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Home My WebLink About064-070-02264-0 N Rob t Jacobsen 30 Le ester Dr.,'lot 131, PP#12, Maga. contr: & M Elec., Magalia Permit #1-77P,E(util. MH) ELEC. _� t GAS SUPP T TRUCTURE OMPACTION TES UAR 7 64-07 2• '- r Contr: Sams Mobile Home er. Broderick, CA Permit #4950-77MHI Issued ` i 64-07-22 'y" Wayne Garvey 6235 Leicester Dr., lot 131,PP#12, Maga. pp contr:C. Hinkle, Paradise ermit��317'2681B�� d'ecics%MH) . 64-07-2277 contr. C Hinkle, Paradise 6;J3 Permit #4040-81�B(new pri.garage' 64-Q7-22, permit 35-g2 (electric prm-gar i t - I ' - I fI I1 V t ' cfli � j �l i PERMIT NO. 4040-81B ti PERMIT EXPIRES OWNER Wayne Garvy �• CONTR. C. Hinckle, Para. ASSESSOR PARCEL 64-07-22 LOCATION 6235 Leicester Dr., lot 131, PP4612, Magali Temp. Power Pole Called PG&E Temp. Elec. Service i Called PG&E Temp. Gas Service Cal led PG&E JOB FINALED (Date) 1Ae Signature J = OK O = Not -OK - = Not Applicable MOBILEHOMES MISCELLANEOUS - * = Not Ready Date MOBILEHOME UTILITIES (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) U . ,,xcept li 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 2. Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/0 -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts- Beams-Rftrs:=Connec.-Shthg.-Rfg. -Bracing__ 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 5. Alum. Awn.; Columns-Connections-Splice-Decal-Enc�js-ies 6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors - 7. Utility Clearance 7. Elec. Card -BI Date Card -BI Date Card -BI Date Card -BI Date ' Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except N's 1, Zoning Requirements -Setbacks -Easements Card -BI Date Date Card -BI Date - POOLS (Plans) OK except N's 1. Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances _ 4. Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector • 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/0 to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip.w/5'-Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card B-1 Date Card -BI Date Card -BI Date Card -BI Date Card B-1 Date Card -BI Date Card -BI Date Card -BI Date. = OK = Not OK = Not Applicable RESIDENTIAL (Singld and Duplex) = Not Ready Date UNDE OOR (Plans) OK exce t#'s Date FRAMIN ontinued oning requirements -Setbacks -Easements 48. SWoper!y Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Doors -One 3' -Check Garage -3rd story, 2 exits g., Garage; Soils -Steel- / /" Ftg. Depth 50 - adroom-Rise-Run-Landing-Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. tod o Roof Overhang -Attic Vents -Rafter Outriggers 5. Ste walls, Main; Steel-Blockouts-Wrapped-Slab 52. g -Nailing -Veneer temwalls, Garage; Steel-Blockouts-Wrapped-Slab 5 . Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54.Gikzing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear IIs; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Ser a Test 11. Electric; Underground - 12. Plenums & Duct teriat-Support-Ins. 13. Girders-Sincho ts- o Card-BI Date / and -BI Date Card -BI Card -BI Date Card -BI Date Date Card -BI Date Card -BI Card -BI Date Card -BI Date Date Card -BI Date Date FI tans) OK except N's Date PLUMBING (Permit) OK except hi's 5 Ext. Steps -Door & Sidelight Protection -Landings r _ 14. Wa r Ht.; V -Access -Combustion Air 58. s -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meth. Protection 15. Wat Pipe Test & Anchors -Nail Protection 16. D.W. \ T st-Fttngs & Anchors -Nail Protection 59-41t�ii4ing 17. Shower n; Test, First Floor -Tub Access txtures & Tub Access 18. Test Tu ower, 2nd Floor -Tub Access 61. lec. Trim & Subpanel; Breaker Sizes -Labels _ --ff 19. Gas Pipq; Size & Anchors ire ace or Stove; Clearances -Hearth 64 lec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date . ixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date eceptacles at Kit. Counter Date EL ICAL Permit OK except q's 67. Garage tre oor, Swing -Landing -Closer in Garage -Damper 20. Fi e & Transformer Clearance -Ins. Protection 6 Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In g -e Floor-Mech. Protection 21. I eceptacles Spacing -Lights &Switches at Doors 70. Plb. ec. & Mech. Equip. Listed for Location 22. iz & No. of Conductors -Stapled 71. ec. Receptacles in Garage; (G.F.I.)-Romex Protec. 23. o Innstst alled Close to Edge of Studs & C.J. 24. quip. Ground made up w/Mech. Fasteners -Bond Gas & Water 7 rr- of am -Looked in Attic ❑Yes 737GUard-Rstfs_&_Deck Construction -Post Caps 25-.2 Appliance Circuits in Kitchen & Conductor Size 7 n. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked un ee- Flum- ❑ Yes Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or AI 27. ge Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insu ed Neutral ❑Yes ❑No 75. Following instld.: Drive Yes ❑ No; Walks ❑ Yes o; Planters ❑Yes ❑No 28. Service - r Conductors & Ground -Main Disconnect .Z6.-Stysee-, Brown -Finish 29. Equip. Clearances; Panels-Motors-Mech. Equip. 7t•-Disconnect-Clrnces-.C. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light Za__V Ate-Abeve-Roof; Pibg.-Appliance-Firepl.-Clearance to Opngs. 7 connect, Electrical, Plumbing 80. or Elec. Trim; G.F.I. Receptacle -Underground Card B -I I Date84v-A0enTHnTh:iTrThraffMt House Card B-1 Date Card -BI Date g ton Date MECHANICAL (Perrr,it) OK except N's _ $3o-6®ccecGions=from. Previous Inspections 84,�st Meters Tagged; Gas -Electric 31. A.C. Ducts; Insulation & Support 85. a er ewer Connected -C/O to Grade -HD Approval 32. Ve Fan; Exhaust above Insulation 86,&oerg7'CSmpIiance Certificate -Other Certificates 33. Cond sat Drain & Overflow; Size & Grade _ 34. Furnas ent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic A c, ss & Platform if Furnace in Attic Card -BI ate -BI Date Card -BI Card -BI - _ --- Dat _-- Card -BI Date Date Card -BI Zate Card -BI Date ate Card -BI Card-BIate Date FRAMING Plans OK exc sCorgme is at Final: Z 36. Sills; Proper Material An 37._t3 s: Studs -Nailing, Spacing & Bracing -Plates -Sound - 38. 3 Be_a_ring Walls over Girders & Floor Nailing_ op in Walls (rat proof) _ _4B-7rttE-S Furred Ceilings -Stairs -Chases -Tub 41. _er_& Beam -Size & BearingOno 42._J1�aQe ost Caps -Anchors -Connectors 43. Cl�i Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. 44.ireplace Ties or Type A Flue -Fireplace Throat rl _ VI 45 ss; Size & Rom_ex Protection -Draft Stop -Ins. Baffles 4 ows or Exiting Doors -Sill Hgt. & Dimensions 47, ql eeFire Protection Framing (NOTE: Anentry must be made each time youvisit jobsite) ` COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS r 7 County Center Drive - Oroville, Califo,nia 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT P R�.J NO. u 671- ASSESSOR PARCEL NU BE —L17a-I- ZO ING ; BUILDING PERMIT OWER CS' 2 LJ es - TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER' AI ADD �•ESP �M FI.r CONTRACTOR'S NAMETELEPHONE �,ts( C i' Sr 01— CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ AR HITECT OR ENGINEER LICENSE NO. Plan Checking Fee. $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS 3 PLUMBING PERMIT FilingFee Filin Fee 10.00 Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other Lae ♦ ECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Describe work: r Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6001 OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2,50 NEW CONST. / DWELLING 0 liP�tfl1 20 sq ft OR ADDNS. t ACC. BLDG L/ / CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ElNON 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. %, cense No. Classification L'7 lr as the owner, or my employees with wages as their sole compen- sation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEw cONSTR. I -OUTLET 2,50 ea NON.RESID BRANCH CIRC ITS NEW .CONSTR. (POWER APPARATUS el RESID. (SINGLE OUTLET CIR. / . EXOCCUp OUTLETS OR FIXTURES_ BAL�1 FIXED APPLNSOR Ex. Occup.(o UTLETS (RES['D.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 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 C nsent to Self -Insure. V3--t—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 shal I be deemed revoked. Heating Cooling Hood 3.00 Ventilation Permit Fee S Contractor I certify that I have read this application and state that the above information is correct. 1 agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgment osts, d expenses which may in any wa accrue agai t said County in cos ue f the granting f this per t._ P %� Date '3 �5 0 v Signature of Opp – caner � ontractor ❑ 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 $ TOTAL PERMIT FEE $ OCCUP. GROUP I TYPE OF CONST. PARCEL PD No ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which EC= IRECT PUBLIC BY "' `� PERMIT EXP ES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT'QF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, Calikarnia 95965 - Telephone 916/534• APPLICATION AND PERMIT ' ASSE OF R PARCEL NUMBER _0 % —a2 ZONING T/, 41.9 BUILDING PERMIT OWNER �� TELEPHONE SO. FT. VALUATION 2 y�OCC. %BUILDING OWNER'S MAILING ADDRESS • CO R/ACT R'S NAME TELEPHONE ,Ajrr%ist_*' g� CONTRTO``S MAILING ADDRESS ),qt 4 Fireplace ce4 CONSTRUCTION LENDER UNKNOWN Total Valuation $ i. Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ & ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 'LJ� Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDR s & t32 PLUMBING PERMIT Fee Filin Fee 10.00 Filing b. Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO. SUBDIVISION NAME oe/� PARCEL MAP Each pas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other 21 SPECT Y Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP OROR LESS5.00 Main service EA- ADD'L 100 AMP 2.5'50 NEW CONST.DWELLING 0 P.y OR ADDNS. ( ACG. BLDGS 1' 20 sq ft 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. MOO 5-82 Classification Z? ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed Contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW coNSTR I.Ou L T NON.RESID BRANCH CIRCUITS) 2.50 ea NEWCONSTR. (POWER APPARATUS S1 NON . RES I D. SINGLE OUTLET CIR. / 50 0 EX. OCCUp OUTLETS OR FIXTURES BAL@1 FIXED APPLNS, OR Ex. Occup.(OUTLETS (RESID.) EA. 2.00 Temporary service 10.00. Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 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 shal I be deemed revoked. Heating Cooling Hood 3.00 Ventilation permit Fee S Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for -inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequ ce of he granting of this permit.[ X ��- i f �_ Date Signature of Applicant — Owner ❑ Cantractor JZ 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 $ TOTAL PERMIT FEE -- , Occup. GROUP �f I TYPE OF CONST. V- —/,_,/ PARCEL V PD L/ ND 99UE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTAR OF PUBLIC By 1126"AIT EXPIRES Date/Z- the applicable provi- resolutions to do fees have been paid. WORKS Date�d-2dyy''�p� Receipt No. �7�y�, WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT i 0 PERMIT NO. q� 3726-81B PERMIT EXPIRES— OWNER XPIRES OWNER Wayne Garvey CONTR. C. Hinkle, Para. ASSESSOR PARCEL 64-07-22 LOCATION 6235 LeicesterDr., los 131.,PP#12, Magalia it 1 1 Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E� Temp. Gas Service Cal ledsPG&E JOB F14 LED (Date) Signature 'Sh` • ` I = OK 0 = Not OK — = Noi Applicable -MOBILEHOMES MISCELLANEOUS = Not Ready Date MOBILEHOME UTILITIES (Plans) OK except N's 1. Zoning Requirements—Setbacks—Easements Date DECKS_ COVERS, CARPORTS, ETC. (Plans) OK except ✓<'s 4,. --Zoning Requirements—Setbacks—Easements 2. Soils; Special MH Support—SketchI ootings;—DePr—SpaLioer—Connectors 3. Sewer; Location—Test—Fall-C/0—Concrete 3�ee1cS, Girders and/or Joists—Decking—Bracing—Stairs—Rails 4. Water; Location—Test—Easement Needed (Sketch) ood Awn.; Posts—Beams—Aflrs.—Connec.—Shthg'—Rfg.—Bracing 5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete 5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures 6. Gas; Locatiort—Test—Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 6° Carports; Windows—Doors 7. Utility Clearance 7. Elec. Card -BI Card -BI Date Card -BI - Date Date Card -BI Date Card- Card -BI D e / 0 Card -BI Date ate Card -BI Date Date MOBILEHOME INSTALLATION (Plans) OK except N's 1. Zoning Requirements-Setbacks—Easements i Date P LS (Plans) OK exce t It's 1. Setbacks—Easements 2° Footings; Size—Spacing—Marriage Line 2. Soils; Compaction—Structure Stability 3. Gas; MH Test—Demand—Valve—Connector 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining 4. Electricity; MH Test—Crossovers—Breakers—Clearances ( 4. Elec.; Receptacles and Lighting; Distances—GFI 5. Drain; MH Test—Fall—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI 6. Water; MH Test—Regulator—Connector 1 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed 7° Water and Sewer Connected—C/0 to Grade—HD Approval 7, Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater 8° Gas and Electricity Tagged 8° Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg, Boxes—Enclosures—Panelboards—Ins. to Main in Conduit 9. Exits; Insp.—Sketch ` 10. Cert. of Occupancy j 9. Health Department Approval 10. Plumb; Cir. Test—Water Supply Test Card B -Ir Card -BI Date t Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date i �a1il"a• • '1 a = OK = Not OK = Not Applicable = Not Ready RESIDENTIAL.(Single and Duplex) Date UNDERFLOOR Plans OK except #'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FINAL (Plans) OK except q's 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date Date Card -BI Date PLUMBING (Permit) OK except q's 57. Smoke Detector 14. Water Ht.; Vent -Access -Combustion Air 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 15. 16. Water Pipe; Test & Anchors -Nail Protection D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except q's 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 22. Size Boxes & No. of Conductors -Stapled 70, Plb., Elec. & Mech. Equip. Listed for Location 23. Romex Installed Close to Edge of Studs & C.J. 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. o Insulation-Foam-Looked am -Looked in Attic ❑Yes 25. 2 Appliance Circuits in Kitchen & Conductor Size 73. Guard Rails Deck Construction -Post Caps _ 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or AI 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral ❑Yes ❑No 75, Following instid.: Drive ❑ Yes ❑ No; Walks E] Yes []No; Planters ❑Yes 0 N 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77, A.C. Unit; Disconnect-Cirnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B -I Date Card -BI Date 81. 82. Ventilation throughout House Glass Protection Card B -I Date Card -BI Date Date MECHANICAL (Permit) OK except N's 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 31. A.C. Ducts; Insulation &Support 85. Water & Sewer Connected -C/O to Grade -HD Approval _ 32. Vent Fan; Exhaust above Insulation 86, Energy Compliance Certificate -Other Certificates ^ 33. Condensate Drain & Overflow; Size & Grade 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic Card -BI Date Card -BI Date Card -BI _ Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date _ FRAMING(Plans) OK except q's 36. Sills; Proper Material & Anchors 37. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound 38. Bearing Walls over Girders & Floor Nailing 39. Draft Stop in Walls (rat proof) Comments at Final: _40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. 42. 43. 44. Header & Beam -Size & Bearing Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. Fireplace Ties or Type A Flue -Fireplace Throat 45. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 46. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing (NOTE: An entry must be made each time youvisit jobsite) COUNTY OF BUTTE-- DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, 061iforni,a,95965 - Telephone 916/534-45-/_ �2 APPLICATION AND PERMIT ASSES OR ARCEL NUMBER -7-2_- Z G/ ' BUILDING PERMIT OWER TELEPHONE SO. FT, OCC.1 BUILDING VALUATION OWNER'SM LING ADDRESS CONTACTOR• AME f,J TELEPHON CONTRACTOR'S (LING ADDRESS (p L /,/-,/ `t90.0 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ .- Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 02 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT R•ENGINEER's MAILING ADDRESS Permit fee $ (Q BUILDING ADDRESS ' PLUMBING PERMIT Filing Fee 10.00 Cff S 7- E_�L �L' Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO.SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5,00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex[] MobilehomeV Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Instal lation ❑ OtherV Describe work: t 0 U CsK, ew C C.. I�- .S Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP ORSLESS 5.00 Main service EA. ADD•L too AMP 2.50 NEW CONST. ( DWELLING OCCUP.pi) OR ADDNS. ACC. BLDGS. 20 sq fit 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 Professio s Code and my license is in full force and effect. License No. Classification 18 ❑ I, 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 CON5TR TI.Ou LET 2,50 ea NO N.RESID BRANCH CIRC TS NEWNON.RESID. \SICONSTR./PNGLE OUTLET CIR. OWER APPARATUS &I D0P@1 Ex. Occup OUTLETS oR FIXTURES BAL LNS ' EX. OCCup.(OUTLETSFIXEDP(RESID )REA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 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. 11 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,shal I be deemed revoked. Heating Cooling Hood 3.00 Ventilation Permit Fee S Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I 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. • r X6a! _ Date �n L / 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 33r stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ occuP. GROUP TYPE OF CONST. v PARCEL PD HD IssuE tw, This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRE TOR OF ELIC rt By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt NO. S7 G, f (" N- WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT P11 PERMIT NO. 4.149-7%P,,,E PERMIT EXPIRES 9fi,179 OWNER Robert Jacobsen CONTR. C & M Elec., Magalia LOCATION (A.P. 64—C�-22 30 Leicester Dr., lot 131, PP#12, Magalia i' Temp. Power Pole Called PG&E Temp. Edec. Serv. ' Z 7 Called PG&E Temp Gas Serv. Called PG&E JDB 2 FINg ALED (Date) (Signature) r C' e y Mesh MECHANICAL Grd. F ult Prot. Scr ch Heat Sery e B wn Co Ing mp. Pole Inlsh D cts nder round erior Lath entilation Permanent oor Closer Final /Final MOBILEHOME UTILITIES {,-`- Elec_ Servs e j `7 Elec. Pedestal 1 1 Water Piping Sewer 92 '%'). Gas Piping WUBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity i Water Piping Drainage Gas Piping DATE p p -REMARKS OR CORRECTIONS c(p) (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD ' BUILDING BUILDING (Cont'd) PLUMBING Se ck F I r'kvall S I Piping Formk Para is t Floor Mai Bldg. Restroo Finish 2nX Floor Fo ins Windows 3rd loor Stemall Siding To out Slab Roof Sheaths Water PIhng Jr Piers Roofing Sewer Garage Fdn. Vents Fixtures Footin s Garage Vents Water Htr. Stemwa I I Insulation N 4 Heaters Slab Carport Footings Prov. for ph sically handicapped Conformance of ex. structure Appliances Gas Piping & Tes Temp. as Slab Final Sanitation Patio IREPL CE Final Footin s Footing' LECTRkAl- Masonry Walls Throat Rou h ' Relnf. Stee Final Fixtures Borid Bea FIRE SPRINKLERS Motors Framing Test NWater Htr Stucco Final Sub an s Mesh MECHANICAL Grd. F ult Prot. Scr ch Heat Sery e B wn Co Ing mp. Pole Inlsh D cts nder round erior Lath entilation Permanent oor Closer Final /Final MOBILEHOME UTILITIES {,-`- Elec_ Servs e j `7 Elec. Pedestal 1 1 Water Piping Sewer 92 '%'). Gas Piping WUBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity i Water Piping Drainage Gas Piping DATE p p -REMARKS OR CORRECTIONS c(p) (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 %_ ti 7 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of the California Administrative Code, Title 25, Chapter 51 under permit number for the following location: Owner L . Owner's Address Mobilehome Mfg. Model Year Insignia No.Serial No. It is hereby certified for occupancy at the above described location and may be occupied. Director of,Public Works Date By oa„ THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED MOBILEHOME INSTALLATION INSPECTION CHECK LIST 1.' Is the mobilehome located wit.,required separation from lot lines and buildings and generally conform to plot plan? Yes_ No 2. Does the mobilehome have.required clearances above ground? (Sec.5085) Yes No 3. Are footings and supports properly sized, spaced, and braced asapproved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes_ No 4. Is the mobilehome level? (Sec. 5088) Yes_ No 5. If more than a single unit, are crossover connections properly installed? (Sec. 5088) Yes ✓ No 6. Water A. Is fl ible connector of adequate size and properly installed (1/2" ID miin.)? (Sec. 5566) Yes No B. Test - Does water piping withstand working pressure or 50 lbs. air test? Yes '(_�o_ C. Backflow - If coach is not State of California approved, does station have backflow device and pressure -relief valve? Yes_ No 7. Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes No B. Does it have minimum k" per foot slope and is it properly supported? Yes '--No C. Are any leaks detected in drainage system after running 3;gallons of water through each fixture including washing machine standpipe? Yes No / D. If coach is not State of California approved, does station have required trap and vent? Yes No 8. Gas Piping and Gas Vents A,. Connector - Is mobilehome connected to the gas supply 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 mobilehome gas line inlet without reductions other than the mobilehome connector. Yes No B. Test OK as per following procedure? Yes_ No 1. Open all appliance connector valves. 2. Shut off appliance burner and pilot valves. 3. Air test with manometer to 10"-14" water column, or test with slope gauge (minimum 6ort,-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min, without drop. 4. Connect gas meter to,mobilehome with connector, turn on gas, test connections with soapy water. C. Are all appliance vents properly installed? Yes No 9. Electrical A. Is service large enough to provide adequate amperage -to mobilehome (must equal rating of mobilehome with a minimum of 100 amp) and other facilities on lot, i.e., water pumps, garage, cabana, etc.? Yesz/ No ' B. Is there proper clearances around panels? Yes ✓ No C. Is power supply cord,or feeder assembly properly fused? Yes e/ No_ D. Is continuity test satisfactory as per the following procedure? Yes '-No_ 1. De -energize electrical wiring system of the mobilehome at the pedestal 2. Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected. 3. Switch all breakers and switches in the mobilehome to the "on" position. 4. Connect one lead of a test instrument to the mobilehome grounding conductor and apply the other lead to each mobilehome supply conductor, including neutral. S. All 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 conductors 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 theelectrical tests, the lot or site service equipment may be approved for energizing. 10. Is job card signed by Health Department for water and sanitation? 11. If everything okay, sign off card and tag services. MOBILEHOME DATA Manufacturer and/or Namestyle Length %F A&Width i_t! Vehicle Serial No. State Identification No. Additional Information or Comments: 6 1 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS ,L,4 7 County Center Drive — Oroville, California 95965 F Telephone: 534-4541 APPLICATION AND PERMIT A- lb74";7 Receipt No. I l9 / % 10 J gidei� White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant Building permit expires Date BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Fireplace Contractor to "� I(,,% Total Valuation Mailing Address 51 r Permit Fee Plan Checking Fee&/or Penalty Telephone No. Permit Fee Building Address 0E? I r PLUMBING No.1 @ I FEE FILING FEE J$3.001 q�PERMIT kip 13 1 P Z Each Trap 1.50 1 a Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 /_ A. P. No. �t7 Zoning &Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fe a4- Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA arkin PPlans Declaration I Parcel Map 1 60' R/W I Improvements Lawn sprinkler system 2.00 Bldg. PI s Recd Parcel provaI Plans provol Permit Fee $ $ NEW ADDITION ❑ UTILITIES ❑ OTHER W ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 L411 _ -- Main service 100 AMP ORV OR LESS5.00 Main service EA. ADD'L too AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home A Others Main service OVER 600V 100 AMP OR LESS 25.00 Main service EA. ADD'L too AMP 1.00 NEW CONST.DWELLING OCCUP. & OR ADDNS. ( ACC. BLDGS. ) 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 style of: ayc, Ex. Occup(OUTLETS OR FIXTURES) BA�L@1 00 FIXED APPLNS Ex. Occup. (OUTLETS ((RESID, IKEA) Temporary service 10.00 Mobile Home Facilities 15.00 93 Z -L� 3 ^-- ,z License No._.,7 Classification Misc. Wiring 6.2 5 ❑ 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 fo Workmen's Compensation. I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I Io an certify that in the performance of the work for which this ermit is issued I shall not em P employ y person in any manner so as toecome subject to the Workmen's Compensation Laws of Cal Ifor a. MECHANICAL No.1 @ I FEEPERMIT FILING FEE J$3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 cer ify that I ve r his plication and state that the above infor a Ion is orre e t comply to all County Ordinances and 4ate ws el i tobuilding construction, and hereby auth ize re re nta s County of Butte to enter upon the abo -menti n pr t for 'ns ection purposes. DatZ Sig , ture of Permitee or Agent _2 d , 00 TOTAL PERMIT FEE $ 8 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. a DIRE OR OF BLIC WORKS �I'- -7 By Harp 7 Receipt No. I l9 / % 10 J gidei� White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant Building permit expires Date MOBILEHOME SUPPORT DATA c� Mobilehame Setup Model No. Year Width _(ft.) Length (.ft.) ..-Expando'.Size ft. -- ft. (Draw .support. details* below).. Ori all mobilehomes 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 Footings- (check- one) 1. Wood. either i.ipressure treated or Center Center Support n fd 'grade. Support Footing Sizes W Locations (in.) 2..Concrete pad. x / / 3. Other,: specify . in. (l�•jtin• -- - -- .--- - I{� Supports (check one) 4 1. Concrete block - - --- -: 1 -� x / / 2. Concrete piers ( inin. ) 3. Steel piers 4. Other, pecify Typical Support r j l f ooting Size ( in. x� in. { Max. Pier ' Spacing ( in.) in. Max. Overhang *If center piers are other than drawn above, draw in locations, spacing, and dimensions. BUTTE COUNTY BUILDING DEPARTMENT APPROVED' 1. Owner's name: 2. Installer's na BUTTE COUNTY -DEPARTMENT OF PUBLIC WORKS 7 County Center -Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 3. Is the site currently under permit? Yes :7v( 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? ----------------------- :�® C) Amps 6. What is the mobilehome site service rating? --------------- Amps 7. What is the mobilehome site circuit breaker rating? ------------- Amps 8. Is there any other electric load to be served by the mobilehome (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft.. on LPG.) 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? ----------------------------- Naturall LPG-/ / 11. What is the gas pipe length from meter or tank to /� the mobilehome? /�/ %Y' (ft.) 12. What is the mobilehome gas demand? -----------=------------------ (BTU) (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft.. on LPG.) COUNTY OF°BUTTE - DEPARTMENT OF PUBLIC WORKS • •, 7 County Center Drive — Uroville, California 95965 �% / �f Telephone: 534-4541 (/ j/ / / APPLICATION AND PERMIT .✓ 4« representatives ul the County of Butte to enter upon the above -me tioned property for inspection ses. X�IL A urp Date S1117177 S.i.gnature of Permitee or Agent Receipt No. / G 7 f, Cl 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 OR QF,R BLIC WORKS BY ( Date permit expires Date / - — �� /� BUILDING Owner J^,4 C cl SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Fireplace Contractor ��. Total Valuation Mailing Address (2), 7 _2 Permit Fee Plan Checking Fee &/or Penalty hone No. Permit Fee $ Building Address PLUMBING No. I @ FEE PERMIT FILING FEE $3.00 kj te_ ' Each Trap 1.50 31N n �,./ / Z Repair drainage or vent piping 1.50 j FQ Zoning Verificefion Onl Water piping G- Each gas water heater or vent 1.50 A. P. No, �— )e ZO ase -1 `�4 Gas piping system 1 - 5 outlets 1.50 Each additional outlet 30 Fess C S I on FireDept.GF ire Zone Use Permit Building sewer O.- EQA PPlans D Placa ion rgel�vl' 60' Improvem s Lawn sprinkler system 2.00 Re.' Pa467-1-71 rcel Approval Plans proval Permit Fee $ 02-1 7 NEW ❑ ADDITION ❑ UTILITIES OTHER ❑ ELECTRICAL No.1 @ I FEE PERMIT FILING FEE J$3.00 Main service 100 AMP ORSLESS 5.00 S -- SV Main service EA. ADD'L too AMP 2.50ER Single Family ElDuplex E -]Mobil Homevi Others 11Main 600V 0 0 AMP OR LESS 25.00 Main service 1 service EA. ADD'L too AMP 1.00 >00 SQ. FT. MINIMUM, NEW CONST. DWELING OR ADDNS. ( ACCLBLOGS.CCUP. &) 20sgft NEW UTLET NON-RESID R ( BRANCHMULTI 'D CIRCUITS) 2.50ea EOR MOBILES NEW CONSTPOWER APPARATUS & NON- R. 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)@L2SQ BAL@1 Ex. Occup.( OUTLETSP(RESID.)REA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 ^ License No. Z LI 7) S_ 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 Section3700 of the California Labor Code which requires every employer to be insured against liability - for rkmen's Compensation. 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 thisVentilation permit is issued I shall not employ any person in any manner o as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling 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 .I, 4oin` ec_ TOTAL PERMIT FEE $ 72 1 4« representatives ul the County of Butte to enter upon the above -me tioned property for inspection ses. X�IL A urp Date S1117177 S.i.gnature of Permitee or Agent Receipt No. / G 7 f, Cl 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 OR QF,R BLIC WORKS BY ( Date permit expires Date / - — �� /�