HomeMy WebLinkAbout064-080-008.P. 6 08 A 4-
- 7, 1 16
1 8
FRANK UHOR
290 Colter,,
—1- - -- ----- _ 4. . .......
Contr: C & M Electric, Magalia
Permit 2361-73 P�.E
Y-2 L * 'W 8
64-08�
CONTR - S. 0. S. 19944Z-O!�"� 14
-~Permit #6211-75MHI
IIssued 1,2 -,9- 7,-� I -
-64-08-8
,qONTR : RoriStr7ker, Paradise
{Permit #188-76B(n w deck & patio-
cover/MH)
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���I d'i0 v��
PERMIT NO. 188-76B
P
E
M
MH UTIL
PERMIT NO.
PERMIT EXPIRESZ /��/
.S
OWNER Mr. & . Mrs .. Frank Tfhor
CONTR. Ron Stryker, Paradise
LOCATION (A.P: 64-08-8 )
.290 Colter Way, Magalia �.
p`
Temp. Power Pole
i Called PG&E
Temp. Elec. Serv.
Called PG&E
emp. Gas Serv.
Called PG&E
JOB
/FINALED
(Date) 1
l
(Sign tdre)
COUNTY OF BUTTE — DEPARTMENT -,-OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDJNI§„ „/ BUILDING (Cont'd) PLUMBING
Setback "/ A&190 4W
Firewall
Soil Piping
Forms LT
Parapets
1st Floor
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor,
Stemwall
Siding
To out
Slab
Roof Sheathing
Water Piping
Piers
Roofing
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
Footings
Footing
ELECTRICAL
Masonry Walls
Throat
Rough
Reinf. Steel
Final
Fixtures
Bond B am
FIRE SPRINKLERS
Motors
Framing
Test
Water Htr.
Stucco '
Final
Subpanels
Mesh
MECHANICAL
Grd. Fault Prot.
Scratch
Heating
Service
Brown
Cooling
Temp. Pole
Finish
Ducts
Underground
Interior Lath
Ventilation
Permanent
Door Closer
Final
Final
DATE
11d6 /_1 C
.REMARKS OR CORRECTIONS
COUNTY OF BUTTE — ► DEPARTMENT OF PUBLIC WORKS
7 County Center Drve —. Oroville, California 95965 lAr-Z�a
Tel ephc�e: 53$-4541
APPLICATION AND PERMIT
authorize representatives of the county of Butte to enter upon the
above-mentioned property for insp ction purposes. *�
X Date 711-1
Signatu>re of Permitee or Agent
Receipt No. / y'7® 7S'
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
abov"whichfees been p 'd. OF BLIC WORKS
BYDate �— 26
ilding permit expires Date ................./..-11`'.x..7.7..
BUILDING
Owner H gd- /I FltAgIT V OIR
SQ. FT. OCC. BUILDING VALUATION
ZI7 'r
Mailing Address Ca(_y cFZ w j4'rEL,t
n
tM 1� 14 L 1 A,
Telephone No. ,
3 — O S
Fireplace
Contractor R 0 ^1 T&Y t c
Total Valuation
Mailing Address 696 13 L( Cc 0
Permit Fee
Plan Checking Fee &/or Penalty
Telephone N
(app
Permit Fee
Building Address
PLUMBING No. @ FEE
PERMIT FILING FEE $2.00
Cc L -t 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
F 4091W.
Sa
)FireDept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking Parcel'
Plans Declaration
Parcel Ma P
60R/W
Improv
provements
Lawn sprinkler system 2.00
Bldg. P4we<c'd
Parcel proval
PIc s Approval
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) (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 al d�o
Receps., switches & fix outlets Z
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:
/ZdNlii' L u /0,
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
/ C
License No. X.3 �
9.0 � 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.
I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
TOTAL PERMIT FEE
$
authorize representatives of the county of Butte to enter upon the
above-mentioned property for insp ction purposes. *�
X Date 711-1
Signatu>re of Permitee or Agent
Receipt No. / y'7® 7S'
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
abov"whichfees been p 'd. OF BLIC WORKS
BYDate �— 26
ilding permit expires Date ................./..-11`'.x..7.7..
Permit #6211-75MHI
r, UHOR, FRANK
290 Coltrer•= Way j Magalia
A.P. #64-08-8
Contrs.S•O.S.
(MH Installation)for peril it #2361-73
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COUNTY OF BUTTE — PNEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Oroville, California 95965
Telephpne: 534-4541 rJ
u •
APPLICATION AND PERMIT
autnonce representatives or the t.ounty or butte to enter upon the
above-mentioned property for inspection purposes.
X r%,%� �rA�.--'_ Date ! il_ - ti
Signature of Permitee or Agent I' `
~Receipt No.`T?�
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 `',�-- Date41
Building permit expires Date �� 5
BUILDING
Owner _�c ' � • L, .., . _; � '
SQ. FT. OCC. BUILDING VALUATION
'.
Mailing Address
'
Telephone No.
Fireplace
Contractor , `f, .�' _
Total Valuation
Mailing Addressf �/ /�/� �/��'s ,�
Permit Fee
Plan Checking Fee &/or Penalty
%
Telephone No.
Permit Fee
Building Address t� /1"'^"� r.a r i
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
if
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
�WC.
SaniCation
�FireDept.
Fire Zone
Use Permit
Building sewer 5.00
EQA Parking
Plans_
Pdreel
eclaration
Parcel Ma P
60' R/W
` Im rovements
P
Lawn sprinkler system 2.00
Bldg. P,ns Recd
Parcel Ap royal
Plans` pproval
Permit Fee
NEW ❑ ADDIf ION ❑ UTILITIES❑ OTHER ...
ELECTRICAL' ' No. @ FEE
PERMIT FILING FEE $3.00
Main service incl. 1 meter
.A
Additional meters, each 1.00
Sub -panel (12 or less) (more than 12)
Single Family ❑ Duplex ❑ Mobil Home'Q Others ❑
'Range, Cook -top or Oven 1.00
t
Water Heater or Space Heater 1.00
Light fixtures 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 of, -Water
r20-
Hood, Ex. Fan or F.A. Furn. Motor
Evap. cooler, gar. disp. or D.W.
Air conditioner or heat pump
pump ,�
Mobil Home Facilities 5.00
Temp. Power Pole 5.00
License No. ?,6 9,C -6r 9...r /
Classification
Misc. wiring
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$
WORKMEN'S COMPENSATION INSURANC
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against,Iiability
for Workmen's Compensation.
❑I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance. r
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 11 $
$
1 certify that,l 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
��` -.4� 'A 4 f 1 3V /gip
TOTAL PERMIT FEE
autnonce representatives or the t.ounty or butte to enter upon the
above-mentioned property for inspection purposes.
X r%,%� �rA�.--'_ Date ! il_ - ti
Signature of Permitee or Agent I' `
~Receipt No.`T?�
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 `',�-- Date41
Building permit expires Date �� 5
MOBIL EHOME INSTALLATION INSPECTION CHECK LIST'
1.� Is the mobilehome located wi required separation from lot lines and buildings and generally
conform to.plot plan?' Yesy No
r . .
2. Does the mobilehome havie required clearances above ground? (Sec. 5085) Yes C110
3. Are footings and supports properly sized, spaced, and braced as pee pproved plans? (Note
possible variation at spring shackles.) (Sec. 5082 & 5083) Yeses/ 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 fle le connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566)
Yes No
B. Test - Does water piping withstand working pressure or 50 lbs. air test? Yes No
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 :nd?? es_ No_
B. Does it have minimum '" per foot slope and is it properly supported? _
P P P y pp .rted? Yes No
C. Are any leaks detected in drainage system after running 3 allons of water through each
fixture including washing machine standpipe? Yes No
D. If coach is�nat State�'of�California approved, does station have required rap and vent?
Yes No
'8. Gas Piping.and Gas Vents
A.Connect Is mobilehome connected to the gas supply with an�approved 3/4" minimum
mobilehome Gonnector not more than 6 ft. long? Note: All piping is_t.o-be"at least as
large as the mobilehome gas line inlet without reductions other.-t'han the mobilehome
connector.. Yes No�
B. Test OK as per following procedure? Yes_ N
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
'6oz.-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,'•tgst connections with
soapy water.
C. Are all appliance vents properly installed? Yes
P,
No.
A,
9. Electrical
A. Is service large enough to provide adequate amperage to mobilehome (must equal rating of
r mobilehome with a minimum of 1 0 amp) and other facilities on lot, i.e., water pumps,
garage, cabana, etc..? Yes o_
B. Is there proper clearances around panels? Yes �No
C. Is power supply cord or feeder assembly properly fused? YesNo_�
D. Is continuity test satisfactory as per the following procedure? Yesy 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 rn.obilehome supply conductor, including neutral.
5. 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 the electrical tests, the lot or site
service equipment may be approved for energizing.
10. Is job card signdd by Health Dep a�ltment for water and sanitation?
11. If everything okay, sign off card and tag services. I
MOBILEHOME DATA
Manufacturer and/or Namestyle !—
Length Width
Vehicle Serial No.
State Identification No.
Additional,Information or Comments:
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Orovifie, California 95965 `��
Telephone: 534-4541 / /
APPLICAVON AND PERMIT ri Z_1_____,
autnonce representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X �— P a
Date `3�J25
ignature of Permitee or Agent
Receipt No. �
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 beenpaid.
DIRECTOR 00PUBLIC WORKS
BY Date Z' 9— i 3'
Wilding permit expires Date fes" 1- 7
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mai I i ng Address
Telephone No.
Fireplace
Contractor ,�; �
Total Valuation
Mailing Address W
Permit Fee
Plan Checking Fee&/or Penalty
Telephone No.
��
Permit Fee
Building Address
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
Vw_'
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent j 1.50
j D
A. P. No. / --
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
F
ion
Fire Dept.
Fire Zone
I Use Permit
Building sewer 5.00
EQA Parking
Plans
Parcel
Declaration
Parcel Ma R/W
P
Improv s
Lawn sprinkler system 2.00
Bldg. P ns Recd
Parcel A roval
Plans Approval
Permit Fee
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
ELECTRICAL No.1 @ FEE
PERMIT FILING FEE J$3.00
Main service incl. 1 meter
Additional meters, each 1.00
—
Single Family ❑ Duplex ❑ M biI HoTe Others ❑
Sub -panel 02 or less) (more than 12'
Range, Cook -top or Oven 1.00
(
77*Light
Water Heater or Space Heater 1.00
fixtures b 61
�^
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:
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. �tl
`��, � Classification � —•o
Misc. wiring
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑ I have placed on file with the County of Butte a certificate of
Wo kmen's Compensation Insurance.
ertify 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
G
TOTAL PERMIT FEE
autnonce representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X �— P a
Date `3�J25
ignature of Permitee or Agent
Receipt No. �
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 beenpaid.
DIRECTOR 00PUBLIC WORKS
BY Date Z' 9— i 3'
Wilding permit expires Date fes" 1- 7
I
permit: 2361-73 P,E
UHORI FRANK
290 Colter Way
Unit 12 Lot 224
Magalia
Ut,:LI-Volein
for mobile home except gas)
!I
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive OroviIle, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
P
Signature of Permitee or Agent
Receipt No.
White-D.P.W.
Date
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
Owner
SO. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee
$
$
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. N0.
Zoning &Planning
Gas piping system 1 - 5 outlets
1.50
Each additional outlet .30
Fees
W. C.
Sanitation
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EOA
Parking
Plans
I Parcel
Declaration
Parcel Ma P
60' R/W
Im rovements
P
Lawn sprinkler system 2.00
Bldg. Plans Rec'd I
Parcel Approval
Plans Approval
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) (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 26025
bal d10
Receps., switches & fix outlets b.
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
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee
$
$
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL
No.
@ FEE
PERMIT FILING FEE $3.00
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.
P
Signature of Permitee or Agent
Receipt No.
White-D.P.W.
Date
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
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Orovi Ile, California 95965
Telephone: 53.4-4541
APPLICARION AND PERMIT
auuiurtce represeniaiives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X Date
Signature off Permitee/orrAgent
/
Receipt No. Q 2 / ` L
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 UBLIC WORKS
By Date
Building permit expires Date �: 7 �.�..
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Fireplace
Contractor C zz,--(f /c-
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
A 1,2 Z 11:7
(�
Telephone No.
Permit Fee
Building Address O� T� IF
PLUMBING
No.
@
FEE
PERMIT FILING FEE $2.00
O
Each Trap 1.50
2 Z
Repair drainage or vent piping
1.50
Water piping 1.50
S6
Each gas water heater or vent 1.50
A. P. No. _
ZZ ,n
g
Gas piping system 1 - 5 outlets
1.50
Each additional outlet .30
Fe
SanitaQ
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
4
EQA
Parking
Plans
Parcel
Declara 'on
Parcel Ma
60' R/W
Im rove nts
P
Lawn sprinkler system 2.00
Bldg. Plans Recd Parcel Approval
Plans Approval
Permit Fee
$
$()
$ SO
NEW ❑ ADDITION ❑ UTILITIES OTHER ❑
ELECTRICAL
No.
@
FEE
PERMIT FILING FEE $3.00
QQ
Main service incl. 1 meter
_7.06
Additional meters, each
1.00
Single Family ❑ Duplex ❑ Mobil Home Others ❑
Sub -panel (12 or less) (more than 12)
Range, Cook -top or Oven 1.00
Water Heater or Space Heater
1.00
Light fixtures bal� 10
Receps., switches & fix outlets ba
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professio s Code under the name
style o : +
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
'efD
Temp. Power Pole 5.00
�// f
License No -214 l 7 Classificatio
Misc. wiring
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee
$
Qd
$
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.1
@
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
is
S
auuiurtce represeniaiives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X Date
Signature off Permitee/orrAgent
/
Receipt No. Q 2 / ` L
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 UBLIC WORKS
By Date
Building permit expires Date �: 7 �.�..