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HomeMy WebLinkAbout043-550-012SHA-ST�AN wn - - fa ily43-55-12 50 Hampshire Dr, ChicoPermit#2430-89B(add open ecov ederik�SFB08-0436 0�43-550-'O 12C LLRE 0REROOF 22 SQ W/ COMpRE � YMO ' »� / yv PERMIT NO. 82430-89B PERMIT EXPIRES OWNER WAYNE KILLION CONTR. owner I ' ASSESSOR PARCEL 43-55-12 LOCATION 50 Hampshire Dr,Chico Temp. Power Pole Called PG&E Temp. Elec. Service — Called PG( Temp. Gas Ser Called PGi JOB FINALED Signature r COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS I `} 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 538-7541 747 Elliott Road, Paradis-,*. Phone: 872-6307 � r 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, please contact this office immediately. V -PA, 0'// � 517 C. A, e n, Ch - to %c e. )OF, -'d r->/-- Date /` Date Inspector =. OK 0 = Not OK = Not Read�yable MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 3. Sewer; Location -Test -Fall -C/O -Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 6. Gas; Location -Test -Wrap: / P'U ft. / /"Nat. or/ /"L"ft./ /"LPG 7. Utility Clearance Card -B1 Date Card -B1 Date Card -B1 Date Card -B1 Date Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 10. Cert. of Occupancy Card -B1 Date Card -B1 Date Card -B1 Date Card -B1 Date f MISCELLANEOUS Date DECKS,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s ;efiing Requirements -Setbacks -Easements Fo tings; Soils -Size -Depth -Spacing -Connectors -Steel ecks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.- Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carpor , ind s -Doors 7. EI . Frmg; - nchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Card -B1 ' .)-ioDate Cfo -J Card -B1 Date Card -B1 Date Card -B1 Date 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.;Ground ing; Equip. w/5' -circulating Equip. -Pool g?' Boxes-Enclosures-Panelboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Card -B1 Date Card -B1 Date Card -B1 Date Card -61 Date = ulk - - =VotApplicable ? RESIDENTIAL (Single and Duplex) = Not Ready Date . UNDERFLOOR (Plans) OK except #'s 2. Fig., Main; Soils-Steel-Elec. Grnd.-/ /" Ftg. Del 3. Fig., Garage; Soils -Steel-/ , /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /"Ftg. Dep 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test 10. Gas Pipe; Size -Anchors 11. Water Pipe; Test -Anchors -Regulator -Service Test' 12. Electric; Underground 13. Plenums & Ducts; Clearance-Material-Supprt-Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Insulation Card -B1 Date Card -131 Date Card -131 Date Card -B1 Date Date PLUMBING (Permit) OK except #'s 16. Water Ht. Vent -Access -Combustion Air- Baffle 17. Water Pipe; Test & Anchors -Nail Protection 18. D.W.V.; Test-Fttngs & Anchors -Nail Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, 2nd Floor -Tub Access 21. Gas Pipe; Size & Anchors Card -131 Date Card -131 Date Card -B1 Date Card -131 Date Date ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection 23. Elec. Receptacles Spacing -Lights & Switches at Doors 24. Size Boxes & No. of Conductors -Stapled 25. Romex Installed Close to Edge of Studs & C.J. 26. Equip. Ground made up w/Mach. Fasteners -Bond Gas & Water 27. 2 Appliance Circuts in Kitchen & Conductor Size/G.F.I. 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga. Cu or At 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral Yes No 30. Service -Riser Conductors & Ground -Main Disconnect 31. Equip. Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light Card -B1 Date Card -131 Date Card -131 Date Card -131 Date Date MECHANICAL (Permit) OK except #'s 34. A.C. Ducts Insulation & Support 35. Vent Fan; Exhaust above insulation 36. Condensate Drain & Overflow; Size & Grade 37. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet 38. Attic Access & Platform if Furnace in Attic Card -131 Date Card -61 Date Card -131 Date Card -131 Date Date FRAMING (Plans) OK except #'s 39. Sills, Proper Material & Anchors 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound 41• Bearing Walls over Girders & Floor Nailing 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Header & Beam -Size & Bearing Date FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. 47. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or E=xiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing 51. Property Line Firewall & Openings 52. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 54. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 55. Siding -Nailing Veneer 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 57. Glazing Area -Glass Protection -Skylights,, astir 58. Shear Walls; Nailing -Bolts i 59. Insulation-Walls-Clg. 60. Infiltration -Wal is-Wndws Card -131 Date Card -B1 Date . Card -131 Date Card -B1 Date Date FINAL (Plans) OK except #'s 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector 63. Furnace; Vents -Clearance -Comb. Air -Co actor In Garage; Above Floor- Ducts- Mec rotection 64. Bedroom Exiting 85. G.F.I. & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & Subpanel; Breaker Sizes -Labels 67. Stairs & Rails 68. Fireplace or Stove; Clearances -Hearth 69. Elec. Outlets at Wood Panel; Int. & Ext. 70. Kit. Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance 71. Elec. Outlets & Receptacles at Kit. Counter 72. Garage Fire Door; Swing -Landing -Closer 73. A.C. Duct in Garage -Damper 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor -Mach. Protection 75. Plb., Elec. & Mech. Equip. Listed for Location 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 77. Insulation -Foam -Looked in Attic ❑ Yes 78. Guard Rails & Deck Construction -Post Caps 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No 81. Stucco; Brown -Finish 82. A.C. Unit; Disconnect, Electrical, Plumbing 83. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Openings. 84. Water Well; Disconnect, Electrical, Plumbing 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 86. Ventilation throughout House 87. Glass Protection 88. Corrections from Previous Inpections 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval 911. Energy Compliance Certificate -Other Certificates 92. Roofing Certificate Card -131 Date Card -B1 Date Card -131 Date Card -131 Date Card -B1 Date Card -131 Date Comments at Final: (NOTE: An entry must be made each time you visit job site) JCOUNTY OF BUTTE - nPAR''TMENT OF PUBLIC WORKS -�_ P RMI 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541D� APPLICATION AND PERMIT A 1' zo ASSESSOR FJARCEL LLM R Lt 3 - C) - b / L' ZONQ�p r u _ BUILDING PERMIT OWNER /Jk TBELEPHONE . BUILDING S0_ . 0OCC.1 DFeTi [ /VALIIAhON OWNER'S MAILING ADDRESS Y.— coV. CON7p��ACTOR'S" NAME LJ ­, -J TELEPHONE 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 $ 7- Energy Plan Checking Fee $ ARCHITECT ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee ; PLUMBING PERMIT Filing Fee 10.00 Each Trap 2,00 Solar or heat pump water heater 20.00 LOT NO. d� ga SUBDIVISION NAME I PARCEL MAP' I Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other ' SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00 en TYPE OF WORK New N Addition Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: j 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 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business an Professions Code and my license is in full force and effect. icense No. Classification 21"l, 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.a oR ADDNS. ACC. BLDGS. , /z¢sgft NEW CONSTR U TI.OUTLET NO ..ES'.. .BRA CH CRC., TS 2.50 ea /POWER APPARATUS a\ (SINGLE OUTLET CIR. / Ex. Occup�OUTLET3 OR FIXTURES 209DOt eAL(P30 FIXED ALNS Ex. Occup. OUTLETS P(RESID )REA.) 2.00 Temporary service 10.00 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 �f Consent to Self -Insure. J 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 FiIingFee 10.00 Heating Cooling g 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 County of 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 inr-- against s 'd County in copse ce th'a granting of this permit. X G e I t% Date Signature of pplicant – 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 $ Energy Inspection Fee $ TOTAL PERMIT FEE $ 7i OCCUP. CONST.TYPEJ JSCHOOLJFLOODJPAR.CEJ This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By P MIT EXPIRES Date. Po HD s the applicable provi- resolutions to do have been paid. WORKS Date yG ` Receipt No. �y WHITE-O.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR,. GOLDENROD -APPLICANT .� :Y„i, _ : i^ 0 .,$< '�'1 ",y-• .,..-Z.y,., .-4:Ys^,.``-�I�t`•i :, , . ..,�,sE^�.a�.nrw -t �rc,,• -:.i Y_""'kr 'q. -,+''Q � f COUNTY'OF BUTTE - DEPARTMENT TOF PUBLIC WORKS - BUILDING DIVISION ' 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 / PERMIT APS-%( TION'DATA SHEET r Permit No. OWNER /lJ �� JL c iC /�/� A. P. No.3 'S�S� �l Z Proposed Building,"Use�cQ.• i%c��; Building Inspector Date 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. Energy Design Compliance and supporting documentation ......... 6. Statement of Intent for Non -Heated and AC Buildings .............. 7. Engineered truss details and layout in duplicate (required prior to plan check) 8. Mobilehome installation data including manufacturer's installation instructions....................................................... 9. Fees of $ .......................... 10. Chico Urban Area fees paid ................................... � .... 11. Park fees paid ..................................................... 12. School District fees paid ................. 3. Sanitation approval from/ / L Health Department .. . j 14. City of Chico plumbing_ permit ...................................... 15. Plot plan and business license approval from City of (see City for other requirements) 16 Planning approval tfor (A) Use: (B) Parking: ......... 07, Improverrents�rnay�be req,u red'. 18. Driveway permit (construction approval required prior to occupancy) ... 19. Pre -Inspection for required .... Pre-Inspec. request to Building Inspector (Date) 20. Contractor's license information (No., Name Style, Classification) ....... 21. Certificate of Workmans Compensation Insurance ..................... Owner -Builder Verification (Given to owner, Mail to owner ❑) ........ 23. Recorded copy of Agricultural Acknowledgment Statement ............ 24. Letter of signature authorization .................................... . 25. 26. When you issue the permit, process as follows: ail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other Applicant .—/ i' ' %l rX' < %pate�/k /f Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitted prior to permit issuance: (Circle -new 'tem not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone_Jna11—counter by date Contractor, designer, owner, was advised of above required data by—phone —mal l—counter by date Plans checked by Date Plans approved by Date -w Sots{ofjplans�on hold in File cabinet AP folder Copy—DPW TO Buildinv Department FROM: Environmental Health SUBJECT: Sanitation Clearance r _. Owner Location AP# ag Plan Approved for: Sewage Disposal Water Supply"� Hord final for: Water Supply Final clearance O.R. for: Water Supply Clearance for bedroom mobile home. Other COUNTY.OF BUTTE..- Department of Public.Works 7 County Center Drive, Oroville, CA95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete andreturn this information at your earliest opportunity to avoid unnecessary delay in.processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the maj labor and materials for construction of the proposed property improvement(ye or no) 2. ha /have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name _- Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address . Phone Type of Work Signed: Property Owner c_ Social Security Numbe Date ;� NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. Is tit �00 Sao jdr f;- 5 0 - 01 z- r qeend a s�ba Opeti the rO all be jeaf cant A Oqe1d. to 4/1 -Io 140 I 1 tV • �.. i ' y. PERMIT NO. 629,-85'-,B2 P,E,M t. PERMIT EXPIRES v yy OWNER SHASTAN i CONTR. Owner ASSESSOR PARCEL SFJ -G -VJ ai 43-29-% 125 50 Hampshire Dr LOCATION 2ZZU=f&§aMWXU1 lot 32, Hollybrook,Chicc t' OFFICE' PY, Meter,Byl'•� ate ELECTRIC V'��z Meter By �:t_ , .,?Da e �P t; Temp. Power Pole Called PG&E _ Temp. Elec. Service Called PG&E Temp. Gas Service Cal led PG& E p JOB FINALED (Date) / Z" Signature 1 r I Owner: • 5,t AS l OI CO, Permit No. ENERGY CERT IF ICAT ION _ Lot #32 5/3 -'P 4- / �:2-6' LOCATION A.P. No. DESCRIPTION OF INSULATION ROOF Material Thickness(inches) EXTERIOR WALL Material Fiberolass Batts Thickness(inches)_ 3 5/8" CEILING Batt or Blanket Type Fiberglass Batts Thickness(inches) 91," Loose Fill Type Fiberglass Minimum Thicknesl(Inches) 14" Area covered(ft. ) 913 FLOOR, ELEVATED Material Thickness(inches) FLOOR, SLAB Material Thickness(inches) Width(inches) FOUNDATION WALL Material Thickness(inches) Brand Name Thermal Resistance (R Value) Brand. Name Owens- .orni no Thermal Resistance(R Value) R13 Brand Name Owens-Corning Thermal Resistance(R Value) R30 Brand Name Owens-Corning Number of Bags 18 Wt. per bag 35 lb. Thermal Resistance(R Value) R30 Brand Name Thermal Resistance(R Value) Brand Name Thermal Resistance(R Value) Brand Name Thermal Resistance(R Value) I hereby certify that -the above insulation was installed in the above building in conformance with the State of California Energy Requiri ements. LOERKE INSULATION CO. #432518 FIRM NAME/OWNER STATE'CONTRACTOR'S LICENSE NO. November 21, 1985 SIGNATURE OF INSTALLATION APPLICATOR DATE I hereby certify the above insulation and all required items as shown on the Building Department approved plans and attachments have been installed as required by the State of California Energy Requirements. All equipment, devices and materials are of the quality prescribed or are specifically approved by the State of California. �S�/�s �•�N eo , .59-12 J>�y FIRM NAME/0 (Please print) STATE CONTRACTOR'S LICENSE N0. OF GENERAL CONTRACTOR OWNER DATE THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION APPROVAL AND A COPY SHALL BE'POSTED WITHIN THE BUILDING. January 1984 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 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 ork is completed. If you have any question pertaining to this matter, or need,4dditional explanation, please contact this office immediately. -IJS /V'9 -3/S 1\1 A �/t ^'14 3/4 OC %/Y ©i 1L Inspector J = OK 0 = Not OK — = Not Applicable * = Not Ready _ RESIDENTIAL'(Singie and Duplex) Date UND FLOOR Plans OK except #'s Date FRAMING (Continued) Z ng requirements—Setbacks— asements �.49!�roperty Line Firewall & Openings Ftg., Main; Soils—Steel—Ele d.— / /" Ftg. Depth Ext. Doors—One 3'—Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils—Steel— / /" Ftg. Depth tairs; Width—Headroom—Rise—Run—Landing—Fire Protection 4. Ftg., Porches & Decks; Soils—Steel—'/- /" Ftg. Depth W. Plywood on Roof Overhang—Attic Vents—Rafter Outriggers Stemwalls, Main; Steel—Blockouts—Wrapped—Slab 52./Siding—Nailing—Veneer 6. Stemwalls, Garage; Steel—Blockouts—Wrapped—Slab { Stucco Mesh—Drip Screed—Fdn: Vents—Underflr. Access ers— I Glazing Area—Glass Protection—Skylights—Plastic W.V.: Fall—Fittings—Test— ay C/O ewer Te Shear Walls; Nailing—Bolts I9. Gas Pipe• Size— chors -7 $19 K 10. Wat ipe; nchors—Regu lator—Sery ice Test 11. Electric; Underground — - 12. Plenums & Ducts; Clearance—Material—Support—Ins. , 13. Girders—Sills—Anchor Bolts—Joists—Vents—Cripples Card -BI Card -Bl' Date Card -BI Date Date Card -BI Date - Card -Bl Date Card -BI Date Card -BI Date Card -BI Date Date FINA Plans) OK except N's Card -BI Date Card -BI Date Date PLUMBING (Permit) OK except N's 5 . Steps—Door & Sidelight Protection—Landings S e Detector J 41 W ter Ht.; Vent—Access—Combustion Air 5tj, -Furna e; Vents—Clearance—Comb. Air—Connector—. I ar e; Above Floor—Ducts—Mech. Protection Wate Pipe; Test & nchors— ail Protection 16 V.; t—F gs & A ors ail Protecti 5 B dm Exiting 17 ower Pan; Test, First Floor—Tub Access st Tub & Shower, 2nd Floor—Tub Access 60!--GF-1.. &Bath Fixtures &Tub Access Elec. Trim & Subpanel; Breaker Sizes—Labels Gas Pipe; Size & Anchors irs & Rails e or Stove; Clearances -Hearth Card -BI ` Date Card -BI. Date utlets at Wood Panel; Int. & Ext. . Fixt.,& Appliance; Grnd.—Air Gap—Cooking Clearance Card -BI Date Card -BI Date qvElec. 9dilets & Receptacles at Kit. Counter e ire Door; Swing—Landing—Closer Date ELECTRICAL Permit OK except q's .C. Duct ' Gara a—Dam per Fixture &Transformer Clearance—Ins. Protection Elec. Receptacles Spacing—Lights &Switches at Doors 6 Wtr. ;Vents—Clearance—Comb. Air—Connector—P.R.V.— I ar ge; Above Floor—Mech. Protection _ Size Boxes & No. of Conductors—Stapled 7 PI ., EI Mech. Equip. Listed for Location gej;lomex Installed Close to Edge of Studs & C.J. 7 I . Receptacles in Garage; (G.F.I.)-Ro Protec. quip. Ground made up w:/Mech. Fasteners—Bond Gas &Water 7 nsulation—Foam—Looked in Attic Yes 2 Appliance Circuits in Kitchen & Conductor Size Deck Construction—Post Caps dn. Vents dn. nts &.Crawl Hole Door—Drai age &Wood -Earth Clearance Loo nder Floor Yes S feed Wire Size / / ga. Cu or AI—A.C. Wire Size / / ga. Cu or AI ange Circ. / / ga. Cu or AI—Oven Circ. / / ga. Cu or Al, Insulated Neutral ❑Yes ❑No 7.5. / ollowing instld. rive Yes ❑ No; Walks Yes C]No; Planters es El No 26—Riser Conductors & Ground—Main Disconnect — S o; wn—Finish 2 Equip. Clearances; Panels—Motors—Mech. Equip. 7I C nit; Disconnect—Clrnces—Brkr. & Cond. Size -115V Outlet Clothes Closet Light—Shower Light., 78 is Above Roof; Plbg.—Appliance—Firepl.—Clearance to Opngs. t r Well; Disconnect, Electrical, Plumbing . W-Axterior Elec. Trim; G.F.I. Receptacle—Underground Card B I Date YJ Card-BDate , W.XoI tilation throughout House Card B -I Date Card -BI Date Date MEQHANICAL (Permit) OK except N'sdst-VIeters 81. Ala!2,Protection 8,Y C rec .ions from Previous Inspections Tagged; Gas—Electric 1. .C. Ducts; Insulation & Support W. ater &Sewer Connected—C/O to Grade—HD Approval Vent Fan; Exhaust above Insulation g Ener Compliance Certificate—Other Certificates ondensate Drain &Overflow; Size &Grade 147 mace—Vent; Access -Comb. Air—Return Air Vent -115V outlet 3,+." Attic Access & Platform if Furnace in Attic Card -BI fLAY 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: 3L/4ills; Proper Material & Anchors Walls; Studs—Nailing, Spacing & Bracing—Plates—Sound Bearing Walls over Girders & Floor Nailing 190' -Draft Stop in Walls (rat proof) ire Stops; Furred Ceilings—Stairs—Chases—Tub Header & Beam—Size & Bearing Hangers—Post Caps—Anchors—Connectors 43. Ing. Joist—Rftr. Ties—Purl in—Roof Brac. Trus 'Shthng,—Rfng. -44—Fireplace Ties or Type A Flue—Fireplace Throat 4.1., -Attic Access; Size & Romex Protection—Draft Stop—Ins. Baffles Bdrm. Windows or Exiting Doors—Sill Hgt. & Dimensions .. arage Fire Protection Framing (NOTE:Anentrymust be made each time youvisit jobsite) J OK 0 = Not OK = Not Applicable MOBILEHOMES * = Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except q's 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except H's 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 2• Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/0 -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.-Rig.-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 N's 1. Zoning Requirements -Setbacks -Easements Card -BI Date Date Card -BI Date POOLS (Plans) OK except p's 1. Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -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 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/0 to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater B. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Health Department Approval 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 10. Plumb; Cir. Test -Water Supply Test Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date J " COUNTY OF BUTTE -DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovillf:,.Califo6a 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. 1 ASSESSORPARCEL NUMBER �� ZONING BUILDING PERMIT O WNL�QE ISS � ELEPH NE '- 0 SO. T. OCC. BUILDING VALUATION O 'S AILING AD ESS CO T ACTOR'S EPHONE —0027 � * CON ACTOR;�MAILING DDRESS Fireplace CON TRUCTION LENDER UNKNOW, [s Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 15,.Q • �� $ ' ARCHITECT OR ENGINEER'S MAILING ADDRESS"Y Permit fee $ BUILDING ADDRESS PLUMBING PERMIT Filing Fee 10.00 s ' Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO. 3� SUBDIVISION NAM 1 19 PARCEL MAP Each qas water heater or vent 5.00 - Gas piping system 1 - 5 outlets 5.00 s . USE OF STRUCTURE SF 9' Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home S I G I W I 10.00 e TYPE OF WORK New ®/Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe work: o_r er Id -L -7,f Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600v OR LESS 100 AMP OR LESS 10.00 �t edi plall Main service EA. ADD'L 100 AMP 2.50 IV, Ilya NEW CONSDWELING OR ADONST ( ACCLBLOGS.CCU 21/20sgft 3, CONTRACTORS LICENSE LAW I deciar 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 force and effect. ]7 License No. 1 Z%y�% Classification 1S ❑ 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 NON.RESID BRANCH CIRC ITS 2.50 ea NEW CONSTR. POWER APPARATUS & NON-RESID. SINGLE OUTLET CIR. Ex. Occu / OR FIXTURES P\o 2AL@30 BAL®30Q FIXED FIXED TS 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 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): Ie permit is for $100.00 (valuation) or less. 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 qZ max -6D Codin Hood 3.00 3' 6-b 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.TOTAL I also ajependqqify and keep harmless the County of Butte against all liabnt ost and expenses which may in any way accrueagainst se ce of the granting of this permit. X _7—�� Signature of ppli nt — Owner❑ Contractor ❑ Agent An OSHA permit i requir d for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ 3 PERMIT FEE occuPGROUP TYPE of CONST. PARCE PDMD SSVE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECT OF PUBLIC PER EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date 3 Receipt No. 9:52BY _ WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT 55 V Section 26-8.1 of the Butte County r,'ode requires this acknowledgement MAP 'be recorded. prior to issuance of a building permit. El C CLM, - F, U;%vr.R The property described herein is adjacent to'land or included 811- 6 25 EE within an area zoned.for agricultural purposes, and residents of this property 'Way be subject to inconveniences or discomfort arising from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations .including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, stroke, noise, and odor. Butte County has established agricultural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience or disconform from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: Being a portion of Lot -13, of the Second Subdivision of the John Bidwell Rancho, according to the Official Map thereof filed in the Office of the Recorder of the County of Butte, State of California, . Septarber 17, 1.900 in Map Book 5, at page 27; and being a portion of Lots 3, 4 and 5 of the McCulley Block formerly Lot 12 of the Section- Subdivision of the John Bidwell Rancho, filed for record May 5, 1903 in the Office: of the Recorder of said County of Butte, State of California in Book 4 of Maps, at page 23, more particularly described as follows: Parcel 3, as shown on that certain Parcel Map recorded in the Office of the Recorder of the County of Butte, State of California on May 18, 1983, in Book 92 of Parcel Maps, at page 70... Date: February 15, 1984 State of County of N 9 Present E a On this the PROPERTY OWNERS: SHASTAN COMPANY, INC., A CALIFORNIA CORPORATION Jdy yHaMdrt, rest n 15th day of February 19 84—, before j .I STATE OF CALIFORNIA Butte )ss. COUNTY OF --_.--- _— _--i On February 15, 1984 before me, the undersigned, a Notary Public in and for,— said State, personally appeared Jay S. Halbert -- —personally known tome basis to be the persordwho executed the within instrument asence. --Tibce t0 - the President and -- ------ Secretary, on behalf of _ ShastanCompany, Inc. - the corporation therein named, and acknowledged to me th such corporation executed the within Instrument pursuant to i by-laws or a resolution of its board of directors. WITNESS my hand and official seal. SlgnatureAdA&M 60:11— Sharon R. Howell ------------------ OFFICIAL SEAL SHARON R. HOWELL NOTARY PUBUC — CALIFORNIA couNTY or /vTT! K Comm. Exp. April 12, 1985 al Seal. RSc 1 1 setback of 5 ft. from the )perty lines and:a setback II LA) dee aster Plan i plans. /01/- 2o.00 Zo.ov 3 50ft-frons Vii road r `fe ' e s all be clear bW JCtures or_egijipment e eave overhang.. 0 44,00 G a5 -mss ' 0 4.4.00 rLAN H Iz EY, -- n r l AN - _V, IMM X32' I T p� g # of plans and peen ns, MUS'i {yep on Me job at .au ti es an i is un Ow ul v o R t!n ohans�es �r alt . ons. e �" 7 rif on permission from the a °f F 'o s. gZ qty of Butt. g o w �L LA °t1TTE COLIN i � �-- Q _r,E. FTAH T sQ C(i 2 CL p� $ DING DEPART E TOw, I� o v , VIA 8 � N S`l' 3(0' gill � 111.50 � OL Q . .. .. .. � ..�.. � �.... :. .. .K �...... .t. � '. � :. •. .. y,.�p:.•.i�'++rf:•7rS�'�Y.:,w _. ... _ •nr.•Yt4ar. rY�„�yy:c...w...' �. FORM I PLAN ' + RESIDENTIAL EN i CHECK'/ INSPECTION SUMMARY -Owner SH&:; -rAN Climate Zone Permit No. 402 /,�aor Area path: Package D A ❑ B ❑ C IR Point System ❑ Budget ❑ Other ,hapliance MIN R-VALUE DESCRIPTION REQ'D INSTALLED ITEMS (1) INSULATION: Roof/Ceiling K ® Wall ❑ Slab Floor Perimeter --- ❑ Raised Floor _ (2) INFILTRATION: ❑ (A) A vapor barrier is�required in climate zones, 1, 14 & 16.. (B) All manufactured windows and sliding glass doors shall meet the 1972 ANSI Air Infiltration Standards and shall be certified and iabeled. ® (C) All swinging doors and windows leading to unconditioned areas shall be fully weatherstripped. BUTTE COUNTY Tight - the above standard features plus: DEPARTMENT 13(D) Continuous infiltration barrier ® (E) Electrical outlet plate gasket ❑ (F) Air-to-air heat exchanger APPROVED (3) GLAZING: (A) Location Area Glazing Vloor Area Single Double .Triple M • [� Total Bldg Arnz 1 ® North n '55, 6- i _ East la 1 b South `Z 0 ' West 5=l,v 2•== ❑ Skylights -- (B) _Shading Shading Coefficient Description [[� East i oF-A►=eS ® South ® West 'o !o ,• ❑ Skylights ® (C) South Overhang Length of projection _ft. Description ❑ (D) Moveable insulation: Area ft ,Description '(E) Thermal mass ; ® Type A- •---Ab - Area 15'3,/ Ft.2 HC. -,•73 R= Z7 MC= '7, 3 . Location _ 5 E;E Fc,-;�J. ❑ Type - Area Ft.2 HC= R= MC= Location ❑ Type - Area Ft. HC= R= MC= Location ❑ Type - Area Ft. HC= R= MC= Location J ❑ Type - Area Ft.2 HC= R= MC= Location ❑ Type - Area Ft. 2HC= R= MC= Location 7/83' _ FOR M 1 ❑ (4) MASONRY AND FACTORY -BUILT FIREPIACES shall be equipped with tit feting closeable metal or glass doors covering the entire opening of th dire ox; a com'5usion air intake equipped with a readily accessible, openable, and tight fitting damper to draw air from the outside of the building; and a tight fitting flue damper with a readily accessible control. sF T�TEw" `''l° f OT. Za •_ *1(5) HEATING, VENTILATING, AIR CONDITIONING SYSTEM (A) Heating Central Gas Furnace m 7/ % ® 50am/T ,-P c5 (brand and model number) SE P9101Z To Btu/hr (heating capacity) ❑ Heat Pump (brand and model number) ACOP Btu/hr (heating capacity at 47°F) ❑ Active Solar type (liquid or air) Collector brand and ft2 model number solar fraction collector area collector i orientation collector tilt rated y -intercept .rated slope ❑ Other ( (describe) *1 (B) Cooling ® Electric Air Conditioner (brand and model number) (seasonal EER) Btu/hr (cooling capacity at 95°F) ❑ Electric Heat Pump EER Btu/hr (cooling capacity at 95°F) ® Other- (describe) ther(describe) (C).`STAGE THERMOSTAT, which controls the supplementary heat on its�second'stage, shall'be required for heat pumps. ® (D) AN AUTOMATIC SETBACK shall be provided for all thermostats, except those controlling heat pumps. (E) AN INTERMITTENT IGNITION DEVICE shall be provided for all gas-fired fanst' -central furnaces, gas-fired fan type wall furnaces and gas cooki`ng�appliances. (F) BACKDRAFT DAMPERS shall be provided for all fan systems exhausting air •to the outside. ® (G) DUCT CONSTRUCTION & INSULATION-: All transverse duct, plenum, and fitting joints shall be'sealed with pressure sensitive tape or mastic to prevent air loss and shall be insulated to conform to the provisions of Section 1005 of the UMC, 1976 Edition. 7/83 2 (6) DOMESTIC WATER SYSTEM ® (A) Gas Only V P K -00")d 40 Gallons (brand and model number) {tank size) Heat Pump w/Electric Backup (brand and model number) Gallons (tank size) ' E3 *2 Active Solar (collector brand and model number) (rated y -intercept) (rated slope) (solar fraction) ft2 (backup heater type, brand and model number) (collector area) (collector orientation) (collector tilt) C3 Location of Solar Panels p. Other (Describe) ® (B) TANK INSULATION. Storage type water heaters and storage and backup tanks for solar systems shall be externally wrapped with R-12 insulation or.greater. - ® (C) PIPE INSUTATION. The five let of pipe closest to the water heater and outside conditioned space shall be insulated with a minimum of R-3. Steam and steam conditioned space shall be insulated with a minimum of R-3. Steam and steam condensation return piping and recirculating hot water piping outside the building envelope shall be insulated in accordance with T20 -1408(d). .(D) FLOW RESTRICTORS shall be provided for showerheads and faucets as outlined in the new appliance efficiency standards, ane shall be certified to the Energy Commission. (7) LIGHTING ® (A) Lamps used in luminaries for general lighting in kitchens and bathrooms shall have an efficacy of not less than 25 lume es per ;. watt (usually florescent). *l Submit -do ion.of sizing heating and cooling equipment by Manual J, sizing charts form 44 or other approved methods,.section 2-5352(g), and fill out the followin Heating: Winter design temperature °, elevation Z C'� heating .load BTU elevation factor ,o x heating load maximum outlet capacity gas furnace BTU /A Cooling: Summer' des temperature °, cooling load BTU *2 Submit T.I.'P.S.E. chart or other approved system (for L. ASr un-1of solar panels. COOLING MAY BE INADEQUAT9, DESIGN COMPLIANCE STATEMENT: The above building design meets the requirements of :J Title 24, Part 2, Chapter 2-53 of the Californ Administ tion Code. 7/83 SIGNAT dOBUI ING DE IGNER OR APPLICANT 3 Y.1 COUNTY OF BUTTE - DEPARTMEN-I OF PUBLIC WORKS a 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT N0. ASSESSOR PARCEL NUMBER �a ZONING BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC, BUILDING VALUATION NER'S AILING ADDRESS ' 3 CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ (L 7 _ 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 Water piping 5.00 LO NO. SUBDI VISIO f NA E 1' PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 --/ USE OF STRUCTURE SF LTJ Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home JSJGJW.J 10-00e TYPE OF WORK New Addition ❑ Remodel [:1 t'litiesIn allation❑ Other Describe work: 3 � f7 -7.f Permit Fee $ P Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 10ov OR LESS 100 AMP OR LESS 10.00 D �V Main service EA. ADD'L 100 AMP 2.50 NEW CONS. OR ADDNST ( ACCLBI ��') 21h Q$q ft I✓l CONTRACTORS LICENSE LAW I declar 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 ful force and effect. License No. Classification F]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. MULTI -OUTLET 2.50 ea NON-RESID BRANCH CIRC ITS &'1 NEW CONSTR. ( POWER APPARATUS . / NON-RESID. SINGLE OUTLET CIR 20050a Ex. Occup(O OR FIXTURES 1.030 IXEDTS PR EX. OCCUp. OUTLETS (RESID.)EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ r 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. Ihave placed on file with the County of Butte Building Department 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 r'ia Hood 3.00 7 Ventilation 3� permit Fee $ Contractor 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 authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to ave, indemnify and keep harmless the County of Butt against all liabilities, dgments, costs and expenses which may in a y way accrue against said Co ty in co eq a he granting of this permi . Date 1� Signature of Applicant — Owner❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep an demo I ion or construct- ion of structures,,Pm sin height. Mobile Home Installation Fee $ �. "1 n TOTAL PERMI E $ '-toCsv P OCCUP. GROUP TYPE OF CONST. PARCEL PD HD ISsuE 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 In Receipt No. WHITE-O.P.W.. YELLOW- ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT , IP 1Tj , . , M i wa Jim -z" it is U00,0�ful to . ad I I t�r�rgs on some@ Athou•1 dept onI a Job ; or oyk�r. 1 •nuke nr��,' �ht�rq.� ;fir#�! tii l�o�+ .,bitten Per"ssio r � ' I ( ' 6'a�aye ; anshlp shop Be is Off: SI h/tatoals �° , ^ ; Procticos ansa with i'C�c��i': - case in th6 �`+CCprGiG4�c�t3 I•'.t3L�.�' IY:e O{ f1 ty .6w.. .,?r£�C� f e i3tti)iCoi a and ' 'I Numbing UfU�tQt .l ;wu4. q� ni i '• I i ��I � i '� ' ! ' � r � i lull?% 1 2 DYC/P qel cov o e, eY4001 C/ OPER -21 `' To bottom oil � P /.07e- �+ 1 (0 JN, 0c) owA Oreehov •-� '�'� I I I� . lig �'I�I� ��� �' � � -21 `' To bottom oil � P /.07e- �+ 1 (0 JN, 0c) owA