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El t 4A 4 (R w elf, all$ jo IT WO 4 ir if Ploy IF 141 WI'04 9�� :TA j W6 If 1 4 P w '0 �s L 'I lit �D VIM" 4 '7Y tv 0 Xfl' ell r, 'y g if 1, . 0' 11 �1, ; I 4;� 411 IT it Irk, rKg. m rJ41 v J. 1 M f>5 Jw PI Flo IT f tit ell —lair j 0! 41 V , Vm1f e�V jo Ito 4, 4p 100 ji, Wow, BUM; rvW VO4me 17 7 T "It I r tit 4 oil A r RTM lit it, '% I I -e * -L, OM BUILD)NO'D A ffit, 11 1 I% 14 _Q P p 01 It !l,' VV, q J7, pti F it PT5 1, )41D L1. :d jI �4 1 _41 4,* 1 14' yt Y 7 3q It, I It 40 41a r It A x, j" St 'Oki, IT AqP I IT, 'J, T Y, 0� IT A -q? T, fOOMM7 7 IS try I, A 17 11, It �41 T, % j 'A (4� wit T �* 1441 W if VA own po, .,Q 'N 4 - "ui VA IV, 4 Mop" T T� LAW iq .,I y X? l;kI 15 7 5 If Quit a k; Nq It f—, Ad.:A LLII— li! I 11�1 'r'i , .. W177 JK "IT .. ......... 6,11 . , , ., "I'll 7,47 yi 71111-7,79127"FPKi it�k W T PR' Ii lit"i Ii WIPT .1141PIM ire 'PROVIii, Pq I" 7777, ""T V, -in 0 e It fp TG 6 q, 0 I, it 1, 0`� 0 (d '4, lip T JO nlL Tjr 'r 41, T4 0,. Tho.balts coi is or instances are not I ee tol ar U- jq� 'hav"i been. sPI out a 't h a instancep are not installed and in oth ./Ad ke,6 11dri 'ti a this sl',d'a at the connO, t�.6 roof lumbe't iggest the u f lect strur 1, gt6de point, and I assume that this requireci work will be picked up at tr,o tws ti i a Similar Sitution does n,ot :rsocqur,# 9. The frame clips securing -the roof beams to the plate of Ao, nstalled backwards. Removiz the framing clips 4' ny wall plate and 11 0 d n-eeds td be 4P lar ie across beam No�o 6 is m l t of the defl in An theplywood disphviagm on the in a correct fa I rna ion would be to-provi4e strop nstalled. rc)Qf stLcure- too from the beam tion to CAF-T*i at the Closet walls ldrequire diaphragm noiling a 8 d c -A"'hjed above a ri ablj-. tie. ony wall exceeds t T tt—rjc�_o f b e, a strength 7a:--,,kddAt'ona.1 support is required at each beam tv, load carr ility. Double up. a udt) provi -iail securely to the- exis nd i kid. , QjIf is deFyondent upon t ap 11 s th a NTFgm athe, roof structure J sub, h 16d he. e'l'ng iv't u tapa e I I heref'o )F 41 6�IZOOIZ 2. The intarior diaphragm estikbLisherl in the Se !qs 8 means o i small any wall"Is inadequately nailed. is diaph,zagm wall a 6_1 be 10d his�ls at 611 on and, W s a shner diaphriagm te as ins ti n t y be nailed with 10d nail at X4(� JP114P�, hoeve. thc edg lall, ds U4 re son t 1� Ahing ahall be 10d nr4ilp Pt' no ter all dges and 1211 oo Center. This diaphragm wall. a made tip of b1ts and pieces, i rf g o'n �he d p�rbgm shb paci Nh'4`ng n the cente field of tb whithis a permitted m e tho d Howeve in order 'to utilize the tititall 't,�,,,r plleciv6 as you have done, F-dge blocki g is required on all horizontal shest, sh a bt! maiils at 1211 Spticings. 'Thu diaphrq9M itUnts j ges at such blocking's i nailijiig ic ted applios to both end wells of the strticture. d Perticular Xteon. ion must be paid so that th,. 'idephragm create' a greater then 611 on center w i Ls An lternate to the blocking a i �e the uti by the end vi 1'eathing exhibits adtiquate con-tinulty'. 1a aying the existill g 611a n s im. I 1Z OIL* 4�0 rV 441tV *AM T 4 40 L, 10 'Cot SECTION A SECTION B -B 40P A.TMf-i PA_ I ago TPPWUi A Li MAWS 01 PV-tt" IU14o -roe P ITV-moev .1 T'i I V w 1 L4,. oa aem 44jas Wri r 0 8 'ffE CO U UNTY WILDING DEPARTMENT P RO V tu 0 ND NT -F R ERNAT b A r It 0 1 AN CH M� At F -Aft b SHEET No, WMATES .��" A T kit ENGINMAING NSULTANts 0 20813 PAM K, AV IE N U t' F—eTs 2 A:P: x„50-11 Noel Foster (j&a.--/c)O.-C7/$ NW Corner Pine Tre Lane & Bald Ro k Road, Bald Rock; /l% Perm512-74 (new single famil ) {2=50=11 P rmit #3134-76B(lst & nd renewal f r permit #1512-74) 62-50-11 Permit #3579-76B(add open dec/SF) 61 � r Ii 1 I 1 I I s 0 ti 79 ' 7� +-HERMIT NO. '1'512-74B„P,E,,M. P E Y M MH UTIL. '”"PERMIT NO. PERMIT EXPIRES fp 7 OWNER Noel Foster %ONTR. MUD= Owner i_OCATION (A.P. 65-50-11 ) f NW -Corner -Pine Tree Lane &_Bald.Rock Rd., Bald Rock r f� I ' t w r t Temp. Ower Pole��1 Ca ed PG&E /TeElec. Serv. lled PG&E . Gas Serv. lled PG&E ' FINALED (Date) (Signature) COUNTY OF BU',TTIE — DEPARTMENT OF, PUBLIC WORKS BUILDING INSPECTION RECORD t• DATE REMARKS OR CORRECTIONS tri /• Qt2 - 7C //�C( r e 4, H��l�?S 1Z} i�ar✓�u��G�/GL� t Q/O�/S `ioTo✓l Jdw o/ p�prov�b`1 /3�N > C* PT Xtbe 7,-ES7- -7 r-7 l 12, BUILDING BUILDING (Cont'd) PLUMBING Setback 4.7 9711Z Firewall Soil Piping 0 Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings6W,—/ —3 —2 Windows 3rd Floor Stemwall Siding G' To out �- Slab Roof Sheathing Water Piping Piers Roofing -- �;t 6 Sewer -- ,�— Garage Fdn. Vents --- Fixtures ' Footings Garage Vents Water Htr. Stemwall Slab Prov. for physically handicapped Heaters Appliances Carport Footings Conformance of ex. structure Gas Piping & Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final • Foot in s Footing ELECTRICA Masonry Walls Throat Rough 59KE A46 ZOE Reinf. Steele � , Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh oef MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final DATE REMARKS OR CORRECTIONS tri /• Qt2 - 7C //�C( r e 4, H��l�?S 1Z} i�ar✓�u��G�/GL� t Q/O�/S `ioTo✓l Jdw o/ p�prov�b`1 /3�N > C* PT Xtbe 7,-ES7- -7 r-7 l 12, COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WO 7 County Center Drive — Oroville, California 95965 Tel ephdne: 53424541 APPLICATION AND PERMIT auth rize representatives of the County of Butte to enter upon the abov [tJ propert for ins ection purposes. X Date Signal kre of Per itee or Agent Receipt No. S 7 — 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 PJJBLIC WORKS By Dates&—�)— / 1-4 Buil Ing permit expires Date ................. (�.-?....7..x... BUILDING Owner SQ. FT. `OCC. BUILDING VALUATION Mailing Address 7 J Telephone No. Fi Fireplace Contractor f / I 9� Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone Na. Permit Fee $ -e1 a $ Building Address % PLUMBING No.1 @ FEE PERMIT FILING FEE $2.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent - 1.50 .� A. P. No. `5 1 o - U 1 Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F 0. t'ati d I Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parki-n—gT Plans Parcel Declaration Parcel Ma p 60' R/W Improvements p Lawn sprinkler system 2.00 Bldg. d 17"'1s�- Parce rovaI Plans Approval Permit Fee $ $ NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE , PERMIT FILING FEE $3.00 • ()-6 Main service incl. 1 meter 30-6 Additional meters, each 1.00 Sub -panel Y s) ( ore than 12)- 4 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Rang Cook -t p or Oven 1.00 (�• Water He -15'r or Space Heater 1.00 Light fixturesal to R• S. w' s & fix o ets 2 O - 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: Ho Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. lisp. or D.W. 1.00 Air conditioner or heat pump Water pump • r--6' Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring )f t 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 orkmen's Compensation Insurance. Y MI certify that in the performance of the work for which this ermit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood / 2.00 a(} & Permit Fee $ $ etc 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 $� 2 auth rize representatives of the County of Butte to enter upon the abov [tJ propert for ins ection purposes. X Date Signal kre of Per itee or Agent Receipt No. S 7 — 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 PJJBLIC WORKS By Dates&—�)— / 1-4 Buil Ing permit expires Date ................. (�.-?....7..x... COUNTY OF BUTTE — 6EPAR-T'MENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Tel ephane: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the abo ' ned=orspectionurposes. Date Signature o Per ' ee or Agent Receipt No. /W /epo 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/�Id. DIRECTOR OF/P�'JBLIC WORKS By Date'/tf ,;7 b Bilding permit expires Date BUILDING Owner �Q[�Z, �8�' SQ. FT. OCC. BUILDING VALUATION MailingAddress /?_ 0 S)9// AM /E Te3��'/ lephone o / Fireplace Contractor // Li Total Valuation Mailing Address Permit Fee Plan Checking Fej&lgrPevMfy c/ Telephone No. Permit Fee $ - Building Address A145 y�//t/� % �� PLUMBING No. @ FEE PERMIT FILING FEE $3.00 % IA � Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. �— 4VII VII & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Few W.0 Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcelparcel Declaration Ma P 60' R/W ImprovementsLawn 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 �/ s r A-- 600V OR LESS Main service 100 AMP OR LESS 5•00 s OC Main service EA. ADD•L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home ❑ Others Main service �VER 600V 00 AMP OR LESS 25.00 Main service EA. ADD•L 100 AMP 1.00 NEW OR ADDNST ( ACCLBLOGS.LING CCUP. &) 2¢sgft NEW CONSTR. MULTI -OUTLET NON•RESI D• 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)@2't BALD} 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 EfI 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. Dl 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. @ FEEPERMIT 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 $� Q authorize representatives of the County of Butte to enter upon the abo ' ned=orspectionurposes. Date Signature o Per ' ee or Agent Receipt No. /W /epo 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/�Id. DIRECTOR OF/P�'JBLIC WORKS By Date'/tf ,;7 b Bilding permit expires Date SOCIATES Noel Foster P.O. Bo -x" 186 Sart Martin, California Dear Mr. Fotter: ENGINEERING 2060 PARK AVENUE OROVILLE, CALIFORNIA ' 95965 PHONE (916) 599.6457 September 28, 1976 Re.: Berry Creek Cabin Construction Mr. Jim Glan-der, Deputy Direction of Public Works, in charge of the" building division, County of Butte, and myself made an on site inspection.of the construction work being performed for your Berry Creek cabin September 22, 1976. The inspection was to accomplish two basic objectives. 1.- Determine what methods should be used to conclude the construction of the home and obtain the necessary approvals, permits and authorizations. 2. To establish a bench mark reference upon which corrective efforts to the basic structure could be made in order to physically comply -.with the selected method under No. 1 above. I. We determined that the best way would be to have Cook Associates complete the composite drawings that were started at the request of Ted Ryan earlier in the summer with the discrepancies that have. been noted by the structural investigation incorporated into those drawings. The resulting composite drawings would then be the record drawings in the Department of Public Works for the determination of compliance with the approved and adequate standards. Enclosed for your consideration is the work authorization for the composite drawing for use in completing the structure. Specific deficiencies that were observed by myself during the September 22nd inspection include the following: 1. The end walls of the structure' act as a sheer diaphragm however, the edge nailing is inadequate as presently installed. The DR. LLOYD M. COOK En, D. JOE E. COOK M. E. DAN ,1. COOK C. E. t i ` 1!, .4 C�, DEPT. OF rjrl- F� SEP 2 9 AM Noel Foster San Martin, California September 28, 1976 Page 2 edge nailing on the diaphragm sheathing shall be•l0d nails at no greater than 6" spacing. Nailing in the center field of the plywood -sheet shall be 10d nails at 12" spacings. The diaphragm nailing as indicated applies to both end walls of the structure. Particular attention must be paid so that the diaphragm created by the end wall sheathing exhibits adequate continuity. 2. The interior diaphragm established in the second floor as a means of stabilizing the small pony wall is inadequately nailed. The nailing of this diaphragm wall shall be 10d nails at 6" on center all edges and the interiors may be nailed with 10d nails at 12" on center. This diaphragm wall is made up of bits and pieces, which is a permitted method. However, in order to utilize the small pieces as you have done, edge blocking is required on all horizontal joints. The diaphragm edges at such blocking shall be nailed at not greater than 6" on center with 10d nails. An alternate to the blocking and edge nailing as described would be the utilization of standard 4x8 sheets overlaying the existing small pieces cut into this diaphragm. 3. The effectiveness of the diaphragm is dependent upon the plate being secured to the -floor deck. The floor deck' acts as the resisting member to stabilize the pony wall and the roof structure - above. Nail the diaphragm plate to the plywood sub floor with 16d nails and provide 2 nails per stud space.' The nailing is therefore approximately 8" on center. 4.' The temporary ridge beam support located in the closet area. of the upper deck is unstable and needs to,be revised: i 5. The collar tie across beam No. 6 is missing and needs to be installed. An alternate to the installation would be to provide strap ties from the beam in question .to the plywood diaphragm on the face of the closet walls. Such an alternate would require diaphragm nailing as described above and a suitable tie. 6. The roof beam reaction on the pony wall exceeds the strength of the single stud. Additional support is required at each beam bearing to provide adequate load' -carrying capability. Double up studs under each of the beams, and nail securely to the existing stud. .(Cut. to tight. fit), 7. The first three collar ties have been split out on the right side at the connection to the roof beam.- Replace these collar ties and I'would suggest the use of a select, structural grade lumber so that a`similar situation does not'reoccur. COUNTY OF BUTTE DEPT. OF PUBLIC WORKS Er, S E P 2 91976 AM PM 718AIN1111211121314A6 I J Noel Foster San Martin, California September 28, 1976 Page 3 B. The bolts connecting the collar ties to the roof beams in many instances are not installed and in other instances are not tight. I recognize that the structure is not completed at this point and I assume that this required work will be picked up at this structure is completed. 9. The frame clips securing the roof beams to the plate of the pony.wall are installed backwards. Remove the framing clips very carefully so as not to destroy the pony wall plate and install in a correct fashion to resist the outward thrust of the deflecting roof structure. 10. Revise the deck construction to comply with the Code Loading Requirements. ,The composite drawings will detail the above work. Should you have any questions concerning the listed items, please do not hesitate to call. It is very important that the.structure be concluded in strict conformance with the composite drawings. Departures from the •drawings will only serve to extend the problems that have already been experienced. V t 1 DJC:nj cc:*Jim Glander Enclosure ery ru y yours, COOK ASSOCIATES Dan Jok COUNTY OF BUTTE DEPT. OF PUBLIC WORKS p 1p (N IS n y 1`�_ D10 SEP AM2 9 1976 . 718191101lli12ili2i3i4l5pM 6 A i .y'PEAMIT NO. 3573-76B 35-7 PERMIT EXPIRE OWNER NOEL FOSTER CONTR. owner LOCATION (A.P. 65-50-011 Pine Tree Lane & Bald Rock(Nw cor) F. UZI emp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Sery. Called PG&E JOB FINALED— (Date) 1A (Signa f(t re) r Setback Forms Main'Bldg. Footings Stemwal I Slab Piers Garage Footings Stemwa I I Slab Carport Footings Slab Patio Footings Masonry Walls Reinf. Steel Stucco Mesh Scratch Brown Finish Interior Latl Door Closer DATE COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Firewall Parapets Restroom Finish Windows Siding Roof Sheathing Roofing Fdn. Vents Garage Vents Insulation Prov. for phsically handicaocedy Conformance of ex. Footi FIREPLACE FIRE Final MECHANICAL Heating Cooling Ducts Ventilation Final REMARKS OR CORRECTIONS Soil Piping 1st Floor 2nd Floor 3rd Floor Topout Water Piping Sewer Fixtures Water Htr. Heaters Appliances Gas Piping & Test Temp. Gas Sanitation Final EL Fixtures Motors Water Htr. Subpanels Grd. Fault Prot. Service Temp. Pole Underground Permanent Final (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE — DEPAR'%MENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Telephone: 534;4541 / jjjCUUJ APPLICATION AND PERMIT autnurlce represeniativ 6 my or 0uite to enter upon the above- ned property inspec on purposes. X Date Signature /of Permiteelor ent Receipt No.��"���i White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF P IC WORKS By Date / — 7 C, ?% Building permit expires Date ��' BUILDING Owner^ -+ -- SO. FT. OCC. BUILDING VALUATION Mai l i ng Address 66 'it, t NJ` r} IZ ',Q C[A t `_ Telephone No. Fireplace Contractor OCATotal Valuation Mailing Address Permit Fee Plan Checking Fee &/orPenalty Telephone No. Permit Fee $ Building Address 1 F — wzi PLUMBING No. @ FEE PERMIT e FILING FEE $3.00 Each Trap 1.50 t. 1L) ek Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. Zoning 8 Planning Gas piping system 1 - 5 outlets 1.50 $ Each additional outlet Fees tion ept. Fire Zone Use Permit .30 Building sewer 5.00 EOA arking Plans Parcel D parcel Map P 60R/W ' Improvements Lawn sprinkler system 2.00 ~Permit Bldg. Plans Recd Parcel Approval Plans Approval Fee $ NEW ❑ ADDITION ® UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE _ d tD��%�� PERMIT FILING FEE $3.00 Main service 1000V OR 0 AMP ORLESS5.00 AddMain Y7'�O U% service EA. ADD'L 100 AMP 2.50 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Main service OVER 600V 100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW LING OR ADDNST ( ACCLBLDGOCCUP. &) 22sgft NEW CONSTR. MULTI.OUTLET NON•RESIO. 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) BAL@�1 Ex. OCCU FIXED APP LNS. OR P• OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 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. certify that in the performance of the work for which this ermit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. 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 MECHANICAL - No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ TOTAL PERMIT FEE $ u C autnurlce represeniativ 6 my or 0uite to enter upon the above- ned property inspec on purposes. X Date Signature /of Permiteelor ent Receipt No.��"���i White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF P IC WORKS By Date / — 7 C, ?% Building permit expires Date ��'