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HomeMy WebLinkAbout027-310-007r D 0 BECKER 8056 lvina Ave, Palermo \\ Permit# BECKER Delno x 781-67E^ 957-67B -84B, E(convert covered pore ?_3 t - p" l 1076-67B'�3; 1536=67P V to{,living area eroof/SF) 84. 67E 'SOS 61 PIC 0- 532 -071AIlff w�s Melvina Ave. just no: of Ave. I Permit#3477-85B(ls enewal/380 84 I Palermo ` (addition & remodel) ,�27-31-07 Meter change - CONTR: Ford Electric" • Permit 9-86B(2nd renewal/3807-84) 4-�i�6'7-_- (,�*a'dd carport) 0 27-:31-07 1585-90B I BECKER, George }- T 8056 Melvin6i Palermo. G� l { Contr : Don C. George �/� ' /'G (reroof/sf) i 1 i I I ' i `f f I i L � � ' f; r �'� t _� - ` , ` t _� - COUNTY OF BUTTE - DEPARTMENT OF 7 County Center Drive - Oroville, I^s!ifornla 95965 - Telephorie: 91 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER Z-7-31-7 ZONING BUILDING PERMIT OWNER MR. GOER1534-1908 TEL PHONE SQ. FT. OCC. BUILDING VALUATION S 1111 11 t -lip 500,00 OWNER'S MAILING ADDRESS 8 CONTRACTOR'S NAME DON Q. CRORCF, INC. TELEPHONE 531 CONTRACTOR'S MAILING ADDRESS Fireplace ' CONSTRUCTION LENDER UNKNOWN Total Valuation is 500.00 Filing Fee $ 10.00 LENQER'S MAILING ADDRESS Permit Fee $ 10, 00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee ,$' Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $$ BUILDING ADDRESS 8056 �ELVINA PALERMO. CA, Permit fee .V, _ -20.00 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 J LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE j SF ® Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home JSFG W 10.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other ® Describe work: _ RE—OOF 5 SQUARE AREA WITH BUILT—UP ROOVING. Permit Fee $ Contractor 3 ELECTRICAL PERMIT Filing Fee 10.00 Main service 6001 OR LESS 100 AMP OR LESS 10.00 i Main service EA. ADD'L 100 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. 452266 C-39 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 license ontract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Prof Code for this reason NEW CONST. ( DWELLING OCCUP.tr OR ADDNS. ( ACG. SLOGS. 2h¢sgft NEW CONSTR. ULTI.OUTLET NON.RESID BRANCH CIRC ITS 2,50 ea /POWER APPARATUS tri (SINGLE OUTLETCIR. I Ex. OOCUp(OUTLETS OR FIXTURES 120 0 50C aA 030 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) 1 2.00 - Temporary service 10.00 Mobile Home Facilities 15.00 Misc.}Miring 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 Buiidin •e ment a Certificate of Workmen's Compensation Insurance or ficate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to beco , 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. 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 against said Count n-eonrs quence of the granting of this permit. X Date MAY, 10, 1990 y SignatGre of Applicant — Owner ❑ Contractor ❑ Agent:] An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE 20.00 TOTAL FEE $ HAz I CUA I PARK I SCHL I FLD PAR PD rD I ISSUE This permit is nereby issued under the applicable provi- sions or the Butte County Code and/or resolutions to do work in&%ated above for which fees have been. paid. / DIRE�T OF PU LI - WORKS / B /1f Date y'.� - - PERMIT EXPIRES Date-. _� Receipt No. � "! L/ WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION 4 PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER ;,7-1-31-7BUILDING ZONING PERMIT OWNER MR. GOE GE BECKER TELEPHONE 53 —1908 SO. FT. OCC. BUILDING VALUATION MAILING ADDRESS- 80 6 MELVINA PALERMO, CA, CONTRA CTOR'S NAME DON C- GFORGE INC - TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ 500.00 Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 10-00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee ,$' Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 8056 MFT,VTNA PALERMO, CA- Permit fee $ PLUMBING PERMIT Filing Fee 10.00 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 5.00 Mobile Home S G W 10.00 e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Installation❑ Other ® Describe work: _ RE—OOF 5 SQUARE AREA WITH BUILT—UP ROOFING. Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD -L 100 AMP 2.50 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. 452266 C-39 License No. Classification F] 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 OCCUPM OR ADDNS. ACC. BLDGS. / YzQsgft NEW CONSTR ULT' -OUTLET NON -RE BRANCH CIRC ITS 2,50 ea POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20@y0¢ BAL030 Ex. Occup. OUTLETS FIXED PIRESID.ILINIS 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 I have placed on file with the County of Butte Building Department 1t� 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 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the 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, udgments, costs, and expenses which may in any way accrue against sa o equence of the granting of this permit. X Date MAY , 1 0 , 1 9 9 0 tura of Applicant — Owner❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct- n of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE 20.00 TOTAL FEE $ HAz CUA PARK SCHL FLD PAR PD HD ISSUE This permit is hereby issued under sions of the Butte County Code and/or work i ' ated above for which fees DIRE T OF PU LI B PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Dat ho rReceipINo.� /�n 117 / 0 HITE-D.P.W., TELLOW-ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT M Temp. Power Pole_ Called PG&E _ Temp. Elec. Service Called PG&E_ 4; Temp. Gas Service _ Called PG&E_ 32 ? ®� 8 JOB FINALED (Dat, Signature e PERMIT NO. - 3H07 -84B E 7` OJ�- PERMIT EXPIRES DELNO BECKER OWNER owner ib CONTR.. 1 ASSESSOR PARCEL 27-31-7 « 1 LOCATION 8056 Melvina Avenue, Palermo I, ff , tl fe" o j Temp. Power Pole_ Called PG&E _ Temp. Elec. Service Called PG&E_ 4; Temp. Gas Service _ Called PG&E_ JOB FINALED (Dat, Signature e 5 1 V, _, OK, 0 Not OK - = Not Applicable MOBILEHOMES = Not Ready MISCELLANEOUS :_1 _* Date MOBILEHOME UTILITIES (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except q's 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 2. Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/0 -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4, Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat.or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements Card -BI Date Date Card -BI Date POOLS (Plans) OK except N's 1. Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances 4, Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/0 to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date J = OK O A,Not O14. . . = Not Applicable RESIDENTIAL (Single and Duplex) SIE = Not Ready Date UNDERF OR Plans OK except #'s Date FRAMING Continued 1.Mining rogtriremenis-Setbacks-Easements 4 . P operty Line Firewall & Openings 2.&q --Main; Soils-Steel-Elec. Grnd.- / - Ftg. Depth 4 Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50, -6tairs-Width-Headroom-Rise-Run-Landing-Fire Protection 4. F ., Porches & Decks; Soils -Steel- / /" Ftg. Dept -54--P4ym=d_on Roof Overhang -Attic Vents -Rafter Outriggers 5 temwalls, Main; Steel-Blockouts-Wrapped-SI 52 Sidiug-Nailing-Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab53_esh-Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 9. Gas Pipe; Size -Anchors 5 . Glazing Area -Glass Protection -Skylights -Plastic 55. -Shear -Walls; Nailing -Bolts 10. Water Pipe; Test -Anchors -Regulator -Service Test 11.Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bol -Joists-Vents-Cripples Card -BI Date (v Q Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Dat Card -BI Date Date FI L (Plans) OK except N's Card -BI Date Card -BI Date Date PLUMBING (Permit) OK except"#'s 14. Water Ht.; Vent -Access -Combustion Air 6. Ext. Steps -Door & Sidelight Protection -Landings . Smoke Detector 58...6uraaee--Rents-Clearance-Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 15. Water Pipe; Test,&✓Anchors-Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 17. Shower Pan; Test, First Floor -Tub Access 59. 1 ::SEX;ting 60 -9.F -F -&--Bath Fixtures & Tub Access 18. Test Tyb & Shower, 2nd Floor -Tub Access 61-Etec,. Trim & Subpanel; Breaker Sizes -Labels 19. Gas `ipe; Size & Anchors 62- Stairs &_Rails 6z Fireplace or Stove; Clearances -Hearth 64.r-Ehec Outlets at Wood Panel; Int. & Ext. Card -BI / Date Card -BI Date 65. . ix . Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. e�El c. OufTts & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except N's 67. Garage-Fire-f5mr,,-Swing-Landing-Closer 68. -A:2: Duct hr-Garage=Damper t re & Transformer Clearance -Ins. Protection 69. ., - ance-Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 2 Receptacles Spacing -Lights &Switches at Doors :e S' a Boxes & No. of Conductors -Stapled 70.•-Wtr.,-Eiec-'&-Mech. Equip. Listed for Location es inarage; (G.F.I.)-Romex Protec. 2 Romex Installed Close to Edge of Studs & C.J. 24. quip. Ground made up w/Mech. Fasteners -Bond Gas & Water Insulation -Foam -Looked in Attic E] Yes pfiance Circuits in Kitchen & Conductor Size 73. GtuaFd Rails & Bee et,etruction-Post Caps u ee ' Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 74. _klole Door -Drainage &Wood -Earth Clearance Looked under Floor ❑ Yes 27-4ange-Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral ❑Yes 0 N 75. Following instld.: Drive t0.4es ❑ No; Walks es [:]No; Planters es El No -28--SeFvice-Riser Conductors & Ground -Main Disconnect 76.--G4neee;-Brown-Ftirrieh 2g-E'q p. Clearances; Panels-Motors-Mech. Equip. 77,•p,G_L4;i.t�-.D.l.soon neet-CIrnces-Brkr. & Cond. Size -115V Outlet lothes Closet Light -Shower Light 78, Ptbg.-Appliance-Firep1.-Clearance to Opngs. 7 isconnect, Electrical, Plumbing Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B -I Date Q Q. Z9 S Card -BI Date .,,.Ventilation throughout House 82 Card B -I Date �Tj--gCard-BI Date Date MECHANICAL (Permit), OK except q's 31. A.C. Ducts; In anon &Support 1-1'8-3. Corrections from Previous Inspections 84. Gas Tacf_Meters-Tagged; Gas -Electric 8 .. er Sewer Connected -C/O to Grade -HD Approval 32. Vent Fan; haust above Insulation 33. Conde to Drain & Overflow; Size & Grade 8&__E_ nerpy-Zom a ificate-Other Certificates 34. Fur ce-Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Xtic Access & Platform if Furnace in Attic Card -BI Dat - i Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FR ING Plans OK except q's Comments at Final: 36. ills; Proper Material & Anchors 3zK Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound 3 Baring Walls over Girders & Floor Nailing r top in Walls (rat proof) -4 . ire Stops; Furred Ceilings -Stairs -Chases -Tub 4 Header & Beam -Size & Bearing s -Post Caps -Anchors -Connectors 4 Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfn_g_._ 44.--Fir2ptace Ties or Type A Flue -Fireplace Throat 45-Attm-Access; Size & Romex Protection -Draft Stop -Ins. Baffles 46_.84rfrt-Windows or Exiting Doors -Sill Hgt. & Dimensions ge Fire Protection Framing (NOTE:Anentrymust be made each time youvisit jobsite) COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 - 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE R&te-2- c OWN R PERMIT NO. 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. �(� M e .V box r w« i4e 4A J ' r i Inspector_.__ Date /D A S ___ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PE MIT V/v ASSESSOR PARCEL NUMBER - 3/^ G ZONING Av - BUILDING PERMIT OWNER O 1= p l� TELE HON 5.,`� P69 �`l" O SO. FT. OCC. BUILDING V TION ' OWNER'S MAI NG ADDRESS Q - fox 5 �C,ei� l 9s9(o8 do, � CONTRACTOR'S NAME®alk"` TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is 44590, Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ • 00 ARCHITECT OR ENGI EER LICENSE NO. P�llapng}Checking Fee $ 20 r 04r 6(16�24/ �QO $ - C" ARCHITECT OR ENGINEER'S MAILING ADDRESS --pe" Permit fee $ 95/ &<) BUILDI G ADDRESS ////^� fin},/ DW C V //V/ / / r C. PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 Q Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5,00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SFK Duplex❑ Mobilehome❑ Other SPECIFY Building sewer 5.00 Mobile Home ISI G W 10.00e TYPE OF WORK New ❑ Addition[:] ,R/emodel tl li jos Elstal lati nn .�ther ❑ Describe work: w�v� L) o uVlN — S Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. G0'cC . OR ADDNS. (DWELLING 2%ftq ft , , b"t� CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business20@50t and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR. MULTI -OUTLET 2,50 ea NON-RESID BRANCH CIRC ITS NEW CONSTRPOWER APPARATUS & NON-RESID, (SINGLE OUTLET CIR. Ex. Occup(o X OR FIXTURES DAL®30 IED A PLNS R Ex. OCCUp. OUTLETS (RESID )EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify at I have read this application and state that the above information is cor. ct. I agree to comply to all County Ordinances and State Laws relating to b Ilding coternstruction, and hereby authorize representatives of the Countyot Bu a to enupon the above-mentioned property for inspection purposes. Lave, gree to sindem nd keep harmless the County of Butte against u tr c� and expenses which may in any way accrue conseq ce of the granting of this rmit. Dat ' 4C Q ` Signature of Applicant — OwnerContractor ❑ Agent ❑ An OSHA permit is required for excavo •ons over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ G 3 w TOTAL PERMIT FEE $ ��� OCCUP. GROUP TYPE of CONST. PARCEL No ISSU This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECT OF PUBLIC By. PER EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Z� N 'Q Receipt No. ��� WHITE-D.P.W., YELLOW-ASSFSSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENf & OUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE,.CALIFORNIA 95965 - TELEPHONE: 916/534-4541 PERMIT APPLICATION DATA SHEET TTom�,, Permit No. OWNER !iG`�U F.3ECi���P A. P. No. Proposed Building Use ���✓`— �'O�/y Poe�� Cit/tiG Permit Fee Based Upon/) Complete Contract Price ✓DPW Valuation Building Inspector Other (Explain) Date IV HCl - F? At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED t� 1. All items have been submitted. . . . . . . . . . . . 2.. Plot plans in duplicate/triplicate. . . . . . . . . . . 3. Complete plans in duplicate./triplicate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . Plans with Energy Design Compliance Statement. . . . . . e Energy Forms No. SiGICO' 7 , 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . 9. Letter of signature authorization. . . . . . . . . . . 10. Sanitation approval from Health Dept. . . 11. Planning approval for (A) Use: (B) Parking: . 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner0, Mail to owner ❑.) 15. Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . .. 17. Pre-Inspec. request to Pre -Inspection for Required. Building Inspector (Date) 18. Recorded copy of Agricultural Acknowledgment Statement. 19. Other When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other f" - Applicant 7 %z Date f = - lei Copy of plans sent Health Dept., Fire Dept`��Other Date During the plan checking process, the following data must be submitted prior to permit issuance. (For required items not checked above at ime of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designe ,caner as advised of above required data by _407elephone Mail Other By Date /1 Plans checked by Plans approved b, Other: Copy—DPW Date Date FORM 7 ENERGY SHEET FOR ADDITIONS TO RESIDENTIAL BUILDINGS PERMIT N0. 07- PACKAGE "A" (Additions) NAME O SQUARE FOOTAGE JOB ADDRESS OExisting Residence TYPE OF. WORKk/2.T C'� New Addition f New Total The following information sheet, showing+mandatory features and required features of` Package "A" must be completed and attached to all plans for additions. to dwellings. ,Additions to dwellings include room additions,.converti'ng garages and patios to living areas, house moves that add footage and attic conversions, and any space that is ex- isting non -conditioned space that is converted to conditioned space. Remodeling of existing conditioned space is not included. ZONE 11 ZONE 12 ZONE lE INSTALLED APPLIES TO NEW AREA CEILING R-30 R-30 R-38 soo<ALL R-11 R-11 R-19 FLOOR R-11, R-11 R-19 ✓SLAB R- 7 R-11 R- 7 4/GILAZING 65 .65 .65 SHADING &­�'OUTH OPTIMUM OVERHANG or .36 S.C. !/WEST - .36 S.C. LOOSE FILL INSULATION (Density) ,--INFILTRATION CONTROL (Weatherstrip doors, certified windows, caulking) VAPOR BARRIER (Zone 16) -DUCTS PER UMC - Ch. 10 LIGHTING KITCHEN & BATH NOT LESS THAN 25 LUMENS/WATT _ MIG/AXIMUM GLAZING 16% OF AREA PLUS REMOVED GLAZING NEW HVAC AND HOT WATER IN CONJUNCTION WITH AN ADDITION SHALL COMPLY AND FILL OUT DATA ON BACK OF THIS SHEET 7/83 13 *1 ❑ ❑o a on ❑ *2 HEATING VENTILATING, AIR CONDITIONING SYSTEM (A) Heating Central Gas Furnace (brand and model number) SE Btu/hr (heating capacity) Heat Pump (brand and model number) ACOP Btu/hr w (heating capacity at 47°F) Active Solar type (liquid or air) Collector brand and ft2 model number solar fraction collector area collector orientation collector tilt rated y -intercept rated slope Other (describe) (B) Cooling Electric Air Conditioner (brand and model number) (seasonal EER) Btu/hr (cooling capacity at 95°F) Electric Heat Pump EER Btu/hr (cooling capacity at 95°F) Other (describe) DOMESTIC WATER SYSTEM (A) Gas Only Gallons (brand and model number) (tank size) Heat Pump w/Electric Backup (brand and model number) Gallons (tank size) Active Solar (collector brand and model number) (rated y -intercept) (rated slope) (solar fraction) ft (backup heater type, brand and model number) (collector area) (collector orientation) (collector tilt) Location of Solar Panels Other (Describe) *1 Submit documentation of sizing heating and cooling equipment by Manual J, sizing charts (form #4) or other approved methods, section 2-5352(g), and fill out the following: Heating: Winter design temperature °, elevation ', heating load BTU elevation factor x heating load maximum outlet capacity gas furnace BTU Cooling: Summer design temperature cooling load BTU *2 Submit T.I.P.S.E. chart or other approved ystem ( orm #5) to document sizing of solar panels. ® DESIGN COMPLIANCE STATEMENT: The ab ve building esign meets nts of Title 24, Part 2, Chapter 2-53 of t e Calif9rnia Admin KEY &.LAUGHLIN, INC. CIVIL ENGINEERS 1646 POOLE BOULEVARD YUBA CITY. CA 95991 (916) 674-3481 &'4477 fl.41) PROD EcTlaAw-v9fl. 'L,?, -i By -DATE CHECK DATE SHEET / OF M- �1 CO iC l Cox �� z kA All -7 'A ZYZ- 4--y «o) C9 TABLE 2-53U11. ALTERNATIVE COMPONENT PACKAGES FOR CLIMATE ZONE 11 BUILDING ENVELOPE t if Insulation Minimums I,} • Ceiling R 30 Wa111 sjlR11 (R5.0) Slab Floor Perimeter R 7 Raised Floor R 11 Glazing i Maximum U Value f� 0.65 Maximum Total Area no requirement Maximum Total Nonsouo Facing Area 9.6% f gas or heat gas or heat Minimum South Facing, pump Area 6.4% Shading { f B R 30 R 19 (R 5.5) ` (..R 7 R 19 0.65 14.0% no requirement no requirement South Facing Glazing p! optimum !I optimum overhangor ' overhang or r 0.36 shding', 0.36 shading coefficient '� coefficient West Facing Glazing 0.36 shading; 0.36 shading coefficient coefficient Thermal Mass required ` not required C R 30 - R 11 (R 4.0) R 7 R 11 i 0.65 16.0% no requirement no requirement optimum overhang or 0.36 shading coefficient 0.36 shading coefficient not required Continuous Infiltration Barrier not required not required not required Electrical Outlet Plate Gaskets not required not required not required SPACE CONDITIONING SYSTEM Heating System Type gas or heat gas or heat gas or heat pump pump pump Air -to -Air Heat Exghenger not required not required not required DOMESTIC WATER HEATING SYSTEM TYPE gas, heat pump, gas, heat pump, + solar with gas or solar with or solar with backup heat any type of any type of backup heat backup heat 1. The value in parentheses is the R -value for the entire wall assembly if. the wall weight exceeds 40 pounds per square foot. The insulation must be integral with or installed on the outside of the exterior mass. The inside surface of the thermal mass, including plaster or gypsum Loard in direct contact with the masonry wall, shall be exposed to the room air. The exterior wall used to meet the R -value in parentheses cannot also be used to meet the above thermal mass requirement. 2-46 C-51 BRC IF � � rpti r D T 1l 't1 11 v R1 inr� • 0 0 z�3LP �D p L L T L L n 3 Q L ��cA Z _ lie A c 10 Ze ts Ic 01 �� S 3 L-- T- L\ L\ D D D 0 1-t rod Q� - A cX. �D v 0 A-4 Z _ J A A b p =3 3 L p D 0 0 i3 z a os 0 in p m Y A$°t3c pv n Z rr !D -3LAQ NN 4_0 N x m v A-4 Z _ ts Ic lft���i�d►�'�tA 4b- � zz r VA � CE r N N �' Q � � � tJ J1 Jl Jl � t!� � � •�l � � � N � fJ � N ^l J► IL Am ra L C t` v r m i COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 /,/�`'_�/ APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 27-31-07 ZONING BUILDING PERMIT OWNER Delno Becker TELEPHONE -1908 SO, FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS a e o CONTRACTOR'S ARE owner TELEPHONE 1st renewal permit CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER none UNKNOWN Total Valuation Is Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee @ 2 FEE $ 20.00 ARCHITECT OR ENGINEER none LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ 30.00. PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Palermo 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 SFKI Duplex❑ Mobilehome❑ Other conv cov porch to living SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00 ea TYPE OF WORK New❑ Addition❑ Remodel❑ Utilities❑ Installation❑ Other Describe work: _ 1st renewal permit #3807-84 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): El am licensed under provisions of Chapt. 9, Div. 3 of the BUslnes$ 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 thig3pson NEW CONST. DWELLING OCCUP.e , OR ADDNS. AGC, BLOGS. /20sgft NEW CONSTR. MULTI -OUTLET 2,50 ea NON.RESID BRANCH CIRC ITS POWER APPARATUS e (SINGLE OUTLET CIR. Ex. OCCUp(OUTLETS OR FIXTURES 20®50t SALeso Ex. OCCUp. OUTLETS (RESID )FIXED APPLNS. KEA.) 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 FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte toe er pon the above- boned property for inspection purposes. I also Yee t save, ind ni _and keep harmless the County of Butte against all li il'ties jud and expenses which may in any way accrue I st i y n onse ence of the granting of it. rf/ X Date f ignotur o pplicant — Owner [IContraror ❑ Ag r ❑ An OSHA permit is required for excavations over "deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ 30.00 OCCUP. CONST.TYP! FLOOD PARCEL PD No 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 ave been paid. ECT PURL RKS By pate PER E IBES Date 12-21-86 Receipt No. 6_/ WHITE-O.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT — �L . — COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-534-4541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building -permit.' No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and aterials for construction of the proposed property improvement (yes or do) 2. I (have/have not) signed an application for a building permit for the proposed work. - 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I.have hired the following person to coordinate, supervise, and provide the major work: - Name Address' City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Sign Date f NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. ",X.- . COUNTY OF BUTTE DEPT. OF PUBLIC WORKS SEC 6 i985 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT i PERMIT NO. ASSESSOR PARCEL NUMBER 97-31-n7 ZONING BUILDING PERMIT OWNER T)PI nn Rprki-r TELEPHONE 9019 SO. FT. OCC.1 BUILDING VALUATION OWNER'S MAILING ADDRESS CONTRACTOR'SN ME nwninr TELEPHONE renewalermit CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee 1F20-00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ 30-00 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 palinrmo 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 ak Duplex❑ Mobilehome❑ OtherBuilding Gas piping system 1 - 5 outlets 5.00 sewer Mobile Home S I G I W I 5.00 I 110-00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: 2nd— ri-eewal of permit #3907 84 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADO'L 100 AMP 2.50 NTRACTORS LICENSE LAW I declare under pens (check one): rtyerjury ❑ 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) ❑ I am exempt under Sec. , Business and Professions Code for thi reason NEW CONST. ( DWELLING OCCUP.tr 1/22SQft OR ADDNS. C ACC. BLDGS. NEW CONSTR. MULTI -OUTLET 2.50 ea NON.RESID BRANCH CIRC ITS POWER APPARATUS tr (SINGLE OUTLET CIR. Ex. OCcup(OUTLETS OR FIXTURES 2ALI 30 eL0 FIXED APPLNS. R Ex. Occup. OUTLETS (RESID )EA.� 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. �yirin 15.00 g 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 FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation penult Fee $ Contractor I certify that I have read this application and state that the above information is correc gree to comply to all County Ordinances and State Laws relating to but ng co struction, and hereby authorize representatives of the Countyot But to enter pon the ve-mentioned property for inspection pur oses. t so a ret sa mnify and keep harmless the County of utte gainst at Iia Ilitie g s, costs, and expenses which may in a wa accrue in ty in nsequence of the granting of this permi . Date 7 gnatuof Applicant — Owner Contractor ❑ Agent Ey An OSHA permit is required for ex ov ions over 5'0" deep and d mol' ion or construct- ion of structures over 3 stories in eight. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ 30.00 OCCUP. CONST.TYPEJ I IFLOODIPARCELI PD I NO I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which iRECT� PUB By PERMff EXPIRES Date 19 the applicable provi- resolutions to do fees have been paid. �ORKS Date 91_7o77 Receipt No. WHITE-O.P.W., YELLOW-AS8E880R. PINK -INSPECTOR, GOLDENROD -APPLICANT 5 u° 0 3a COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-534-4541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally -plan to provide the major labor andterials for construction of the proposed property imp ovement (yes or no) 2. I (have/have not) signed an applic.a ion for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Cont a tors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and v e the major work: Name Address City Phone n r tors License No. L 5. I will provide some of the work but I�ve contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Sigr Date _�1 % <G NOTE: This Owner -Builder Verification is sent to you as required by'Sections 19831 and 19832 of the California Health and Safety Code. ` k, �. This verification must be completed and returned to our office before we are per- mitted to issue the permit. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT z;7;17 - ASSESSOR q4 ASSESSOR PARCEL NUMBER 27-31-07 ZONING BUILDING PERMIT OWNER DELNO BE K R TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS P.0 B xlerMQ CONTRACTOR'S AME OWNER TELEPHONE 3rd renewal permit CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER NnNF VNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee FE $ 20.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 8056 MELVINA AVE. Permit fee $ PLUMBING PERMIT FllingFee 10.00 Each Trap 2.00 PALERMO 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 cony porchto living SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 0.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other ❑ Describe work: 3rd renpwal of pprmi t 418117-94 Und renewal 99790-86) Penult Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 000V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penal y 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 ITS ❑ 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. , OR ADDNS. ( ACC. BLDGS. h2sgft NEW CONSTR. I.OUTLET NON.RESID BRANCH CIRC TS 2.50 ea POWER APPARATUS &) SINGLE OUTLET CIR. 00001 EX. OCCUp OUTLETS OR FIXTURES pA 090 FIXED P(RESID )REA.D 2.00 OCCUp. E EX. OUTLF Temporary service 10.00 Mobile Home Facilities 15.00 Misc. byirin g 15.00 Permit Fee $ --K—WORKMEN'S COMPENSATION INSURANCE I declare under p nalty 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 10.00 Heating Cooling g Hood 3.00 Ventilation Penult 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 Inst said County in consequence of the granting of this permit. X Date lynatura of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. min Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ 30.00 OCCUP. CONST.TYPC ISCHOOLIFLOODIPARczL Pu 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 tees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Dat® 12-21-88 Receipt No. WNITC-D.P.W., YELLOW-A38CS3011. PINK-INSPCCTOR. GOLDENROD -APPLICANT � C i � ink r� �t� t SIP, r 8 � � � �(,