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031-290-033
31-29-33 ie Browh 630 lumas Ave., Oroville Per ��5516-78B,P,E(addition..& remodel eroof carport/duplex) X23.9-33Permit #686-79ocate ele su panel) SF 31-29-33 Contr : Lagrone Htg & Ate�- ¢ _ ermit #3004-79P,E, 'inst, 1` C) SF 10 ' 31-29-33 Permit#�745-81B (lst & 2nd renewal 551 •�8)SF 03.1-29 0.-033 91-4321 BROWN;_ ELIZABETH. CONT.,R : ELY' .ROOF I NGS . 630 'PLUMAS AVE', `OROV I LLE R`EROOF/SF y ,? 92 031-290=003 05-0455 KEYES, KENNETH s' •' 630 PLUMAS AVE, GROVILLE o ,Cont: MIKE HURSTw UPGRADE ELEC PANEL,. _ 031_290-033' -= r:.+ 0571326 KEYES, KENNETH Y 630 PLUMAS AVE,,OROVILLE,'` Cont: GEORGE ROOFING _ REROOF 34 SQ _ ' 0 1 LCI O,�7�'��ra 9 y i i ti - Clq . CMI cw .si BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP051326 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS 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 Issued Date: 05/20/2005 APN: 031-290-033-000 the Business and Professions Code, and my license is in full force and effect. License class : 02 y License Number: A -g66 Site Address: 630 PLUMAS AVE ORO Date: s .ZD—OS Contractor: Map Map Index: OWNER -BUILDER DECLARATION Description: REROOF W/COMP (34) 1 hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a I<EYES KENNETH M &REBECCA LYNN permit to construct, alter, improve, demolish, or repair any structure, prior Owner: to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of 630 PLUMAS AVE the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or OROVILLE, CA she is exempt therefrom and the basis for the alleged exemption. Any 95965-3223 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 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 (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: GEORGE ROOFING such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one 6810 LINCOLN BLVD year of completion, the owner -builder will have the burden of OROVILLE, CA 95966 proving that he or she did not build or improve for the purpose of sale.). (530) 533-6393 ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed Contractor: GEORGE ROOFING pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 of the Business and Professions Code 6810 LINCOLN BLVD OROVILLE, CA 95966 Date: owner: (530) 533-6393 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: License #: 452266 ❑ I 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. f�I have and will maintain workers' compensation insurance, as Architect: required by Section 3700 the Labor Code, for the performance of Engineer: the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: -Z / Q Policy#: A,7g Total Square Ft: 0 S. F. Valuation: $0.00 E3 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 Census Code: become subject to the 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. Date: ,I-- Applicant: WARNING: Failure to secure workers' co ensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutions to do nd" dicated ab ve for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Name: ^^ ,, By Dat -a6 Address: PERMIT EXPIRES ON:Cj ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ • Notification in accordance with Section 19827.5 of California Health 8 Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby duthorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Nam f f�/GC�C� y�� Signature: Date: o�r� �`%�10/ O Owner ❑ Contractor Agent for Owner ❑ Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION APPLICANT SIGNATURE X Shirley e /agentor George Roo i Of For office use my OWNER Name Perry Broster Address 7950 Graves Creek Rd. City Atascadero State CA Zlp 93422 Phone 805-466-8708 Fax E-mail Lic.# APPLICANT SIGNATURE X Shirley e /agentor George Roo i Of For office use my CONTRACTOR Name GEORGE ROOFING Address 6810 Lincoln Blvd City Oroville State CA Zip Phone (530) 533-6393 Fax (530)533-0287 E-mail dan@abcgc.com Lic.# Class dan@abcgc.com 452266 1 C39 APPLICANT SIGNATURE X Shirley e /agentor George Roo i Of For office use my ARCHITECT/ENGINEER Name N/A Address 6810 Linocln Blvd City Oroville State CA Zip Phone (530) 533-6393 Fax E-mail dan@abcgc.com State License Number APPLICANT SIGNATURE X Shirley e /agentor George Roo i Of For office use my APPLICANT NAME Name GEORGE ROOFING Address 6810 Linocln Blvd City Oroville State CA Zip 95966 Phone (530) 533-6393 Fax (530)533-0287 E-mail dan@abcgc.com APPLICANT SIGNATURE X Shirley e /agentor George Roo i Of For office use my Zoning Flood Zone SRA Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: LOCATION AP# 31 • aQa C)3 Y -)j Property Address 630 Plumas Ave. Oroville, Ca. 95966 Cross Street PERMIT NO. NO. BP BIN # WORKER'S COMPENSATION Policy Number 272-596-02 Carrier STATE FUND If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work Reroof House - Comp Sq. Footage 34 Squares ❑ Structure Built Without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be required. FOR REFUNDS Retunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: Amount Receipt #: ) / go Date - E�>\ Bldg SRA Sheriff SMIP Other Total REV: George Roofing BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP050455 B. C. Building Permit 01-16-04 pq 1 LICENSED CONTRACTORS 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 Issued Date: 02/16/2005 APN: 031-290-033-000 the Business and Professions Code, and my license is in full force and effect._��� License class : License Number: �35�67 Site Address: 630 PLUMAS AVE ORO Date: -� 6-0S Contractor: 1fr'�- Map Index: Description: UP GRADE ELECTRICAL SERVICE -NEW OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the PANEL 100AMP Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a Owner: KEYES KENNETH M &REBECCA LYNN signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 630 PLUMAS AVE she is exempt therefrom and the basis for the alleged exemption. Any OROVILLE, CA violation of Section 7031.5 by any applicant for a permit subjects the 95965-3223 applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 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 (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, Applicant: KEYES KENNETH M & REBECCA LYNN provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ Contractor: HURST, MIKE I am Exempt under Article 3 of the Business and Professions Code Date: 15 OAKCREST DRIVE OROVILLE, CA 95966 ----owner: WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: 530-589-5330 ❑ I have and will maintain a certificate of consent to self -insure for MIKE-TERRI@SBCGLOBAL.NET workers' compensation, as provided for by Section 3700 of the License #: 335967 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 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Architect: insurance carrier and policy number are:. Engineer: Carrier: Policy #: J4 I certify that in the performance of the work for which this permit is Total Square Ft: 0 S. F. issued, I shall not employ any person in any manner so as to Valuation: $0.00 become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' Census Code: compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. - Date:" Applicant: WARNING: Failure to- secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees.-� CONSTRUCTION LENDING AGENCY This permit is hereb issued under the plicable provisions of the Butte County Code and/or 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.)l6 Resolutions to do rk indicated ab a or which fees have been paid. Name: BY // Dater - L/v PERMIT EXPIRES ON: —A h Address: Date ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: {/rS Signature: Date: O Owner ,� Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pq 1 .. ,. a. ..r^� -�-�n'r-�;^ s'F�'>'�br�A511j;� R'�i��4M'4 "�:'-�"t-r�i�a" , s'� __^Nk:.!',i R'"#R:,�:: x;v�:�'.�,R '�':�r y,-rc?:9�s�;�,.> rµ�ytla�r,F�'";`t:•:+�f'vp �y _,.r i�yCX}hq; n .:031'=29-0 BROWN '033 ELIZABETH 91-432.1 CONTR; HELY 630° p ROOFING L'•UMAS , k REROOF/SF' AVE, OROV I LLE- + 1 t , t t COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PER 1 ASSESSOR PARCEL NUMBER 31-29=033 ZONING BUILDING PERMIT OWNER Elizabeth Brown TELEPHONE . 534'0'-'47 SO. FT. OCC. BUILDING VALUATION 31 @ 1860.00 OWNER'S MAILING ADDRESS - 630 Plumfm Avrlr Oran lle CONTRACTOR'S NAME 'F,1v R TELEPHONE 4 =76 CONT ACTOR'S M ILING ADDRESS P.O. box 704, Chico Fireplace CONSTRUCTION LENDER UNKNOWN Total valuation 1$1.860.00 LENDER'S MAILING ADDRESS Filing Fee $ 15.00 Permit Fee $ 36.00 ARCHITECT OR ENGINEERLICENSE NO. Plan Checking..Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $51.00 PLUMBING PERMIT Filing Fee 15.00 630 Plum?; Ave, Orovil1le Each Trap 1 5.00 Solar or heat pump water heater 1 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 1 7.00 Each qas water heater or vent 1 7.00 USE OF STRUCTURE SF [J Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 1 5.00 Building sewer 15.00 Mobile Home S I G I W 615.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other Describe work: Reroof Permit Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 200A OR LESS 18.50 Main service 200A TO 1DDOA) 37.50 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._ 4b 2 Classification �'�'�� ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.pI ADDNS. ACC. BLDGS. 3.6$sq.ft. NE NEW CONSTRMULTI-OUTLET NON•RESID BRANCH CIRC ITS @ 5.00 POWER APPARATUS .&) OUTLET CIR. EX. Occup( OUTLETS OR FIXTURES p� 20 76 A FIXED APLNS. Ex. OCCUp. OUTLETS (RESID )REA.) 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 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. 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 becomesubject 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 15.00 Heating 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 liabiliti s, judgments, costs, and expenses which may in any way accrue against saicVCounty in con equence of the granting of this permit. X �� Date l� Signature pp ❑ Contractor ❑ Agent ® An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST TYPE TOTAL FEE g51 OO HAz DFEES IMP FLOOD CDF PARCEL PO HD ISSUE j This permit is hereby issued under the sions of the Butte County Code and/or e_% work indit;a d abo�te f r which feg� lr IREfI'.� F PUBLIC/Vy BY PERM 7 XPIRES Date applicable provi- resolutions to do I�ve been paid. �j� RKS Date14 Q 1 . /'1031W Receipt No. 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 AND PERMIT PERMITO. ASSESSOR PARCEL NUMBER 31-29-033 ZOlsNG BUILDING PERMIT OWNER Elizabeth Brown TELEPHONE 534-0347 SQ.FT. OCC. BUILDING VALUATION 31 @ 1 860.00 OWNER'S MAILING ADDRESS 630 Plumas Ave. Oroville CONTRACTOR'S NAME TELEPHONE 1343-7663 CONT AW:SL%jff ADDRESS P.O. box 704, Chico Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation 1$1.860.00 LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ 36.00 ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $51.00 PLUMBING PERMIT Filing Fee 15.00 Each Trap 1 5.00 Solar or heat pump water heater 1 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 SF [I Duplex❑ Mobilehome❑ Other Mobile Home S I G I W @ 15.00 SPECIFY TYPE OF WORK New Addition❑ Remodel❑ Utilities❑ Installation❑ Other[ Permit Fee $ Describe work: Reroof Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200AORLESS 18.50 Main service 200A TO IOOOA) 37.50 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 an my license is in full force and effect. License No. Classification ��_ NEW CONST. DWELLING OCCUP.&\ OR ADDNS. ACC. SLOGS. I/ NEWCONSTR ULTI.OUTLET NON-RESID BRANCH CIRC ITS (POWER APPARATUS el (SINGLE OUTLET CIR. Ex.Occu Occup( p\OUTLETS OR FIXTURES 3.6Q sq.ft. @ 5.00 zo @ 76 I, as the owner, or my employees with wages as their sole compen- FIXED APPLNS.❑ Ex. OCCUp. OUTLETS (RESID )REAJ I 3.00 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) Temporary service Mobile Home Facilities Misc. Wiring 15.00 15.00 15.00 ❑ I am exempt under Sec. , Business and Professions Code for this reason Permit Fee $ — WORKMEN'S COMPENSATION INSURANCE Contractor I declare under penalty of perjury (check one): MECHANICAL PERMIT FiIIng Fee 15.00 ❑ The permit is for $100.00 (valuation) or less. 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 ❑ I shall not employ any person in any manner so as to become subject Hood 6.50 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. Ventilation Permit Fee Contractor - $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabiliti s, judgments, costs, and expenses which may in any way accrue against saiounty in con_sequence of the granting of this permit. Mobile Home Installation Fee S Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 51.00 HAz 1 DFEES I IMP I FLOOD I CDF I PARCEL I PO HD ISSUE l / X&1:f1Date_ qJ This permit is hereby issued under the applicable provi Signature of Applic t - OwnerElContractor E]Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. sions of the Butte County Code and/or resolutions to do work in 'ca d aWefwhicAfeve been paid. IRE PUBKS Receipt No. 103160 BY PERM T XPIRES Date Date WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT :r COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 1 7 COUNTY CENTER DRIVE - OROVILLEVO .FORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APP 0- -ION DATA SHEET Permit No. OWNER_ �� Z/��!/�%7Z% GC.cJ/v o. :5,/-_72 9� Proposed Building Use G�-a0 % Building Inspector Date jkl At time of rmit application, I was advised the following data must be submitted prior to permit processing and/'or issuance: 1. DATE RECEIVED APPROVED All items have been submitted . ....................................I 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans " . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form ......................................... 6. . Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ............... 8. Enginpered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13• " School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit............ f ...................... 16. Plot plan and business license approval frorkCity of _ 17. (see City for other requirements) Planning approval for (A) Use: (B) Perking: ..... 18. Improvements may be required. Contact Land Development Section DPW . 19. Driveway permit (construction approval required prior to occupancy) 20. -Building Pre -Inspection for required...Pre-Inspec. request to Inspector (Date) t 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner o) " . " " " 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ........... ..................... . 26. 27. '�. 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 i Applicant Date e-� 7 -71 -> Copy of !.az-Mat form sent Health Dept. -'Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following dat prior to per -nit issuance: (Circle new d above). 1. Index permit for above items No. 2. Additional items required: 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 —mal l—counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 3 ZONING BUILDING PERMIT owNE;��A� h✓ fC TELEPHONE s�y� � SO. FT. OCC. BUILDING ALUATION OWNER'S MAIL NG ADDRESS lobo CONTRACTOR' NAME L oa iU 4=-, TELEPHONE CO R CTOR•S MAILING ADD" �ESS , . 701/ Fireplace CONSTRUCTION L NDER UNKNOWN C Total Valuation $ LENDER' MAILING ADDRESS ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 15,00 Permit Fee Plan Checking Fee $00 $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILg1((fid3oNG ADDRESS � +/ J/ iwv Permit fee a PLUMBING PERMIT Filing Fee 15.00 Each Trap 1 5.00 Solar or heat pump water heater 1 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 1 7.00 ' Each qas water heater or vent 7.00 USE OF STRUCTURE SF'171 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 WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT FiVingFee 15.00 Main service V OR LESS 200AORLESS 18.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): �j I am licensed under provisions of Chapt. 9, Div. 3 of the BuSlnesS and Professions Code and my license is in full force and effect. License No.2!2gfo Classification t? �� ❑ 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 Main service 200ATO10o0A) 37.50 NEW CONST. ( DWELLING OCCUP.IE\ OR AODNS. ACC. BLDGS. / 3.6asq.ft. NEW CON5Tfi.ULTI.OUTLET NO ESID BRANCH CIRC ITS @ 5 00 POWER APPARATUS &) (SINGLE OUTLET CIR. L__ Ex. OOCUp(OUTLETS OR FIXTURES20 @ 76d �AL1REA.� Ex. Occup. OUTLETS ((RESID I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring15.00 Permit Fee $ — WORKMEN'S COMPENSATION INSURANCE 1 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. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating Coolin g 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 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 S Energy Inspection Fee $ OCC CONST TYPE TOTAL FEE $f HAz I DFEES I IMP FL000 cDF PARCELI PO HO ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC BY PERMIT EXPIRES Date applicable provi- I resolutions to do have been paid. WORKS Date Receipt No. ID � /6 WHITE-O.P.W.. YELLOW -ASSESSOR. PINM•INSPCCTOR. gni nru on n.�eei .��uT 741 Z I -55i6�zv � 6 �1 _ � , • -tea; P , E n ` P O. 'PERMIT EXPIRES Leslie Brown OWNER owner CONTR.. LOCATION (A.P. 31-29-33 630 Plumas Ave., Owille 4 - f.l �4 t a S. • Temp. Power PoCe Called PG&E Temp. Elec. Serv. Called PG&E t. Temp. ,�Gas Serv. CaYled PG&E Q�OB 1fyINALED (Date) t • b, (Signature } COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS -BUILDING INSPECTION RECORD ILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor – g Main Bldg. it Restroom Finish 2nd Floor Footings Windows 3rd Floor StemwalI Sidina To out Slab Roof Sheathing – Water Piping Piers Roofing –$' . Sewer Garage Fdn. Vents Fixtures Footings Garage Vents 117 Water Htr. Stemwa I I Insulation Heaters Slab Carport Footings Slab Prov, for phsically handica ed Conformance of ex. structure Final --I(:) Appliances Gas Piping & Test Temp. Gas �— Sanitation Patio FIREPLACE Final /0 Footings Footing ELECTRICAL Masonry Walls Throat Rough –.• Relnf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing -- Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heatino Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES ------------------ Elec_ Service Elec. Pedestal Water Piping Sewer Gas Piping MOBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS W1S - Ah ' QD /c l � (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Centdr Drive, Orovi Ile — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE BUILDING OR PROPERTY ADDRESS 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 matt{r, or need additional explanation, please contact this office immediately. i r Inspector i + ��� � Date i t COUNTY OF BUTTE- DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7; County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT ASSESSOR PARCL NUMBE ZON NG BUILDING PERMIT owN R TELEPHONE s'I -D SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILIN DDRESS 3 CO RACTOR'S NAME TELEPHONE ' CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN • Total Valuation $ ' Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ D ARCHITECT OR ENGINEER - LICENSE NO. Plan Checking Fe $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS � �S PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets OF STRUCTURE UR'*' SF Duplex[-] Mobilehome❑ Other U , SPECIFY Building sewer Lawn sprinkler system 4115.00 TYPE OF WORK New ❑ AdditionEIL Remodel n U ilities ❑ Installat(gn❑ Other gal, Describe work: _�y-�°/y�Pg� -SSS/(�%,� ,Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 ' Main service EA. ADD'L 100 AMP 2;50 NEW CONST. DWELLING OCCUP.N) OR ADONS. ACC. BLOG.S. / 20 sq CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): EJ 'I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) „ ❑ 1 am exempt under Sec. , Business and Professions Code for this reason NEW COONS R.BMU RANCH CIRCTITS 2.50 ea NEw CONSTR. ( POWER APPARATUS SJ NON-RESID. SINGLE OUTLET CIR. 50 @ 25C Ex. OCCUp OUTLETS OR FIXTURES' BAL�1 Ex. Occup.�pUTLE TS P(RESID )REA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00'(valuation) or less. ❑ 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. K� I shall not employ any person in any manner so as to become subject �l 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 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, and expenses which may in any way accrue against id ounty in consequence of the granting of this permit. i - ,� Q X .� /J�1.t9Lt/V� Date v / Signature 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 $ TOTAL PERMIT FEE $ TO r O OCcuP. GROUP I TYPE OF CONST. PARCEL PD I ND IssuE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which aDlqCtORVOFPUBLIC. ByDaIt••e� PERMIT EXPIRES Date ,� the applicable provi- resolutions to do fees have been paid. WORKS J��/ Receipt No. `Y" 0� WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORK 7 County Center Drive — Orovi lie, California 95965 Telephone: 934-4541 APPLICATION AND PERMIT BUILDING Owner es 11-e, SQ. FT. OCC. BUILDING VALUATION Mai l ing Address 63-0 .leoone Contractor Mailing Address Fireplace �\ Total Valuation ' Telephone No. Permit Fee Building AddressPlan S ve • Checking Fee&/or Penalty /'/0'. Permit Fee PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 D Repair drainage or vent piping 1.50 A. P. NO. J z i / -� 9 -- 3 3 Zoning 8 Planning Water piping 1.50 Each gas water heater or vent 1.50 Fees �ar)�t n Fire Dept. F_ ire Zone Use Permit Gas piping system 1 -5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improve ents Each additional outlet .30 Building sewer 5.00 Bldg. PI s Rec'd Parc! A rova Plan pproval Lawn sprinkler system 2.00 NEW ❑ ADDITION UTILITIES ❑ OTHER ❑ Permit Fee $ 6_00 rs 0� ya , ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 d r Main service 600V OR LESS 100 AMP OR LESS 5.00 Single Family Duplex Mobil Home ❑ Others ❑ Main service EA. ADD'L 100 AMP 2.50 100 AMP O 25.00 Main service OVER P OR LESS .a Main service/ EA. ADD'L 100 AMP 1.00 NEW CONST *OR ADDNS. C A GS CCUP. !i\ 20sq It e 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 Y le of: NEW CONSR.S,D MUL I.OUTL T NON-RESID BRANCH CIRCUITS) 2.50ea NEW CONSTR. (POWER APPARATUS .&, NON-RESID. SINGLE OUTLET CIR. Ex. Occuo(OUTLETS OR FIXTURES 1 BAL� BAL@ Ex. OCCU FIXED APPLNS. OR p•�OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 171 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ 16 $ Z 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. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. Igt I certify that in the performance of the work for which this 4hL 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 Land Development Fee $ TOTAL PERMIT FEE $ (� aUnIUIILe IepleSenl-Gllve5 UI LIIU LoUUnty oI OUtce 1U enter upon Ine above-mentioned property for inspection purposes. Date U ignature of Permitee or Agent Receipt No. n White-D.P.W. - Yello Assessor - Pink- nspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or re tions to do work indicated above for which fees have been aid. DIRECTOR OF P LIC WORKS r By %m -a - 7 Bue ding permit expires Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date 5---23 Sign re of Permitee or Agent Receipt No. -;23f3 rC62 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 Date Building permit expires Date .14 - 3--701 BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Contractor Idgl��-- MailingAddress b i e Fireplace Total Valuation O Telephone No. X33 j]p) Permit Fee Building Address Plan Checking Fee&/or Penalty Permit Fee PLUMBING No. @ FEE PERMIT FILING FEE $3.00 OD Each Trap 1.50 Repair drainage or vent piping 1.50 A. P. No. - a —JAF4ni Zong & Planning Water piping 1.50 Each gas water heater or vent 1.50 Vs I W!Gl Sam t8flon Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 p EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 BI ans Recd Parcel Approval Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Permit Fee $ vz-5-4 _ ELECTRICAL No. @ FEE J 7Sy PERMIT FILING FEE $3.00 B Main service 600V OR LESS 100 AMP OR Less 5.00 Single Family Rr Duplex ❑ Mobil Home ❑ Others Main service EA. ADD'L 100 AMP 2.50 Main service OVER eooV 25.00 100 AMP OR LESS Main service EA. ADD•L 100 AMP 1.00 NEW CONST OR ADDNS. ACCLBLDGS.LING CCUP. s� 22 sq ft 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 st le of: y T NEW CONSTR BRANCH CIRCUITS NON.RESID ( BRANCH CIRCUITS) 2.50ea NEW CONSTR. POWER APPARATUS 6 NON-RESID. SINGLE OUTLET CIR. Ex. Occuo(OUTLETS OR FIXT11RES 50@@ BAL@1 Ex. OCCU FIXED APPLNS. OR P•� 0 'TLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification C- - ,-"a Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ DD $ OC 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 forWorkmen'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 tPERMIT FILING FEE $3.00 3.00 Heating 000 9`tl . ©� ,Q.3 Cooling a t4 Ventilation Hood 2.00 Permit Fee $ b Im $ f Gt 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 Land Development Fee $ TOTAL PERMIT FEE $ S� a authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date 5---23 Sign re of Permitee or Agent Receipt No. -;23f3 rC62 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 Date Building permit expires Date .14 - 3--701 J COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 Telephone:' 534-4541 APPLICATION AND PERMIT EPA 'All, F" out I Iul Z ICjJ1-7IItGl1vC5 VI llle LUUllly UI DUlle tU enter Upun the above-m'entio0ned property for inspection purposes. �f iX4]�-�:�i��C'sGbh/ Date"- Signature ateSignature of Permitee or Agent 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 which fees have been paid. DI9,E6._OR.O1F PUBLIC WORKS By LIZ 'W62V erg Date Building permit expires Date "bdsa-_+"�(,�A—to BUILDING Owner SO. FT. OCC. BUILDING VALUATION Mailing Address `I TeJA3hLe No. Contractor Mailing Address Fireplace Total Valuation " Telephone No. Permit Fee Building AddressPlan Checking Fee&/or Penalty Permit Fee " PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1,50 Repair drainage or vent piping 1,50 A. P. No. .^` Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 F beefw< ' reDeptJ Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EOA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 IT,g. Parcel A roval Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Permit Fee $ $ Uaoej ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 atm Main service 600V OR LESS 100 AMP OR LESS 5.00 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD•L 100 AMP 2.50 Main service OVER 600V 25.00 100 AMP OR LESS Main service/ EA. ADD'L 100 AMP 1.00 NEW CONST. OR ADDNS. ACCLBLDGS.LING CCUP. Y) 20sgft C 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 st le of: y NEW CONSTR BRANCHCIR-OUTLET NON.RESID BRANCH CIRCUITS) 2.50ea NEW CONSTR. (POWER APPARATUS 8 NON-RESID, SINGLE OUTLET CIR. 250 Ex. Occup(OUTLETS OR FIXTIIRES g L 1@ Ex. OCCU FIXED APPLNS, OR p• OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 R1I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ C 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. ❑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 $ $ 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 I Land Development Fee $ TOTAL PERMIT FEE $ 2 out I Iul Z ICjJ1-7IItGl1vC5 VI llle LUUllly UI DUlle tU enter Upun the above-m'entio0ned property for inspection purposes. �f iX4]�-�:�i��C'sGbh/ Date"- Signature ateSignature of Permitee or Agent 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 which fees have been paid. DI9,E6._OR.O1F PUBLIC WORKS By LIZ 'W62V erg Date Building permit expires Date "bdsa-_+"�(,�A—to ;i f IN v ;} 1t