The URL can be used to link to this page

Home My WebLink About035-300-035SUNBEAM CONSTRUCTION COMPANY v Ayp - C t, O rov i t le Crestwood Unit #l, lot 39 sr Permit #5332-77B,P,E,M(new SIF) ' 35-30-35 - JEW OWNER *; ,. '04�: _LARA GIBSONI000 .Contr : un eam Const, I44s Altos P rmit#3920-79B(replace siding)SF •n 6. 035-300-035 :''PERMIT#97-Q747 _ , r GIBSON; Clara 2240 Jan Ct`: , fi Orovill Cont: Selig'°Const; j x Vinyl' Siding/SF' .. r . P R PERMIT NO. 5332-77B,P,E,M .a PERMIT EXPIRES �O `0-�l l) OWNER SUNBEAM CONST. CO. CONTR. owner LOCATION (A.P. 35-13=24 part ) Eda Ct, Crestwood Unit ¢#1, lot .#39 U `Oroville 1 ' Q i M^ I 1 4 Temp. Power Pole Called PG&E AEV Temp. Elea Serv. Jq--7' Called PG&E° Temp. Gas Serv. Called PG&E /JOB FINALED (Date) il (Signal re) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD Footings structure A� Temp. Gas Slab Final:2;7 Sanitation Patio FIREPLACE Final Footings Footinq EUECZB�CAL- Masonry Walls Throat A Rough 11112 ` 17 Reinf. Steel Final Fixtures Ilk Bond_ Beam FIRE *RIIJKLERS Motors stucco BUILDING BUILDING (Cont'd) PLUMBING Setback ^2 0° i62 Firewall Soll PIpIn Forms Brown Parapets 1st Floor Main Bldg. Ducts Restroom Finish 2nd Floor Footings %% fy Windows 3rd Floor Stemwall MOBILEHOMEU ILI Sidinq To out Slab 42 ✓" Roof Sheathing Water Piping' Piers r Roofing ?-4'-79- Sewer 1:7 ce-Of Garage DATE Fdn. Vents Fixtures Footings Stemwall -?rO-7% �, Garage Vents Insulation Water Htr. Heaters Slab Carport Po Prov. for phsically handica e. Conformance of ex. Appliances Gas Piping & Test Footings structure A� Temp. Gas Slab Final:2;7 Sanitation Patio FIREPLACE Final Footings Footinq EUECZB�CAL- Masonry Walls Throat A Rough 11112 ` 17 Reinf. Steel Final Fixtures Ilk Bond_ Beam FIRE *RIIJKLERS Motors stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Under round Interior Lath Ventilatio Permanent Door Closer Final Final MOBILEHOMEU ILI ES ------------------ Elec_ S6rvice Elec. Pedestal Water Piping Sewer Gas Piping M0016EHOMEINSTA L TI N• -------------Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS N (NOTE: An entry must be made on this form each time you visit the job site.) THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH THE CURRENT REGULA- TIONS, CALIFORNIA ADMINISTRATIVE CODE, TITLE 25, STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT: Lot 39 -7 Street Lot Number Tract No. EXTERIOR WALLS , Manufacturer Certainteed Thickness/Type 'R `Value 11 - CEILINGS Batts: Manufacturer Thickness R Valu,- alueBlown: Blown:Manufacturer Certainteed Thickness 8 3Z4" No. Bags 18 Wt./Bag Sq. Ft. Covered 899 R Value 19 FLOORS _ Manufacturer Thickness/Type R Valu,- alueSLAB SLABON GRADE , Manufacturer Thickness/Type R Value Width of Insulation inches FOUNDATION WALLS Manufacturer Thickness/Type R Value GENER NTRACT6K11 19 — IM LICENSE No. LICENSE 153200 B1. d b ; TITLE—s-� _ DATE / � INSULATION CONTRACTOR: HAWKINS INSULATION CO., INC. LICENSE No. 215-925 TITLE mer DAA August 15, 1978 -- - COUNTY OF BUTTE -PA DE RTMENT OF PUBLIC WOR 7 County Center Drive - Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of t3utte to enter upon the above-mentioned property for inspection purposes. X nate Signature of Permitee or Ag Receipt No. /70-7�% 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 PUBLIC WORKS 7,7 By- By Date Bolding permit expires Date j a - �° - 7? BUILDING Owner Sunbeam Construction Co. SQ. FT. OCC.'J- BUILDING VALUATION 894 I $13,410.00 Mailing Address 11190 Hooper Lane 385 J Los Altos, CA. 94022 4 �elATT&82 Fireplace Contractor owner Total Valuation $14,950.00 Mailing Address Permit Fee 72.00 Plan Plan Checking Fee &/or Penalty Telephone No. Fee $ 72.00 $ 72 00 Building Address yd 14-%ra Ct., Oroville PLUMBING No.1 @ I FEE PERMIT FILING FEE 1$3.00 3.00 Each Trap 5 1.50 7.50 Repair drainage or vent piping 1.50 Water piping 1.50 1.50 Crestwood Unit #1, Lot 39 ZonthgLYGrificafign Q.1, Each gas water heater or vent 1.50 �_ r A. P. No. 35 -24 port. Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F C. N Fire Dept. Fire Zone Use Permit Building sewer 1 5.00 5.00 EQA Parking Parcel Declaration 60' R/W l Improvements p ove�ments Lawn sprinkler system 2.00 �QQPlansI� BI hrn;i e1~Ytff Parcel pproV 3c Pi ,, p al Permit Fee $ $ NEW J ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 3.00 Main service 1000V OR 0 AMP ORLESS5.00 Main service EA. ADD'L 100 AMP 2.50 Single Family J2 Duplex ❑ Mobil Home ❑ Others ❑ OVR 600V Main service 100E EAMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW CONST. ( DWELLING OC J &\ 2�Sq ft 25.55 OR ADDNS. ACC. BLDGS. L l NEW CONSTR. MULTI -OUTLET NON.RESID. ( BRANCH CIRCUITS 2.50ea NEW CONSTR. POWER APPARATUS & NON-RESID. (SINGLE OUTLET CIR. J I 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) BAL 2r 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 ,WTI am exempt from the Contractors License Laws of the State of California. Permit Fee $ 28.55 $ 28 5 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 s as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 3.00 Heating Cooling Evap. 1 ._00 3. 00 Ventilation Hood 2.00 Permit Fee $ $ 8 00 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 25.00 TOTAL PERMIT FEE $ 55 150 authorize representatives of the County of t3utte to enter upon the above-mentioned property for inspection purposes. X nate Signature of Permitee or Ag Receipt No. /70-7�% 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 PUBLIC WORKS 7,7 By- By Date Bolding permit expires Date j a - �° - 7? This set of plans and spec;fications MUST U kept pn the io.k rat alp t;mes and it is unlawful to mrl qny chanaes or alterations on some without writteftermission from the Department of Public Workunty of Butte. t The Bldg. Setback shall be 5 4t.from -the side props ty line and 50 ft. from centerline if the road, permitting a maxi- mum of a 2 ft. eave overhang but entirely uof all, eseents.ms / e � p/ass aster p� k . t, • IC117 on rile ililclz 97 f \\ 1� . i t , I'✓\ 11101 %ll' Al6. :ore c4iFoI?iviA`;�,: oz N 1±� • a' a .�a BUTTE. COUNTY BUILDING DEPARTMENT APPROVED 0/I0V/L L E91.9UT TE.CO 0 iQC4L hc0,12IL11 1 4. 07 f ti �• tV j �1 J/ l 1 t The Bldg. Setback shall be 5 4t.from -the side props ty line and 50 ft. from centerline if the road, permitting a maxi- mum of a 2 ft. eave overhang but entirely uof all, eseents.ms / e � p/ass aster p� k . t, • IC117 on rile ililclz 97 f \\ 1� . i t , I'✓\ 11101 %ll' Al6. :ore c4iFoI?iviA`;�,: oz N 1±� • a' a .�a BUTTE. COUNTY BUILDING DEPARTMENT APPROVED 0/I0V/L L E91.9UT TE.CO 0 iQC4L hc0,12IL11 1 4. 07 ej HERMIT NO. 3920-79B a PERMIT EXPIRES _ 6/27/80. �e '+ OWNER C,LARA GIBSON CO. Sunbeam Const' LOCATION (A.P. 35-30-35 _ '2240 Jan Ct., Oroville • l ' y Temp. Power P,�o /e_ Called PGCE Temp. Ele�erv. Called PG&E Temp Gas Serv. galled PG&E ,1 JOB I( ?f v FINALED (Date) It (Signature) Setback Forms Main Bldg. Footings Stemwal l Slab Piers Garage Footings Stemwa l l Slab Carport Footings Slab Patio COUNTY OF BUTTE — DEPARTMENTS OF PUBLIC WORKS BUILDING INSPECTION`RECOD mvai mou n Relnf. Steel Final Fixtures Bid Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh i MECHANICAL Grd. Fault Prot. Scratch Heating 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 OBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE -REMARKSOR �CORRECTIONS (NOTE:.An entry must be made on this form each time you visit the job site.) PLUMBING., ICA L BUILDING BUILDING (Cont'd) Firewall Soil Piping Parapets 1st Floor Restroom Finish 2nd Floor Windows 3rd Floor Siding To out ` Roof Sheathing Water Pi inc ' Roofing, "•' Sewer Fdn. Vents Fixtures - Garage. Vents Insulation Water Htr. Heaters Prov. for ph sically handica ed Conformance of ex. structure Appliances Gas Piping Temp. Gas Final Sanitation FIREPLACE Final Footinq mvai mou n Relnf. Steel Final Fixtures Bid Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh i MECHANICAL Grd. Fault Prot. Scratch Heating 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 OBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE -REMARKSOR �CORRECTIONS (NOTE:.An entry must be made on this form each time you visit the job site.) PLUMBING., ICA L COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Tel g4hone: 634-4541 APPLICATION AND PERMIT ' BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Contractor, Mailing Address Fireplace Total Valuation Telephone N01111-51 ge Permit Fee Building Address 2Plan Checking Fee&/or Penalty Permit Fee PLUMBING No.1 @ 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 s S ion ire Dept. FireZone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 AM, Pune-i�ec'd Parcel Approval Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Permit Fee $ $ ` ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 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 e O 25,00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 1.00 NEW CONST.( OR ADDNS. ACCLLING BLDGS.CCUP. 41 2�sgft 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: S � ry 1312 Ift r►1 Gri w 5 i� . TLET NEW CONSTR BRANCH CIRCUITS)— NON.RESID � BRANCH CIRCUITS) 2.50ea NEW CONSTR (POWER APPARATUS t1 NON-RESIDI. SINGLE OUTLET CIR. EX. OCCUDtOUTLETS OR FIXTURES 2@51000 FIXED APPLNS, OR Ex. Occup.(OUTLETS (RESID,) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 nn License No. r) 'i�D O Classification t) Misc. Wiring 6.25 ❑ 1 am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ MECHANICAL No.1 @ 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. 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 $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 Land Development Fee $ TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned property or inspection purposes. is •Date a Signa ture.of Permitee or Agent Receipt No. .26iL" 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. W OR OF PUBLIC WOR/,/K'S ^/l (9• Dat4 '��✓ " Building permit expires Date A Z?-� i' t � 1 . , _ �.� . � {'� ' ,. ty '.t' .. , `'��4 � �' COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, Californ a�95965 - Telephone (916) 538-754 - ^ PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT 0 ASSE$SQfi6 U E AR ZONING , BUILDING PERMIT OWNEUARA GIBSON l� TELEPHONE SO. FT. OCC. BUILDING VALUATION 1 79 °WN L14V" JMIEsZM RT, OROVILLE 95966 CONTRACT S,.Nu�AMNST `�a TELEPHONE O°wOR 3631 "riritrKei ssi ANE, CHICO CA 95928 CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 0(20.00 Permit Fee $ 99 A `+`+ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BDILD`i vE;iAN OOURT, OROVILLE Energy Plan Checking Fee $ PERMIT FEE S19 W LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE ' SF ❑X Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat' um water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑X Describe Work: VINYL SIDING Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.00 Main Service zoonORLE S 23.00 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 f II force and effect.,r License Class Lic. No. -7/10 4%_ 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 Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. SO OR ADDNS. ( a ACC. Bins. 3.52FT. == .T. MAUNCHOUTLET CIRCUITS @7,50 POWER APPARATUS a SINGLE OUTLET CIS. 20 Q 1.00 Ex. Occup. °uTLE UREs BAL .50 A P 'S ° Ex. Occup. ourLEtDrRES D.EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 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' compensa;ion insurance carrier and policy number are: Carrier (O A -t 1 06N A 1 wi)EN40 TY Lr. 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 provisl ns. / 1 P X�l/ELA� Date_?7 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. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 119.00 RAZ. D. FEES IMP I FLOOD I CDF PARCEL I PD HD I 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. k/Date By J9t7 4&1. G>/ PERMIT EXPIRES ON Dale Receipt No. WHITE-B.D. , -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF ec;VEkOPMENT SERVICES -BUILDING DIVISIO 7 County Center Drive - Oroville, alifornia 95965 - Telephone (916) 538-75 7� PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT -/ ASSES(Jr,R k—' 035 ZONING BUILDING PERMIT OWNEtLARA GIBSON TELEPHONE SO. FT. OCC. BUILDING VALUATION -CUNTIF— 7279 OWNE72TId"GATtOURT, OROVILLE 95966 CONrMlfJTONST TELEPHONE ' "V�MMMILANE, CHICO CA 95928 CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation Is ARCHITECT OR ENGINEER LICENSE NO. —Filing Fee $ 20.00 Permit Fee $ 99.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDIM[ EshN COURT, OROVILLE Energy Plan Checking Fee $ PERMIT FEE $ 119.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑X Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heafpump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ X Describe Work: VINYL SIDING Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service OO.A OR LESS 200A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter ii 9 (commencing wth Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.I,� License Class 71164 2 OWNER -BUILDER DECLARATION I 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 Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( 8 ACC. BLDS. sD 3.SQ FT. CONST. NEW MULTI -OUTLET NON-RESID. ANC CI CU ITS 7.50 POWER APPARATUS 8 SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES BA� @': o 00 Ex. Occup. OUTLETS REESIO.OFR.A. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 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' Pompe sa on insurance carrier and pol, y numb are: Carrier c- oI�NIA- �tbERul ] 1 ljnS. Co, MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number Sh (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 fo ith compI with those provisi ns. / % 7 X % /%r Date=/ Sign r of Applicant - ❑Owner ❑Contractor ❑Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 119.00 HAZ. D. FEES IMP I FLOOD I CDF PARCEL I PD I HD I ISSUE This permit is hereby issued under of the Butte County Code and/or indicate ove for which fees hav By�20 PERMIT EXPIRES ON the applicable provisions Resolutions to do work n paid. Datall /9�e Receipt No. WHITE-D.D.S..-BD-'CANARY-ASSES R PINK -INSPECTOR GOLDENROD -APPLICANT I