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HomeMy WebLinkAbout063-140-003A.P: 3-1* -3 MR. & MRS. TOM NEWTON w/s Forest Ranch Way app. 500' so. Robt E..Lee_Dr.p.Forest Ranch Permit 1614-73B,P (new single family07y A.P. -��- 103-/ TOM NEWTON W/S.For_est Ranch Way, 500' S. of Robert E. Lee Dr.o.�+,��� 2Y-� "Permit 1970-74B (RE W 1614-73) 63714-3 15339 Forest Ranch Way, Forest RAnch:. Permit#3432-88B(fireplace insert)SF f oil �: �. ��;� ���. ' d1� �. - �i.�i, I - ss� Il ���'ad r . . (T - T" 7rw4r•p-r. , COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville. California 95965 - Telephone: 916/538-7541 'APPLICATION AND PERMIT PERMIT NO ASSESSOR PARCEL NUMBER Co 3 - / — 3_ Z NTNG BUILDING PERMIT OWNER r,,,� K)ew o e1A TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS .O ' -� a - F -C) re St G.nc� Inv. CONTRACTOR'S NAME r TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace 0 UO CONSTRUCTION` LENDER UNKNOWN Total Valuation Is OOC . LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $ Z7, t; ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee ,$ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 l 3 3 Q re S� G✓1C C Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 / USE OF STRUC/ URE I SFX Duplex❑ Mobilehome❑ C., e , fl' e t NC'C r� I SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 / Mobile Home S G W 0.00 ea / TYPE OF WORK New D� Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: re -Q G�� f n' Se r► I / Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 4 l 11 Main service e00V 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 and Professions Code and my license is in full force and effect. License No. Classification 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure Is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason LIN CCUP.y\ oa ADDNST DWELGS+/z¢sgft /� NEW CONSTR U TI.OUTLET 2.50 ea NO N.RESID BRANCH CIRC ITS POWER APPARATUS e r (SINGLE OUTLET CIR. z0@50t ) Ex. Occup OUTLETS OR FIXTURES eAL030 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) 2.00 / Temporary service 10.00 / Mobile Home Facilities 15.00 / Misc. �Yirin 15.00 / g Permit Fee $ Contractor 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 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 Filing Fee 10.00 Heating Cooling / Hood 3.00 / Ventilation 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 County of Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. � %G-�%�_ �/ X � /r_J /)+'-� Date Signature of Applicant — Ownerg Contractor El El 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 $ -7, SU OCCUP. CONST.TYPEJ SCHOOL FLOOD PARCEL PD ND 39UE This permit is hereby issued under sions of the Butte County Code and/or indicated above for which DIRECTOR.OF PUBLIC B �, ����� y PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date /v17 Receipt No. , r WHITE-O.P.W., YELLOW-Ase[ssoR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS --PERMIT NO.�� 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 63- _ 3 ZO ING BUILDING PERMIT OWNER h rV'ewto TELEPHONE SO. FT. , OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS P-0- 1 O re,%+ I� cx-%C� CONTRACTOR'S NAME / W 1 TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace 1° 1000 CONSTRUCTION LENDER UNKNOWN Total Valuation $ 0O Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $1-7,90 ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee ,$ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS �— Penalty $ BUILDING ADDRESS Permit fee $ 1 O PLUMBING PERMIT Filing Fee 10.00 -(- /5-331 ,moo res 1 G✓tG Each Trap 2.00 p reS� 4n Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Ji Each qas water heater or vent 5.00 USE OF STRUC URE 1 SF�Q Duplex[] Mobilehome❑ Other f -���-e INSEE SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00 ea TYPE OF WORK New [� Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: re -1P � &C e- I Ix Ser+' Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 L! �� rNA L,4 YT C_' ), W B00V OR LESS Main service 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 e CONTRACTORS LICENSE LAW I declare 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. License No. Classification 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. // DWELLING OCCUP.eI ,�z2SQft OR ADDNS. 1 ACC. BLDGS. NEW CONSTR U TI.OUTLET NON.RESID BRANCH CIRCUITS) 2.50 ea POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20050C DAL@ 90 FIXED APPLNS. OR EX. DCCUp. OUTLETS (RESID.) EAJ 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. ❑ 1 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. 19I 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 Filing Fee 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, j dgments, costs, and expenses which may in any way accrue against said C my in conse enc of the tin of this permit. J®. X Date - _ Signature of Applicant — 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 $ -0 Occup. CONST.TYPEJ SCHOOL FLOOD PARCEL PD ND I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated a ve for which IRZ TO�)F PUBLIC By lUi} PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. WHITC-D.P.W., YELLOW-ASSE330M. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - Department of Public Works 7 County Center Drivl,'Oroville, CA 95965 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 and return 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 m abor and materials for construction of the proposed property improvement (yes r no) 2. I (have/have not) signed an app ication 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 Social Security Number - 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. PERMIT NUMBER - B 1614-73B,p P E41 PERMIT EXPIRESCW© / , OWNER Mr. 8c' Mrs. Tom Newton CONTR nt.mPr '�• LOCATION (A. P. 57-47-3 ) w/s Forest Ranch Way app. 500' so. Robert E. Lee Dr.) Forest Ranch i. t s T C R y� bT � / COUNTY OF BUTTE i Department of Public Works BUILDING. INSPECTION -RECORD �. ��y ,• .% Zoning Setback fZ— f Z- /3 Forms Foundation --20 —7 Piers & Girders % �) 3 Fireplace q--30-7-7-3. Rgh. Plumbing tt L J7 ` 7 'j Bond Beam/Lath &Plaster � _ f Rein. Steel Gas Piping & Test Found. Vents 14-- Framing —Framing / — 7 _ -7 Plmg. Topout _/ 7- — L 7 '7 3 Rough Elec. -773 Wtr. Htr. i � Furnace 24 Kitchen Vent of —:7 Firewall Garage Vents Sanitation & Water ELECTRIC ®® GAS BUILDING Temporary./ %-- 7--C7'�'� Temporary Cert. of Occup. L/— Final '— Final Final DATE REMARKS OR CORRECTIONS f d �9lae� c�c�.� /Lam- a ��c% �o�.e s��t 7- 18-7 Li8-7 u -x- C /biz //5 L w cr07 0'4,10 00 ie 40 c�5 e vc y /u 1. Z ' y 3 -nova c�Cw �.r �o.z� t 8 •�,� Fe o,rs 17 �Y� COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WO 7 County Center Drive — Oroville, California 95965 ^� Telephone: 534541 APPLICATION AND PERMIT BUILDING Owner f SQ. FT. OCC. BU DING VALUATION D 16 Mai I ing Address 00" C � X � d 3 FO Sr NL 0 Q c Telephone No. 3-3/3 6 0,Z)". oo Fir lace oo Q Contractor Total Valuation , 1579, Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ $ Building Address �CPERMIT PLUMBING No. @ FEE FILING FEE $2.00 Nj¢ •� S" !� / S` g,Q Each Trap 1.50 EG- / o2ess"7' V.,V Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F W SanAff ron 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. Plat'�c'd �_ Parcel pro�val Ap Plans Approval Permit Fee $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No.1 @ I FEE PERMIT FILING FEE $3.00 Main service incl. 1 meter k GK -M/%' No, 16 3 Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Single Family, Duplex ❑ Mobil Home ❑ Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures 20 bai_ 10 Receps., switches & fix outlets 2 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. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring 'twI 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. ❑'`.� have placed on file with the County of Butte a certificate of rkmen's Compensation Insurance. I c Qify 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 becorpe subject to the Workmen's Compensation Laws of California. MECHANICAL No.1 @ I FEEPERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ I certify that I have ead this application and state that the above information is correct. I"ag\ee to comply to all County Ordinances and State Laws relating to�bui lding construction, and hereby TOTAL PERMIT FEE aurriunce represeniatives of tne--Gounty of Butte to enter upon the This permit is hereby issued under the applicable provisions of above -menti ed property for inspdetion purposes. the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. X V. DaeA911 30 % DIRECTOR OF UBLIC WORKS Signature of Permitee r Agent �2�.� BY !" ate S t Receipt No. z 3 - -�O White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant MUH nL_Q mit expires Date............ ........ --�' COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS X - 7 County Center Drive — Oroy.ille,. California 95965 Telephone: 534-4541 APPLICATION AND PERMIT "Li o rce represcntauvCs UI LIM UUUitty UI Buiie to enter upon the above-mentioned property for inspection purposes. X c'`�'� �✓ _� —E Date Signature of Permi tee r Agent Receipt No. Q 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. DIRE TOR OF PUBLIC WOR/KS By Date Building permit pires Date BUILDING Owner k� SQ. FT. OCC. BUILDING VALUATION Ma" ' g Add ss Tel one No. Fireplace Contractor �� Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee Building Addr ss� PLUMBING No. @ FEE PERMIT FILING FEE $2.00 --'�-�C� 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. — � Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fees W.C. Sanitation IFireDept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans ParcelParcel Declaration Ma P 60' R/W Improvements P Lawn sprinkler system 2.00 Bldg. Plans Recd Parcel Approval Plans Approval Permit Fee $ NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE 3.00 ,D d 1�� Lap, Main service incl. 1 meter R.� — Additional meters, each 1.00 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Sub -panel (12 or less) (more than 12) Ra ge, C ok-top or Oven f 1.00 /,® Water eater or Space Heater 1.00 '00 Light fixtures al610 ,a® R s es & fi ets 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. Motpr 1.00 Evap. cooler, gar.LJilsp. or W. Q 1.00 �,Q 0 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power.Pole 5.00 License No. Classification Misc. wiring 02 ,dam I am exempt from the Contractors License Laws of the State of California. Permit Fee $ ,ate $ 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. ❑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 0� Cooling 7" Ventilation Hood 2.00 Permit Fee $ 520 $ 7e 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 �/ s �/ / C "Li o rce represcntauvCs UI LIM UUUitty UI Buiie to enter upon the above-mentioned property for inspection purposes. X c'`�'� �✓ _� —E Date Signature of Permi tee r Agent Receipt No. Q 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. DIRE TOR OF PUBLIC WOR/KS By Date Building permit pires Date COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville,California 95965 Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above -menti ed property for inspection purposes. �1 X Ir✓ / Date7 3 Signature of Permite or Agent Receipt No./ Q �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 which fees have been paid. DIRECTOR OF PUBLIC WORKS BY Date Building permi+ expires bade S..3o.�.7 BUILDING Owner S / O -N ` SQ. FT. OCC. BUILDING VALUATION v Mai I i ng Address S C l an rG r If 14�� Tele hon`No. Fireplace o Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty � Telephone No. Permit Fee $ $ Building Address Sri PLUMBING No. @ FEE PERMIT FILING FEE $2.004 /If-( '� � (j /� Each Trap 1.50 Qe-) �� G�G'n y� _ GG Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. % " -- . Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fees W.C. Sancta ire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans DeParcel claration Parcel Ma P 60' R/W Im rovements P Lawn sprinkler system 2.00 Bldg. Plans Recd Parc Approval Plans kpproval Permit Fee $ �r NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Single Family34 Duplex ❑ Mobil Home ❑ Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures p20 al 25 Receps., switches & fix outlets b o 10 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. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring �.r 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. _XI 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 $ S Z authorize representatives of the County of Butte to enter upon the above -menti ed property for inspection purposes. �1 X Ir✓ / Date7 3 Signature of Permite or Agent Receipt No./ Q �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 which fees have been paid. DIRECTOR OF PUBLIC WORKS BY Date Building permi+ expires bade S..3o.�.7 CERTIFICATE OFINSURANCE C2 UNIGARD MUTUAL INSURANCE COMPANY ❑ UNIGARD SECURITY INSURANCE COMPANY Unigand tn', El UNIGARD INSURANCE COMPANY `'' �4 ❑ UNIGARD JAMESTOWN MUTUAL INSURANCE COMPANY Date-------------- 5ZJ—-----19 13- THIS IS TO CERTIFY that the Insured named in the following schedule is at this dote insured with the company(ies) shown above under the policy(ies) described in the following schedule affording coverage for the liability as imposed by law upon the Insured for damages, as defined in the policyliesl, and subject to the terms and conditions of said policy(ies.) This Certificate of Insurance neither affirmatively or negatively amends, extends or alters the coverage afforded by the Policy(ies) listed and issued by the companyhesl indicated above. SCHEDULE Named F 7 y Certificate j-County of Butte Insured Thomas V. and Susan E. Newton Holder Department of Public Works and 5 Ralland Circle, Apt. C 7 County Center Drive` Name and Address Chico, Ca. 95926 Oroville, Ca. 95965 Address L _J L Kind of Insurance Policy Number Policy Period LIMITS OF LIABILITY Bodily Injury Property Damage Single Limit Comprehensive Eff. y, Liability Including Automobile Exp. Comprehensive Eff. Liability Excluding Exp. Automobile Comprehensive Auto- Eff. mobile Liability Exp. Manufacturers' and Eff. Contractors' Liability Exp. Owners', Landlords' Eff. and Tenants' Liability Exp. Contractual Eff. Liability Exp. Automobile Liability ❑ Owned Automobiles Eff. ❑ Hired Automobiles Exp. ❑ Non-Owned Automobiles Other: Eff. Exp. Workmen's Eff. 05/15/73 Coverage Coverage Compensation WC 13-9531 Exp. 0 5 15 7 4 Statutory bilit $ 100 000 each accident DESCRIPTION OF OPERATIONS Construction of Residence Lot 22 Forest Ranch Subdivision #1 Forest Ranch, Ca. ....�.. _ UNIGARD MUTUAL INSURANCE COMPANY UNIGARD INSURANCE COMPANY UNIGARD JAMESTOWN MUTUAL INSURANCE COMPANY.., 7 S., UNIGARD SECURITY INSURANCE COMPANY���?'%}(�Q���� x SECRETARY PRESIDENT SECRETARY PRESIDENT COUNTERSIGNED AT DATE (MO. DAY YR.) A�ET Chico Ca. 105/15/73 I Gorman & indo Tnsurance 2144 EDITION 2.68 (872 PRINTED IN U.S.A.) ©s May 22,-1973 Tom Newton RE: Building Permit Application 5-C Ralland Circle No. -16.14-73 -Chico, California 95926 , Dear Sir: With reference to the above subject and your application to construct a new home in the Forest Ranch area, I am returning one set.of.plans, to you showing necessary changes -marked in red. -- — - - _ Please resubmit two (2) new sets of plans in accordance with these changes. Should you have.any questions, please contact us. Yours very truly, Clay Castleberry Director of Public Works J.F. Glander JFG:dd Assistant Director Enclosure ! �' 1 — l.oS r: .�iln' -Jft It) ..r- i)i'-u " . .. i r 67.E f(jt f.; .fLq brtcT -t7,1. i .:!^. .y,T. �T'.'7n -Y f'7 r "v, 91 E. 1)c', 14FILE NO.:ar,^i Bi;TTE COUNTY I IF,, Actien - t, 2. 31 Poetic Wo4.s Deo, h `R�E) Vtil� 'Joy 'C.: i (F,r Inform.V1 Director ---- - -----=•V— Dep. Dir. Sec. Rd Mcint. -- Shop Bldgs. G Ping. I ._ 7`)11T Planning Permits Mapping ' _Seb. C::! _. Co. Bldgs. Des_ & Can. Constr. Rd. Dcs. Br. Des. C Watt.. Res.