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HomeMy WebLinkAbout031-260-019I \ �31-26-19_� ' 1, DOLAN MEFFORD 1160 Sierra, Thermalito 5`/00'70 Permit #4983-75P(install sewer line/SF) 31-26-19 i Permit #2484-76P(replumb sink, laundry rm, & replace part of sewer) SF 31-26-19 Permit#812-86E(ele ser ch/SF) I I i PERMIT NO. 4953-75P P I E i M. �i ).'MH UTIL. ''-PERMIT NO. _ PERMIT EXPIRES 'OWNER Dolan Mefford CONTR. owner LOCATION (A.P. 31-26-19 ) 1160 Sierra, Thermalito Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E jos �!—1 FINALED (Date) i (Si n ture) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD c BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms i Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Garacie Vents Water Htr. Stemwall Slab Prov. for physically handicapped Heaters Appliances Carport Footings Conformance of ex. structure Gas Piping & Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures { Bond Beam FIRE SPRINKLERS Motors !!! Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole ` Finish Ducts Underground t{ Interior Lath Ventilation Permanent Door Closer Final Final DATE REMARKS OR CORRECTIONS 0 THERMALITO IRRIGATION DISTRICT 410 GRAND AVENUE OROVILLE. CALIFORNIA 95965 TELEPHONE 533-0740 CSA 26 SEWER SERVICE APPLICATION AND CONNECTION PERMIT Service Address: 'S, e- y 0. - Owner's Name: Date: Address: 1 1A,. Acct. No: _ a , I A.P. No....:.-.,, -� t Phone: No. Units: Applicant/Agent: Agents Proof: '�� ;' ri Address: Fees: Phone: Application4. „$ Arrearage Preliminary Review By: Date: a CSA 26 Remarks: `h " ' SC -OR 1 st mo. S.C. Other Total Fees 1, f-, a•7 c Collected By: Date: Field Review By: •Y Date: Remarks: S MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON: T"*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). DISTRIBUTION: WHITE - TID, YELLOW - APPLICANT, PINK - DPW, GOLDENROD - DPW to TID COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 Teleppone; 534'4 41 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the PC- above-mentioned property for inspection purposes. X Date Signature of e/fmit or Agent Receipt No. 60 Q White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. R�R OF PUBLIC WORKS By Date 4/7 Y— permit expires Date �? BUILDING Owner L �� Q SQ. FT. OCC. BUILDING VALUATION Mailing Address 0 1 e. W_ G Tele hone No � �, J ' Fireplace Contractor Ne fz Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penal ty Telephone No. Permit Fee Building Address �� ^- %%�G! PLUMBING No. @ FEE PERMIT FILING FEE $3.00 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. 3 / _ I Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F W. Itooh Fire Dept. FireZone Use Permit Building sewer 5.00 5 EQA I Parking Parcel Declaration Parcel Ma P 60' R/W Improvements p ovements Lawn sprinkler system 2.00 �Pl�ans Bldg. 4es Recd r Parcel Approval Plans Approval Permit Fee $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 / , n[s -4 L L, t --UJ L 4 Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (marathon 12) - Single Family Duplex ❑ Mobil Home ❑ Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures b4150 Receps., switches & fix outlets 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: Hood, Ex. Fan or F. A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit .is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. 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 MECHANICAL NO. FEE PERMIT FILING FEE Heating Cooling Ventilation Hood Permit Fee $ $ TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the PC- above-mentioned property for inspection purposes. X Date Signature of e/fmit or Agent Receipt No. 60 Q White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. R�R OF PUBLIC WORKS By Date 4/7 Y— permit expires Date �? ¢i• 0 812-86E MYRTLE MEFFORD 1 1160 Sierra Ave. t ,1 t_ Oroville OFFICE COPY Address /I C��i 42 r r_ � GAS Meter By Date ELECTRIC Meter By Date � ,�-- I eyi z J COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PrERMIT NO. q _ K 7 County Center Drive - Oroville,1aliforgia 95965 - Telephone 916/534-4541 CY W APPLICATION AND PERMIT ASSESSOR'PARCEL NUMBER _L)4 - 1 ZONING _ BUILDING PERMIT OWNER/.TELEPHONE % -ter SO, FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS ,, o ) � ► F df.) t1F .�rr l? v CONTPACTOR'S NAME ((1 u i 14 le V TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTR} CTION LENDER ��'r' 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 $ AR C'HITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS y �rt V 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 Er Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other g i Describe work: _ P y U I C Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 ff)(` f 1 r -y v OR LES Main service loo AMP ORS SLESS 10.00 ri /fir 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. License No. Classification ❑v 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.ed\ yzQsgft OR ADDNS. ACC. BLOGS, r NEW CONSTR.MULTI-OUTLET 2,50 ea NON-RESID BRANCH CIRC ITS /POWER APPARATUS e (SINGLE OUTLET CIR. Zo®yoe Ex. Occup(OUTLETS OR FIXTURES eAL030 FIXED APLNS. Ex. OCCup. OUTLETS PR IRESID )EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 /!�� (P) 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. ZI-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 pennl4 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, an5,expenses which may in any way accrue against said County in consequence of the granting of this permit. X 'Y Date tri Signature of Applicant � Owner ❑ Contractor ❑ Agent i 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 $ TOTAL PERMIT FEE $ 7 %' OCCUP. CONST.TYPE IFL40D PARCEL PD No Y3 SUE This permit is hereby issued under sions of the Butte County Code and/or t k indicated above for which I DIRECTOR OF PUBLIC BY �` :."�' — PERMIT EXPIRES Date Iihe applicable provi- resolutions to do fees have been aid. b p WORKS Date SA., 1 A. . r( Receipt No. WHITE-D.P.W., YELLOW-A88E880 PINK -INSPECTOR. GOLDENROD -APPLICANT f COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, OroviIle — Phone: 534-4541 - ••'�• "=---- Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 T- 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_ C� Inspector �� Date COUNTY OF BUTTE - DEPARTMEAT OF PUBLIC WORKS 7 County Center Drive - Oroville, Cilifor45965 - Telephone 916/534-4541 APPLICATION AND PERT ASSES O PA G L N M ER — ZONING i BUILDING PERMIT OWN r TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S A I G A FESS I/` CON C R'S NAME r TELEPHONE CON RACTOR'S MAILING ADDRESS Fireplace CONST CTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCH IT CT OR ENGINEER LICENSE NO. Pian Checking Fee $ Energy Plan Checking Fee $ ARCHIT CT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADD RE t ,e✓�r v Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 V _ Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAMEPARCEL 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 I S I G JW I 0.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other Describe work: OFC CA V, r t/ ri Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Ion Main service 100 OR LESS 100 OROR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): F -1I 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 eAPLINIS 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.N) OR ACDNS. l ACC. BLDGS. // 'h2sgft NEW CONSTR. MULTI -OUTLET NON-RESID BRA C CIRC ITS 2,50 ea POWER APPARATUS e (SINGLE OUTLET CIR, Ex. OCcu Occup(OUTLETS OR FIXTURES zo a a0e 5AL030 FIXED Ex. Occup. OUTLETS P(RESID )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. ❑ 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate f' Consent to Self -Insure. � CJ 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 County of 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, an expenses which may in any way accrue against �d County in co quence f the granting of this per it. X Date Signature of Applicant Owner❑ Contractor ❑ Agen 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 $ TOTAL PERMIT FEE $ OCCUP. CONST.TYPEJ PLOOD PARCEL PD I NO SUE This permit is hereby issued under sions the Butte County Code and/or work in icated bove for which fees I EdTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS DateR44� Receipt No. WNITE-D.P.W., 7ELLOW- S'ISO PINK -INSPECTOR, GOLDENROD -APPLICANT 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 materials for construction of the proposed property improvement (yes or 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 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 Signed: Property Owner .Social -Security Numb r �? 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. J/1 JA COUNTY OF BUTTE — DEPYARTMENT OF PUBLIC WORKS 7 County Center Drive — Uroville, California 95965 Telephone: 53.1-4541 APPLICATION AND PERMIT .UL IUIILc IcF/I CJGIIIaUVCJ UI lllu I�UUllljr UI DUIIC LU CIILCI Upull Ulu above-mentioned property for inspection purposes. X , .' ! ` nates Signature of Permitee or -Agent Receipt No. 14163'6 r White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date Building permit expires Date _ z ��� BUILDING Owner /, / -c t / ,L! i,�+! � � %%��.� /` �( SQ. FT. OCC. BUILDING VALUATION Mailing Address 11120 .J!L eA9 % 4 V45— Telephone No. Fireplace Contractor 1'CJ /yL Tot_al. Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ Building Address J g / 0 ��� �V/ ��� PLUMBING No. @ FEE PERMIT FILING FEE $3.00, / Each Trap z 1.50 pp Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. : z / Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fel s W. . Sanitation Fire Dept. Fire Zone Use Permit Building sewer 5.00 5 po EQA Parking Plans Parcel Declaration parcel Ma p 60' R/W ImprovementsLawn sprinkler system 2.00 fil,d-aPi°ans Ret d Parcel Approval Plans Approval Permit Fee $ /41, 0,0 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 y� r fi ��C%/�j �ijC%/�C .S/i}•k Main service 100 AMP OR"LESS 5.00 Main service EA. ADD'L too AMP 2.50 OVER eoov Main service 25.00 100 AMP OR LESS Single Family ©� Duplex ❑ Mobil Home ❑ Others ❑ Main service EA, ADD'L 100 AMP 1,00 NEW LING OR ADDNST ( ACCLBL GS. OCCUP, &) 20sgft NEW CONSTR. MULTI.OUTLET NON-RESID, (BRANCH CIRCUITS) 2.50ea NEW CONSTR POWER APPARATUS & NON•RESI 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: y Ex. Occup(OUTLETS OR FIXTURES)®� BAL�1 Ex. Occu FIXED APP LNS, OR p• OUTLETS (RESID,) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 ❑'I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. *I certify that in the performance of the work for which this ❑ permit is issued I shall not employ any person in .any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT FEE $/ Qp .UL IUIILc IcF/I CJGIIIaUVCJ UI lllu I�UUllljr UI DUIIC LU CIILCI Upull Ulu above-mentioned property for inspection purposes. X , .' ! ` nates Signature of Permitee or -Agent Receipt No. 14163'6 r White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date Building permit expires Date _ z ��� _ COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - OroviIle, California 95965 7(oTelephone: 534`--4541 c APPLICATION AND PERMIT �� authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X oM Date Signature o/4/6,367 f�Permitee Agent Receipt No. / 6 3 6 / White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By� Date Building permit expires Date / 7J BUILDING7'r-7 Owner ©L 4 ` r er, SQ. FT. OCC. BUILDING VALUATION Mailing Address Te a hone No„D S Fireplace Contractor ©(,(J /)/ • Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee Building Address / D �� �� PLUMBING No. @ FEE PERMIT FILING FEE $3.00 — Each Trap 2 1.50 pa Repair drainage or vent piping 1.50 QO Water piping 1.50 Each gas water heater or vent 1.50 A. P. �Z ��—%Gas Zoning & Planning piping system 1 - 5 outlets 1.50 Each additional outlet .30 F s W. . Fire Dept. Fire Zone Use Permit Building sewer 5.00 p EQA Parking Parcel Plans Declaration I Parcel Ma P 60' R/W L- Im rovements I P Lawn sprinkler system 2.00 Parcel Approval Plans Approval Permit Fee $ / e7 10 $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER []� ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 /D[ Main service 600V OR 100 AMP LESS RSLESS 5.00 h/YU� �o P%O�� Main service EA. ADD•L 100 AMP 2.50 Single Family ✓❑� Duplex ❑ Mobil Home ❑ Others ❑ Main service OVER soov 100 AMP OR LESS 25•00 Main service/ EA. ADD'L ioo AMP 1.00 OR ADDNS.EW CONST, ( ACCLBL GLING OCCUP. &) 2¢sq ft NEW CONSTR. (MULTI -OUTLET NON-RESID BRANCH CIRCUITS) 2.50ea NEW CONSTR. POWER APPARATUS & NON-RESID, (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Ex. Occup(OUTLETS OR FIXTURES) 8AL2@51 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID,) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 El 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 orkmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 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 $% 00 authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X oM Date Signature o/4/6,367 f�Permitee Agent Receipt No. / 6 3 6 / White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By� Date Building permit expires Date / 7J