HomeMy WebLinkAbout042-600-058,42-60 -5
DONALSON • , g, M
Craig � 1 ,
1125 Streamside-Ct, 10 -6=
f Manor.;.. Chico
(new single family)
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RE I E
42-60-58 .518-91B,P,E,M,
DONALSON,Craig
1 ' 125 Streamside Ct, lot 16-A Walnut
Manor, Chico
(new single family)
0F( ICE Y
Address
-c5f
GAS
Meter "'�-�=ate�
.
ELECTRIC A>
L meter By- L& Date
OFFICE COPY r
Address
-27
-GAS 117
Meter Y Dates
D
Date
Me-m�rY----
JOB FINALE
Signature
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC lNORKS
196 Memorial Way, Chico — Phone: 891-2751 -
7 County Center Drive, Orovi Ile — Phone: 538-7541
747 Elliott Road, Paradise — Phone: 872-6307
CORRECTION NOTICE
OWNER PERMIT NO.
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, ple�aose contact this office immediately.
�l
U 16le r -C9
1 °
3 r e
i-
1
rtN tr—'S
�a
Date —/6- Inspector
Owner L� , Permit No.
F.NFR(:Y CF.RTI-FTCATION
Wa,.4*1�— Wta—pct_
1,0CAT ION
ROOF
MATERIAL
THICKNESS
EXTERIOR WALL
I(1=
A.P. NO.
DESCRLPTION OF' 1\SOLATION
BRAND NAME} '
THERMAL RES.
MATERIAL FIBERGLASS BRAND NAME CERTAINTEED
THICKNESS '%S frK THERMAL RES. 1?�
CEILING
BATT OR BLANKET TYPErSak&4A5,%RAND NAME CERTAINTEED
THICKNESS { afl THERMAL RES. vp
LOOSE FILLTYPE INSUL-SAFE IIIBRAND NATE CERTAINTEED
THICKNESS va.!is a THERMAL RES. 3fl
FLOOR,ELEVATED
PIATERIAL FIBERGLASS
THICKNESS
FLOOR, SLAB
MATERIAL
THICKNESS
WIDTH
24 WALL
PI A T E R S AL
THICKNESS 3� H
BRAND NAME CERTAINTEED
THERMAL RES.
BRAND NAME
THERMAL RES.
BRAND NAME
THERMAL RES.
I HEREBY CERTIFY THAT THE ABOVE INSULATION WAS INSTALLED IN THE ABOVE
BUILDING IN CONFORMANCE WITH THE STATE OF CALIF. ENERGY -REQUIREMENTS.
SHASTA INSULATION INC. #530235
FIRM NAP STATE CONTR. LICENSE NO.
-z V--cf /
I hereby certi.fy rlie above insulation and all required items as shown
on the Building Depart. approved plans and attachments have been installed
as required by the `tate of California Energy Requirements.
All equipment, dev ces.and materials are of the quality prescribed or
are specifically a1)prove,d by the State of Calif.
---------- ----------------------
FIRM NAME/OWNER (PLEASE PRINT) STATE CONTRACTOR'S LICENSE NO.
yam, 'A.1�
SIGNATURE OF GENFRAL CONTRACTOR/OWNER DATE
This certificate must be on file with the BUILDING DEPARTMENT prior to
final inspectiori`appcoval and a copy shall be posted within the building.
JANUARY 1984
v=0K
O = Not OK
=Not Applicable`
' = Not Ready MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
2. Soils; Special MH Support Sketch
3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails
3. Sewer; Location -Test -Fall -C/O Concrete
4. Wood Awn.; Posts-Beams-Rftrs.-Connectors
Shthg: Rfg.-Bracing
4. Water; Location -Test -Easement Needed (Sketch)
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete
6. Carports; Windows -Doors
6. Gas; Location -Test -Wrap: / /" L" ft.
/ /"Nat. or/ P L" ft./ P'LPG
7. Electric
7. Utility Clearance
8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
Card B-1 Date Card B-1
Card B-1 Date Card B-1
1. Zoning Requirements -Setbacks Easements
POOLS (Plans) OK except #'s
2. Footings; Size -Spacing -Marriage Line
1. Setbacks -Easements
3. Gas; MH Test -Demand -Valve -Connector
2. Soils; Compaction -Structure Stability
4. Electricity; MH Test -Crossovers -Breakers -Clearances
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
5. Drain; MH Test -Fall -Flex Connector
4. Elec.; Receptacles and Lighting, Distances-GFI
6. Water; MH Test -Regulator -Connector
5. Elec.; Pool Lighting; 15 volts-GFI
7. Water and Sewer Connected -C/O to Grade -HD Approval
6. Elec.;Enclosures; Conduit Entries -Terminals -Listed
8. Gas and Electricity Tagged
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
9. Exits; Insp.-Sketch
'8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
10. Cert. of Occupancy
Boxes-Enclosures-Panel boards- Ins. to Main in Conduit
9. Health Department Approval
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
MISCELLANEOUS
Date
DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rftrs.-Connectors
Shthg: Rfg.-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
Date
Date
Card B-1 Date Card B-1
Card B-1 Date Card B-1
Date
POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distances-GFI
5. Elec.; Pool Lighting; 15 volts-GFI
6. Elec.;Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
'8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panel boards- Ins. to Main in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
4 O
O=Not OK
- = Not Applicable
' = Not Ready
RESIDENTIAL (Single & Duplex)
Date UNP RFLOOR (Plans) OK except #'s
Hing -Setbacks -Easements -Flood -Slope
VPtg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
t /, Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
F/9,, Porches & Decks; Soils -Steel-/ /Ftg. Depth
emwalls, Main; Steel-Blockouts-Wrapped
Stemwalls, Garage; Steel- Blockouts-Wrapped
6a. tWd Downs and Special Anchors
1-2-41/ . Slab; Steel -Wrapped l/L!
8. rs-Fireplace Ftq.-Steel
B' D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10. Gas Pipe; Size -Anchors
11. Water Pipe; Test -Anchor -Regulator -Service Test
12. Electric; Underground
13. Pienums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
15. Insulation
Date b"t -q / Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date PLUMBING (Permit) OK except #'s
X. Water Htr.; Vent -Access -Combustion Air -Baffle
Water Pipe; Test & Anchor -Nail Protection
D.W.V.; Test -Fittings & Anchor -Nail Protection
19. Shower Pan; Test, First Floor -Tub Access
20. Test Tub & Shower, Second Floor -Tub Access
-11. Gas Pipe; Size & Anchors
Date C..q,ej ( Card B-1 GG Date Card B-1
Date Card B-1 Date Card B-1
Date ELECTRICAL (Permit) OK except #'s
22. Fixture & Transformer Clearance -Ins. Protection
ZZ'Eiec. Receptacles Spacing -Lights & Switches at Doors
Size Boxes & No. of Conductors -Stapled
2 . Romex Installed Close to Edge of Studs & C.J.
2 . Equip. Ground made up w/Mech. Fastners-Bond Gas & Water
V2 Appliance Circuts in Kitchen & Conductor Size/GFI
Subfeed Wire Size /tqa. Cu or AI-A.C. Wire Size &)/ ga.
Al or At
Range Circ. a/ ga. Cu or Oven Circ. / / ga. Cu or Al.
Insulated Neutral XNo
Servic Conductors & Ground -Main Disconnect
,1^ Equip. Clearances Panels-Motors-Mech. Equip.
hes Closet Light -Shower Light -Spa Light
3,5, -Smoke Detector
Date 6 4:,q i Card B-1 (Tr Date Card B-1
Date /.✓J I -A 1 Card B-1 (:; Date Card B-1
Date MECHANICAL (Permit) OK except #'s
,,OA.C. Ducts Insulation & Support
38"Vent Fan; Exhaust above insulation
36. Condensate Drain & Overflow; Size & Grade
37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet
36. Attic Access & Platform if Furnance in Attic
Date (,�j�p� ( Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date FRA NG (Plans) OK except #'s
Sils, Proper MaterialAn
C
Qk Walls Studs -Nailing, Spacing & Bracing -Plates -Sound
41' Bearing Walls over Girders & Floor Nailing
Af. Draft Stop in Walls (rat proof)
Z73ire Stops; Furred Ceilings -Stairs -Chases -Tub
4. Headers & Beam -Size & Bearing
Date FRAMING (Continued)
45. Hangers -Post Caps -Anchors -Connectors
Cing. Joist-Rftr. ties-Purlin o c -T hthng.-Rfng.
irep r Fireplace Throat clearance
0, Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
:!P,Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
--'&6-Garage Fire Protection Framing
1. Property Line Firewall & Openings
Sf.- Ext. Doors -One T -Check Garage -3rd Story, 2 Exits
33:--Sfairs; Width -Headroom -Rise -Run -Landing -Fire Protection
. ply od on Roof Overhang -Attic Vents -Rafter Outriggers
ding -Nailing Veneer
Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
Wr Glazing Area -Glass Protection -Skylights -Plastic
ft -Shear Walls; Nailing -Bolts
5 .1 nn1rt at (o n - W�eiN Fg s
60. Infiltr on -W s-Wi ows
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date FINAL tans OK except #'s
xt. Steps -Door & Sidelight Protection -Landings
2. Smoke Detector
e; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
6 droom Exiting
G.F.I. & Bath Fixtures & Tub Access -Spa
r619 Elec. Trim & Subpanel; Breaker Sizes & Labels
irs & Rails
6 . fireplace or Stove; Clearances -Hearth
6c/ E Outlets at Wood Panel; Int. & Ext.
it.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
7/. c. Outlets & Receptacles at Kit. Counter
7 . Garage Fire Door; Swing -landing -Closer
.,7si 1C.0.,,Duct in Garage -Damper
tr. tr.; Vents -Clearance -Comb. Air-Connector-P.R.V.
I�DoGarage; Above Floor-Mech. Protection
PI lec. & Mech. Equip. Listed for Location
7 E!9p-. Receptacles in Garage; (G.F.I.)-Rome rotection
7Pfnsulation-Foam-Looked in Attic Yes
-49,Gtmfd Rails & Deck Construction -Post Caps .
v-7,P.-Fi ents & Crawl Hole Door -Drainage & Wood -Earth
earance Looked under Floor 0 Yes Of
af Folio ing instld.; Drive es 0 No; Walks 0 Yes 0 No;
P nters Yes
84-"Vc_W;S4wa,-FAdK
Unit; Disconnect, Electrical, Plumbing
Vents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to
Well; Disconnect, Electrical, Plumbing
or Elec. Trim; G.F.I. Receptacle -Underground
n 'iation Throughout House
ss Prot ction
. Correc ' ns from Previous Ins p tions
89. Ga t -Meters Tagged; -Electric f l
r &Sewer Connected -C/O to Grade -HD Approval
Energy Compliance Certificate -Other Certificates
Date!J..�& Card B-1 Date Card B-1
Date Card B -1%h JJ, Date Card B-1
Date Card B-1 Date Card B-1
Comments at Final:
(NOTE: An entry must be made each time you visit job site)
�JCOUNTY OF BUTTE - DEPARTMENT OF PUULIC WORKS
7 County Center Drive - Orevllle, California 06006 - Telephone: 010/630.7641
1 = APPLICATION AND PERMIT
PBRMIT NO.
,15 11Q_Wn
S L
BUILDING PERMIT
442-60-58 CRAIG DONALSON
60, FT, OCC, BUILDING VALUATION
P.O. Box 4055
420 M 5,880.00
153 1,530.00
N OR's MAILING A0011119111111
Fireplace i A 1.000.00
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $ 60.410.
0
Filing Fee
$ 10,00
LENDER'S MAILING ADDRESS
Permit Fee
$ 316.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$ 15.00
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$
PLUMBING PERMIT FIIIngFee 1 10.00
Each Trap
9 2.00 18.00
Solar or heat pump water heater
20.00
LOT NO.
16-A
SUBDIVISION NAME PARCEL MAP
Walnut Manor
Water piping
5.00 •
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF E� Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
1 1 5.00
Building sewer
1 5.00
Mobile Home S I G I W
10.00 ea'
TYPE OF WORK
New ❑X Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work:
I Rarlrnom Mast -pr 6n --FSR
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filin Fee 10.00
Main service 6001 OR LESS10.00
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
1 declare under penalty of perjury (check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the BUSinesS
and Professions gode and my license is in full force and effect.
License No. 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 CONST. DWELLING OCCUP.e,00
OR ACDNS. ( ACC. BLDGS.
h2sgft '
NEW CONSTR. MULTI -OUTLET
NON.RESID BRANCH CIRC ITS
2,50 Be
POWER APPARATUS tr
(SINGLE OUTLET CIR.
Ex. O(
cc UpOUTLETS OR FIXTURES
20050t
eAL030
EX. l)CCUp. OUTLETS ((RESID )FIXED APPLNSREA.)
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. bVirin 9
15.00
Permit Fee
$ 73.00
WORKMEN'S COMPENSATION INSURANCE
I declare and r penalty of perjury (check one):
❑e permit is for $100.00 (valuation) or less.
lyI 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
FiIirig Fee 10.00
Heating
Cooling
1 6.00 6.00
Hood
1 33W 1 3.00
Ventilation
2 1 3.011 6.00
permit Fee
$ 31.00
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.
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
agains said Gpunt in copse ence of the granting of this p `mit.
X / J to S
Sign ure of p is nt Owner❑ Contractor Agent
An OSHA perm. is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in h8:3eight.
Mobile Home Installation Fee $
Energy Inspection Fee $ 30.00
o
co ST TYPE
TOT L $
FEF,,
F,,$
538.00
HAz. cuA
PARK HL
Lo
PAR
Po
Issu
This permit is hereby issued unser 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 Ly' -L24- iL
PER EXPIRES Date - rZ2�� 2r
Receipt No. / 00
WHITE-D.P.W.. YELLOW-ASSE330R. PINK -INSPECT . GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT -OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 9161538-7541
PERMIT APPLICATION DATA SHEET
/ Permit No.
OWNER A. P. No.
Proposed Building Use Z Building Inspector4a
Date �5
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED APPROVED
1. All items have been submitted . ....................................
2. Plot plans in duplicate/triplicate, signed by preparer of plans........
3. Complete plans in duplicate/triplicate, signed by preparer. of plans . .
4. Complete engineered plans and calcs, with wet signature on plans ..
5. Hazardous Material Form ..........................................
6. Energy Design Compliance and supporting documentation .........
7. Statement of Intent for Non -Heated and AC Buildings ...............
8. Engineered truss details and layout in duplicate (required prior to plan check)
9. Mobilehome installation data including manufacturer's installation
%k (� instructions ...d l •�, ....... L� l .off..
' /10. Fees of $ —T �C � (rf ,
11. Chico Urban Area fees paid ........... .
�.............. ..... ��'•� �•34�: • X7'°3
%( __L 12. Park fees paid ... �•� yt
_L_l3• ( (/ S2:� School District fees pai . r./�. 5—•
14. Sanitation approval from Health 'Depar men 717
/4/x5. City of Chico plumbing permit .....................................
16. Plot plan and business license approval from City of
(see City for other requirements)
17. Planning approval for (A) Use: (B) Parking: ..
18 Improvements may be required. Contact Land Development Section DPW
�(� �. Driveway permit (construction approval required prior to occupancy) -
20. Pre -Inspection for required Pre-Inspe°. uestt
p Building Inspector (Date)
21. Contractor's license information (No., Name Style, Classifications ...
22. Certificate of Workmans Compensation Insurance ..................
23 Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) .... .
4 PY f�Recorded co of Agricultural Acknowledgment Statement .........
iC 9
25. Letter of signature authorization ...................................
26.
27.
When y��ou��sue the permit, process as follows: Mail too owner. Mail to contractor.
�felephone2��/and hold for pickup at C_I_� _L_office. Deliver w/inspector.
Other _
Applicant ,l l ( �-' - Date �• ��
i
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date
Copy of plans sent____HealthDept. Fire Dept. Other Date By
The following data must be submitted prior to P41r1mit is,&dancrCircle -ew it m not c c ed above).
1. Index permit for above items No.
2. Additional items required:
Contractor, designer, owner, was advised of above required data by_phone----nail—counter by .date
Contractor, designer, owner, was advised of above required data by—phone _malI—counter by date
Plans checked by Date Plans approved by
r,e_5 Date
Sets of plans on hold in File cabinet AP folder
A
COUNTY DF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville,-California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
i
I
PERMIT NO. i
_ zo"'"G - BUILDING PERMIT
T ELE PHC�N.E $O, FT. OCC I BUILDING VALUATION
42 5 880.00
153 j C 1 1,530.00
CONTH �v.. .. ._._..._
MECHANICAL PERMIT
CONTRAQ TOR'S MAILING ADDRESS
j
Fireplace A 1,000-00
D
UNKNOWN
Total Valuation S O 0/
CONSTRUCTION LEVO ER —
Filing Fee
LENDER'S MAILING AODRESS -
Permit Fee
LICENSE NO.
Plan Checking Fee
ARCHITECT OR ENGINEER
Energy Plan Checking Fee
ARCHITECT OR ENGINEER'S MAILING AODRESS'
Penalty
;ertify that I have read this application and state that the above information
t I agree to comply to all County Ordinances and State f Laws relatinthe County Ogt
Permit fee
SUILOING ADDRESS
PLUMBING PERMIT
Each Trap
_
Solar or heat pump water heater
PARCEL MAP
Water piping '
LOT NO. SUBDIVISION NAME O�
T_
Each qas water heater or vent
Gasp system 1 - 5 outlets
USE OF STRUCTURE
Building sewer
ryI
SFU Duplex❑ Mobilehome❑ Other SPECIFY
Mobile Home S G W
`—" TYPE Or WORK
iPermit
' Remodel❑ "Utilities❑ Other C1
Fee
_Installation❑
New Addition❑
Contractor
Describe �c.k:
ELECTRICAL PERMIT
LESS
• MAS I Gl\___OR
Main service '1'0'0'AMP OR LESS
NforCONTRACTORS LICENSE LAW
r penalty of perjury (check one):
siness
licensed under provisions of Cha ti is in force hand ueffecL
Profess n C de my D
ense No.Classification
s the owner, or my employees with wages as their sole compen-
on,will do the work,and the structure is not intended or offered
sale. (Sec. 7044)
as the owner, am exclusively contracting with licensed contract-
.. (Sec. 7044) Business and Professions Code
m exempt under Sec._�—.
this reason
Main service EA. ADO'L 100 AMP
NEW CONST. ( DWELLING OCCUP
OR AOONS. ACC. BLDGS.^�
S 10.00
$316.00
s rs on0
S I S.OD_
$
APPARATUS hl
( SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES
FIXED APPLNS. OR
EX. Ocoup• OUTLETS IRESIO.I EA.
Temporary service
Mobile Home Facilities
Misc. `'firing
Permit Fee
Contractor
INUM
WORKMEN'S COMPENSATION INSURANCE
MECHANICAL PERMIT
I decrrlaare under penalty of perjury (check one):
Heating
Lhe permit is for S100.00 (valuation) or less.
on file with the County of Butte Building Department
��.. I have placed
a Certificate of Workmen's Compensation Insurance or a Certificate
Cooling
of Consent to Self -Insure.
not employ any person in any manner so as to become subject
Hood
❑I shall
to the W. C. laws of California.
It after making this statement, should you become subject
Ventilation
Permit Fee
Notice to Applicant:
the W. C. provisions of the Labor Code, you must forthwith comply with such
Contractor
to
provisions or this permit shall be deemed revoked.
Mobile Home Installation Fee
;ertify that I have read this application and state that the above information
t I agree to comply to all County Ordinances and State f Laws relatinthe County Ogt
Ener Inspection Fee
occ g/CONST TYPE
Filing Fee 1 10.00
L 104ea
0,00
2
'mr3.00
2.5
Correc .
to building construction, and hereby authorize representatives, TOTAL FEE S b t v
Butte to enter upon the above-mentioned property for inspection purposes. _ I PAR PO HO I ISSUE
y HAZ CUA I PARk SCHL FLO
I also agree to save, indemnity and keep harmless the Count of Butte against
all liabilities, judgments. costs, and expenses which may inma y way 'accrue
against said Co4nty consequent f the granting oatelt iZ r` ` I This permit is nereby issued uroer the applicaole provi-
sions of the Butte County Code and/or resolutions todo
work indicated above for which fees have been paid,
0.-i , Contractor %9a^t ! � qu � �j , ntRFrTOR OF PUBLIC WORKS
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