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HomeMy WebLinkAbout041-520-022J -44 FERGUSON, Wayne 1,531-72P;E �-� `�P - �'a- .*2396-74B-. * E app. 700' off Condor Rd. a ' pp. 500 east of 'Oregon Gulch Rd.,- Oroville (utilities for two mobile homes) •` 1(*ramada, MH�� y -3o - �� 1' �(**util. for replaces permit 1'5- I _ i .. I { WA RGUSON I PP- 700! off Con or ­ Rd -app. Of Oreo G, � aPP • • 500' e , b rX'�lch Rd., Oroville , Wayne . _,pprox. 700' off Condow .• 00' E. of Rd., app ,POO'Oregon 9 Gulch Rd., Oro. # 2397-74P ,E (util . , MH) s -3 o- 7s � 04.1-520-022 05-1334 EDWARDS, JESSIE 1 42 CONDOR RD, ORO_ VILLE Cont: OWNER DEMO SF _ J -44 FERGUSON, Wayne 1,531-72P;E �-� `�P - �'a- .*2396-74B-. * E app. 700' off Condor Rd. a ' pp. 500 east of 'Oregon Gulch Rd.,- Oroville (utilities for two mobile homes) •` 1(*ramada, MH�� y -3o - �� 1' �(**util. for replaces permit 1'5- I _ i .. I { Lo 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. BPO51334 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: 041-520-022-000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Site Address: 42 CONDOR RD ORO Date: Contractor: OWNER -BUILDER DECLARATION I 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 permit to construct, alter, improve, demolish, or repair any structure, prior 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 the Contractor's Slate License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applic nt 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, 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.). Map Index: Description: DEMO SINGLE FAMILY RESIDENCE Owner: EDWARDS JESSIE B & HELEN M 42 CONDOR RD OROVILLE, CA 95965 Applicant: EDWARDS JESSIE B & HELEN M 42 CONDOR RD OROVILLE, CA 95965 ❑ 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: ❑ 1 am Exempt under Article 3 of the Business and Professions Code Date: '2d Owner: - d- WORKERS'COMrENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 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 insurance carrier and policy number are: Carrier: ;P.Olic 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 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: Ci • �� Applicant: WARNIN Failure to secure workers' compensation coverage is unlawfu� d 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 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Name: Address: License #: Architect: Engineer: Total Square Ft: 0 S. F. Valuation: $0.00 Census Code: This permit isjhereby issued unde a Resolutions/ do work indicate ,, e I By: / PERMIT EXPIRES EXPIRES ON: w ice! provisions of the Butte County Code and/or fees have been paid. Date: ❑ 1 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 1 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 Bu County. I hereb 2uthorize representatives of Butte County to enter upon the above mentione property for inspection purposes. Print Name:�� S�" `j/ Signature: Date: c Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor � , , Complainant: _ Address: Phone Number: Other Comments: Building Inspector must draw a plot plan with all buildings and violations: Additional continents from Building Inspector: OVER C, . _ - �. . E � '� ' _' �' + G� V ���,��� ���� 1 �� a �'� �� '{ COMPLAZNAN ADDRESS: PHONE NUMB OTHER COMMENTS• LkO V r!' 4 0 06V d w.vE/Z . y2 olva z- `1 17 7-1) w✓ S d�10 ✓�� O y- 4 e e1' 4nv f6 ��/, / 61v.4 .f Orsc of l/2� T� � 71IIA D�-- it�o GO✓�/ � .T oG &-I?,/Yl r 7fCT C ' M/ C-✓� L li"a 0 Vlf( 12 e r j A"S PERMIT NO. 2396-74B P E ' M r IMH UTIL. PERMIT NO. t% PERMIT EXPIRES ' OWNER Wayne Ferguson f ,F,ONTR. LOCATION (A.P. 41-25-30 ) approx 700' off Condor Road, approx 500' east of Oregon Gulch Road, Oro. j. Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E } ,/JOB, -- FINAL ED (Date) (Signature tl COUNTY OF BUTTE — DEPARTMrkT OP -PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setba k 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 Pier Garage Roofin Fdn. rents Sewer = Fixtures Footings Garage Vents Water Htr. Stemwall Slab Prov. for physically handicapped Heaters. Appliances Carport Footings Conformance of ex. structure Gas Piping & Test Temp. Gas Slab Final if Sanitation Patio FIREPLACE Final Footings Footing EL Masonry Walls Throat Rou h Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framin Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish -Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final DATE REMARKS OR CORRECTIONS V= COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WOR S 7 County Center Drive - 5 le, California 95965 Tel,�ph_one:.534-434-4541 APPLICATION AND PERMIT auuwiice ieNresentauves or me County or Butte to enter upon the above-mentioned property for inspection purposes. x/� C! Date. -� gnature of Permi, a or Agent Receipt No. �Z 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 P LIC WORKS BY Date vLd % B din ermit ex fires Date.................7�L�.� .. J BUI DI G Owner FP_)76�0 S SQ. FT. OCC. BUILDING VALUATION Z6 Mailing Address ` T Bo fz ()'/ i C,.C.. e Telephone No. Fireplace Contractor Total Valuation Mai I i ng Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ Z� Building Address ox (�c) r �n�, PLUMBING No. @ FEE PERMIT FILING FEE $2.00 0-/- Each Trap 1.50 �� _ �,Jj i� Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. - Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F_ FireDept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma 60' R/W Im rovements P Lawn sprinkler system 2.00 Bldg. P a ec'd Parc.Approval prova Plans l Permit Fee $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 i4 YJ�\4 aQ�_ L Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Single Family ❑ Duplex ❑ Mobil HomeLIDO Others ❑ Range, Cook -top or Oven 1.00., Water Heater or Space Heater 1.00 Light fixtures bal 410 - L /Isgt 7 Receps., switches & fix outlets CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Hood, Ex. Fan or F. A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring — 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. 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 $ $ 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 TOTAL PERMIT FEE $Z DC auuwiice ieNresentauves or me County or Butte to enter upon the above-mentioned property for inspection purposes. x/� C! Date. -� gnature of Permi, a or Agent Receipt No. �Z 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 P LIC WORKS BY Date vLd % B din ermit ex fires Date.................7�L�.� .. J ...r. �, -�.-!J s ;. P, r COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drtke - 'broville, California 95965 Telephone: 533-1230, Ext. 259 APPLICATION AND PERMIT r--�'� BU I LD I N G �t ,� Owner � . � � :•-n r��-, � ..c;� wS+•t�� SO. FT. OCC. BUILDING VALUATION' - Mailing,Add'ress •ti- v Fireplace Contractor r,'/t✓ Total Valuation ' Mailing Address Permit Fee Plan Checking Fee&/or Penalty _ Permit Fee $ $ l� O� �/ _ BuildingAddress / � ,! GiP I[ PLUMBING No. FEE PERMIT FILING FEE $2.00 „� , oU . � ,� %� per/ � /J pal On./ /C l Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 2 1.50 '{ �// _ �'� Ai (, p-f'-�/L°r �'`=4` f "" -- `% l- Each gas water heater or vent 1.50 A. P. No. �-- �=, j) Zoning-' ;, Gas piping system 1 - 5 outlets `) 1.50 Each additional outlet .50 Fire Zone Fire Dept. Sanitation ��ij Planning L Building sewer i. 5.00 Plans Fees ci I W. C. -----•^ R/W Encroachment Lawn sprinkler system 2.00 NEW ❑ `ADDITION-❑ OTHER ❑X Permit Fee $/i( /a/i $ I(/-. 41 � ^� / fyr ELECTRICAL No. @ FEE `PERMIT FILING FEE.- $3.00' Main service incl. 1 meter40 /D , !; G Additional meters, each 1.00 Sub -panel (12 or less)- (more than 12) USE OF STRUCTURE Single Family ❑ Duplex ❑ Others Q, Range, dryer or water heater 1.00 Oven, Cook -top or space heater 1.00 Light fixtures 25 Receps., switches & fix outlets ✓ CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Hood, Ex. Fan or F. A. Furn. Motor .1.00 Evap. cooler, gar. di sp. or D.W. 1.00 Air conditioner or heat pump Water pump y Misc. wiring 4q,.r;11- C License No. Classification / ❑ I am exempt from the Contractors License Laws of the State of Califomiz. Permit Fee MECHANICAL No• @ FEE `". WORKMEN'S COMPENSATION INSURANCE •l 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. I certify that in the performance of the work for which this t 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 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 relatinq to buildinq construction, and hereby �SPermit 1n St umentottiforontr oa Motion $0.07/$1000 Evaluation $ TOTAL PERMIT FEE $i� D autnorize representatives or the county or t3utte to enter upon the above-mentioned property for inspection purposes. Xrzsb 422-1 Date Signature of Permitee or:Agent Receipt No. White-D.P.W. — Pink Inspector — Goldenrod -Assessor — Yellow -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 i By _ Date 7— -7--2 Z- // r Building Permit Expires Date -7- 2 -7- '7 -7 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORK / 7 County Center Drive , Oroville, California 95965 Telephone, 533-1230, Ext. 259 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X L Date �~ 7 Sid0ature oiF;ermitee Agent ` Receipt No. / �z �z 2 — White-D.P.W. — Pinkector — Goldenrod -Assessor — Yellow -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 UBLIC WORKS By Date %— z 7 %'"Z Building Permit Expires Date- 7— "�3 BUILDING Owner f SQ. FT. OCC. BUILDING VALUATION r Mailing Address .c Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Permit Fee $ $ Building Address�� G. �� �t .-PLUMBING No. @ FEE PERMIT FILING FEE $2.00 z Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 % +2� �i1 Each gas water heater or vent 1.50 A. P. No. Zoning A-2 Gas piping system 1 - 5 outlets 1.50 , Each additional outlet .50 Fire Zone Fire Dept. Sanitation Planning Building -sewer Z 5.00 , Plans Fees c/' W. C.,, R/W Encroachment Lawn sprinkler system 1 2.00 NEW ❑ ADDITION ❑ OTHER Permit Fee $191 cell $ Q a .Q ELECTRICAL N o.1 @ FEE RMIT FILING FEE $3.00 OCI Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) USE OF STRUCTURE Single Family Duplex ❑ Others Range, dryer or water heater 1.00 Y 6 r Oven, Cook -top or space heater 1.00 Light fixtures 2 ' Receps., switches & fix outlets CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Misc. wiringAaa--� - f✓�i/ld,rtL= License No. Classification ® 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. 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 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 sSPermit I.sf umentar on rq Motion $0.07/$1000 Evaluation $ TOTALt' PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X L Date �~ 7 Sid0ature oiF;ermitee Agent ` Receipt No. / �z �z 2 — White-D.P.W. — Pinkector — Goldenrod -Assessor — Yellow -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 UBLIC WORKS By Date %— z 7 %'"Z Building Permit Expires Date- 7— "�3 N e-/ -I es -* a Or ��a S spa 00'. z �- irF srof!- fin ift=P ins and specifications MUST be 4ltalc, lOLI at all times and it is unlawful to any changes or alterations o Written Peremisson from the Departmentn same w pubic Works, County of Butte, of Public BUTTE COUNTY GILDING DEPARTME , S�� PP N► V �n v + PERMIT NO. " P E +� M MH UTIL. PERMIT NO. 2397-74P,E PERMIT EXPIRES 7 7r OWNER Wayne Ferguson CONTR. (LOCATION (A.P. 41-25-72 ) d( rr , approx. 700' off Condor Rd., approx. ;t( 500' east of Oregon Gulch Rd. Oroville r , • r i Temp. Power Pole Called PG&E Temp. Elea Serv. .� d Called PG&E �/ Temp. Gas Serv. Called PG&E7; J JOB FINALED (Date) Signature) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setba — Irewall 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 SewerL! Garage Fdn. Vents Fixtures Footings Gara a Vents Water Htr. Stemwall Prov. for physically Heaters Slab handicapped Appliances Carport Conformance of ex. Gas Piping & Test Z�— Footings structur Temp. Gas Slab — © Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing -Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent 727�—� Door Closer Final Final DATE REMARKS OR CORRECTIONS d S�� COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WO KS / ' 7 County Center Drive — Oroville, California 95965 ���� Telephone: 534-4541 /y j APPLICATION AND PERMIT autnonze representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. x/� Date —� ignoture of PerP2i- a or Agent Receipt No. �Z 2-� ' c� 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 OFA:71UBLIC WORKS BY Date_ ;7--Z--7V ilding permit expires Date................-..�'�. BUILDING Owner (i(,/ ��� fJS% SQ. FT. OCC. BUILDIOG VALUATION Mailing Address Q Z_517 Telephone No. Fireplace Contractor L-' �(� Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ $ Building Address A ��� f e)DEi �/V PLUMBING No. @ FEE PERMIT FILING FEE $2.00 t a3" Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 , - Each gas water heater or vent 1.50 A. P. No. / ^- A—� Zoning la Gas piping system 1 - 5 outlets 1.50 -, Each additional outlet .30 s Fire Dept. Fire Zone Use Permit Building sewer 5.00 :f Ctr) nitation EQA J Parking Plans Parcel Declarati n parcel Ma P 60' R/W Improvements P Lawn sprinkler system 2.00 d Fis Recd Parcel Approval kor Plans Approval Permit Fee $ $ �) Q NEW ❑ ADDITION ❑ UTILITIES OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 ¢'-V Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Single Family ❑ Duplex ❑ Mobil Home 1Z Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures 20P2o Receps., switches & fix outlets 20 25 CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. di sp. or D.W. 1.00 Air conditioner or heat pump _ Water pump. (i Mobil Home Facilities 5.00 �3(y Temp. Power Pole 5.00 License No. Classification Misc. wiring �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. I certify that in the performance of the work for which this ermit 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 TOTAL PERMIT FEE $ i autnonze representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. x/� Date —� ignoture of PerP2i- a or Agent Receipt No. �Z 2-� ' c� 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 OFA:71UBLIC WORKS BY Date_ ;7--Z--7V ilding permit expires Date................-..�'�. R le ,p •�X cv,JA 1:. 0.� • SCO �( a J � O i ^ LT co r' p 10 • - 0 • CD l \_ CD moss- � �� = _o0)CD o N CD eco w �' -+ S o- A O O� CN CQ CL- CD 3• CD - 1