae anaior resolutions to do work indicated
above for which fees have been paid.
DIRr R OF ELIC WORKS
By Date
permit expires Date —