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HomeMy WebLinkAbout031-252-009i 31-252-9 LILFORD LONGown 1752'1Oth. St., Thermalito Permit ##2156-7 (inst. bldg. sew) ?' CS F 31-252-09 UaPermit#3639-88B(reroof, Sid' g, sheathi dd rafters/SF) y 031=25-2-009 ;93-1298 M LONG, TILFORD 1752 10TH, OROVILLE CONTR: AMERICAN INTL FURNACE/SF 031-252-009 'PERMIT#96-2393 LONG, Tilford 1752 10th St., OXOVlll Reroof/SF , 4 II I� i i 1 M �� 031-252-009 PERMIT#96-2393' LONG, Tilford 1752 10th St.,, Orovi.11e Reroof/SF e 6 % ,h 031-252-009 PERMIT#96-2393' LONG, Tilford 1752 10th St.,, Orovi.11e Reroof/SF e 6 % COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVIS 7 County Center Drive - Oroville, Cahfornia`95965 - Telephone (916) 538-7 ... �PE MIT NO. APPLICATION AND PERMIT99-3 ASSESSOR PARCEL NUMBER 031-25--2 ZONING .— BUILDING PERMIT OWNER TILFOPX LONG TELEPHONE SQ. FT. OCC. BUILDING VALUATION 10 60 600 OWNERS MAILING ADDRESS 1752 10TH ST OROVILLF 95965 CONTRACTOR'S NAME OWhTFli TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER W ITE UNKNOWN Total Valuation $ Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER NONE LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDINGADDRESS PERMITFEE $ 37.00 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar or heat pump Water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF ❑ 1uplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other IT Describe Work: REROOF/CCHP — Mobile Home S I G W I @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main ServiceEOOV OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A To ,000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: —❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUP. OR ( 8 ACC. BUDS. ) SO. 3.5Q FT. NEW CADDNS. CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER SINGLE APOUTPARATUS ) 8 LET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 Q 1.00 BAL Q .SO Ex. Occup. ( OUFIXED TLETS PLNS..ORR.A ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE S Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier., policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 9 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 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 workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. _ c X l= Date b/ Signature of Applicant - ❑Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ 37.00 HAZ. I D. FEES IMP FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for Ich fees have been paid. r p B - ate 10/15/96 PERMITEXPIRESON 1(JT /C17 (Date) LUbb4t3 '� rReceiptNo. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - 7 County Center Drive - Orovillp;'�Calornia 95965 - Telephone APPLICATION AND PERMIT BUILDING DIV[ N (916) 538-7 :. PERMIT NO. ASSESSOR PARCEL NUMBER 031-25-2-009 ZONING - BUILdINGPERMIT OWNER TILFORD LONG TELEPHONE SQ. FT. OCC. BUILDING VALUATION 10 •0.60 600 OWNERS MAILING ADDRESS ST OROVILLE 95965 CONTRACTOR'S OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER NONE UNKNOWN Total Valuation $ Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ 17.00 ARCHITECT OR ENGINEER NONE LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS 1752 10TH r DROVITLE, PERMITFEE $ 37.00 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LAT NO. SUBDNISKONS NAME PARCEL MAP Solar or heat pump water heater 23.00 Water piping 15.00 }( USEOFSTRUCTURE SF ❑ 'Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other 1� Describe Work: REROOF/COMP — Mobile Home IS I GI W @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filinq Fee 20.'00 Main Service / 000V OR LESS 200A OR LESS ) 23.00 Main Service ( 200A TO ,000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: .._-❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUR OR ( 8 ACC. BLDS. ) So. 3.5¢ FT. CNS. NEW CONST. MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 ( 8 POWER APPARATUS ) SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES) 20 Q 1.00 BAL .50 Ex. Occup. (outtEEDrs PPLNS. OR PES D.) EA) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 9 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) �, ❑ 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 workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X �_ Date �a '" �� f Applicant - ❑ O ❑ Contractor ❑ Agent SignatureIrmit An OSHA is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE I TOTAL FEE $ 37.00 HAZ. 1 D. FEES IMP FLOOD COF PARCEL PD HD I� UE ,� This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for ich fees have been paid. B ate 10/15/96 PERMITEXPIRESON 10/15/97 (Date) Receipt No. 206648 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 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 materials for construction of the proposed property improvement: YES[ --N ] NO[ ]. —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: CONTRACTOR'S 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: CONTRACTOR'S 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 SIGNED: PROPERTY OWNER: C SOCIAL SECURITY NUMBER: DATE: NOTE: This owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. May 1995 2.26 Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: 0 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. 0 There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. 0 For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "ownerbuilder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Sincerely, Michael C. Vieira, C.B.O. Manager, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. May 1995 2.27 031-25-2-009 r LONG, TILFORD 93-1298 M 1 1'752 10M, i CONTR:, OROVILLE AMERICAN INTL FURNACE/' ' t� ' f ay: 1 rR ` X i COUNTY OF BUTTE -',DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville. 0ifornia 95965 - Telephone: 916.'538-7541 APPLICATION AND PERMIT PERMIT NO. �►3- /z 9e ASSESSOR PARCEL NUMBER 031-252-009 ZONING (1-2 1 BUILDING PERMIT OWNER Tilford E. Long TELEPHONE 533-5707 )� SO. FT. OCC. BUILDING VALUATION 1 OWNER'S MAILING ADDRESS 1752 10th St., Oroville 95965 CONTRACTOR'S NAME American International Inc. TELEPHONE CONTRACTOR'S MAILING ADDRESS 299 W. Julina St., San Jose 95110 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 15.00 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 Permit fee $ PLUMBING PERMIT Filing Fee 15.00 1752 10th St. Oroville Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF L3 Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORKfy� New ra u Addition Remodel 'FU Utilities InstallationC Other ❑ Describe work: 50 K Direct Vent _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 200A OR LESS j $,50 Main service 200A TO 1o00A) _ 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one .^ ❑ I am licensed under provisions of;.;Oiapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. t /^ v License .JO. 4 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) ElI, 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 AODNS. ACC. BLDGS. 3.60 sq.ft. NEW CONSTR.ULT,.OUTLET NON.RESID BRANCH CIRC ITS I @ 5.00 POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. OccupOR FIXTURES 20 764 A FIXED APPLNS. OR Ex. Occup. OUTLETS (RESI0.) EA.) 1 3.00 Temporary service 15.00 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 15.00 Heating • kAJ Cooling Hood 6.50 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X''" '—'"`— -- — Date Signature pp ❑ ContractojZ Agent ❑ $i nature of Applicant — owner 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 $ Ener Inspection Fee $ Energy P occ CONST TYPE TOTAL FEE $ 211 00 HAz I DFEES I IMP I FLOOD I CDF I PARCEL I PD HD ISS This permit is hereby issued under the Bions of th Butte County Code and/or Work In C ed abov r hich fes DIREC O U LI By PER XPIRES Date t, applicable provi- esolutions to do ave been paid. RKS e Receipt No. WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. / 7 County Center Drive - Oroville, CalLfo:4iig 95965 - Telephone: 916.538-7541 APPLICATION AND PERMIT UU ASSESSOR PARCEL NUMBER 031-252-009 ZONING C-2 a BUILDING PERMIT OWNER Tilford E. Long TELEPHONE 533-5707 S0. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1752 10th St., Oroville 95965 CONTRACTOR'S NAME American International Inc. TELEPHONE CONTRACTOR'S MAILING ADDRESS 299 W. Julina St., San Jose 95110 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 15.00 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 Permit fee $ PLUMBING PEZRR�Iinee 15.00 1752 10th St. Oroville Each Trap00 Solar or heat pump wat00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping00Each qas water heater 00USE OF STRUCTURE [I Duplex❑ Mobilehome❑ Other Gas piping system 1 - .00SF Building sewer.00SPECIFY Mobile Home s.00 TYPE OF WORK New u Addition Lj Remodel L; Utilities LM Installation❑ Other ❑ Describe work: 50 K Direct Vent Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 200A OR LESS 18.50 Main service 200A TO IOOOAI 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): �l 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. �1���LG � Classification e' 3 y ❑ 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.& OR ADDNS. ( ACC. BLOGS. 3.6Q sq.ft. NEW CONSTR.ULT I -OUTLET N ON.R ESID BRANCH CIRC ITS I @ 5.00 POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occup( OUTLETS OR FIXTURES 20 @ 760 -AL 0 450 FIXED Ex. Occup. OUTLETS PRESID.IREAT I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. byirin g 15.00 Permit Fee $ — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. =j__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 FiIingFee 1 15.00 Heating Direct Vent Cooling g Hood 6.50 Ventilation permit Fee $ 24.00 Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this perm" . X Date 3 Signature of Applicant — Owner❑ Contractor AgentAn OSHA for excavations ion OF HAstructuresmit is requiredIons over 5'0" deep and demolition or construct- Mobile Home Installation Fee S Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 24.00 HAz I DFEES IMP FLOOD I CDF I PARCEL I PD I HD SS This permit is hereby issued under the sions IthButte County Code and/or work ed abov r hich fe O U LI By PER XPIRES Date applicable provi- resolutions to do s ave been paid. t I e , t Receipt No. WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT PERMIT NO. PERMIT EXPIRES L OWNER TILFORD LONG CONTR. owner ASSESSOR PARCEL 31=252=-O LOCATION 1752 10th Sty ORoville • - 4 G 1d'/�G� bait- (�rsJ��, tv�� ��i°�+�-� P4 A^ S Gdz�izG" Y �a Temp. Power Pole _ Called PG&E_ Temp. Elec. Service Called PG&E _ Temp. Gas Ser Called PG! JOB FINALED Signature OK 0- Not OX NotReayable dMOBILE HOMES MISCELLANEOUS Date MOBILE HOME UTILITIES (Plans) OK except #'s Date DECK OVERS,CARPORTS,GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements oning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch ar voTrMJS-,-Suiis=Size-Depth-Spacing-Connectors-Steel 3. Sewer; Location -Test -Fall -C/O -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts- Beam s-Rftrs.-Connec.- Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 6. Gas; Location -Test -Wrap: / P'U ft. / /"Nat. or/ /"L"ft./ /"LPG 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors, 7. Utility Clearance . Frmg; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh Card -B1 Date Card -61 Date 10. Roof; Shthg-Roofing Card -B1 Date Card -131 Date 11. Ext.; Steps -Doors -Landings Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Card -131 Card -131 Q�) Date jj-/ Card -B1 Date V Date Card -B1 Date 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test- Demand-Valve=Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances Date POOLS (Plans) OK except #'s 5. Drain; MH Test -Fall -Flex Connector 1. Setbacks -Easements 6. Water; MH Test -Regulator -Connector 2. Soils; Compaction -Structure Stability 7. Water and Sewer Connected -C/O to Grade -HD Approval 3. Pool Structure; Steel -Connections -Thickness - Dead Men -Lining 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 4. Elec.; Receptacles and Lighting, Distances-GFI 10. Cert. of Occupancy 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater Card -B1 Date Card -61 Date 8. Elec.;Grounding; Equip. w/5' -circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit Card -131 Date Card -131. Date 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Card -B1 Date Card -131 Date Card -61 Date Card -61 Date =OK 0 = 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.-/ /" Fig. De 3. Ftg., Garage; Soils -Steel-/ /" Ftg. Depth 4. Fig., Porches & Decks; Soils -Steel-/ /"Ftg. De 5. Stemwalls, Main; Steel-Blockouts-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 -131 Date Card -B1 Date Card -131 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 AI 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 Liqht Card -131 Date Card -131 Date Card -131 Date Card -81 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 -131 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 Hate 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 -131 Date Card -131 Date Card -131 Date Card -131 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 -Meth. 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; PIbg.-Appliance-Firep I. -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 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates 92. Roofing Certificate Card -131 Date Card -131 Date Card -131 Date Card -131 Date Card -B1 Date Card -131 Date Comments at Final: (NOTE: An entry must be made each time you visit job site) 9 ie(D 66 MIN ALL !mss @) it-, � '� G NOTE: All Materials & Workmanship Accordance wi;i7 Recognized Shall Be in u dQ S of a gualit , Gccd Practices and Unifoq Buydr qs ribsd- or fhe S ecified uso the National El p Codast and ectricPlumbing & Mechanical a x �C - coda. a -q'' 0c, this set of plans and kept on th© job at all times andcations MUST make any chengeS or �t is Ur, !awful tc written Permisson from theation.s on ser �� withoul Works, County of Butte. �Pertment of Public BUTTE COUN I Y 3UILDING DEPARTMEN APPROVED 363'7- gY vir Would -rk y Mr �hJ�yh� T was NA4r9 vrj AJoI K,v(-)w ANS Ae ����f COUNTY OF BUTTE - DEPARTMENT OF PUBLIC 7 County Center Drive - Oroville, California 95965 - Telephone: APPLICATION AND PERMIT WORKS PERMIT 0. 916/538-7541 ASSESSOR PARCEL NUMBER .31 -25A - 0 0 ZONING BUILDING PERMIT OWNER/ A- F TELEPHONE T or DV � r SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING 1 _7,5 �- o* S+ OroV D t?o.vo -0 CONTRACTOR'S NAME TELEPHONE OU)Ne,r- CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN 7 Total Valuation $ 3 6-D LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $ .23 , D ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ C �� ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS Permit fee $ 419 60 1 C) + PLUMBING PERMIT Filing Fee 10.00 Each Trap 2,00 Solar or heat pump water heater 20.00 LOT NO. SUBDI VISION NAME PARCEL MAP Water piping 5,00 Each qas water heater or vent 5.00 USE OF STJ3.UCTURE Gas piping system 1 - 5 outlets 5.00 SF ❑ Duplex❑ Mobilehome❑th6 er 1 �G r`a g Building sewer 5.00 SPE Y Mobile Home S G W 10.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other Permit Fee $ Describe work:d_l-o o F 'd'• /1/ e t.-) S,`ebl ve Contractor A4 e a M ,_ • N e a f 1.1 j ELECTRICAL PERMIT Filing Fee 10.00 _ .� x J t� re,,Fk R ' r Main service 80.11 OR LESS 100 AMP OR LESS 1�•0� Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE L W I declare under penalty of perjury (check one): NEW CONST. DWELLING OCCUP.a OR ADDNS. ACC. BLDGS. , /20sq ft ❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business NEW CONSTR. MULTI -OUTLET NON.RESID BRANCH CIRCUITS) 2.50 ea and Professions Code and my license Is In full force and effect. POWER APPARATUS a SINGLE OUTLET CIR. License No. Classification EX, OccU OUTLETS OR FIXTURES P t 25005AL&03 . (� I, as the owner, or my employees with wages as their sole compen- FIXED APLNS EX. OCCUp. OUTLETS P(RESID )REA.I 2.00 sation, will do the work,and the structure is not intended or offered Temporary service 10.00 for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- Mobile Home Facilities 15.00 ors. (Sec. 7044) Misc. Wiring 15.00 ❑ I am exempt under Sec. , Business and Professions Code for this reason Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one):MECHANICAL PERMIT Filing Fee 10.00 ❑ The permit is for $100.00 (valuation) orLsss_'_'� Heating ❑ 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. Cooling g 1 shall not employ any person in any manner so as to become subject Hood 3,00 to the W. C. laws of California. Ventilation 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 Permit Fee f provisions or this permit shal I be deemed revoked. Contractor I certify that I have read this application and state that the above information Mobile Home Installation Fee $ is correct. I agree to comply to all County Ordinances and State Laws relating Energy Inspection Fee $ to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. TOTAL PERMIT FEE $ r �� 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 oefyP. CON9T.TYPC S�HooO PL000 PARCEL PD HD I390 against said Co my in nseque a of the granting of this permit. ,LII X/7401 ��.� —g'? Date This permit is hereby issued under the applicable provi- -:p sions of the Butte County Code and/or resolutions to do plicant - Wner onrractor ❑ Agent ❑ Signature oXmit work indicated above for which fees have been paid. An OSHA is required for excavations over S'0" deep and demolition or construct- CT R 0 PUBLIC WORKS ion of structures over 3 stories in height. Receipt No. o2%a y Z' BY /J ate uXv WHIT[-D.P.W., YELLOW-ASSEDSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT PERMIT EXPIRES Date OWNER COUNTY OF BUTTE - DEPARTMENT,,OFA PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE- OROVILkE„CALI ORNIA 95965- TELEPHONE: 916/538-7541 PERMIT ARPLICATION DATA SHEET Permit No. /- DV - , Proposed Building Use 64'r -a <-I rod"d Building Inspector sicltk.i4, A. P. No. 3 1 - a ©a�j A"5� Date / /T At time of permit application, I was advised the following data must be submitted prior to permit processing andJor/issuance: DATE RECEIVED APPROVED y' 1. All items have been subryi5tted. . . . . ' ai 2. Plot plans in duplicate./triiplicate, signed by preparer of plans. 3. Complete plain's dup£I ct/te./triplic'ate signed by preparer of plans. 4. Complete engineered plans and calcs, with wet signature on plans. 5. Plans with Energy Design Compliance Statement. . . . . . 6. School District "Fees Paid" Stamp on Floor Plan. . 7 Statement of Intent for Nor. -Heated and AC`Bu-ildings. 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-Ine suranc. .. . . . 13. Contractor's License Infcrmation (no., name style, classif.) 14. Owner -Builder Verificaticn (Given to owner0; Mail to owner ❑,) -15. Improvements may be regL fired. . . . . . . . . . . . 16. Mobilehome Installation Eata. . . . . . . . . . Pre-Inspec. request to 17. Pre -Inspection for Required. Building Inspector (Date) 18. Recorded copy of Agricultural Acknowledgment Statement. 19. Driveway Permit. 20. Plot plan approval from c ty of 21. Engineered trusses in duplicate (required prior to plan check). 22. When you issue the permit, process as follows:L,�Mail to owner, Mail to contractor. Telephone and hold for pickup at office, Deliver w/inspector. Other •a j a.I / . ' :5; Copy of plans sent Health Dept., Applicant'_ `� Date's”' Fire Dept., Other Date The following data must be submitted prior to permit issuance 1. Index permit for above iterrs-No. 2. Additional items required: (Circle new item not checked above). Contractor, designer, owner, was advised of above required data by_phone_—mail counter by date Contractor, designer, owner, was advised of above required data by_phone_mall_counte date d Plans checked by Date Plans approved by - V ate/1-2 -b Sets of plans on hold in File cabinet AP folder Copy—DPW COUNTY OF BUTTE -,Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 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 materials for construction of the proposed property improvement (yes or no 2. I ((ave/have not) Ve signed an application for a building permit for -the proposed wo 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 r Signed: Property Owner Social Security Number Date 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. k, 1 G � D /61/ NOTE:—All Materials Accordance wi; j, (taco & Workmanship Shall Be in u S of cl 9nized Good Practices and guGl,ty prescribe; for fhe Specified . Uniform Building Plumbin �use to the a X �� the N Tonal Electrical .Mechanical Codes aril Code,,gq it Oct nils set of plans and specibe kept on the job at all times andcations MUST mak© any changes or �t Is un!awful tc written alterations on sat;�a Permisson from fhe p� without Works, County of Bum. partment of Public tSUTTE COUN i 7 3UILDING DEPARTMEN APPROVED ,.*37 - 9 r A r -PERMIT NO. 2156-76P. PERMIT EXPIRES 444 Q/ 7 7 OWNER LILFORD LONG CONTR. owner LOCATION (A.P. 31-252-F9 1752.10th. St., Thermalito Temp. Power Pole Called PG&E _ Temp. Elec. Serv.. Calle G&E Temp. as Serv. ailed PG&E ' OB FINALED Ile (Date) (Signature) r F .. ti p Temp. Power Pole Called PG&E _ Temp. Elec. Serv.. Calle G&E Temp. as Serv. ailed PG&E ' OB FINALED Ile (Date) (Signature) COUNTY OF BUTTE — DEPARTMENT OF, PUBLIC WORKS BUILDING •INSPECTION RECORD Bond Beam FIRE SPRINKLE Framing Test BUILDING BUILDING (Cont'd) Mesh PLUMBING Setback Firewall Soil Piping Cooling Forms Parapets 1st Floor `Ventilation Main Bldg. Restroom Finish 2nd Floor OR CORRECTIONS Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Pi In Piers Roofing Sewer l 7 Garage Fdn. Vents ' Fixtures Footings Stemwall Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for phy n ed Confforormance of ex. sically C structure Appliances Gas Piping & Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footin s• Footing ELECTRICAL Masonry Walls I Throat Rough Reinf. Steel I Final Fixtures Bond Beam FIRE SPRINKLE Framing Test Stucco Final Mesh MECHANICAL Scratch Heating Brown Cooling Finish Ducts Interior Lath `Ventilation Door Closer Final DATE/z/REMARKS OR CORRECTIONS Water Htr. Subpanels Grd. Fault Prot. Service Temp. Pole Underground Permanent Final (NOTE: An entry must be made on this form each time you visit the job site.) THERMALITO , IRRIGATION' DISTRICT 410 GRAND AVENUE c�►.'�i OROVILLE, CALIFORNIA 95965 TELEPHONE 533-0740 CSA 26 SEWER SERVICE APPLICATION AND CONNECTION PERMIT Service Address: Y." Owner's Name: I,*- A .. ,(I Date: %7 L Address: -?�- .� J_ Acct. No: - ! i _ A.P. No.:%3!-;2_4S�' .?- I� Phone: ... - — No. Units: Applicant/Agent: T. Agents Proof: -)1,4 Address: Fees: Phone: Application $ / ,! Preliminary Review By. -44, r"'. f Date: Arrearage / ,c. CSA 26 Remarks: SC -OR 1st mo. S.C. Other Total Fees 1)4r36 Collected By: Date: Field Review By: Date: l Remarks: G MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON: Q Date of TID approval of completed building sewer (early connection). ❑ 30 days after date above, or on date of D.P.W. approval of completed building sewer, which ever comes first ("existing construction", prior to Mar. 5, 1974). ' ❑ 180 days after date above, or on date of D.P.W. approval of completed building sewer, which ever comes first ("new construction", after Mar. 5, 1974). Ula J H1t$U 1 IUN: WHITE - TID, YELLCW -APPLICANT, PINK -DPW, GOLDENROD - DPW tO TID COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Telephone: 5`34-4541 /^ —�� APPLICATION AND PERMIT VJ BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mai I ing Address Telephone_,IJo. Fireplace Contractor 4 OC4 Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ Building AddressPLUMBING No.1 @ FEE PERMIT FILING FEE J$3.00 4. Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. .� — .�. Zoning $ Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Res 4ec. I Sar44a-4+err Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans I Parcel Declaration Parcel Ma P 60' R/W Im rovements P Lawn sprinkler system 2.00 Bld4_I1U ,Rr.-1d Parcel Approval Plans Approval Permit Fee $ -� $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER M ELECTRICAL No.1 @ FEE PERMIT FILING FEE J$3.00 Main service 600V OR 100 AMP ORLESS5.00 Main service EA. ADD'L 100 AMP 2.50 Single Family. Duplex ❑ Mobil Home ❑ Others ❑ Main service 1100EAMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW OR ADDNST ( ACC`BLDGOCCUP. &) 2¢sgft NEW CONSTR. MULTI -OUTLET NON•RESID. BRANCH CIRCUITS) 2.50ea NEW CONSTR. (POWER APPARATUS & NON RES,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) Bq 2U Ex. OCCU 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 full 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. 1 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 @ I FEEPERMIT 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 TOTAL PERMIT FEE $ authorrce represerttaUS veof the County of butte to enter upon the above mentioned property for inspection purposes. Date!J / Signature o ermitee or ent 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 whipp fees have been paid. v CTOR OF PUBLIC WORKS B Date AD i M -permit expires Date /7