HomeMy WebLinkAbout047-540-001Da
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p4 -'?-5,,440 -Cc
Peter D. Peterson -
-W/Sapr_i-wr-d-,_,-app-lk m-i-.-S—of G anella--Rd:
app.2 mi:IW:of Hamilton -Nord -Cana Hwy,M
Chico f
Perm 430/46-76P,E(relocate MH util.)ELEC-
4,
I
GAS- - .
� n _ - L C ✓, ' 30
SUPPORT STRUCTURE REQ i j
y COMPACTIONtTEST REQ, �JO �/Vr.
f
i47-14=
t,
—Permit k304i%7:6MHi
AP 47-1 -
F . PETER D. PETERSON g
Y 3
N -.-•of Hw ?.-@--Sacra.
River,�/-2/;76 ;
coritr:_L phi.11ips_,—Ch&c.o__ _
Permit# 5174--74:B,-P;•E; M(remad'e1' - r
i
AP 47-1[,, 04
LC0NTR-:-L-assen'-Pupp--Ch-jc-omi 1801-
75E(service change)'
3 -
t
� t
30,Y6 76
PERMIT NO. iW6--76P,E
ti
�i
PERMIT EXPIRES 4. �,47
;OWNER Peter D. Peterson
owner
CONTR.
LOCATION
ONTR.
LOCATION (A.P• 47-14-5 )
i W/S pri. rd., app. 1k mi.S.of Gianella Rd.,app.
2 mi. W. of Hamilton Nord Cana Rd., Chico
• I'
T,
f
i#
Temp. Po "r Pole
Call PG&E
Temp. lec. Serv. -
lied PG&E 6 -i t/ ��� f�AIAM-
r
Te p. Gas Serv:
Called PG&E '
JOB -7 Z (es
FINALED
(Date)
(Signature)
Carport
Footings
Slab
Patio
Footings
Masonry Wall:
Reinf. Stee
Bond Beam
ex. Gas Piping & Test tic 1 57/^/ Cs—
Temp.
s -
Tem . Gas
Sanitation
FIREPLACE I Final
Framing TestWater 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
DAT X-
4;�/%soREMARKS OR CORRECTIONS
.qca� Z), w4 �, eC PInA 6,�M0 4r 4S,ea, c.;- ,
(NOTE: An entry must be made on this form each time you visit the job site.)
ELECTRICAL
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
+J r '
BUILDING BUILDING (Cont'd)
PLUMBING
Setback —/0-7
Firewall
Soil Piping
Forms
Parapets
1st Floor
&
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
Stemwall
Siding
To out
Slab
r Roof Sheathing
Water Piping'
F—X05 7AJ �—
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Stemwal l
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Prov. for physically
handicanoed
Appliances
Carport
Footings
Slab
Patio
Footings
Masonry Wall:
Reinf. Stee
Bond Beam
ex. Gas Piping & Test tic 1 57/^/ Cs—
Temp.
s -
Tem . Gas
Sanitation
FIREPLACE I Final
Framing TestWater 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
DAT X-
4;�/%soREMARKS OR CORRECTIONS
.qca� Z), w4 �, eC PInA 6,�M0 4r 4S,ea, c.;- ,
(NOTE: An entry must be made on this form each time you visit the job site.)
ELECTRICAL
MOBILEHOME INSTALLATION INSPECTION CHECK LIST
l: Is the mobilehome located wit equired separation from lot lines and buildings and generally
conform, to Iplot plan? ..Yas, • No
2. Does'`th.6 mol ilehome ttiave required clearances above ground? (Sec.5085) Yes�'�No
3. Are footings and supports properly sized, spaced, and braced as per approved plans? (Note
possible variation at spring shackles.) (Sec. 5082 & 5083) Yes No
4. Is the mobilehome level? (Sec. 5088) Yes \
.5. I.f-more�an.single unit, are crossover connections properly installed? (Sec. 5088)
Yes o
6. Water a
A. Is flex' connector of adequate size and properly installed (1/2" ID min.)?'(Sec. 5566)
Yes Nc ,
B. Test - Does water piping withst nd working pressure or. 50 lbs, air test? Yes�o
C. Backflow - If coach is n t California approved, does station have backflow device
and pressure -relief val ? s No
7. Wastes and Drains
4A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yeses No
B. Does it have minimum" per foot slope and is it properly supported? Yes
C. Are any leaks detected in drainage system after running 3- allons of water through each
fixture.inclu ing washing machine standpipe? Yes No,
D.,` if 'ate s ate of_California approved, does station have required trap and vent?
Yes
8. Gas Piping 'and Gas Vents
A. Connector - Is mobilehome connected to th_e gasksupply with an approved 3/4" minimum
mobilehome connector not more than 6 ft. long? Note: All piping is to be at least as
large as the mobile me gas line inlet without reductions other than the mobilehome
connector. Yes No e l C `'
B. Test OK as per following procedure?` Yes No
1. -Open all appliance•connector Vaal`ves.
Shut off appliance burner and pilot valves.
U—'.Air test with manometer to 10"-14" water column, or test with slopeg auge (minimum
6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without
drop.
4.LConnect gas meter to mobilehome with connector, turn on gas, test connections with
soapy water. �r�
C. Are 411 appliance vents properly installed? Yes�No
N
9. Electrical
A. Is service large enough to provide a equate amperage -to mobilehome (must equal rating of
mobilehome with a minimum of 10 mp) and other facilities on lot, i.e., wa rpumps,
garage, cabana, etc.? Yes o / `/V . /74
_.. �
B. Is there proper clearances around panels? Yes l "No�,� /
C. Is power supply cord or feeder assembly properly fused? Yes
D. Is�ontinuity test satisfactory as per the following procedure? Yes
�!! De -energize electrical wiring system of'the mobilehome at the pedestal.
2, ke sure that the power supply cord ror feeder assembly conductors, including neutral
condo or, have been disconnected.
3. witch all breakers and switches in the mobilehome to the "on" position.
4. onnect one lead of a test.instrument'to the mobilehome grounding conductor and
apply the oilier lead to each rnoUileltame supply conductor, including neutral.
5. non-current., carrying metal parts of the mobilehome (aluminum siding, gas line,
water line) ,• including fixtures and appliances,, shall be tested for continuity from
such equipment and the grounding conductor. `
6. Upon completion of the above procedure, the power supply cord or feeder.assembly
conduc:tors.shall be connected to the site service equipment. A further continuity
test shall then be made between the grounding electrode and the chassis of the
mobilehome. Upon satisfactory completion of the electrical tests, the lot or site
service equipmentmay be approved for energizing.
10. Is job card signed by Health li!�partment for water and sanitation? 0>7;
11. If everything okay, sign off card and tag services.j�'��T/illi
MOBILEHOME DATA
Manufacturer and/or Namestyle
Length Width
Vehicle Serial No. S� ► �C S 7
State Identification No. Sr7
Additional.Informati.on or Comment r
%-q -- %- v-.+.;t•�rr�yr".r«...e ..r:-er r.,-�a�•yy s;aux,;fir .�,�.v��.�tt �-
COUNTY OF -BUTTE - DEPARTMENT 0/FJ PUBLIC WORKS
7 County Center Drive --Uroville, California 95965
y Telephone: 534-4541 /UZ,6(/►
APPLICATION AND PERMIT CJ 7
-4 Date
Signature of Permitee or Agent �.. / /
BY .�� .I'!' _ Date (n
Receipt No.
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant Btuilding permit expires Date
BUILDING
Owner -
SQ. FT. I OCC. BUILDING VALUATION
Mailing Address .'- %��� �V-7
Telephone No.
Fireplace
C
Contractor U/049Ix
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee&/or Penalty
-
r
Telephone No.
Permit Fee
Building Address all -C r!?%j / Q/,
PLUMBING No. @ FEE
PERMIT FILING FEE J$3.00 ,
(r
77/i!? 2� JJ refr�i yA !�
Each Trap 1.50
i 1 D -
�7a off- i �f i �!
Repair drainage or vent piping 1.50
Water piping
Alor4 14 eF9 A/,
Each gas water heater or vent 1.50
A. P. No. _. Lr» _
Zoning 8 Planning
Gas piping system 1 - 5 outlets 0, h9i,9 C
)
Each additional outlet .30
Fees
4,(:
Sanitation
Fire Dept.
Fire Zone
Use Permit
Building sewer
EQA
Parkin
PlansBldg.
Declaration
Parcel Map
60' R/W
Improvements
Lawn sprinkler system 2.00
Plcn�ec'd
Parcel Apprrl
An Approval
Permit Fee $
$ -IYI
NEWADDITION
❑ ❑ UTILITIES OTHER ❑
ELECTRICAL No. @ FEE
PERMIT FILING FEE J$3.00
V OR
Main service 100 AMP ORSLESS 5.00
Main service EA. ADD'L too AMP 2.50
Single Family ❑ Duplex ❑ Mobil Home Others ❑r
Main service OVER 600V
100 AMP OR LESS 25.00
Main service EA. AOD'L too AMP 1.00
NEW OR ADDNS. (ACC. BLDGS.) WELLING CCUP. &) 2�sgft
NEW CONSTR- MULTI -OUTLET
NON•RESI 0. BRANCH CIRCUITS) 2.50ea
_
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:
Ex. Occup(OUTLETS OR FIXTURES) 50 BAL 2ta
04
Ex. Occu FIXED APPLNS. OR
p•(OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
-
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$ Q
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.
MA I certify that in the performance of the work for which this'
11.'N 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.1 @ FEEPERMIT
FILING FEE J$3.00
Heating
Cooling
Ventilation
Hood 1 2.00
Permit Fee $
$
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
authorye representatives of the County of Butte to enter upon the
above- entioned pr pe ty for inspection purposes.
X �, .;In r.,DIRECTOR
TOTAL PERMIT FEE
$
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.
OF UBLIC WORKS
-4 Date
Signature of Permitee or Agent �.. / /
BY .�� .I'!' _ Date (n
Receipt No.
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant Btuilding permit expires Date
_ - �. .... -c �.. � - ..r-.y�,.r.,... a.0 y.-.�'•--n-"�`:, r"-..�.---•"^k . +K,-ra..^.-:v y�,it,^-.-t-.-+"�'�1r"----�,1`i}.-. ,.�.. -Y' '�_..J� .ti-�*'-.. �.�,...J.
�t• COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive `t—` -Urbille, California 95965
Telephone:, 534-4541
APPLICATION AND PERMIT !
e
Signature of Permitee or Agent
Receipt No. _f (_/4y ? 7
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
By "'— i Date 6-10
6-10-
Building permit expires Date 77
BUILDING
Owner Az / j•,
SQ. FT. OCC. BUILDING VALUATION
Mai ling Addressl}
t
t�� .1_
Telephone No.
Fireplace
Contractor OW 41!4
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee&/or Penalty
Telephone No.
Permit Fee
Building Address
PLUMBING No.1 @ FEE
PERMIT FILING FEE $3.00
//ZVz Z e._ /i .i.r./
Each Trap 1.50
s UJ �:� r ��f7i$)r/ y
Repair drainage or vent piping 1.50
Water piping 1.50
li/r1r'.n r� li A,/9%a t
Each gas water heater or vent 1.50
�/ ,
A. P. No. �°Y 7 ` �' / +
Zoning 8 Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
Fees I
W.d/
-6er -54on-
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
I Parcel
Declaration
Parcel Ma P
60' R/W
Improvements
Lawn sprinkler system 2.00
Bldg. Plans Redd
Parcel Ap, ovaI`
�P
Pla sfl"s proval
Permit Fee $
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
jj, ,
1f�
Main service 10O00 AMP OROR SLESS 5.00
Main service EA. ADD'L too AMP 2.50
Single Family ❑ Duplex ❑ Mobil Home Q' Others ❑
Main service 1100EAMP OR LESS 25.00
Main service EA. ADD'L too AMP 1.00
NEW CONST. OWELING
OR ADONS. ( ACCL BLOGS.CCUP. &) 20sgft
NEW CONSTR. MULTI -OUTLET
NON-RESID. BRANCH CIRCUITS) 2.50ea
- - - -
'
NEWCONSTR. /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:
s.
Ex. Occup (OUTLETS OR FIXTURES) BAL2t
EX. CCU // FIXED APP(RESID.) EALNS. OR
OP'%2.00
OUTLETS )
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
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 Section3700X the California Labor
Code which requires every employer to be ins red against liability
for Workmen's Compensation.
Elhave placed on file with the County of Butt a certificate of
'workmen's Compensation Insurance.
O 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. \\
I certify that :have -read thi applicathon and state that the above
informatidh is correct: I agree to'comply to all County Ordin nces
and StataNLaws relating toybuilding—construction, andRhereby
authorize_ repr�sentatjves of the Courity.of Butte to enter upon the
above=mentioned property for inspection purposes.
I f /
X ; ,T� � � It- - � Dat i /�J/��J�i
MECHANICAL No.1 @ FEE
PERMIT FILING FEE J$3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
l`y /clti/[ %/d
$
-30 .60
TOTAL PERMIT FEE
$'�>O'2�
p y issued under the applicable provisions of
This Butte
C is County Co
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR 0 PUBLIC WORKS
e
Signature of Permitee or Agent
Receipt No. _f (_/4y ? 7
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
By "'— i Date 6-10
6-10-
Building permit expires Date 77
�� aY��'hM��P MI�uai'Y�.W"I- "+i.''1 � Y�� .i fit+" i-,.-t�J�4���YF'. •�� �i' t �:�.1.. � a "F.
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE
OROVILLE, CALIF. - 534-4541
CERTIFICATE OF OCCUPANCY
This mobilehome has been installed in accordance with the requirements
of the California Administrative Code, Title 25, iapte 5, under permit
nuTber�6 •~ — for the following location: f i 1
Owner
Owner's Address_��l--�-- %
Mobilehome Mfg. /— /e Model Year L—T-7
Insignia No —/ S7:5- Serial No. meq/ S/ S 6
1 / 57 Z �� b cc��ocation and
It is hereby certified for occupancy at the above descri ed'
may be occupied.
Director of Public Works
Date —Z (! 7 6, �i
By
THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED
J COUNTY OF BUTTE — DEF4RT=NT OF PUBLIC WORKS
7 County Center Drive — Orovi Ile, California 95965 `
Telephone: 534-4541
APPLICATION AND PERMIT �1 ,
Signature of Permitee or Agent
/ 3 BY Date —
Receipt No. r/6
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Iding permit expires Date
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
_ Tele ho a No.
a
"�
Fireplace
Contractor
Total Valuation
Mai I i ng Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee
Building Address !q -r �r ,
PLUMBING No. @ FEE
PERMIT FILING FEE J$3.00
Q^-7 cam; fV_Each
Trap 1.50
D
Repair drainage or vent piping 1.50
Water piping bw
AlEach
gas water heater or vent
A. P. No.
Zoning & Planning
Gas piping system 1 - 5 outlets
E-..30
Each additional outlet
F
SffR ativrr
Fire Dept. FireZone
Use Permit
Building sewer
EQA
Parking
Plans
I Parcel
Declaration
Parcel Ma p
60' R/W
Imp
provements
Lawn sprinkler system 2.00
Bldg. PI s Recd I
Parcel Apk4l
ans Approval
Permit Fee
NEW ❑ ADDITION ❑ UTILITIES OTHER ❑
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service i°o°o AMP ORV OR LESS5.00
t'
Main service EA. ADD'L 100 AMP 2.50
Single Family ❑ Duplex ❑ Mobil Home Others ❑
OVER 600V
Main service 00 AMP OR LESS 25.00
Main service EA. ADD'L 100 AMP 1.00
NEW CONST. WELING
OR ADDNS. ( DACCLBLDGS. OCCUP. &) 20sgft
NEW CONSTR. MULTI.OUTLET
NON-RESID. BRANCH CIRCUITS) 2.50ea
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
Ie
St Of:
Y
Ex. Occup(OUTLETS OR FIXTURES) 50 B,qL�
FIXED APPLNS. OR
Ex. Occup.(OUTLETS (RESID.) EA) 2.00\
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring
6.25
FT
14 I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
1
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.
F-1 have placed on file with the County of Butte a certificate of
'Workmen's Compensation Insurance.
imI 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 rel ting to building construction, and hereby
auth ze representat es of the County of Butte to enter upon the
abovi Ced rop ty or inspection purposes.
I Date y�V li7
TOTAL PERMIT FEE
L
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicatedabove for which fees have been paid.
DIRECTOR OF/r LIC WORKS
Signature of Permitee or Agent
/ 3 BY Date —
Receipt No. r/6
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Iding permit expires Date
OWNER �C-? =.� �O� ��.E�prt/ AP NO.-
At
O.
At time of permit application, the applicant was advised the following data or information
'must be submitted
prior to permit processing and/or issuance:
V 1. All items have been submitted.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
7.
Plot plans in duplicate/triplicate.
Complete plans in duplicate/triplicate.
Complete engineered plans and talcs.
Fees of $
Letter of signature authorization.
Sanitation approval.
Planning approval
Workmen's Compensation Insurance Certificate.
Contractors license information.
Parcel declaration.
Access declaration.
Aunt Minnie information.
Deed of access.
Deed of parcel creation.
Parcel map.
Pre -inspection request for
Other �"heo:L Du T Fyisiia G _Si Tom, AZe Sq id 17` iS .Olt
6/y1j6
By Date
Bldg. Inspector
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' When permit is issued, process as follows:
1. Mail to owner.
2. Mail to contractor.
3. Deliver with inspection.
4. Telephoneand hold for pickup.
5. Other ?Fl`��c�1
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During plan checking process, the following data or information must be submitted prior to
permit issuance:
1. Index permit for items numbered
2. Applicant advised by telephone we need
3. Send letter to applicant. We need
above.
4. Pre -inspection for NOT verified. (Index)
/5. Other
i/ 6. Plans chebt4d and/or ap ved by Date
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Additional Processirig or Notes:
•
COUNTY OF BUTTE —„ DEPARTMENT OF PUBLIC WORKS
sij
7 County Center Driv@ Ofo'ville; California 95965 7
Telephone: 534-4541 -4/7—/6
APPLICATION AND PERMIT
aut or a represent ves of the County of Butte to enter upon the
abovh
BUILDING
OwnerSQ.
o Al
FT. OCC. BUILDING VALUATION
Mailing Address A,>e91 &owJ C-/
dTelephone No.
�Ly 3Y2-22
Fireplace
Contractor CO
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee&/or Penalty
Telephone No.
Permit Fee
Building AddressPLUMBING
No.1 @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
np� 2 /
w
Repair drainage or vent piping 1.50
R- %%'7119
WaterP�P 9 I in 1.50
Each gas water heater or vent 1.50
A. P. No. " /�"r ®�Z
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
Fees
W.
Fire Dept.
FireZone
Use Permit
Building sewer 5.00
EQA
I Parking
Declaration
Parcel Map
60' R/W
IImprov�ements
Lawn sprinkler system 2.00
Bldg. Plans Recd
Parcel A
Pl sa�pprovol
Permit Fee
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
r 7
Main service 600V OR
100 AMP ORSLESS 5.00
Main service EA. ADO'L 100 AMP 2.50
�-�/
Single Family ❑ Duplex ❑ Mobil Home LI Others ❑
Main service OVER 600V
00 AMP OR LESS 25.00
Main service EA. ADD'L 100 AMP 1,00
NEW CONST.IIELBLDGS.LING CCUP. &) 22syft
( /
OR ADDNS. ACC
NEW CONSTR. MULTI.OUTLET
NON.RESI D, BRANCH CIRCUITS) 2.50ea
NEW CONSTR. (POWER APPARATUS &)
NON-RESID.
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:
Ex. Occup(OUTLETS OR FIXTURES) 50 @�
BAL@101
Ex. Occup. ( FiXED OUTLETS P(RESID.)REA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
LN
I am exempt from the Contractors License Laws of the State of California.
Permit Fee
WORKMEN'S COMPENSATION INSURANCE
I 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.
1 certify that in the performance of the work for which this
permit is issued I shall not em
P employ y an y 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 r sting to building construction, and hereby
'
AM
TOTAL PERMIT FEE
O
e entione pr p rty for inspection purposes.
1/1
X Date
Signature
�of/P/er�miite�e or Agent
Receipt No. _`7 6, .s 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 OOUBLIC WORKS
BY
riding permit expires Date
e
e, FE MEMO
OWNER � � �, ��'T ;2S�� AP N0. - f7r- 1y 6ef
At time of permit application, the applicant was advised the following data or information
must be submitted prior to permit processing and/or issuance:
Y 1. All items have been submitted.
2
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
Plot plans in duplicate/triplicate.
Complete plans in duplicate/triplicate.
Complete engineered plans and calcs.
Fees of $
Letter of signature authorization.
Sanitation approval.
Planning approval
Workmen's Compensation Insurance Certificate.
Contractors license information.
Parcel declaration.
Access declaration.
Aunt Minnie•infoimation.
Deed of access.
Deed of parcel creation.
Parcel map.
Pre -inspection request for
Other
By `b 1 194aS Date
Bldg. Inspector
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When permit is issued, process as follows:
1. Mail to owner.
2. Mail to contractor.
3. Deliver with inspection.
4. Telephone and hold for pickup.
5. Other
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During plan checking process, the following data or information must be submitted prior to
permit issuance:
1. Index permit for items numbered above.
2. Applicant advised by telephone we need
3. Send letter to.applicant. We need
4. Pre -inspection for NOT verified. (Index)
5. Other
Plans c cked and/or app4eved by Date(
caeca=ean=aceeaac=aeeccc�aaa=aeaaaaaaaaaaam�aeaaaaaaaaaaaaaaaaaaaaenmmammammmamam'
Additional Processing or Notes:
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MOBILEHOME SUPPORT DATA
Mobilehome Mfr.. Setup Model Nold_ 3 Year
Width (ft.) Length (ft.)-Ex-Oando.Size=----ft: x ft.
(Draw support details below) .
On all mobilehome��<manufactured after October 7, 1973, furnish manufacturer's installation
manual and structural setup sheets :(if. not .on .file with the County of Butte).
SIn le , Footin&s-(check.one)
1. Wood :either ,
pressure treated or
Center Support fdn:`grade.:'
Footing Sizes
(in.) /,;( 2* -. °Concrete pad.
3. Other,...specify
- - - - - - Supports (check one)
1. Concrete block
2. Concrete.piers
3. Steel piers
4. Other, specify.
El
.� ....................
Typical Support
looting 'Size'
(in.)(in.)
3a ...Max. Pier
Spacing
3-
p3n.)
(in.) (in.) -
t C� Overhang
^If center piers are other than drawn above,
draw in locations, spacing, and dimensions.
aurrE courvrr
BUILDING DEPARTMENT
APPROVED �
1. Owner's name:
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS
7 County Center Drive, Orovi.11e,.CA.
PHONE: 534-4541
MOBILEHOME INSTALLATION SHEET
A- `Revs o
2.
Installer's
name:
3.
Is the site
currently under permit?
Yes / / No
(If yes, furnish permit number ) OR
Is the site an existing site? Yes No
(If yes, furnish two (2) plot plans.)
4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and
clear of all setbacks and easements? Yes No
(If no, clarify )
5. What is the mobilehome electrical rating? -----------------=----- Amps
6. What is the mobilehome site service rating? --------------------- Amps
7. What is the mobilehome site circuit breaker rating? ------------- JzP 7) Amps
8. Is there any other electric load to be served by the mobilehome
site service? --------------------------------------------------- Yes / / No
(If yes, identify the load and size:. (Load) (Amps)
9. What is the mobilehome site gas pipe size? ---------------------- _(in.)
10. What is the type of gas service? ----------------------------- Natural / / LPG /57
'll. What is the gas pipe length -from meter or tank to the mobilehome? C (ft.)
12. What is the mobilehome gas demand? ------------------------------ (BTU)
(This informatiori not required if pipe length less than 6 ft. on natural gas
or less than 50 ft. on LPG.)
NOTE.—All Materials, & Workmans
Accordance • with R?-n-mni,P4 Cin,,4
of a quality prescr;hP+i for +he Sned.
Uniform Buildinq, Plumbing & Machai i
the National Electrical Code.
A' n .
Abe requfrecl for }/�
Septic system and location
s%iawlmveai to be as per
Shall Be in
sctices and
use in the
Codes and
r.;
This set of p
kept on the in',
make any chane
written permissi
Works, County
Butte County HealA - Dept. Re-
quirements.
M'
A
f
gack shall
be 5
etbSQ
it.
the line and
th® side Property the ,read; permittiAQ
of eave orerh�9
e centerlinof a 2
max;mum
d �► j,tv .......w.�
1 a9 a� ie t•o $ W ter V_5 17-1 .q -
■
aase� MUST baa
all times and it is unlawful to
sr alt ratinns on same without
rom the Department of Public
Butte.
L
All uti�ty connect
�•� ns Sha
; located within 4 ft, outside the re
third section of the mobile hor
on the left (road) side ofthe
home.. mob
y
�EttgH:00B
E
SUTTE COUNTY
G ®EPARTMEKt
BUI�DIN
APPROVED
'i PERMIT NO. 5174-74B,P;E,M
P
E
M
MH UTIL.
PERMIT NO.
PERMIT EXPIRES
OWNER Peter Peterson
CONTR. L. Phillips, Chico
s
LOCATION (A.P.
app. 1 mi. N. of Hwy 32 at Sacramento
River, Chico
J
Temp. Power Pole
Called PG&E
Temp. Elec. Serv. /
Called PG&E % °� (04—
Temp. Gas Serv.
Called PG&E
JOB
FINALED v`
(Dat
;t� (Signature)
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS ,
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont'd) PLUMBING
Setback Firewall .a Soil Piping
Forms Parapets 1st Floor
Main Bldg. Restroom Finish 2nd Floor
Footings G Windows lj ^ - 3rd Floor
Stemwall Sidinq To out
Slab — L—O — % S Roof Sheathing Water Piping' 3 a -
Piers Roofing Sewer
Garage Fdn. Vents Fixtures
Footings Garage Vents Water Htr.
Stemwall Prov. for physically Heaters
Slab handicapped Appliances --
Carport Conformance of ex. Gas Piping & Test Z — -5--
Footings structure Temp. Gas T'�^
Slab Final-Sanitation •'—
Patio FIREPLACE Final O
Footings Footing ELECTRICAL
Masonry Walls Throat Roucih
Reinf. Steel �— Final Fixtures
Bond Beam FIRE SPRINKLERS Motors
Framing 1 — Test Water Htr.
Stucco Final Sub anels
Mesh MECHANICAL Grd. Fault Prot.
Scratch Heating q-30 Service
Brown Cooling coe — Temp. Pole
Finish Ducts % — % Underground
Interior Lath Ventilation Permanent
Door Closer Final -- Final
DATE REMARKS OR CORRECTIONS
%`c
�,eo d Alb S sz�v G Lc�
Tb 6&6 dAlb
ll
u t-- h� %�!/�(!T �y1 LGA 7" �
742T- a t- P)4�4
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS/
7, County Center Drive - Orovi Ile, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
aumorize representatives or ine county or tsutte to enter upon the
above-mentioned property for inspection purposes.
X .rr . .4 Date
/Signature of Permitee or Agent
Receipt No. Ili "
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 PUBLIC WORKS
Date
Building prmit expires Date
BUILDING
Owner , j ' -
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Fireplace
Contractor �;,-,f ;���;, ,��
~
Total Valuation
�
Mailing Address f��f ✓� ;,� 2i •; r
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee
Building Address ��� ��*��
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
rrh 1P "L (T-
Each Trap 1.50
/ r
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No. �" �- /!y/^ ("
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
Fees I
W.C.
Sanitation
FireDept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
Declaration
Parcel Ma p
60' R/W
Improvements
p
Lawn sprinkler system 2.00
Bldg. Plans Rec'd
Parcel Approval
Plans Approval
Permit Fee $
$
NEW ❑ ADDITION ❑ UTILITIES OTHER ❑
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
�.�3 r;_A"Oe C?
Main service incl. 1 meter-
3 t-eT r-� ,f ,�-� _ �,�
Additional meters, each 1.00
Sub -panel (12 or less) (more than 12)
-
Single Family 2' Duplex ❑ Mobil Home ❑ Others ❑
Range, Cook -top or Oven 1.00
Water Heater or Space Heater 1.00
Light fixtures bop2
Receps., switches & fix outlets brill@ 10
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. d i sp. or D.W. 1.00
Air conditioner or heat pump
Water pump
Mobil Home Facilities 5.00
- - ' . c (- • y> >f ' - �� �
Temp. Power Pole 5.00
License No. S'�� 1 / C'•/ (� Classification � / U
Misc. wiring
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $ 71r
$ i s
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
$
aumorize representatives or ine county or tsutte to enter upon the
above-mentioned property for inspection purposes.
X .rr . .4 Date
/Signature of Permitee or Agent
Receipt No. Ili "
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 PUBLIC WORKS
Date
Building prmit expires Date
.�
r.
• .r�kY �
-.I� -.-.t r . � vim.,,,/. �..� .. a \ T �- +-ti.. +� ,
t ��
/�'o��,�
tr COUNTY OF BUTTE — ' DEPARTMENT OF PUBLIC WORKS rl X74C-
!.7
4 -
r.7 County Center Drive — Oroville, California 95965,,.
1 Telephone: 534-4541
r
APPLICATION AND PERMIT
` -
BUILDING
Owner ��-�a' ��j�s��/
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
.11
Telephone No.
Fireplace
Contractor ,1,6 Zq X.,/ 0
Total Valuation
Mailing Address 5/E4�1 A yr10"eJ "JAY
Permit Fee
Plan Checki ng Fee &/or Penal ty
. ,�Sj2.
Telephone No.
�—nary•
Permit Fee $
$ �� d
�`'
Building Address �>oV, /rt'�' �%-`f
PLUMBING No. @ FEE
PERMIT FILING FEE $2.00 Z,,pp
/�
d� /4"., 9Z 1� T �fiL/lN r�- itl7<n ~
Each Trap 1.50
�1 vC`/L
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
-117— ��,/ _
A. P. No. c%`""" -
Zoning & Planning
Gaspiping-system 1 - 5 outlets 1.50
Each additional outlet .30
Fes`
W.:-C'
Sanftaf on
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
I Parcel
Declaration
Parcel Ma P
60' R/W
Im rovements.
P
Lawn sprinkler system 2.00
Bldg. Plans RecdAp
Parcel Approval
Plans�provol
Permit Fee $
$ -2-37.
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER 0
ELECTRICAL No; @_ _FEE
PERMIT FILING FEE $3`00 37oW
Main service incl. 1 meter
Additional meters, -each 1.00
Single Family ® Duplex ❑ Mobil Home ❑ Others ❑ M
Sub -panel (12 oifless) (more than 12) /,SO
,RangeCook top or Oven 1.00 Z Ori
.-
Water Heater or Space Heater _ „,1.00 —> f .,
Light fixtures 9 20 Bi25
o
'
ReL5eps., switches & fix oulltts
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: % / / _ /r �
Hood'Ex. Fan or F.A. Furn. Motor Z,. 1.00 Z •AA
Evap. cooler, gar.Afsp. or DtW. Z 1.00 Z-0 O
Air conditioner or heat pump
Water pump
Mobil Home Facilities 5.00
r'ez tr K� lr�r�/ Cr/ i/•
Tem Power Pole 5.00
p.
c"r
License No. ) 2 Classification
Misc. wiring
❑ I am exempt frem the Contractors License Laws of the State of California.
Permit Fee $
$
WORKMEN'S COMPENSATION INSURANCE
1 am aware.of the provisions of Sectio 3700 of the Ca it fo nia Labor
Code which requires every employer to be insured against liability,
for Workmen's Compensation. f- X., T <. �� s� t}'�
I have placedKon file with the County of Butte a certificate of
WorKm�en's Compensation Insurance.�--
work
'at�
❑I certify that,in the performance of the work for which this
ermit is issuedf.I shall not -em to an erson1„i'n',an manner
P, �, P Y� Y P_ Y.
so as to become+subject to the Workmen's Comperisation Laws of
California. -
MECHANICAL No. @ I FEE
17 f�
Z—
PERMIT FILING FEE $3.00 3.p0
`Heating
/• ,�, f ;
/�/ 1J
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 Law�relatipgno building construction, and hereby
TOTAL PERMIT FEE
p /
$
v—Ityl—,UU— W cerci UPUII LlM r
1 ab -e entione property for inspection purposes.
to 1�� ,—��` •,,�(a ./� ,,. ��'\ �� / '/
X �✓ ori///�•\�1.//✓/i� r (G
_ �r Date
Signature of Permitee or Agent
Receipt No. /z/ 9-/
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 PUBLIC WORKS
BY / / Date_
Balding permit expires Date........
.........................
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Oroville, California 95965 UUU
.0 Telephone: 534-4541
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X —*A a— Date IO > >
ignature of PermiteeeErr Agent
�U��"
Receipt No. /J�
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�jhich fees have been paid.
UAIRECTOR OF PUBLIC WORKS
BY Date
el/
Building permit expires Date 0 1�
BUILDING
Owner&�"SQAJ
SQ. FT. OCC. BUILDING VALUATION
Mai I i ng Address
Telephone No.
Fireplace
Contractor
Total Valuation
Mailing Address �i
Permit Fee
Plan Checking Fee &/or Penalty
t Crt�
eephone o
Tl
Permit Fee
Building Address��,e ��
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
fie Air v
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No. —Gas
D
Zoning &Planning
piping system 1 - 5 outlets 1.50
Each additional outlet .30
F eb`
&C-
Sanitation
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
I Parcel
Declaration
Parcel Ma P
60' R/W
Im rovements
P
Lawn sprinkler system 2.00
Bldg. Plans Rec'd
Parcel Approval
Plans Approval
Permit Fee $
$
NEW ❑ ADDITION ❑ UTILITIES OTHER ❑
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00 ,310
#4 W 9
Main service incl. 1 meter�Z} "00
tt
500 PEe/k [ �- J-/ 74 7q
Additional meters, each 1.00
Sub -panel (12 or less) (more than 12)
—
Single Family JX Duplex ❑ Mobil Home ❑ Others ❑
Range, Cook -top or Oven 1.00
Water Heater or Space Heater 1.00
Light fixtures ba
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:
Za S S' e lY "M P X W vT k 14 /S
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
ovp-
Temp. Power Pole 5.00
License No. -Lq :� 3 / L°—//J ClassificationU
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.
RI have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
lecertify 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
$
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X —*A a— Date IO > >
ignature of PermiteeeErr Agent
�U��"
Receipt No. /J�
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�jhich fees have been paid.
UAIRECTOR OF PUBLIC WORKS
BY Date
el/
Building permit expires Date 0 1�
7)
f
t
C �
its ti- ,-s
J
t
COUNTY OF BUTTE —� DISPARTMENT OF PUBLIC W R
7 County Center Drive '— Orovi Ile, California 95965
y r, Telephone: 534-4541
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentione /roperfor inspection r oses.
r'
X ! DateZ
t/- Signature of Permitee or Agent
Receipt No. /ZZPZ
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 OFAUBLiC WORKS
By / ��' / Date L-6 ?J
B llding permit expires Date................�.......�....
BUILDING
Owner a7,--c-e D
SQ. FT. OCC. BUILDING VALVA ION
Mailing Address
Telephone No.
Fireplace
Contractor ,e!LcLO M �/�/�� /p f
Total Valuation
Mai ling Address %�� jLc uJ
Permit Fee
Plan Checking Fee &/orPenalty
�C
Tel hone o.
�S%Z,.�/0
Permit Fee
p'
Building AddressPLUMBING
No.1 @ I FEE
PERMIT FILING FEE J$2.00 Z.. OO
.m,X� 114vy ez "q �� /Zi�/d! t
Each Trap 1.50 Q. 5 Q
Repair drainage or vent piping 1.50
Water piping 1.50 /,.;-0
6,411 Gr
Each gas water heater or vent 1.50
�` �l
A. P. No. d
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
F
Sanka on
FireDept.
FireZone
Use Permit
Building sewer 5.00
EQA
I Parking
Plans
Parcel
Declaration
Parcel Ma p
60' R/W
Im provements
Lawn sprinkler system 2.00
J
Bldg. Plans Rec'd
Parcel Approval
Plans pproval
Permit Fee $
$ S
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
ELECTRICAL` No.1 @ FEE
PERMIT FILING FEE $3.00 300
Main service incl. 1 meter
Additional meters,each 1.00
Single Family Duplex ❑ Mobil Home ❑ Others ❑
Sub -panel (12 ess) (more than 12)
Rango"toolliefop or Oven 1.00 Z,.O fj
Water Heater or Space Heater 1.00
Light fixtures iZ-
M20025
R s. wi es & fix o is , 0
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: t
Q iK
Ho Ex. F r F.A. Furn. Motor 1.00 Z . 0,0
Evap.coo Ier,gar.OKP,-or D4 1.00 Z-0 C)
Air conditioner or heat pump
Water pump
Mobil Home Facilities 5.00
V ��G ,�� ���� y�L"�1![�d
Temp. Power Pole 5.00
c�
License No. 2 (0 % Classification 12?
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 3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
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
TOTAL PERMIT FEE
$
authorize representatives of the County of Butte to enter upon the
above-mentione /roperfor inspection r oses.
r'
X ! DateZ
t/- Signature of Permitee or Agent
Receipt No. /ZZPZ
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 OFAUBLiC WORKS
By / ��' / Date L-6 ?J
B llding permit expires Date................�.......�....