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HomeMy WebLinkAbout039-470-025AP 39-47725 r SHEARIN, Melba .L,_ Geo a Thurman _ 1231-71B - n/s Ro Ave e app' 700' E. -�� 1132_71E Pine Ave of Lo e 71P_ ermit 5795-77B /" n/s Rodgers 700"E. of Lone .Pine, (install firepla stove) 3 / co .- CONTR: Fred Aisthorpe .0.� Box 1026 Chico 39=47725 Chew sin le f Contr,�: ervamatic Solar sing ply) _ 447-84P(solar wtr htr)SF 1 1796 Rogers� w - - - - -- Ave, ChicoA�� - •- --•— t•_�' Contr: Servamatic Solar System?,/ -Chico Permit#454-85P - - (install gas, wtr ht f)SF ' r 4,4' d j� t __ _ .. ,.\ � i. ;i � , a -7�.-:.L.. ,. "Y,vr..rr•n-A..-.�-..-.-,^^^.�-..,.,-w._,..,.�+•.r, ^+.i> ":+ :rwTM.�. _�.'�-n �-. , 't-.,.�.,� d 1s_._..-+•_�...•t ��'�r...l .'_�'�^`.. .�'f'ti r.-... .r -- ... gs rGl� i 77- 13 COUNTY OF BUTTE - D6ARTIMENT OF PUBLIC WORKS + 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APr CATION AND PERMITI K . I PERMIT NO. ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING' ADDRESS CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS - Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER •ENGINEER'S LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR MAILING ADDRESS Permit fee $ BUILDING ADDRESS PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Each qas water heater or vent . 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF ❑ Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home ISI G W 10.00 e TYPE OF WORK New F] Addition ❑ Remodel❑ Utilities❑ Installation El Other E] Describe work: — Permit Fee $ ' Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELING OR ADDNS. ( ACCLBLDGS.CCUP.&) 21/20sgit CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check one): ElNON I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code andI _ my Classification license is in full force and effect. License No. ❑ 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 CONSTR ULT' -OUTLET 2,50 ea NO N.RESID BRANCH CIRC ITS NEW -CONISTR POWER APPARATUS .&) & RESD. (SINGLE OUTLET CIR 20@50C Ex. Occup(o OR FIXTURES BAL@300 FIXED A PLINIS Ex. OCCUp. OUTLETS (RESID.)REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 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 $ TOTAL PERMIT FEE $ , OCCUP. GROUP I TYPE OF CONST. PARCEL PD HD SSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. WHITE-D.P.W., YELLOW-ASSFSSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT r' COUNTY OF BU:TTE._, E�LIClW DEPARTMENT OF PU61NIKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 5344541 Skyway and Elliott Road, Paradise— Phone: 872-2961, Ext. 57 CORRECTION NOTICE A routine inspection indicates that the following vii ati of ty Otdinance exist at the above address and should be cve aa notify this office when correction of work is completed. If y u ny gion pertaining to this matter, or. need additional explanatfon Oe/,�gryjact this office immediately. J Inspector /� Date_ 1111. COUNTY OF BUTTE - DEFrAATMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO! �Sy �s- ASSES PARCEL NUMBER I� ZONING BUILDING PERMIT OWNER TELEPHONE SQ. FT. OCC.1 BUILDING VALUATION OWNER'S MAILINCprADD ESS CO TRACTOR'S NAME r TELEPHONE tro-N'r RAC OR'S MAILING AD RESS CX/G' Fireplace CONSTRUCTION LE DER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 l Water piping 5.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home S G W 4:r-0::0:ea TYPE OF WORK New❑ L Addition Remodel❑ Utilities❑ Installattiion❑ Other Describe work: 76/1 44r_&_e W4 *,f AlEf4 /Z — Permit Fee $ AS a Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUR.& OR ADDNS. ( ACC. BLDGS. 2/20sgff CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ,Et I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and m license is in full force and effect. Y License No. '��Jb 6 S/S' Classification G =3 6 ❑ 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 CONSTR ULTI-OUTLET 2,50 ea NON-RESID BRANCH CIRC ITS NEW CONSTPOWER APPARATUS &) NON_RESIRD. (SINGLE OUTLET CIR. 20@50e Ex. Occup(o Ts OR FIXTURES BAL®30 FIXED Ex. Occup. our OUTLETS P(RESID )KEA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 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 liabil' s, judg ents, costs, and expenses which may in any way accrue agains s Counn o equence of the granting of this perm't. X Date /Pf Signature of Applicant — Owner❑ Contractor ❑ Agentte� An OSHA permit is required for excavations over 5'0" deep and demolition or construct-ZDIRE ion of structures 3 storiesin height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP I TYPE OF CONST. PARCEL PD I ND I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which O F PUBLIC BY PERMIT ate the applicable provi- resolutions to do fees have been paid. WORKS Date Jo? Receipt No. ,J���y WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT u C,,zti AlJ+Al* COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER TELEPHONE ,SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS CONTRACTOR'S NAME ' 0 /` C _ 'ADDRESS TELEPHONE 'I CONTRACTOR'S MAILING . ". ,: , Yi) •�� , . / i ;i 'UNKNOWN Fireplace CONSTRUCTION LENDER Total Valuation Is Filing Fee $ 10.00 ' LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS �,, • . PLUMBING PERMIT Filing Fee 10.00 - Each Trap 2.00 Solar Water Heater 20.00 I " I Water piping 5.00 LOT NO.SUBDI VISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF 0 Duplex❑ Mobilehome❑ Other SPECIFY Building sewer 5.00 Mobile Home S I G I W 10.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe work: •-' �'� Permit Fee $ f [ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ( ACC. BLDGS. 1 2/20sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury p y p � y (Check One): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and m license is in full force and effect. ±, _ License No. �- (� ' L 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 CONSTR ULTI-OUTLET 2,50 ea ID BRANCH PIRA ITS NEW NEW CONSTR /POWER APPARATUS &1 CO NON -R ESID. SINGLE OUTLET CIR. / OR FIXTURES eALeaoe Ex. Occu / BAL@30 Pto FIXED APPLNS. OR FIXED A Ex. OCCUp- OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 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. 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 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 inconsequence 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 $ TOTAL PERMIT FEE $ ' `ISSUE OCCUP. GROUP I TYPE OF CONST, PARCEL PD FD This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC r By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS . Date _ / Receipt No. -, ,� / WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT 4'ERMlf NO. 5795-77B PERMIT EXPIRES OWNER George Thurman CONTR. owner LOCATION,(A.P. 39-47-25 ) n/s.Rodgers Ave. app. 700' E.'of Lone Pine Ave., Chico s c Temp. Power Pole Called PG&E _ Temp. Elec. Serv.. Called PG&E _ Temp. Gas Serv. _ Called PG&E _ JOB FINALED Relnf._Steel I Final I Fixtures Bond Beam IFIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heatin'a 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 INSTALLATMN - - - - - - - - - - - = - - Support Elec. Continuity Water Piping Drainage ' Gas Piping DATE REMARKS OR CORRECTIONS vv (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 -RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms 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 Stemwall Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for physically handicapped Conformance of ex. structure Appliances Gas Piping & Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Relnf._Steel I Final I Fixtures Bond Beam IFIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heatin'a 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 INSTALLATMN - - - - - - - - - - - = - - Support Elec. Continuity Water Piping Drainage ' Gas Piping DATE REMARKS OR CORRECTIONS vv (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO�� ASSESSOR RCL NUMB ZONI BUILDING PERMIT OWNERR TE EPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS f CONTRACTOR'S NAME � �L[7�A•J�P—H_ONE^ / CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDI G ADDRESS PLUMBING PERMIT Filing Fee 10.00 JSolar Each Trap 2.00 Water Heater 20.00 0, 0,41610 Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home S G W 10.00 e TYPE OF WORK New F-1 Add ition❑ Remodel❑ Utilities Installation❑ Other ❑ Describe work:f7���51�o Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST.(DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. t 2h2sgft CONTRACTORS LICENSE LAW 1 declare under penalty of perjury (check one): �l am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No.����� Classification t 3a ❑ 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) ❑ 1, 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 CONSTR ULT' -OUTLET 2,50 ea NO N.RESID BRANCH CIRC ITS NEW CONSTR.POWER APPARATUS &' NON-RESID. (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20@500 300 FIXED APPLNS. OR Ex. OCCUp. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 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. ave 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. 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 Countyot 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, juPents , costs, and expenses which may in any way accrue against sai C unn copse en of the granting of this permit. X Date �— Signature o Iicant — 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 $ i �� OCCUP. GROUP I TYPE OF CONST. PARCEL PD I ND I ISSUE This permit is hereby issued under the applicable provi- sions 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 �S PERMIT IfJPIRES Date Z 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 Tel ephone:'634-4541 APPLICATION AND PERMIT 14 BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address} elephone No. FireplaceA ©Q Contractor Total Valuation p Mailing Address Permit Fee p Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ O Building Address /(U� �'' Ci PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 /� /� ,A4 Each gas water heater or vent 1.50 S A. P. No. J -r�i Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 s S8n 48 en I Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration parcel Ma P 60' R/W ImprovementsLawn sprinkler system 2.00 l3MT.—?Ta`M,7W-e-rn I Parcel Approval I Plans Approval Permit Fee ,$ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER 0 ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 V OR Main service 10000 AMP ORSLESS 5.00 Main service EA. ADD'L 100 AMP 2.50 Single Family ® Duplex ❑ Mobil Home ❑ Others ❑ Main service OVER 600V 100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW CONST. DWELING OR ADDNS. ( ACCLBLDGOCCUP. &) '20 sq ft NEW CONSTR. MULTI.OUTLET NON.RESID. BRANCH CIRCUITS) 2.50ea NEWCONSTR. 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)50 @25¢ 109 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 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. C VI 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 $ ...r....+ a. 1. a�..0 v a..a a.1 VU4nay V ..JU al;.LU V11LUI UPUII UIC above-mentioned property for inspection purpose Signature ermitee or Agent Receipt No/ 70j/ 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 0 UBLIC WORKSII By. _ Date //- rte- BuiYding permit expires Date //