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Home My WebLink About040-280-051l a d DONNA CHRISTOPHERSONO__28-51 !9121 Midway Durham % Contr: Holiday Pools, Chico Permit#2274m84B,P,E(new private pool) 40-28-51, 92=854B CHRISTOPHERSON; Donna v. 9121'Midwa - Midway, Durham • } cont: Ely 'Roofing *A Z �: ` reroof%sf :; 1,/D�g,•, 1 I i f f j I a i r k� I j 4�, ;�i'0ti �rr.:i• l z `" }F ` "� * ;rt ` ;" "" r 4 �.- r -�92-854B icy_ �CHRISTOPHERSON, Do 9121 Midway,"nna cont: E1 Durham reroof/sf Roofing -COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - 7 County Center Drive - Oroville, California 95965 - Telephone: 916.'538-7541 APPLICATION AND PERMIT PERMIT NO. L/ ASSESS RAR EL NUMBER At'W U4' -1UU-051 ZONING <12 BUILDING PERMIT SQ. FT. OCC, BUILDING VALUATION OWNER Donna Christopherson TELEPHONE 1 ;j94-2612 1560 OWNER'S MAILING ADDRESS 4,ltj r— 11L."VIL 9121 .,i i u w a , 93 CONTRACTOR'SNAME G1 �cOOiin, Inc TELEPHONE il{3-lubj CONTRACTOR'S MAILING ADDRESS V U box 704, Chico CA 95927 Fireplace CONSTRUCTION LENDER UNKNOWN X C Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 15.00 Permit Fee $ .:)u ARCHITECT OR ENGINEER –' LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS le"i4Wav '' Permit fee , $ �� 509121 PLUMBING PERMIT Filing Fee 15.00 a^ K r G Trap .,1,- 5,00 ...},. ,. v, • Solar or heat pump water heater 20.00 LOT NO.SUB DIVISION NAMfE PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 U OF STRUCTURE SF ® Duple. Mobilehome '. Other -Id SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W44= TYPE OF WORK New ❑ Addition ED Remodel❑ Utilities❑ Installation❑ Other Describe work: reroofing 25 yr Coup 26 sqs Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200AA00ORLESS 2OR LESS 18.50 Main service 200ATO1000AI 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ® I amensed under provisions of Chapt. 9, Div. 3 of the Business and fessions Qde and my license is in full force, and effect. Ao. b(I�.SiS6 Classification C-39 'ti 17I, 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) r, u 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 OCCUPM OR -NS. ACC. BLDGS. I/ 3.6Q sq.ft. NEW-CONS.COO NST R.MULTI-OUTLET NON-RESID BRANCH CIRCUITS 5.00 (POWER APPARATUS e l SINGLE OUTLET CIR. 'FLice(se Ex. Occup(OUTLETS OR FIXTURES 20 @ 75FIXED d Ex. Occup. OUTLETS P(RESIO IREA.) I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. byirin 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. ,In 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 sh 11 not employ any person in any manner so as to become subject to tht W. C. laws of California. Notice to App nt: 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 FiIingFee 15.00 Heating Cooling 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 �'�� % -� -� �1 Date -3-16 s 9 L Si nar re of A licam - Owner g pp ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures,ove4 3 stories in height.REC Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ (p- HAz I DFEES I IMP - I FLOOD I CDF I PARCEL PD HD ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees O OF PUBLIC By ' PE IT EXPIRES ate applicable provi- resolutions to do have been paid. WORKS Date.3- 7j'- f e - . 7 ,: c� I t [OZ/nO - Receipt No. y� WHITE-O.P.W., YELLOW -.ASSESSOR• OINK•INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916,'538-7541 APPLICATION AND PERMIT QPERMIT NO. A /I ASSESSOR PARCEL NUMBER _ AP# 040-280-051 ZONING SAI; If I ... BUILDING PERMIT OWNER Donna Christo herson TELEPHONE 894-2612 SOFT..,', OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS • 91'21 Midw.a , 44 ree CA- — q-1 - I . CONTRACTOR:S NAME E1 Roo,f.in .! Inc TELEPHON 343.-76E636 CONTRACTOR'S MAILING ADDRESS - - -- ., •. - P 0 Box 704 Chico CA 95927 "" Fireplace CONSTRUCTION LENDER UNKNOWN X Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee g $ 15.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS .912`1 14idway, Permit fee $ 46.50 PLUMBING PERMIT Filing Fee 15.00 K r awl Each Trap 1 5.00 Solar or heat pump water heater 1 20.00 'LOT NO. SUBDIVISION NAMEPARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF 91 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[A Describe work:reroofing 25 yr comp 26 ' sqs Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 200A OR LESS 18.50 Main service 200ATO1000A) 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): Q 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 ,jo. 607386 Classification C-39 ❑ 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.�\ OR ADONS. ACC. BLDGS. / 3.6Q sq.ft. NEW CONSTFtMULTI-OUTLET NON-RESID BRANCH CIRC ITS @ 5,00 POWER APPARATUS (SINGLE OUTLET CIR,& Ex. Occup(OUTLETS OR FIXTURESFIXED z0 76 APIL NS EX. OCCup. OUTLETS P(RESID,)REA.� I 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 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 Cooling 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 ag inst said County I'nc s quence of the granting of this permit. X �� Date 3-18-92 Signature of Applicant — Owner E] . Contractor [I Agent El An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories inheight. Mobile Home Installation Fee S Ener Inspection Fee $ Energy P occ CONST TYPE TOTAL FEE $ 4(per I HAZ DFEES IMP FLOOD cDF I PARCEL PD HD ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees BY ��ECOF PUBLIC IT "E=XPIRES PE ate applicable provi- resolutions to do have been paid. WORKS Date.3—ZJi9Z 3 ' _ Receipt No. 102-00 ` WNITC-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. !:OLDEN RO D -APPLICANT i T - t PERMIT NO. 2274-84B,P,E PERMIT EXPIRES • Y k OWNER DONNA CHRISTOPHERSON CONTR. Holiday Pools r• ASSESSOR PARCEL 40-28-51 LOCATION 9121 Midway; Durham j • x� Temp. Power Pole f t Called PG&E s Temp. Elec. Service Called PG&E Temp. Gas Service Called PG&E JOB FINALEO (Date) V' Signature k � . g. � = OK , 0 = Not OK — = Not Applicable * = Not Ready 4 r, MOBILEHOMES MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except H's 1, Zoning Requirements—Setbacks—Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'s 1. Zoning Requirements-Setbacks—.Easements 2. Soils; Special MH Support—Sketch 2. Footings; Size—Depth—Spacing—Connectors 3. Sewer; Location—Test—Fall-C/O—Concrete 3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails 4. Water; Location—Test—Easement Needed (Sketch) 4. Wood Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.—Rfg.—Bracing 5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete 5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures 6. Gas; Location—Test—Wrap:/ /"L"ft./ /"Nat.or/ /"L"ft./ /"LPG 6. Carports; Windows—Doors 7. Utility Clearance 7. Elec. Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except #'s Card -BI Date Date Card -131 Date POOLS (Plans) OK except N's 1. Zoning Requirements—Setbacks—Easements 1, etiiacks Easements 2. Footings; Size—Spacing—Marriage Line Soils; Compact i on—Str re Stability 3. Gas; MH Test—Demand—Valve—Connector 3. Pool Structur Connections—Thick ss—Dead Men—Lining 4. Electricity; MH Test—Crossovers—Breakers—Clearances 4. Elec.; Receptacles and Lighting; Distances—GFI 5. Drain; MH Test—Fall—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI 6. Water; MH Test—Regulator—Connector 7. Water and Sewer Connected—C/O to Grade—HD Approval L 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed 7• Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg. Boxes—Enclosures—Panel boards—Ins. to Main in Conduit 9. Exits; Insp.—Sketch 10. Cert. of Occupancy i 9. Health Department Approval W. --Plumb; Cir. Test—Water Supply Test Card B-1 Date Card -BI Date jjCard-BI Date Card -BI Date Card B-1 Date Card -BI Date I �Card�Bl Date Q 2 Card -BI Date r. V = OK 0 = Not OK - = Not Applicable = Not Ready RESIDENUAL (Single and Duplex) �E Date UNDERFLOOR Plans OK exce t#'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel -B loc kouts-Wrapped-S lab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. O.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors - 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. 12. Electric; Underground Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date FINAL (Plans) OK except N's Card -BI Date Card -BI Date Date PLUMBING (Permit) OK except p's 56. 57. Ext. Steps -Door & Sidelight Protection -Landings Smoke Detector 14. 15. Water Ht.; Vent -Access -Combustion Air Water Pipe; Test & Anchors -Nail Protection 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth Card -BI Date Card -BI Date 64. 65. Elec. Outlets at Wood Panel; Int. & Ext. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. 67. Elec. Outlets & Receptacles at Kit. Counter Garage Fire Door; Swing -Landing -Closer Date ELECTRICAL Permit OK except N's 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 22. Size Boxes No. of Conductors -Stapled 70. Plb., Elec. & Mech. Equip. Listed for Location 23. Romex Installed Close to Edge of Studs & C.J. 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. Insulation -Foam -Looked in Attic E] Yes 25. 2 Appliance Circuits in Kitchen &Conductor Size Guard Rails &Deck Construction -Post Caps 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral ❑Yes ❑No 75. Followinginstld.: Drive E3 Yes ❑ No; Walks ❑Yes ❑ No; Planters ❑Yes ❑ No 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77, A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B -I Date Card -BI Date 81. 82. Ventilation throughout House Glass Protection Card B -I Date Card -BI Date Date MECHANICAL (Permit) OK except q's 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 31. A.C. Ducts; Insulation & Support 85. Water & Sewer Connected -C/O to Grade -HD Approval 32. 33. Vent Fan; Exhaust above Insulation Condensate Drain & Overflow; Size & Grade 86, Energy Compliance Certificate -Other Certificates 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FRAMING Plans OK except q's Comments at Final: 36. Sills; Proper Material & Anchors 37. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound 38. Bearing Walls over Girders & Floor Nailing 39. Draft Slop in Walls (rat proof) 40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. Header & Beam -Size & Bearing 42. Hangers -Post Caps -Anchors -Connectors 43. 44. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Sh_thng.-Rfn_p_._ _ Fireplace Ties or Type A Flue -Fireplace Throat 45. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 46. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing (NOTE:Anentrymust be made each time youvisit jobsite) COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 4 196 Memorial Way, Chico — Phone: 891-2751 d 7 County Center Drive, Oroville — Phone: 5344541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION OTICE 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 works completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. Inspector Date COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS r 196 Memorial Way, Chico — Phone: 891.2751 7 County Center Drive, Orovi Ile — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE -R I' PPMAIT AI!' A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this ('matter, or need additional explanation, please contact this office immediately. fi 1A. N. it,' -t r / r ,J Inspector__ Date_ ' COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE 4► 1 rp/// , >' L-, %-y . y A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. 1' Inspector_:' ► Date Y C COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS . 7 County Center Drive - Oroville, Califorgia 9596 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. ASSESSQR PARCEL NUMBER 3— J ZON BUILDING PERMIT OWN dIO/✓ TELEPHONE SQ. FT. OCC. BUILDING VALUATION IJ t a OWN R'S MAILING DRESS r1_4 1610 CONTRA TORS ME s TELEPHONE -s CON R C O 'S MAI NG A DRE Fireplace CONSTRUC ION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARC I ECT OR ENGINEER LICENSE NO. Plan Checking Fe $ Penalty $ ARCHIT CT OR ENG ER' MAILING ADDRESS Permit fee $ 15-100 BUILD G AD ESS GcJ�. �s• 0/cPLUMBING PERMIT FiIIngFee 10.00 Sf Each Trap 2.00 Solar Water Heater 20.00 e Water piping 5.00 ,Q v LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5,00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCWRE //%% SF ❑ Duplex❑ Mobilehome❑ Other,�/� 1U0� SPECIFY Building sewer 5.00 Mobile Home S G W 10.00 e TYPE OF WORK New�Addition❑Remodel❑ Utilities Installation❑ Other ❑ Describe work: — Permit Fee $ ('lp Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP OR00V OR LESS10.00 Main service EA. ADD'L too AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ( ACC. BLDGS. 2�t22Sgft 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) ford d effect. �j Q/J( License No. -3 7 J / ✓3 Classification ❑ 1, 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 NO N•RESID BRANCH CIRC ITS 2,50 ea NEW CONSTR POWER APPARATUS &) NON.RESID, (SINGLE OUTLET CIR, 20e50a Ex. Occup(OUTLETS OR FIXTURES BAL9300 FIXED APPLNS. OR EX. Occup. OUTLETS (RESID,) EA•) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring G G 15.00 ` O Permit Fee $ IJI 00 Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. mless the County of Butte against I also agree to s ,indemnify and keeops all liabilities iu ments, cos ,and ees which may in any way accrue against sai • Co ty in on ee� nce oft ing of this permit. X f� Date tgnature of Applicant — Owner Cantr t Agent ❑ An OSHA permit is required for cavations over 5' " deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP, GROUP TYPE of CONST. PARCEL D HD ssuE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECT OF PUBLIC By p P /i IT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date v "- _ Receipt No. C. WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT /•