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HomeMy WebLinkAbout027-240-031_ �/�'_J Jam'. � .'r t ! a ':�`�• ��, �i2 �75 Zp IT PERMIT NO. PERMIT EXPIRES OWNER GARY PHILLIPS CONTR. owner ASSESSOR PARCEL 27-24-31port LOCATION 2725 Craig Avenue; Palermo OFFICE COPY Temp. Powe Address Called F , GAS Meter By Date Temp. Elec] ELECTRI Meter By Date Called P"F --J i. Temp. Gas Seri Called PGA JOB FINALED Signature =OK 0=Not OK = Not Readyable MOBILE HOMES Date MOB LE HOME UTILITIES (Plans) OK except #'s oning Requirements -Setbacks -Easements o' , Special MH Support -Sketch . ! .r; Location -Test -Fall -C/O -Concrete Location -Test -Easement Needed (Sketc lectr' ity; Location-Clearances-Grnd.-/ / Ai —7 - est -Wrap: / P'Uft. `/"Nat. or/ /"L"ft./ /"LPG . Utility Clearance Card -131 W Date1'/& rd -B1 Date Card -131 Date3-2.6.90Card-131 Date Date OBILEHOME INSTALLATION (Plans) OK excep Zoning Requirements -Setbacks -Easements potings; Size -Spacing -Marriage Line Gas; MH Test -Demand -Valve -Con 4. Electricity; MH Test -Crossovers- Leaker Clea Drain; MH Test -Fall -Flex Connector Water; MH Test -Regulator -Connector Water and Sewer Connected -C/O to Grade -HE 26 p L-&. s and Electricity Tagged t . Exits; Insp.-Sketch Card -B1 Card -B1 W. Cert. of Occupancy Card -131 Date Card -B1 Date Concrete #'s rances MISCELLANEOUS _ Date DECKS,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.- Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Elec. 8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Card -131 Date Card -131 Date Card -B1 Date Card -B1 Date _ Date 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- Enc losures-Panel boards- Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Card -B1 Date Card -61 Date Card -131 Date Card -131 Date 0 =OK o = NotOK RESIDENTIAL (Single and Duplex) - =Not Applicable = Not Ready Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks; -Easements -Flood -Slope 2. Ftg., Main; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils -Steel-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /"Ftg. Depth 5. Stemwalls, Main; Steel -Bloc kouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test 10. Gas Pipe; Size -Anchors 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric; Underground 13. Plenums & Ducts; Clearance-Material-Supprt-Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Insulation Card -81 Date Card -B1 Date Card -B1 Date Card -B1 Date Date PLUMBING (Permit) OK except #'s 16. Water Ht. Vent -Access -Combustion Air -Baffle 17. Water Pipe; Test & Anchors -Nail Protection 18. D.W.V.; Test-Fttngs & Anchors -Nail Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, 2nd Floor -Tub Access 21. Gas Pipe; Size & Anchors Card -B1 Date Card -81 Date Card -61 Date Card -B1 Date Date 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/Mech. Fasteners -Bond Gas & Water 27. 2 Appliance Circuts in Kitchen & Conductor Size/G.F.I. 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-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector Card -B1 Date Card -B1 Date Card -B1 Date Card -131 Date Date MECHANICAL (Permit) OK except #'s 34. A.C. Ducts Insulation & Support 35. Vent Fan; Exhaust above insulation 36. Condensate Drain & Overflow; Size & Grade 37. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet 38. Attic Access & Platform if Furnace in Attic Card -131 Date Card -B1 Date Card -B1 Date Card -B1 Date Date FRAMING (Plans) OK except #'s 39. Sills, Proper Material & Anchors 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound 41. Bearing Walls over Girders & Floor Nailing 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Header & Beam -Size & Bearing Date FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-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 Outriggers 55. Siding -Nailing Veneer 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 57. Glazing Area -Glass Protection -Skylights -Plastic 58. Shear Walls; Nailing -Bolts 59. Insulation-Walls-Clg. 60. Infiltration -Wal Is-Wndws Card -B1 Date Card -131 Date Card -131 Date Card -B1 Date Date FINAL (Plans) OK except #'s 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. 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-Mech. Protection 75. Plb., Elec. & Mech. Equip. Listed for Location 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 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; Plbg.-Appliance-Firepl.-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 Inpections 89. Gas Test -Meters Tagged; Gas -Electric 96. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates 92. Roofing Certificate Card -61 Date Card -81 Date Card -B1 Date Card -B1 Date Card -B1 Date Card -B1 Date Comments at Final: (NOTE: An entry must be made each time you visit job site) COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE OWN E 1 PERMIT NO. A rospection uine inindTc1a\tes t t the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office r when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. Id - It Inspector COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico— Phone: 891=2751 7 County Center Drive, Orovi Ile — Phone: 538-7541 747 Elliott Road, Paradise — Phone: 872-6307 /,(�CORRECTION NOTICE OWNER A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office _immediately. 1 /'OU/�•G HIO Or 4f/e� SiZ'C USS. cw r�t.T l4�1. Pli.a...q Fr C-3,u.el! •• 0 d 'e / / 9 iQ M 47 !i 1°. if V Inspector//, .�61—Date 3 � 0 —9U MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA — 534-4541 PERMIT NO. Address or location of mobilehome � % Z C- 0.. , `� E ' Owner's name (ZL�' O, Owner's address 4 a`� '' '» �~ s <?'' Insignia or hud number 1A7 4/ Z 3 ZL Manufacturer's name Serial number of V.I.N. 7 Y (Official Approving Installation) Year of manufacture 6 (Date) 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 FOUNDATION SYSTEM. 513B White - Owner, Yellow - Installer, Pink - D.P.W. .. c-r-r:R`t'r++^Ciaj+l,?tenr•..-.,�W,ritryt«y{>�X, r« r;Nj •� <r s. �' r. fKru °'f!'" '�f u i L.; ..44'�c.,�t 't . 9.Mjyr.! . s•, j:Zt � h3'itr"•• .t�', f r. 'vii vy}.,. ��'rt.''""e"r.1!x✓.:'..r^%ti -+` • COUNTY OF BUTTE = DEPARTMENT OF PUBLIC WORKS PERMIT NO. 1 7 County Center Drive - Oroville, Call,forpia 95965 - Telephone: 916/538-7541 F ' APPLICAMN AND PERMIT S ESSOR PARCEL'N MBAR As) {/(J ZONIN BUILDING PERMIT OWNER 1, I Cf m � 0 m O a TELEPHONE - 9a- SO. FT. OCC. BUILDING VALUATION 9WNE 'S.MAILIIJG ADDRESS I o 61v ocfb 95Sa f CONT CTO 'S NAME 110 VA TELEPHONE CONTR CTO MAILING ADDRESS Fireplace C 4'�J L.E: I(rQ UNKNOWN Total Valuation is Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee U Energy Plan Checking Fee E$. $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS T2s- 0 ro 14 vC r Permit fee $ PLUMBING PERMIT Filing Fee 10.00 i ^ a /`fa yr j Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO.' SUBDIVISION NAME PARC L MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex[] Mobilehomeg Other SPECIFY Gas piping system 1 - 5 outlets 5.0 Building sewer 5.00 Mobile Home Is G W 10.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ stallationx Other ❑ Describe work: E, f I rl t e- _ _fS' (, - I Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 i Main service 100 OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one):NEW ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license Is In full force and effect. License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure Is not intended or offered for sale. (Sec. 7044) I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST.DWELLING OCCUP.E OR ADDNS. ( ACC. BLOGS. / 2/2Osq ft CONSTR ULTI.OUTLET NON.R ESID BRANCH CIRC ITS 2.50 ea /POWER APPARATUS 6 (POWER OUTLET CIR. Ex. Occu p�OUTLETS OR FIXTURES eAL030 2AL@ 30 \ Ex. Occup. OUTLETS FIXED PIRESID ILNS REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 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. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liaVQities, judgments, costs, and expenses which may in any 0vay accrue again ail County -i consequ ce of the granting of this permit. X �A Date �Q�D Signature of Applicant — OwnerfS Contractor ❑ Age, ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST TYPE TOTAL FEE $ ' HAz I CUA PARK I SCHL — I F,�ra PAg/ PD HD Is u This permit is nereby issued under sions of the Butte County Code and/or work indicated above for which fees DIR TOR OF PUBLIC B y PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date / Receipt No. WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPAkTMEN1T_OF'1UBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 `J J 30T vk APPLICATIOWAND PERMIT ASSESSOR PARCEL NUhJPER - L!/f" - , ZONING BUILDING PERMIT OWNER 1 TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILINGf ADDRESS - opo, , CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 10:00—' Permit Fee $ 1Z', ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 7,05' Cry Permit fee $ PLUMBING PERMIT Filing Fee 10.00 f 2 Each Trap 2,00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome® Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer ,-f _7111 5.00 Mobile Home ISI G W 11 10.00ea TYPE OF WORK New❑ Add ition❑ Remodel❑ Utilities4 Installation[] Other Describe work: j `- Permit Fee $ Contractor - ELECTRICAL PERMIT Filing Fee 10.00 /1 y I 1 Main service e00V OR LESS 100 AMP OR LESS 10.00 / Main service EA. ADD'L 100 AMP 2.50 �• ��. CONTRACTORS'LICENSE LAW I declare under penalty of perjury (check one): ❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the BusinesS and Professions Code and my license is in full force and effect. License No. Classification �j 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) El 1, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.y , AC /20sq ft NEW CONSTP LTB OUTLET .50 ea NON-RESID .BRA CH CIRCUITS) 2.50 ea POWER APPARATUS &) SINGLE OUTLET CIR. EX. OCcup(OUTLETS OR FIXTURES eAL030 3020@50SAL0 FIXED ALINIS EX. Occup. OUTLETS P(RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ ` C'32 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 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. ril 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 10.00 Heating Cooling g Hood 3,00 Ventilation permit Fee = Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in anyway accrue againstsaidCounty �,co nsequence of the granting of this permit. %� �' �'��'�/ _���' Date % Signature ofL/A.,pplicant - Owner ❑u" Contractor ❑ Agent ❑ - An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures ovee'r 33�storiiess in height. Mobile Home Installation Fee $ Energy Inspection Fee $ „' ` TOTAL PERMIT FEE $ `� t Occu P. CONST.TYPC ISCHOOL17LO001PARC ��,f/ L I,trf PD ND ISSUE This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. 1 A DIRECTOR OF PUBLIC WORKS �/� BY ^ _ Date PERMIT EXPIRES Date f Receipt No. *4' / `-{ WNITE-O.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT I�♦t^i �A'.��-r, �v',rf�t yihi{tv� „.^• �,1 •a. '��Y ::f• •sC7��nf^1^,4fi„�;y it .1`i�vC.7��[f�yi!i��''•�j�,w ''.',' . ".'.t -' . '.,. ,,�'�i `,' t',• -, �' . COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PE RMIT NO. 7 County Center Drive - Oroville; California 95965 - Telephone: 916/538-7541 77 �! Q^ APPLICATION AND PERMIT / �1 jJ ASSESSOR PARCEL NUMBER } 27-24-66 ,� , ZONING A5 - BUILDING PERMIT OWNER William Bambula •�i TELEPHONE 393-3292 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 5970 Sampson Blvd Sacto 95824 CONTRACTOR'S NAME Unknown TELEPHONE CONTRACTOR'S MAILING ADDRESS - Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 25 Craig venue Palermo Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME __7TPARCEL MAP Water piping 5,00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome® Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S 13PIWI 10.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti Iities ❑ Installatim Other] Describe work: CBB Pip j,Oo �J _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main servicei00 AMP OR1 OR LESS10.00 Main service EA. ADD•L too AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect.SINGLE Icense 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) ❑ I am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.& OR ACDNS. ACC. BLDGS. 2/z¢sgfe NEW RFS ULTI.OUT LET 2,50 ea NON -R ESID BRANCH CIRC ITS POWER APPARATUS a OUTLET CIR, Ex. Occu po UTLETS OR FIXTURES 20®50aBAL®30 FIXED APLNS. Ex. Occup. OUT LETS PRESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities ' 15.00 Misc. Wiring r g 15.00 t 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,gi f Consent to Self -Insure. R ' 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 FiIingFee 10.00 Heating Cooling g Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1 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 ca of the granting of this permit. X ins aico conx2tr_�_ Date Signature of Applicant — Owner 52 Contractor ❑ Agent ❑ An OSHA permit is'required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 25,00 ALE HAz CUA PARK L PAR I PD I HD Is Th;s permit is hereby issued under the applicable provi- sions sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. I .EC R O UBLIC WORKS By. Daye PERMIT EXPIRES Date / Receipt No. 59358 WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT