The URL can be used to link to this page

Home My WebLink About042-320-01842-,32=18 pPermit AW S or Dr., Ch' ,o eS x#873 -78B (reroo#SF 1 042- :5.20-018 PERMIT DESIGNATION: B -BUILDING E -ELECTRICAL U -USE PERMIT HM -HOUSE MOVING DEPARTMENT OF P -PLUMBING TV -RADIO -TV ANTENNA V -VARIANCE EP -ENCROACHMENT T -TRAILER S/W-SIDEWALK NOTICE S- SIGN PERMIT D - DEMOLITION 600.1 n .. -1- AAI,I CA -V 0 vvc-Jcv-Vi0 vv-c�cv SUBDIV. HADAAN, RICHARD & C/T I�YN _ 10 ARBOR DR. CHICO 1. � 4 CONTR: RRR ROOFING a REMARK S DATE ISS ..„ RE -ROOF r _„_.. 042-320-018 02-1 HAIMAN FAMILY TRUST N. ! #10 ARBOR DR., CHICO CONT: EDWARDS HOME RE REPLACE GAS WTR HTR LOT BLOCK TYPE of PERMIT PERMIT NO. PLAN NO. t. PERMIT DESIGNATION: B -BUILDING E -ELECTRICAL U -USE PERMIT HM -HOUSE MOVING DEPARTMENT OF P -PLUMBING TV -RADIO -TV ANTENNA V -VARIANCE EP -ENCROACHMENT T -TRAILER S/W-SIDEWALK NOTICE S- SIGN PERMIT D - DEMOLITION 600.1 n .. -1- AAI,I CA -V 0 042-320-018 02-1471 HAIMAN FAMILY TRUST #10 ARBOR DR., CHICO CONT: EDWARDS HOME RENOVATION REPLACE GAS WTR HTR 0 A COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBERZONINCj civ -_:00 g V, BUILDING PERMIT OWNERTELEPHONE � 4n4� e*ly,t •z "7r1 SO. FT. OCC. BUILDING VALUATION OWNERI �jAi1}DDRESSy�' !( T CONTRACTG, 11_'l.c. ccs �4 3 4 k 4 CONT TO S IUNG ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESSI " al I _ _ If /V� /V�n� ` Energy Plan Checking Fee $ hQ /,% PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF j* Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent i 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ;9 Describe Work: 'Yt i.�1re a Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 800V OR UE Main Service 2o0A OR LESS 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 full forc nd effect. / (+ j� l 1 License Class Lic. No. i J 7 ' J O ER -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 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' compensation insurance carrier and policy number are: Carrier Main Service WELL To 46.00 CCU000A NEW CONST. DWELLING LDS. 3.5¢FT. OR ADONS. ( a ACC. BIDE. FT. NEW NON-R61D. T.MULTI-OUTLET CIRCUITS @7.50 POWER APPARATUS a SINGLE OUTLEr CIS. Ex. Occup. OUTLET ORFIXT BALD'. a O Ex. Occu . o xuTlers .=I EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ 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.) 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 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. X _/ ' i' r'' r Date / ` _ Signature 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 R 3 CONST TYPE t TOTAL FEE $ 3 00. HAZ. D. FE IMP I FLOOD COF PARCEL PD I HO 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. By 7 v Date PERMIT EXPIRES ON 66-03 Date Receipt No. ' "v WHITE-D.D.S.-B.O. CANARY-ASSE SOR PINK -INSPECTOR GOLDENROD -APPLICANT 0 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT Q, ;!W-1 l ASSESSOR PARCEL NUMBER 0 47t_®,_ g- =°Nl�i _ BUILDING PERMIT OWNER. TELEPHONE /, YJ SO. FT. OCC. BUILDING VALUATION . OWNEAL�JJCj�ADDRESS / ^ `/NA //(/'i//',/V�)�+ l/rC�'//n` CONTRACTO/' TELEPHONE Cc tJLp�t�Nowvz2-tcss) I N3 -d CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filen Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAIUNG ADDRESS Plan Checking Fee $ BUILDINGADDRESS �/ % h 0A r - CA J n i Energy Plan Checking Fee $ PERMIT FEE $ LOT NO. SUBDNISIONSNAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.0023.00 USEOFSTRUCTURE SFA Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat um water heater Water piping 15.00 Each gas water heater or vent j 15.00 16',OL) TYPE OF WORK New ❑ Addition ❑nn Remodel ❑ Utilities ❑pp Installation ❑ Other Describe Work: / l � k%q / l �N1�Q.C�C j_j`�tj �� l� Gas piping system 1 - 5 outlets 15.00 Buildingsewer 15.00 Mobile Home S G W @20.00 PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.00 600VMain Service 2o.A OR LESS 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 Busin ss and Professions Code, and my license is in full forc nd effect. �� / �v License Class C Lic. No. `� J 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. ❑ 1, 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 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' compensation insurance carrier and policy number are: Carrier 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.) 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 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. X �a&l Date ( �Z Signature of Applicant - ner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service TO tOooA 46.00so 7200A NEW CONST. DWELLING OCCUP. SO OR ADDNS. ( D7 ACC. BLOS. 3.50F7_ NONEW RE°SIIDDT' MULTI.OUTLET @7,50 POWER /+ppARATus a SINGLE OUTLET CIR. 20 p 1.00 Ex. Occup. OUTLET FotruREs aAL p .so ED Ex. Occup. °� R ,°E 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE s MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ oc CONST. TYPE .�j '- TOTAL FEE $ 3'�� HA2. D. FEES MP FLOOD COF PARCEL PD HD 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. By / C� Date PERMIT EXPIRES ONE•D.D.S.-B.D. Date rReceiptNo.J 3.Ncrl! CANARY -ASS SOR PINK -INSPECTOR GOLDENROD -APPLICANT r� 042-320-018 '00-2320 HAMAN, RICHARD & OAROLYN 10 ARBOR DR. CHICO CONTR: RRR ROOFING� RE -ROOF COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DMSI(3N 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) �-' APPLICATION AND PERMITell'Ko ASSESSORPAWMBER ZONING BUILDING PERMIT OWNERI.Va� TELEPHONE 2rr SO. FT. OCC. BUILDING VALUATION I 1 h r.f0 i Ii /J♦ OWNERS MAIUNG ADDRESSI-1� r CONTRAACTO NAME / TELEPHONE Ao imp CONTRACTORS MAILING ADDRESS 5T, /�N166 � �S 2 w l(.�./ fry Y [iy CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Film Fee $ 20.00 Permit Fee $ C'` r/ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ SUILDINGADDRESS w ^ Energy Plan Checking Fee $ $ PERMIT FEE S tG LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMITFilin g Fee" 20.00 Each Trap 7.00 USEOFSTRUCTURE / SFJ Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump 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 ❑ Describe Work: Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE _ ELECTRICAL PERMIT Filing Fee 20.00 .MOIEain Service zo600V.A oRR LEsSS 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 II fond effect.f 7 License Class LIC. No. O ER -BUILDER DE LARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor c nse Law for the following reason: f ❑ 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. it ❑ 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 " 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' co pbnt tion insurance carrier and policy number are: Carrier Any Iii . Policy Number sR`•- f "1'14fa 2`%) (The above sections nee-rnot be competed iffiiie 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.'o,'compensation provisions of sect'on 3700 of the Labor Code, I shall forthwith cgmply wi ose provisions. !!%� X (. ate Signature of"Applican I Owner b o`ntractor [3 Agent An OSHA permit is re .oi for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mein Service TO ,000A 46.00so. WEE200A NEW CONST. DWELLING OCCUP. 3.52FT. ADDNS. ( ACCO BBLDLS NOR EW CONST. M NOµgESID, I c @7.50 FOWER APPARATUS 8 SINGLE OUTLET CIS. 20 1.00 OUTLET EX. OCCU B @ . FlXED APPLNS. OR 5.00 Ex. Occup. ounETs RESID. EA Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE I TOTAL FEE $ `�%' C'v FEES IMP I FLOOD I COF PARCEL PO HD ISSUE t„s This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated a ve for which fee shave been paid. /` /(l By -.+ r�Date PERMIT EXPIRES ON Date ReceiptNo. WHITE-D.D.S.-B.D. ` CANARY-ASSESSO PINK -INSPECTOR GOLDENROD -APPLICANT f� i COUNTY -OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT o. (Rev.12/96) APPLICATION AND PERMIT ASSESSORPARc NUMBER / /�/ ZONING BUILDING PERMIT OWNER, MAPD* TELEPHONE 2 - SQ. FT. OCC. BUILDING VALUATION .OWNERS 1UNG CONTRACTOR' NAME 0 TELEPHONE CONTRACTOR'S MAILING ADDRESS l.r/ /#60 CA 95928 CONSTRUCTION LENDER I Fireplace LENDER'S MAIUNG ADDRESS Total Valuation $ ('r/ ARCHITECT OR ENGINEER LICENSE NO. / Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ SUILDINGADDRESS lO ie y- -Pg. IGT Energy Plan Checking Fee $ $ PERMIT FEE $ cc/ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE F Duplex ❑ Mobilehome ❑ Other LSSPECIFY Solar or heat pump water heater 23.00 Water piping 0 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 800VOR LE Main Service 2o.A OR LESS 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 VII f0 Ce nd effect. License Class N Lic. o. % /7351 O ER -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 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' cc m tion insurance crier and policy number are: Carrier Policy Number t (The above sections nee not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 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 workers' compensa ' laws of California, and agree that if I should become subject to the workers' co pensation provisions of section 3700 of the Labor Code, I shall forth c ply wi saWA X _ Signature o pplican cagent An OSHA permit is re ' for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service To 46. NEW CONST. DWE wNa oCcuP. so CU s o OR ADDNS. ( & ACC. SLDS. 3.50FT; ET NO CONST..'. MULTI-OUTLIATS @7,50 POWER APPARATUS 8 SINGLE OUTLET CIR. 20 @ 1.00 Ex. Occup. OUTLET OR FIXTURES BAL- O .SO Ex. Occup. OU E�oSA RES ORD.)EA5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE --7 �v TOTAL FEE $ l , HAZ. D. FEES IMP FLOOD CDF PARCEL I PD I HD UE This permit is hereby issued under Ofthe Butt unty Code an r indicated ve for which have ByDate lzz� PERMIT EXPIRES 41 the applicable provisions Resolutions to do work been paid. Dete r Receipt No. WHITE-D.D.S.-B.D. CAN RY-ASSE S PINK -INSPECTOR GOLDENROD -APPLICANT— e; RMIT.NO. r 873-78B jgp ® PERMIT EXPIRES 2/2879 OWNER RICH HIAMAN CONTR. Four Counties Roofing Company LOCATION (A.P. 42-32-18 ) #lO'Arbor Drive, Ohico Temp. Power Pole. Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E JOB FINALED (Date (Si ature) Mesh MECHANICAL • o COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS '= BUILDING INSPECTION RECORD Scratch Heating BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms ;r - Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Piping Piers Roofing ' :;?2-0,-1,9 . Sewer Garage Fdn. Ven Fixtures Footings Stemwa l l Garage Vents Insulation Water Htr. Heaters Slab Carport p Footings Prov. for phsically handica ed Conformance of ex. structure Appliances Gas Piping & Test Temp. Gas Slab Final 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 Door Closer Final Final MOBILEHOME UTILITIES ------------------ Elec- Service Elec. Pedestal Water Piping Sewer Gas Piping MQ§ILEWOME INSTALLATI N - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE •REMARKS OR CORRECTIONS r (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 F;7Telephone: $34-4541 / APPLICATION AND PERMIT BUILDING Owner 'c 'a SQ. FT. OCC. BUILDING VALUATI N Mailing Address #10 Arbor Drive Heavy shake re-roo Chico, California Telephone No. Fireplace Contractor Four Counties Roofing Company Total Valuation Mailing Address P.O. BOX 3215 Permit Fee Plan Checking Fee &/or Penalty Chico , California Tel aph3=e�4q,1 3� VVw Permit Fee $ Building Address #10 Arbor Drive PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Chico, Ca. 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. o. 3�—`�(� Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fob/ -s Fire Dept. FireZone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma 60' R/W p Imp rovements p Lawn sprinkler system 2.00 al,l ol___ o__ a Parcel Approval I Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 Heavy shake re -roof Main service 00 OR AMP ORSLESS 5.00 Main service EA. ADO'L too AMP 2.50 Main service 100 A sMP 00OOR LESS 25.00 100 A Single Family ® Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD'L too AMP 1.00 NEW LING O OR ADDNST (ACCLBLDGSCCUP. &) 20sgft NEW CONSTR. MULTI -OUTLET RESID. ( BRANCH CIRCUITS) 2.50ea -NON. NEW CONSTR. 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: Four Counties Roofing Company Ex. Occup(OUTLETS OR FIXTURES)@� BAL@1 Ex. Occup.(OUTLETS((RESID.)REA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. 252071 Classification B -1-C-39 Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ MECHANICAL No. @ 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. X❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. F -1I 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 $ $ 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. X 0 "_-h Date 2-;ty-79 Signature of Permitee or Agent Receipt No. /,7�a60 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant TOTAL PERMIT FEE J$ 28 00 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. DIR_f_ R OF ,0#IBLIC WORKS Building permit expires Date i e >. �. �,