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Home My WebLink About031-281-017031-281-017 PEF.MIT#95-0665 ROEDER,-George y _ 1424,A0,th St. Orovil _e Cont}; George Roofing _41 f t4 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES -:BUILDING'DIVISI" 7 County Center Drive - Oroville, California, 95965 - Telephone. (916)-,538-'754 PERMIT NO. APPLICATIONA W PERMIT ASSESSOM=ER•� ZONING BUILDIOPERMIT 'OWNER _N E, so. FT. ocd. BUILDING WALUATION.- OWNERS MAILIN ADDRESS A Q q, q CONTRACTOR'S TELEPHONE," CONTRACTOR'S LING ADDRESS - Ile Fireplace CONSTRUCTION LENDERU 4 NI(NOWNz I Total Valuation $ Filing Fee $ 20.00 RESS LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER . LICENSE NO. Plan Checking Fee Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING AD DRESS Penalty $ BUILDING ADDRESS PERMITFEE $ 4�, t4 1 L PLUMBI Filing FeIk, 2 0. 0 0. Each Trap 0 LOT NO. SUBDrVtSi ON13 NAME '43 1 �PARCEL MAPSolar or heat pump water heater 23'00 Waterpiping 15.00 USEOFSTRUCTURE sl;� Duplek�60 Mobil4h�ome 0 Other"i 4 SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets, 15.00 Building sewer 15.00 TYPE OF WORKorne New 0 Addition 0 Remodel 0 Utilities 11 lnstallation 0 Other Describe .,'Work:.—T/C C1. Mobile H S1 GI W1 (LD20.0.0 PERMITFEE Contractor ELECTRICAL PERMIT Rlinq F66 20�.00 r, V OR LESS Main Service '0 0 20 A OR LESS 23.00 Main Service200A To 1000A 46.000 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 6 of the Business and Professions Code, and my license is in full force and effect.@ )_ M License Class Lic. No. (C OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: I i 0 1, as owner of the property, or my employe6swith wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. 0 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project. am:exenpt�'un under Sec: - ,,rBuiiness-a d0r"fessi6ffs'C%o-J'e,f r,. is reason NEW OR CONST. DWELUNG OCCUP: AD& ACC. BLDS. 1 sQ' 3.50 Fr., CONDNS.S T. MULTI -OUTLET NEW ET NONLRESID. BRANCH CIRCUITS 97.50 & APPARATUS ) SINGLE OUTLET CIR. IX Ex. Occup. OUTLET OR FIXTURES ( 20 I.DO BAL 0 .50 FIXLET ED Ex. Occup. A OR ( . U T S P(PR LENS SID ) EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00,, PERMITFEE, WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 0 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. _10' I 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' cornTation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number not completed the permit is for work of a valuation (The above sections need n be. c mplefe of one hundred dollars ($100) 1or. less.) I 0 1 certify . that in the % performance. of the work for which this permit is issued I , I shall or ., not employ- any person in any manner' so as to become subject to - workers' compen sition. laws of California, and, agree that if I sh uld become subject to the' n provisions of sktion_3700.'of 'the Labor Code, I shall workers' compensation' -forthyvIth comply -with those provisions. X GA _X q&,el Ir-., Date Siva 't -re Of A1pplicant_o.Owner —b Contractor Agent An,OSHA permit is required 16r excavations over 50" deep and demolition or construction of."itructures over 3'stories i'wlieight. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC C CON . s T. TYPEJ TOTAL'FEE $ 0- --L2 HAF. D. FEES IMP FLOOD COF PARCEL PO I HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMITEXPIRESON the.applicable provisions Resolutions to' do 'Work been paid. Date (Date)f WHITE-D.D.S.-B.D: CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISI 7_ County Center Drive - Oroville,-Califo nia ,95965 -Telephone (916) .538-754 PERMIT NO. APPLICATION AND PERMIT - ASSESSOR- UMB /) ZONING Y BUILDI PERMIT OWNER SQ. FT. OCC. BUILDING VALUATION OWNERS ADD S � p LL •'O CONTRACTORS NAM TELEPHONE CONTRACTOR'S LING ADORES. tjr it) e Fireplace CONSTRUCTION LENDER UNIONOWN Total Valuation $ L9 Filing Fee $ 20.00 'S LENDERMAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDINGADDRESS PERMITFEE $ .ov PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP Solar Or heat pump water heater 23.00 USEOFSTRUCTURE SF-b.e-Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 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 0Remodel ❑ Utilities ❑ Installation ❑ Other() Describe Work:'/ / Q� ��77 Mobile Home S I G W @20.00 PERMITFEE g Contractor ELECTRICAL PERMIT Filing Fee 20.00 - - - Main ServiceE00V OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 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 u11 force and effect. ,�/ License Class Lic. NO. Q 1.s—'o1 �Gc {D O NER-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 wfth 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. ❑ I am exempt under Sec. Business and Professions Code for this reason ' NEW CONST. DWELLING OCCUR SO. OR ADDNS. ( & ACC. BLDS. ) 3.5¢ FT. NEW CONST. / MULTI -OUTLET NON-RESID. \ BRANCH CIRCUITS ) @7.50 POWER APPARATUS ) d SINGLE OUTLET CIR. Ex. Occup. (OUTLET OR FIXTURES ) 20 @ 100 and so Ex. Occup. ( OUTLETS (R ISE ISE D OR) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor WORKERS' COMPENSATION DECLARATION I 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. I 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' compepsation insurancq ,(� carrier and olicy number are: / Carrier �) C-C,_/tiai MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number�9 (The above sections need not be completed�rf 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 orth I comply with thoseip�ovisions. X Date g re of Applicant - ❑ Owner Contractor A '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 $ 1� ,PD HAZ. I D. FEES I IMP I FLOOD I CDF PARCEL 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 which fees have been paid. BY Date IWI 4A9s, PERMITEXPIRESON (Date ' Receipt No. / % }�l� WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT ,� ; .. � `�. • ;, j _ �� :� ., � x __ _ ,. .. .. t _ [ 1 - � .. . . . .. _ i _ F. ' _..r , .. 1 ' i .. � 1 .. _ — ` � .. .i 1 .f �. � � i .' � ,. 1 .. .. _� \ �._ ... —t--. _ n �. i .. • Y 1 I r � ,. .. . •. _ ._ri, ... _._ ._ r..'' ti. �. ��." . \ t r it �� 4` _ I , �. `•� . '�, n , � - � . �s ,� �`� �j . ;, � 4 I 1, r.. .,dn... .. __. .. �.. ... aca.._[..._.�.._N-'..6kSar✓�[.•�lii..t ..,:.+i11�{��1,._.r�^,v[`!'f'1'.�Ylr/ll!)A.Ii�i!J�i. �,. [.im�.Z ^'f�:J�[:.'.�cl�il•.li�eG1�7 �JSiA�i[��irS6t2A_'.%'S.:i.l .w._. ...... ..t �::tr��. _.. .._,. .c .. (NOTE: An entry.must be made on this form each time you visit the job site.) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC.WORKS = BUILDING INSPECTION REORD q BUILDING BUI ING (Cont'd) PI UMBING Setback. Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor' Footings Windows 3rd Floor' ' Sfemwall Siding To out Slab Roof Sh eathing Water Piping PiersRoofing Sewer Garage Fdn. Vents Fixtures Footings StemwaI I Garage Vents Insulation Water Htr. Heaters Slab. Carport Footings _ Prov. for physically handlca ped Conformance of ex. structure Appilances Gas Piping & Test' Temp. Gas SlabFinal Sanitation Patio FIREPLACE Final 'Footings' Footln4 ELECNOICAL Masonry Walls Throat Rou h Reinf. Steel Final' Fixtures Bond Beam FIRE SPRIN LERS Motors Framing Test, Water Htr. Stucco Final A Subpanels Mesh ME LAICAL Gird. Fault Prot. Scratch Heating Service Brown Coolina Temp. Pole Finish Ducts Underground Interior Lath Ventilation J Permanent Door Closer Final Final MOBILEHOMEUTILITIE------------------Elect Service V Elec. Pedestal Water Piping - Sewer Gas Piping- A--------------Support Elec.Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS (NOTE: An entry.must be made on this form each time you visit the job site.) COUNTY., OF BUTTE DEPARTMENT,OF,PUBLIC WORKS f. .7 County Center. Drive - 'Oroville;,California 95965 Tel e4one': 5341-4541 APPLICATION. AND - `PERMIT authorize representatives of the County of Butte to enter upon. the This permitjis hereby issued under the applicable provisions of. above-mentioned property, for inspection purposes. the Butte County Code,and%or;,*resolutions to.do work indicated above which,feestihave:been paid: X Date"�� 7 IRECT OF.PUBL`ICWORKS SignA; a re of Per i ee or -Agent 4• r� .. Date Receipt o. L White-D.P.W. — Yellow -Assessor -PInk-Inspector.— Goldenrod -Applicant BUIlding, pPr it expires Date BUILDING:.. Owner SQ. FT.. OCC. BUILDING VALUATibN Mailing Address Q 4.4 ' Telephone No: F i rep l ace - Contractor- _ _r^ �— . ^.' Total Valuation' Mail i ng' Address. 6 ` / 'J Permi#'Fee. Plan Cliecking Fee_&/or Penalty: �. elephone N Permit Fee Building`Address = PLUMBING'- No. @ -FEE PERMIT'FILING'FEE $3.00 Each Trap 1.50 lJ Repair drainage`6r vent piping• • -1.50 Water piping 1.50 Each, gas water heater,or vent. 1.50 A. P. N ,: S, 1 — �,` Zoning &.Planning Gas piping system'1:- 5 outlets . 1.50 Each additional outlet F Snnitatinn Fire'Dept.. Fire'Zone. Use.Permi-t Building sewer 5.00,' . Parking EQA Plans Parcel ;Declaration Parcel Map 60' R/W • Improvements Lawn sprinkler system 2.00 Bld Recd a •Approval s Approval Permit Fee . $• NEW.❑ ADDITION'E] UTILITIES OTHER ELECTRICAL. No: @ FEE PERMIT FILING FEE $3:00 e->'vb Main service incl,. 1 meter Additional meters, -each " 1.00 Sub -panel (12 or less) (more than 12) F. Single Family'® Duplex Mobil Home Q -Others.0 , Range,. Cook -top or -Oven -1.00 Water Heater or Space Heater =1.00 Light fixtures b 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 o v e Hood, Ex. Fan-or-F.A. Fuen. 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. ,2 �0 z Classification I am exempt from the Contractors 'License Laws of the State of Cal ltom ia. Permit Fee ,� $ . MECHANICAL �• : ' @ , .FEE .. WORKMEN'S COMPENSATION -.INSURANCE I 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. 0 1 'have placed on file with the County of Butte a certificate of. ,. Workmen's Compensation Insurance. . r. 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 Cal'iforni'a: PERMIT FILING FEE $3.00 Heating - Cooling' Ventilation ,, Hood t"" 2:00 Permit Fee;•, $' $ 1 certify that'1-Nhave read this application and state that.the above information is"correct. I agree to comply to'al1:County Ordinances and State Laws relating to building construction, . and .hereby. TOTAL, -PERMIT FEE $. authorize representatives of the County of Butte to enter upon. the This permitjis hereby issued under the applicable provisions of. above-mentioned property, for inspection purposes. the Butte County Code,and%or;,*resolutions to.do work indicated above which,feestihave:been paid: X Date"�� 7 IRECT OF.PUBL`ICWORKS SignA; a re of Per i ee or -Agent 4• r� .. Date Receipt o. L White-D.P.W. — Yellow -Assessor -PInk-Inspector.— Goldenrod -Applicant BUIlding, pPr it expires Date .t Y 'Z" 1 n x. 1 k r N k. -r ). Y h A .,� .,F +, r t 1 , 11 ' :t 1, "+ y 4 t i t-'� a r if Y ' - W r }' t 4• ..t v' r ' ° ` •t t '�y `° ,,.q .) ;COUNTY'OF'BUTT�+_•.• •�j't t Z- `' r • �� _ i ! r'' ;� ,t r OF PUBLIC WQRKS , gip, ` r 4: J e , , �z,D& .- �7 z 7 r t i r , f�1 j�[ nn `� a k , I 1 t. 4 1 a �' i t. } r ti } L i s *- 4 .. , i-, t_ �- .ir4 t 1.<. ',' o. i s x t s1 f Pw , I r x r F t 4 M 3 l/ 977: :, ' - qR , , 1 t r -y �� , i. F t j A 9 1 ��%iI. 3•i4��i6 � "i F 'r i t j,. t4 q ri`t: s .�lrt L+ d s.,. r:> �.,8� I��.�-��L+ i,� y C t �i� t' . it i S r .4%l ,t }iJ$?3 r .s ., `1 .f. t - .'," , a,f — �r ' ,a r . (, , s! 7 'li' `� 4. �t-. 1.. y :.}f 4. -♦ is L , . 11 t '�s'�� r! wi rl; ^Tii '1r ,� .r. F c V. 'L,d r} 1 j�h a. c �, t - V 'E> Q P : �" i ry r. z i ,r .. 4 yy F ' ' ` . ; rY r < t , J �.' t ,g. �' - - t. .s~ ,: ,.> 7... _ t J is , f .f. r '' -y '' �. �.- 4.`, ,t s moi- i:�'' rk. I t r �: ' t .. ; t n ., .: V ! . a{ J —w a J! . .t �� ,.,, f` Y . ' _ i J - !- - )r r 1 , 'yam ,;y f a r Y.�; tj -f k - ri �w e 1 4 �. l s• i . 4i i t, L.� { Z 4D r l' , i 1 . . ' ..F~ t. r � . �� 4 Y 'SS ,�t � Y x,� c 1. 1 r ••. .h�. ii ,i ,•I 3.,1?.. .s. _ a - 11 - f f _ f i,, R •Y �. , _ y 1. I 1 til i . t' , A ^ ,� ti'} : t 7.. + - 1 -.. , 6 r 'Nim •�' - t t r I j T. .. a �' S,` Y rr r� �L v '�\t y 4 ryv`' ' f .i If n o'. t; C" o` , i S ^ ` 47, .it; -. 4 ` r a.. , a c , ` 2 .c, r ,c`r �t.� f ' e r +� ,.. a t.. `` t .y f t i 1 I. I� �'tw ,t J ' I I .z 4 - PERMIT NO. 5282-75P � i P. E M f MH UTIL, PERMIT NO. i PERMIT EXPIRES 10/14/76 i 1 OWNER George Roeder CONTR. LOCATION (A.P 31-281-1% ) 1424 10th, St., Oroville S t I ;L Temp. Power Pole Called PG&E Temp. Elec. Serv. r } . PG&E XFINA'LED 1. 4. (Signature) CQUNTY:OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg: Restroom Finish 2nd Floor Footin s Windows 3rd Floor Stemwall Sidinq To out Slab Roof Sheathing Water Pi in Piers Roofing Sewer lD Garage Fdn. Vents Fixtures Footings Gara a 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 ELE Masonry Walls Throat Rou h 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 Interior Lath Ventilation Permanent Door Closer Final Final DATE REMARKS OR CORRECTIONS J ^ THERMALITO IRRIGATION DISTRICT f }., • :y "Q44 410 GRAND AVENUE QROVILLE, CALIFORNIA 95965 TELEPHONE 533-0740 CSA 26 SEWER SERVICE APPLICATION AND CONNECTION PERMIT ``i 1 c Service Address: ! 4214 10 "T c;T Owner's Name:--�'�G RO E.p EIS Date: Address: '� TH Acct. No: 0 12�OV t L,(—C— CA .. "I'116iv_ A. P. No.: S I—Z.> I" f-7 Phone: " 2 1 No. Units: I Applicant/Agent: W/A Agents Proof: 1J4 Address: Fees: Phone: Application $ (j Arrearage. t Preliminary Review By.iA Date: �� 1'�! ,%Sr V / CSA 26, Remarks: SC -OR 1 st mo. S.C. Other / Total Fees` Collected By: Date: Field Review By:. Dater Remarks: !/ 1 .o MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON: !� Date of TIP approval of completed building sewer (early connection). E 30 days after date above, or on date�of D.P.W. approval of completed building sewer, which ever comes first ("existing construction", prior t\d l ar. 5, .1974). , M 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. OroviIIe, California 95965 TeldphC7e:.5,34-4541 APPLICATION. AND PERMIT autnorize representatives ot.tne county of tsutte to enter upon the above-mentioned property for inspection purposes. X Date% ' ji ignatur 04. Permitee or. Agent' - - Receipt No. ) 36 9dd White-D.P.W. — Yellow -Assessor — Pink -Inspector'— Goldenrod -Applicant tiIIIIII - • Uri. This permit ,isthereby 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 r Date.. permit expires Date'1Q Z� i� F BUILDING Owner SQ. FT.._ OCC. BUILDING VALUATION Mal ling Address o2 '�� • " Telephone No: 53 —234 Fireplace _ Contractor Total Valuation Mai I i ng Address ' Permit. Fee Plan Checking Fee&/or Penalty, Telephone No. - Perrti i t -Fee -• ' `is Building Address 1a a 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 , /_ p` �/ A. P. No. c77 Zoning & Planning Gas piping system I - 5 outlets 1.50 Each additional outlet .30 Fakf Ve.1 Srtatjpr I Fire'Dept. FireZone Use Permit Building sewer 5.00 Jam`:, 10 EQA Parking Plans I Parcel 'Lawn I Declaration I Parcel Map 60' R/W Improvements sprinkler system 2.00 Parcel Approval Plans Approval Permit -Fee . $ �d BG NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No.' @ FEE PERMIT FILING FEE $3.00 Mairi'service incl. 1 meter Additional meters' each 1.00 Sub -panel (I? or'I'ess)'(morethan 12) Single Family Duplex ❑ Mobil Home ❑ Others ❑ Range, -Cook -top or Oven 1.00 Water Heater•or Space Heater 1.00 Light fixtures025 Receps„ switches & fix outlets Sm ein 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. coo I er, gar. d I sp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Role . 5.00 License•No. Classification Misc. wiring l am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ MECHANICAL NO. . @ FEE WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700'of the Califo'rnia.,Labor Code -which requires every,empl'oyer to be insured against liability for Workmen's Compensation. ❑have placed on file with the County of Butte a certificate of- , Workmen's.Compensation Insurance.'. I certify -that in the performance of the work for, which this- permit ,is issued I shall not employ any person in any manner. so .as to become subject to .the Workmen's Compensation Laws of California. - - PERMIT FILING FEE X3.00 Heating ' Cooling Ventilation Hood 2.00 Permit Fee $ - $ I certify that .1 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 $ autnorize representatives ot.tne county of tsutte to enter upon the above-mentioned property for inspection purposes. X Date% ' ji ignatur 04. Permitee or. Agent' - - Receipt No. ) 36 9dd White-D.P.W. — Yellow -Assessor — Pink -Inspector'— Goldenrod -Applicant tiIIIIII - • Uri. This permit ,isthereby 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 r Date.. permit expires Date'1Q Z� i� F r ice. .T: - .. - t.'-�� •.t .. •