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HomeMy WebLinkAbout063-170-013.Kr ��-.17-13 CHARLES PRYOR-_- STI e/s Fitzgerald, just Off Hwy 32, Forest Ranch contr: Tilton & Tilton- Chto Permit# 1324-75B(new SF) AP 63-17-13 CONTlt: Al Dietz, Durham Lor BLOCK suBD"'• Permit# 1777-75P(for 1324-75) TYPE OF ;sta / 1/1/71%il AP 63-17-13 PERMIT PERMIT NO. PLAN NO. DATE IS CONTR: Denn Elec, Chico D REMARKS Permit# 1503-75E(for 1324-75) Ka I ii ll7/%3�AF bJ C NTR: Tilton & Tilton, Chico Permit# 194.3-75M(for 1324-75) 63-17-13 CONTR: Tilton & Tilton, Chico Permit #5514-= 75B ( fireplace -type A Z /SF) / Al PERMIT DESIGNATION: B -BUILDING E -ELECTRICAL U -USE PERMIT HM -HOUSE MOVING DEPARTMENT OF P -PLUMBING TV -RADIO -TV ANTENNA V -VARIANCE EP -ENCROACHMENT BUILDING AND SAFETY T -TRAILER S/W-SIDEWALK NOTICE S -SIGN PERMIT D - DEMOLITION 600.1 7 PERMIT DESIGNATION: B -BUILDING E -ELECTRICAL U -USE PERMIT HM -HOUSE MOVING DEPARTMENT OF P -PLUMBING TV -RADIO -TV ANTENNA V -VARIANCE EP -ENCROACHMENT BUILDING AND SAFETY T -TRAILER S/W-SIDEWALK NOTICE S -SIGN PERMIT D - DEMOLITION 600.1 7 31VO 'Ols 31VO OIS 31V0 'OIs 31VO 'O18 3.LV(3 oiS NOIIVNOIS30 =M3BWf1N lIWM3d 87YA021driV snnrjNlVr7r7v.,).rlrw lVNid SM313 W S30NVIlddV 8 93uniXld NI-Hof10b 31VO 'OIs 31VO 013 31V0 '019 31VO '913 a 31VO OIS SU39Wf1N lIWM3d S7dAOWddV rIV,9IV L,9,q7y lVNld S1N3A V S30NVllctdV 3NIl 1:13M3S ONidld U31VM 1331 3LIf1SS32ld SVJ NI-Honmi 31VO '013 31VO 'ols 31VO oi6 31VO O1S 31VO 'OIS sil3awnN IIW83d &AtIWF,F,AMV.YRE,fIIII 87VAOUddV OAIIQ7I119 4(1033?! NOI133dSN1 y 'I 31VO O13 31VO 'OIs 31VO 'O13 31V0 'OIS 3.I�VO 'OIS 31VO 'Ols 31V0 'JIS 31VO 'OIS 31V4 'QJIS 31VO 'OIS 31V0 'OIS 31VO 9D nrm M> aZ n� �� I A0 5i Nim 000 5m =00 I -z 5�m =00 3 z yZ mO rr0 � CSO O�> 1(300 2 Z�. 3m 87VAOUddV OAIIQ7I119 4(1033?! NOI133dSN1 y 'I PERMIT NO. 5514-75B��i`=7S P E M • f MH UTIL. jPERMIT NO. PERMIT EXPIRES OWNER Charles Pryor CONTR. Tilton & Tilton, Chico LOCATION (A.P, 63-17-13 ) ,E/S Fitzgerald, just off Hwy 32,Forest Ranch I i ' 1 Temp. Power Pole Called PG&E Temp. Elea Serv. Call PG&E Tem Gas Serv. Called PG&E /JO / FINALED ^� (Date) 11.1 (Si9 ) r COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD (BUILDING BUIL ING (Cont'd) UMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish Q 2nd Floor Footings . Windows 3rd Floor Stemwall Sidinq To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. Stemwall Prov. for physical y Heaters Slab handicapped Appliances Carport Conformance of a Gas Piping & Test Footings structure Temp. Gas Slab Final ^" Sanitation Patio FIREPLACE Final Footings Footing ELECT CAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test C Water Htr. Stucco - Final Subpanels Mesh MECHANI L 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 f �� COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS j4�_�� 7 County Center Drive fr *_'OroviIre, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT Signature of Permitee or Agent r `�� � BY �-'�-� Date Receipt No.� 7 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant B �ing permit expires Date BUILDING OwnerE Q� SQ. FT. OCC. B DING VALUATION 0 O Mailing Address Telephone No. Fireplace Contractor z]ZTQ L ® Total Valuation �Q Mailing Address '— ^—' STC Permit Fee Plan Checking Fee &/or Penalty Tele hone N � Z Permit Fee O Building Address 4 VS PLUMBING No. @ FEE PERMIT FILING FEE $3.00 3 Each Trap 1.50 Ile ES Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 2 A. P. No. 7-1 Zoning 8 Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F s W S Fire Dept. 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 B,ldcr a—ne�c' Parcel Approval Plons Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER 0, ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 C — /� L (>C Main service incl. 1 meter 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 b 2 10 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 L /L%0N C / n A,< I,, 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 Non? `� .� 1 �� Classification B - / Misc. wiring ❑ 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 Workme s Compensation. 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 $ $ 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. X ry Date -� 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. DIRECTOR OFMI BLIC WORKS Signature of Permitee or Agent r `�� � BY �-'�-� Date Receipt No.� 7 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant B �ing permit expires Date ' PERMIT NO. 1324-15B Zl= /t'J P M 111 E M MH UTIL. PFRMIT NA_ PERMIT EXPIRES OWNER Charles Pryor ;CONTR. Tilton & Tilton, C-hico ,'LOCATION (A.P. _63-17-13 ) e/s Fitzgerald, just off Hwy 32, Forest Ranch o . s Temp. Power Pole at s Called PG&"E Temp. Elea Serv. ,119 Call d PG&E Temp. Gas Serv. Ca11ed PG&E JOB FINALED �Yl. (Date) (Signature COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil-g'ipAk375--q,--7 . Forms 7 Parapets ---� 1st F oor — —% Ma• I SGp- Restroom Finish 2nd Floor Footings % Windows 3rd Floor Stemwa1l ^ — Siding To out Sla Roof Sheathing Water Pipi Piers — -7 Roofing Sewer Garage Fdn. Vents Fixtures Footings Gara e Vents Water Htr. Stemwall Prov. for physically Heaters Slab -% handicapped Appliances Carport Conformance of ex. Gas Piping & Test Footings structure Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Foot i Footin ELECTRICAL. Masonry alls Throat Rough Reinf. Steel Final — Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test i—' Water Htr. Stucco Final Subpanels Mesh ME ICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permane Door Closer I Final Final DATE REMARKS OR CORRECTIONS ®z� �n ?5 _ r J Zri.�MrIFY,IVAT' MMU710 PU BEEM I1tST.1L= EJ fC11 CPSAXCE U -Mi ilii, C17XAthlyENERGY RiCLU1l4.95, CLiF41N}Tk Ai�![gl3tR.1Y'"E El1Rv iY11;E 75, STAWE OF CALIF k.'IA, E:i M EMMA LOCATED ATt . pie %? b F�2E t: ,GZwtic%/ �� f% • - aue-. Narnfee4ur+ Thtekw�a�lfjys .3 :. R Valuoo,1�� •ZFtLIF.GS �. � - _ £stts- H# ufSCq-v"r / lbicka"s it value E7orir Ha�ufaetsrtt TMelmess• .. No. Lagi, Yt./Ba§' . sq. Ft. Cw^ered� 0 R'Yalus_ i9 Y.znufac �- /Ll 7htetrn--2:JTj" 3'L It vatu• ��. SLAB OY CUCE _ Keaufacturer Thicke"S/TY" R Ys7ue Width of 183ulaticm Inches s Y.avwfaetursr • llitehW►ss/T�rpe R Ya7vs GEkiRA�� F l i /L7y Tc)A/ <:a�-Xflaxsr my -s ►'. 1,29 6 r3 t 6T I&= ATITLE L-/9RT/VEJ? YJ.1TE C)C % lh'S' :om mmTA tfCR 5#9N LICENSE Itl7SEF; • S /94-6 By t E '� CITE '� TO: Building Department FROM: Environmental Health RE: Sewage and/or water Clearance Ov NER 99TION, A .Ph! Has been approved for: S;z";dAGE DISPOSAL ATER SUP?LY S95-775 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — O,roviIle, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT / 93-75 �a7o 7 oy - Date Receipt No. �C4�r ��� y White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant BW -permit expires 8 e` 1��-- BUILDING Owner011A1;24J5S7 SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Fireplace ContractorL f- `'� �d/(f Total Valuation Mailing Address / J_1/ Permit Fee Plan Checking Fee &/or Penalty Telephone No Permit Fee Building Address �� �L uS PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 7 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 Fe W(r� FireDept. Fire Zone Use Permit Building sewer 5.00 EQA Parking PlansDeclaration Parcel Parcel Map 60' R/W Improvements Lawn sprinkler system 2.00 Parcel Approval Plans Approval Permit Fee $ $ OTHER ❑ NEW ❑ ADDITION ❑ UTILITIES CK OTHER No. @ FEE PERMIT FILING FEE $3.00 d 13>V-76— Main service incl. 1 meter 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 b Ind 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:,,{Ti ,y v)� UJ 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 Non29(9/S Classification Misc. wiring ❑ 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. (�] 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 ,pp Heating Cooling 37— Ventilation Hood 2.00 ! O Permit Fee $ o� 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. X Date �S�G' 7.� Signature of Permitee or Agent TOTAL PERMIT FEE $ f 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. IRECTO OF PUBLIC WORKS l �a7o 7 oy - Date Receipt No. �C4�r ��� y White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant BW -permit expires 8 e` 1��-- COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS lre:�3- 2�J- TelelShone: 7 County Center Drive - Qroville, California 95965 534-4541 APPLICATION AND PERMIT v authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X rvnf' Date Signature of P,�eer1rmitee�}or7Agent �V Receipt No. / t3 d" White-D.P.W. — Yellow -Assess r — 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 hich fees have been paid. IRECTJJ O OF PUBLIC WORKS BY Date Sum Fdh"nirmltexpires D- 1 1 a 7 S BUILDING Owner _VwSQ. FT. OCC. BUILDING VALUATION Mailing Address ' Telephone No. Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephoune No. ` J Permit Fee Building Address L rz- PLUMBING No. @ FEE PERMIT FILING FEE $3.00 aiv 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. 68-17-13 Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F 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 Recd I Parcel Approval I Plans Approval Permit Fee $ NEW ❑ ADDITION ❑ UTILITIES OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 l�, -(i�f Lv [ /% r Main service incl. 1 meter 2Wd# ep d Additional meters, each 1.00 Sub -panel (12 or less) (moerC6_4z I.,QV Single Family Duplex ❑ Mobil Home ❑ Others ❑ Range, Cook op or open 1.00 1 4.0c) Water He er or Space Heater 1.00 00 Light fixtures b� 2 s., sw' & fix s gyp 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: CAJ JJ 4-TFIC1 C_ Ho d, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump37— // J`7j Water pump / Mobil Home Facilities 5.00 Temp. Power Pole 5.00 [- r f License No.� J �5 3 Classification Misc. wiring ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ 93,70$ MECHANICAL No. @ 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. JI 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. 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 rvnf' Date Signature of P,�eer1rmitee�}or7Agent �V Receipt No. / t3 d" White-D.P.W. — Yellow -Assess r — 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 hich fees have been paid. IRECTJJ O OF PUBLIC WORKS BY Date Sum Fdh"nirmltexpires D- 1 1 a 7 S COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS f �77- 7 County Center Drivg Oroville, California 95965 / Telephone: 534-4541 APPLICATION AND PERMIT 14 BUILDING Owner O -ZZ SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Fireplace Contractor EYZ_ Total Valuation Mai I i ng Address �� _ � Q :3 Permit Fee Plan Checking Fee &/or Penalty Tele hone 3 _ Permit Fee Building Address L� PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 (50 Repair drainage or vent piping 1.50 Water piping 1.50 /05,42 Each gas water heater or vent 1.50 // A. P. No. wz?— 7^ 3 Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F VC4R- I Sanitation FireDept. Fire Zone Use Permit Building sewer 5.00 �61i0(� EQA Parking Flans I Parcel Declaration Parcel Ma p 60' R/W Im rovements p Lawn sprinkler system 2.00 Bldg. Plans Recd I Parcel Approval Plans Approval Permit Fee $ 0-3,03 $ a� NEW ❑ ADDITION ❑ UTILITIESFVI 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 Family Duplex ❑ Mobil Home ❑ Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures bal 2 5 hill) Receps., switches & fix outlets 20 0 25 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: � 4sL.0/� 17.E -- 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. `�lo Classification G 3 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. --have placed on file with the County of Butte a certificate of © Workmen's Compensation Insurance. ElI 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 $ P3 di authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date �f '13`� Signature Doff Pee�rmitee or Agent Receipt No. �/`� � �7 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 hich fees have been paid. RECT OF PUBLIC WORKS BY _ Date S' wg permit piresDa����� ,[« 76 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC 7 County Center Drive —' (5roville, California 95965 �( Telephone: 534-4541 APPLICATION AND PERMIT auuiurice represeniatives or the County of Butte to enter upon the above-mentioned propert for inspection purposes. � r X Date Signature of Permitee or Agent Receipt No. �7 0,�ypG� White-D.P.W. — Yellow-As/Vs�'�nsk-I-tor —5z,C. e�sed•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 AJBLIC WORKS ;�ui Date &-,(/P, .lding permit expires Date...... .................................... BUILDING Owner9 SQ. T. OCC. BUILDIN VALUATION Mailing Address n OC Telephone No. Fireplace Q Q� Contractor Mai I Ing Address Total Valuation Permit Fee Plan Checking Fee &/or Penalty el phone No. Permit Fee $ $ - Building Address �� PLUMBING No. @ 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. N �/ . Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F W . ation Fire Dept. Fire Zone Use Pen -nit Building sewer 5.00 EQA Parking Plans Parcel Declaration parcel Ma P 60' R/W Imp rov ments P Lawn sprinkler system 2.00 Bldg. Plo e—ed Parce Approval PlanApproval Permit Fee $ $ 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) (morethonl2) Single Family Duplex ❑ Mobil Home ❑ Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures 20ai0 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 unde the name style oft ��(tz `" z/ a 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. _.4 f.& Classification 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. ❑have placed on file with the County of Butte a certificate of 'workmen's Compensation Insurance. IV I certify that in the performance of the work for which this L/14permit 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 $ $ 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 Is auuiurice represeniatives or the County of Butte to enter upon the above-mentioned propert for inspection purposes. � r X Date Signature of Permitee or Agent Receipt No. �7 0,�ypG� White-D.P.W. — Yellow-As/Vs�'�nsk-I-tor —5z,C. e�sed•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 AJBLIC WORKS ;�ui Date &-,(/P, .lding permit expires Date...... ....................................