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Home My WebLink About064-190-010..A:P.. 64=19-10 ., `�' Q 4 O 1 MARTI N 450 rnegie Rd. Lot 260, P.P.#14, Mag. CONrR: Bchecker Const. Co., Paradise Permit 7-73B,P,E ' (new single amily) .P. 64-19-10 VERN MARTIN �� 2��' 450 Carneg' Rd., PP#14, Lot 260 CONTR: ecker Const., Para. Perm553-74B (2 decks)-_-_ 64-19-10 Permit #4980-76B(add deck/SF) 64-19-10 Permit #5630-78B(add op en deck/SF) 069-190-010 02-1470 MANZONE, ERIC & DARLENE- 14595 CARNEGIE, MAGA CONT: ALL ROOFING A LED . RE -ROOF 'UZ 064-190-010 02-1 MANZONE, LAWRENCE �NALED 14595 CARNEGIE RD., M ALIA RELOCATE WOODSTOVE SKYLIGHTS 7 \ 064-190-010 05-3064 LILLY 14595 CARNEGIE RD,1 Cont: ADVANCED 1ELEct", ELEC SERV �\k jlkj JL �Cfll� d'1" � � C'�I �� Butte County Department of Development Services. e�Trf, r�xen N ® T E S 7 County Center Drive, Oroville, CA 95965 COUN�y• (530) 538-7601 w wv.buttecounty netidds �pRfEESIDENTIA/L�� APN: `v D1 Permit No. OE; —`'4 cda Owner.` Site Address: 1� Contractor. v Type of Permit: t r - OFFICE COPY Address lySlS Cf�RN�C(E GAS Date Meter By ELECTRI��Mon�S Date Meter By ONS CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE VY i DATE JOB FINALED: SIGNATURE: l Y. It ; .=OK 0 = Not OK MANUFACTURED HOMES MISCELLANEOUS DATE PERMANENT FOUNDATION Lj SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; Fall/C/0-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Clrncs-Grnd Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap Nat Q or LP❑ Inch Sz Ft ingth 7 Blckng; Sz-Spacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-Cirncs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -C/O to Grade 12 Gas and Electricity Tagged 13 Tie Downs Q Foundation Q 14 Exits 15 Cert of Occupancy 16 HUD Label/Insignia Numbers Serial Numbers DATE ID E C K S -C O V E R S`C ARP O RT S `G A RAG E S 1 Zoning -Setbacks -Easements 2 Ftgs; Soils -Sz-DpthSpacing-CnnctrsSteeI 3 Decks, Girders/Joists-Dcking-Brcing Stairs-Guard/Handrails 4 Wood Awn; Posts-Beams-Rftrs-Cnnctrs-Shthg Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Encisrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills-AnchrsStuds-Rftrs-Trusses 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnis y s` DATE IPOOLS 1 Setbacks -Easements 2 Soils; CompactionStructure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI 5 Elec Pool Lting; 15 volts-GFI 6 Elec Enclsrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w/5'-Crcltng Eqp-Htr 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg Bones-Enclsrs-pnlboards4nsultn to Main Conduit 9 Health Dept Apprvl 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Enclsr; Fencing -Alarms 13 Bonding, Diving board or Slide s` °0 s` Pool Drawing J = OK 0 = Not OK RESIDENTIAL (Single & Duplex) DATE JUNDERFLOOR 1 Zoning -Setbacks -Easements -Flood -Slope 2 Ftg Main; Soils-Elec Grnd Ftg Dpth 3 Ftg Garage; Soils-Steel-Elec Grnd Ftg Dpth_ 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth ` 5 Stemwalls Main; Steel-Blockouts-Wrapped 6 Stemwalls Garage; Steel-Blockouts-Wrapped 69 Hold Downs and Special Anchrs 7 Slab, Steel Wrapped 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way C/0 -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test 1.1 Wtr Pipe; Test-Anchrs-Rgltr-Service Test 12 Elec Undrgrnd 13 Plenums & Ducts; Clrnc-Materia"upport4nsultn _ 14 Girders Sills-Anchr BoltsJoists-Vnts-Cripples 15 Acc & Vntitn 16 Insulation mac` c o'" m` o9e o` DATE IFRAMING 17 Sills Proper Materials & Anchrs IS Walls Studs -Nailing Spacing & Braces -Plates -Sound 19 Bearing Walls over Girders & fir Nailing 20 Draft Stop in Walls (rat proof) 21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 22 Headers & Beams-Sz & Bearing 23 Hangers -Post Caps-Anchrs-Cnnctns 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac-TrussShthg 25 Frplc Ties or Type A Flue-Frplc Throat Clmc 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 28 Garage Fire Prtctn Framing -RC Channel 29 Prprty Line Firewall & Opngs 30 Ext Doors -One T -Check Garage 3rd Story, 2 Exits 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 32. Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 33 Siding -Nailing Veneer 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc 35 Glazing Area -Glass Prtctn-SkyLts-Plastic 36 Shear Walls; Nailing -Bolts 37 Brace Int/Ext Wall pnis 38 Insultn-Walls-Ceilings 39 Infiltration-Walls-Wndws s`. DATE JELECTRICAL 40 Fxtr & Trnsfrmr CImc4ns Prtctn 4�1_ �Elec Rcptcls Spacing-Lts & Switches at Doors 4f Jz Boxes & No Of Cndctrs Stapled v 43.Rarnex Installed Close to Edge of Studs & CJ Grnd made up w/Mech Fstnrs rndng Electrode Bond Gas & Wtr 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 47 Subfeed Wire Sz ga ❑ CU or DAL AC Wire Sz ga D CU or DAL 48 Range Circ ga DCU or DAL Oven Circ ga. D CU or D AL Insulated Neutral DYes "No 49o<e'rvice-Riser Cndctrs & Grnd Main Dscnnct �p Clrncs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector a A S e PLUMBING 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 54 Wtr Pipe; Test & Anchr-Nail Prtctn 55 DWV; Test Fittings & Anchr Nail Prtctn 56 Shwr Pan; Test, First flr-Tub Acc 57 Test Tub & Shwr, 2nd fir - Tub. Acc 58 Gas Pipe; Sz & Anchrs 59 Fire Sprinkler; Test 60 Yard Gas Piping mac` �c DATE IMECHANICAL 61 AC Ducts Insultn & Support 62 Vent Fan, Exhaust abv Insultn 63 Condensate Drain & Ovrflw, Sz & Grade 64 Furnace -Vent Acc-Comb Air RtrnNent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic FINAL 66 Ext Steps -Door & SideLt Prtctn -Landings 67 Smoke Detector 68 Furnace Vnts-Clrnc-Comb, Air-Cnnctr In Garage; abv-flr-Ducts-Mech Prtctn 69 Bedroom Exiting 70 GFI & Bath Fxtrs & Tub Acc-Spa 71 GFI Arc Fault 72 Elec Trim & Subpnl, Breaker Sts & Labels 73 Stairs, Guard/Handrails 74 Frplc or Stove, Clrnc-Hearth 75 Elec Outlets at Wood Pnl, Int & Ext 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clrnc 77 Elec Outlets & Rcptcls at Ktchn Counter 78 Garage Fire Door; Swing -Landing -Closure 79 AC Duct in Garage -Damper 80 Wtr Htr; Vnts-Cimc-Com Air Cnnctr-PRV; abv fir Mech Prtctn; LPG Appince Undr House 3" drain 81 Plmb; Elec & Mech Eqp Listed for Loctn 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 83 Insultn-Foam-Looked in Attic 84 Guard Rails & Deck Cnstrctn-Post Caps 85 Fndn Vnts &'Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Drnge Planters D Yes D No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Plmb-Appinc-Frplc-CImc to Opngs 90 Wtr Well, Dscnnct, Elec, Plmb 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd 92 Vntitn thru House 93 Glass Prtctn 94 Corrections from previous Inspctns 95 Gas Test -Meters Tagged, Gas-Elec 96 Wtr & Sewer Cnnctd-CIO to grade -HD Apprvl 97 Energy Cmpinc Cert -Other Certs 98 Address Posted -99 Fire Sprinkler re Butte County Department of Development Services. a�urrf. AREA N ® T E S 1 7 County Center Drive, Oroville, CA 95965 (530) 538-7601 www.bupecounty netidds nn RESIDENTIAL APN:�^O Permit No. cJv Owner- n V L l AMU Site Address- i�/y4P3/'q Contractor. �i Type of Permit: / EPCf}C6 PBWFQ 1 OL..E i OFFICE COPY Address 625z 'rbtil(3&;(nSA GAS Meter By Date ELECTRIC t `�-23 -�j Meter By StmMDate SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE �_jc_i41�- C,eES-F0 of DATE JOB FINALED: ` - 2_3.—Qg _1 SIGNATURE: += OK n = nine nK MANUFACTURED HOMES MISCELLANEOUS DATE PERMANENT FOUNDATION L j SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; FaldC/0-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Clrncs-Grnd Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap Nat 0 or LP❑ Inch Sz Ft Lngth 7 Blckng; Sz-Spacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-Clrncs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -C/O to Grade 12 Gas and Electricity Tagged 13 Tie Downs 0 Foundation Q 14 Exits 15 Cert of Occupancy 16 HUD Label/Insignia Numbers Serial Numbers DATE ID E C K S -C O V E R S`C A R P O R T S `G A R A G E S 1 Zoning -Setbacks -Easements 2 Ftgs; Soils-Sz-DpthSpacing-CnnctrsSteel 3 Decks, Girders/Joists-Dcking-Brcing Stairs-Guard/Handrails 4 Wood Awn; Posts -Beams -Rftrs -Cnnctrs -S hthg Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Encisrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills -AnchrsStuds-Rftrs-Trusses 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls ° 0S 9 0s DATE POOLS 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI 5 Elec Pool Lting; 15 volts-GFl 6 Elec Encisrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w/5'-Crcitng Eqp-Htr 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg Bokes-Encisrs-pnlboards-Insults to Main Conduit 9 Health Dept Apprvl 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Enclsr; Fencing -Alarms 13 Bonding, Diving board or Slide s` Pool Drawing = OK 0 = Not OK RESIDENTIAL {Single. & Duplex} DATE JUNDERFLOOR DATE PLUMBING 1 Zoning -Setbacks -Easements -Flood -Slope 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 2 Ftg Main; Soils-Elec Grnd Ftg Dpth 54 Wtr Pipe; Test'& Anchr-Nail Prtctn 3 Ftg Garage; Soils-Steel-Elec Grnd Ftg Dpth. 55 DWV; Test Fittings & Anchr Nail Prtctn 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth 56 Shwr Pan; Test, First flr-Tub Acc 5 Stemwalls Main; Steel-Blockouts-Wrapped 57 Test Tub & Shwr, 2nd fir - Tub, Acc 6 Stemwalls Garage; Steel-Biockouts-Wrapped 58 Gas Pipe; Sz & Anchrs 69 Hold Downs and Special Anchrs 59 Fire Sprinkler; Test 7 Slab, Steel Wrapped 60 Yard Gas Piping 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way C/0 -Sewer Test 10 UF, Gas Pipe, Sz Anchrs-Sz Test 1i Wtr Pipe; Test-Anchrs-RgltrService Test 12 Elec Undrgrnd DATE M E C H A N I C A L 13 Plenums & Ducts; Clrnc-MaterialSupport-Insultn 61 AC Ducts Insultn & Support 14 Girders-Sills-Anchr BoltsJoists-Vats-Cripples 62 Vent Fan, Exhaust abv lnsultn 15 Acc & Vntltn 63 Condensate Drain & Ovrflw, Sz & Grade 16. Insulation 64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic mac` c 4 \C \C DATE IFRAMING 17 Sills Proper Materials & Anchrs DATE IFINAL 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 66 Ext Steps -Door & SideLt Prtctn-Landings 19 Bearing Walls over Girders & fir Nailing 67 Smoke Detector 20 Draft Stop in Walls (rat proof) 68 Furnace Vnts-Clrnc-Comb, Air-Cnnctr 21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs In Garage; abv-flr-Ducts-Mech Prtctn 22 Headers & Beams-Sz & Bearing 69 Bedroom Exiting 23 Hangers -Post Caps-Anchrs-Cnnctns 70 GFI & Bath Fxtrs & Tub Acc-Spa 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac-TrussShthg 71 GFI Arc Fault 25 Frplc Ties or Type A Flue-Frplc Throat Clrnc 72 Elec Trim & Subpnl, Breaker Szs & Labels 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop4ns Baffles 73 Stairs, Guard/Handrails 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 74 Frplc or Stove, Cimc-Hearth 28 Garage Fire Prtctn Framing -RC Channel 75 Elec Outlets at Wood Pnl, Int & Ext 29 Prprty Line Firewall & Opngs 76 Ktchn, Fxtr & Apptnc; Grnd-Air-Gap-Cooking Clmc 30 Ext Doors -One 3' -Check Garage 3rd Story, 2 Exits 77 Elec Outlets & Rcptcls at Ktchn Counter 31 Stairs; Width-Hdrm-Rise-Run -Landing -Fire Prtctn 78 Garage Fire Door; Swing -Landing -Closure 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 79 AC Duct in Garage -Damper 33 Siding -Nailing Veneer 80 Wtr Htr; Vnts-Clmc-Com Air Cnnctr-PRV; abv fir 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc Mech Prtctn; LPG Appince Undr House 3" drain 35 Glazing Area -Glass Prtctn-SkyLts-Plastic 81 Plmb; Elec & Mech Eqp Listed for Loctn 36 Shear Walls; Nailing -Bolts 82 Elec Rcptcls in Garage (GFI) Romex Frtctn 37 Brace Int/Ext Wall pnis 83 lnsultn-Foam-Looked in Attic 38 lnsultn-Walls-Ceilings 84 Guard Rails & Deck Cnstrctn-Post Caps 39 Infiltration-Walls-Wndws 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Drnge Planters DYes [—]No 87 Stucco Brown -Finish 9 o` 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Plmb-Apptnc-Frplc-Clrnc to Opngs DATE JE L E C T I C A L 90 VJtr Well, Dscnnct, Elec, Plmb r & Trnsfrmr Clmc4ns Prtctn 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd 41 Elec Rcptcls Spacing-Lts & Switches at Doors 92 Vntltn thru House 42 Sz Boxes & No Of Cndctrs Stapled 93 Glass Prtctn 43 Romex Installed Close to Edge of Studs & CJ 94 Corrections from previous Inspctns nd made up w/Mech Fstnrs 95 Gas Test -Meters Tagged, Gas-Elec rndng Electrode Bond Gas & Wtr 96 Wtr & Sewer Cnnctd-CIO to grade -HD Apprvl 46 2 Apptnc Cires in Ktchn & Cndctr Sz GFI 97 Energy Cmpinc Cert -Other Certs 47 Subfeed Wire Sz ga ❑ CU or DAL 98 Address Posted AC Wire Sz 92 ❑CU or DAL 99 Fire Sprinkler 48 Range Circ ga F] CU or DAL Oven Circ ga D CU or D AL Ins ted Neutral ❑Yes DNo °+`' 0\� oe 0�s ervice-Riser Cndctrs & Grnd Main Dscnnct 50 Eqp Clrncs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector II-23-�5 i11b 5. BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP053064 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 11/15/2005 APN: 064-190-010-000 the Business and Professions Code, and my license is in full force and effect. 3 , D �� License Class: License Number: Site Address: 14595 CARNEGIE RD MAG Date: Contractor: Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: ELECTRICAL SERVICE CHANGE Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: LILLY, SCOTT to its issuance, also requires the applicant for such permit to file a 14595 CARNEGIE RD signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section MAGALIA, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95954-9101 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the (530) 873-4409 applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: ADVANCED ELECTRIC & SOUND owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one 3881 G BENATAR WAY year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of CHICO,CA 95928 sale.). 530-891-7597 O I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: ADVANCED ELECTRIC & SOUND ❑ I am Exempt under Article 3 of the Business and Professions Code Date: Owner: 3881 G BENATAR WAY CHICO,CA 95928 WORKERS' COMPENSATION DECLARATION 530-891-7597 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the License #: 623540 Labor Code, for the performance of the work for which this permit is issued. 9 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of Architect: the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Engineer: Carrier.{` F� 0J�� ERS i NS. �•t ('tel-) Y Policy #: \ &= Q 12 I A W 2 U/ O 1 certify that in the performance of the work for which this permit is Total Square Ft: 0 S. F. issued, I shall not employ any person in any manner so as to Valuation: $0.00 r become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' Census Code:-,1�/jl/ compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those / provisions. ---c) s , ` - 15 I.J Date: V f��y S � Applicant: �"'� ' Ij / WARNING: Failure to secure workers' compensation coverage is 1 unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY ap li able visions of the Butte County Code and/or This permit 1,941reby issued unrbov I hereby affirm that there is a construction lending agency for the the for this is issued 3097 Civ.) Resolution to do work indicatee fo hic as have been paid. r /� ///-/Y —0 , performance of work which permit (Sec BY: Date: Name: ✓� / Address: PERMIT EXPIRES (Date) ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above Information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and slate laws relating to building construction. I acknowledge it is unlawful to alter the substance of ny official fo r d ument of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: y C 't G Signature: Date: ❑ Owner W—Contractor ❑ Agent for Owner ❑ Agent for Contractor \ B. C. Building Permit 01-16-04 pg 1 �(eecG� 'Pav��r� r. �.. t BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY" CONTRACTOR OWNER Last Name first Name Address Fax Sq 6�t�3 City Lic. #/ „3S,�,_ State ct_\ I 45,^Jq l Phone o.T 3 "qbq E-mail Fax E-mail Date Approved: CONTRACTOR Name Address City StateG� Zip jq�2b Phone -75Cj,71 Fax Sq 6�t�3 E-mail Lic. #/ „3S,�,_ Class APPLICANT NAME ARCHITECT/ENGINEER Name City C4 \ cj� Statec Address Phone q `— �� Ci Fax 6� 69()-3 1 City I No State Zip Phone Subdivision Name Map Fax E-mail Lot # State License Number APPLICANT NAME Name C t -A Address City C4 \ cj� Statec Zip 1 Phone q `— �� Ci Fax 6� 69()-3 1 E-mail AppurANT SIGNATURE X For office use only: Zoning Flood Zone SRA I Yes I No Occ, Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. BP 0530 BIN # LOCATION AP# oaq-iaO-010 Property Ad�dr�ss n City Cross Street WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must he shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: V.G. Amount: <6 X5.00 Bldg Receipt #`I Date: I 1 iI OVER FOR SUBMITTAL REQUIREMENTS I t KAFORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 REV 6-16-04 SUBMITTAL REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply fora permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND ININK. Residential, New, Remodels, Additions, and Accessory Structures: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPER! OR 3 Sets Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation. (Note: Not required for additions to mobile or modular homes.) ' ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Detached Accessory Building Form, filled out by the property owner (if required). ❑ 8. Sanitation and site plan approval from the Environmental Health Department. ❑ 9. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer. Mobile, Manufactured, or Modular Homes: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ 4. 2 Floor plans. ❑ 5. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation and site plan approval from the Environmental Health Department. ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). Commercial, New, Additions and Remodels: ❑ 1. 4 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations, with code analysis. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation (if required). ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Statement of Intent for Non -heated and A/C (if required). ❑ 8. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer. ❑ 9. Letter of intent. ❑ 10. Hazardous Material Form. ❑ 11. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530) 538-7541. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\BIdgApp1SubRgmts.doc Page 2 of 2 REV 6-16-04 5630-78B y PERMIT NO. PERMIT EXPIRES Vern Martin OWNER owner CONTR. LOCATION (A.P. 64-19-10 450 Carnegie Rd., lot 260, PP#14, Magalia. J, 4 fi A Temp. Power Pole Called PG&E _ emp. Elec. Serv.. Called PG&E _ Temp. Gas Serv. _ Called PG&E _ JOB JOB ignature) - 7.9 S ij .', ` . COUNTY OF BUTTE — DEPARTMV.NT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUPBING Setback — Firewall Soil Piping Forms Parapets C 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 Footin s N, Stemwal I Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for physically handicaped Conformance of ex. structure Appliances Gas Piping &Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final P EGreFootin s - 7 Footing.ELECT ICAL Masonry Walls Throat Rou h Reinf. Steel Final Fixtures Bond Beam FIRE PRINKLERS Motors Framing — 7 7A9 Test Water Htr. Stucco Final Subpanels Mesh ECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME ILITIES------------------ Elec. Sery a Elec. Pedestal Water Piping I Sewer Gas Piping M0316EUOME INSTALLATION --------------Support Elec. Continuity Water Piping Drainage Gas Piping DAT"E/ q -7 7" / O REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) EA �COUNTY OF�BUTTF — DEPARTMENT OF PUBLIC WO 7 County Center Drives =' OrroviIIe, California 95965 Tel ephdne: 534-4541 APPLICATION AND PERMIT RKS ivk�°3O authorize representatives of the County of Butte to enter upon the BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Signature of Permitee or Agent ov � Mailing Address Qr . s Telephone No. Contra for Mailing Address = Fireplace Total Valuation 7z 490 Telephone No. Permit Fee Building Address�— Plan Checking Fee &/or Penalty — Permit Fee PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 A. P. N —/ o Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 F s Sang n Fire Dept. FireZone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 Bld .Plans Recd � ParceLfip royal Plans pprova! Lawn sprinkler system 2.00 NEW ❑ ADDITION UTILITIES ❑ OTHER ❑ Permit Fee $ $ Q ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service soov OR LESS 100 AMP OR LESS 5•�0 Single Family Duplex ❑ Mobil Home ❑ Others Main service EA. ADD'L 100 AMP 2.50 100 AMP O 25.00 Main service OVER P OR LESS Main service EA. ADD'L 100 AMP 1.00 NEW CONST. ( OR ADDNS. ACCLBLDGS.LING CCUP. 7i\ 22sgft // 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: NEW CONSTR /MULTI -OUT T NON -REBID ` BRANCH CIRCUITS)i 2.50ea NEW CONSTR. POWER APPARATUS 8 NON-RESID. SINGLE OUTLET CIR. Ex. OCCUp(OUTLETS OR FIXTURES) g @2j FIXED ALINIS Ex. Occup. (OUTLETS P(RESID )REA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ MECHANICAL No. @ 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. IRI 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 Hood2.00 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 Land Development Fee $ TOTAL PERMIT FEE$ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X (xj--- �� V � l � ate Z/,a e Signature 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 been paid. DIRECTO&OF PUBLIC WORKS ey — Date_I 1-7 — tZ B ding permit expires Date F— ZS -77_ —K-1-1— ,.ria.. J 0 -190-010 + 02-1470 MANZONE, ERIC & DARLENE 14595 CARNEGIE, MAGALIA CONT: ALL ROOFING RE -ROOF COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION A 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 n, / p �� . (Rev. 12/96) APPLICATION AND PERMIT r,? y ASSESSOR i °a"U1 U . U' p ZO"NN° BUILDING PERMIT OWNER - i;A-/73-:39-:7.� i. 1 '� \ TELEPHONE SQ. FT. OCC. BUILDING VALUATION L �. r ` OWNERS MAIADDRESS. - :� +� LING , �. --� A f ' r S 9z) CONTRACTOR'S NAME TELEPHONE _7 CONTRACTORS MATING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ • 0 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ Ss.o ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS- -ar � Energy Plan Checking Fee $ $ X11 �1� L[,!A. (G . I PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Feel 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ . Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other GY Describe Work: , ,- . - ti Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W 4 @20.00 PERMIT FEE S J t t ELECTRICAL PERMIT Fling Fee 20.00 Main Service NOA OR LESS 23.00 L LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. L '� License Class (� . 7 �i Lic. No. i i 4 ''� J OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation � of one hundred dollars ($100) or less.) 111 1 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 workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X 0 ; 'k y 4. ! . \. ` i ' l Date t, I la L ? Signature of Applicant - ❑ Owner CcYContractor ❑ Agent' An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Main Service zooA T° lOooA 46.00 NEW CONST. OWELLINO OCCUP. SO OR ADDNS. 6 ACC. OCS. 3.50FT. P1ONq°Ip, MULTI -OUTLET BRANCH CIRCUITS @7.50 POWER APPARATUS b SINGLE OUTLET CIR. Ex. Occup. an0 @ 1.00 OUTLET OR FIXTURES.50 Ex. Occup. oFlUTEis RsID.°Ew 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE t MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEES HOZ. D. FEES IMP FLOOD COF PARCEL PD HD ISSUE 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. By J .t l . Date PERMIT EXPIRES ON �- - �' - Date ReceiptNo. 3S 3S �5� $S OU WHITE-D.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT i COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 Mo. (Rev. 12/96) APPLICATION AND PERMIT oaiy ASS 9RP ELNU Brij _� /--jam l0 o (u ZONING BUILDINGPERMIT ��/y OWNER • y�.EPMO=E ` �"� SO. FT. OCC. BUILDING VALUATION ' O . OWf1ER MAILI ADD Ess Ss CONTRACT R'S NAMET I/niv03 NONE 1 CONTRALTO MAILING KESS / J CONSTRUCTION LENDER 5 Fireplace LENDER'S KWUNG ADDRESS Total Valuation $ .00 ARCHITECT OR ENGINEER LICENSE NO. —Filing Fee $ 20.00 Permit Fee $ 36• ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee. $ BUILDING ADDRESS Energy Plan Checking Fee $ PERMIT FEE 515-00 LAT NO. SUBONISe NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE / SF d Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat um water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other G9' Describe Work: Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G W @20.00 PERMIT FEE _ - t7 ilk ELECTRICAL PERMIT Fling Fee 20.00 OOOV OR LE ) Main Service ZO.AORLESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is i fu l r and effect.t-� Q License Class Lic. No. / -1 3 DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. OwnuNo occuP. so OR ADDNS. ( a ACC. OCS. 3.5¢F, NEW CONSTMULTI.OUTLET @7,50 POWER APPARATUS 6 SINGLE OUTLET CIR. E(, OCCU �L 00 OUTLET OR FIXTURES j 20 @ 1.00OWNER-BUILDER Ex. Occup. oFlxlmt�sRa ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed If the permit is for work of a valuation of one hundred dollars ($100) or less.) elcertify 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 workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply ith those provisions. X Date Signature of Applican - Owner WContractor ❑ Agent/ An OSHA permit is required for excavations over 5'0" deep and demolition or construction46� of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ 55 -0 HAZ. D. FEES IMP I FLOOD I CDF PARCEL I PD MD SSUE This permit is hereby issued under the applicable provisions of the B e County Code and/or Resolutions to do work indica d ove for wh)M fees have been paid. -( �� By Date PERMIT EXPIRES ON Date Receipt No. rJ 3J a5 SS • I WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 02-1483 064-190-010 MANZONE, LAWRENCE 14595 CARNEGIE RD., MAGALIA RELOCATE WOODSTOVE & ADD SKYLIGHTS I III COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION Oct 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT 'per '/ ASSESSOR PARCEL NUMBER 0654-190-010 ZONING R 1 BUILDING PERMIT OWNER MANZ. E LAWRENCE TELEPHONE 873-3924 SD. FT. OCC. BUILDING VALUATION CONr OWNERS MAILING ADDRESS 14595 CARNEGIE RD. MAGAIJAs CA 95954 CONTRACTOR'S NAME OWJ�n TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace A 1 500• LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 2 0.00 Permit Fee '$ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 32.00 BUILDING ADDRESS 14595 CARNEGIE RD. MAGALIA CA 959-54 Energy Plan Checking Fee $ $ PERMIT FEE $ 106.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.0023.00 USEOFSTRUCTURE SF CX Duplex ❑ Mobilehome ❑ Other SPEeIIFv Solar or heat um water heater Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Q Describe Work: WOODS'IOVI REI)CATTON AND ADDITION (T 2 G' X 20� t SKYLIGIM Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 OOOV OR LESS Main Service 200. OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.POWEPPARATUS License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. I am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: compensation, as provided for by section 3700 of the Labor Code, for the 1(I have and will maintain a certificate of consent to self -insure for workers' performance of the work for which this permit is issued. 0 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. SO OR ADDNS. ( a ACC. BLOS. 3.50FT; NON.RESID MULTI -OUTLET @7,50 a SINGLER AOUTLET CIR. 20 .00 EX. Occup. OUTLET OR FIXTURES SAL 1.50 FIXED APPINS. OR Ex. Occu . ouTLETs RESID. EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE _ MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number (The above sectio eed of be complete a permit is for work of a valuation of one hundred dolls` ($1 or less.) I certify that in the perfdr n the work for c this permit is issued, I shall not employ any person I .a come subject to workers' ! compensation laws of California, an ag`?ee a s uld become subject to the' workers' compensation proTi s f io 37Z of the Labor Code, I shall forthwith comply with those n j r �� to (7 — 7-63- Qig�nature of Applicant -r wt e1 gentAn OSHA permit is require for excavations 0F, ii demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection; Fee �' $ c T . , : •OTAL FEE $ 106, HAZ. "' r .7. D. FEES IMP } FLOOD CDF PARCEL PD HO ISSUE This,p it Is hereby Issued under the applicable provisions of the'Butte�Courity Code and/or Resolutions to do work indicated above.ior' hich fees have been paid. y " - !' Date -� PERMIT EXPIRE ON — Date Receipt No.-� WHITE-D.D.S.-B.D. — CANAR - SESS R PINK -I SPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION + 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev.12/96) APPLICATION AND PERMIT !9 ^/ AS E S�b�+RP C NUMBER - -010 ZONING R 1 BUILDING PERMIT OWNER MANZONE LAWRENCE TELEPHONE 873-3924 SO. FT. OCC. BUILDING VALUATION CONT EST 1 000. . OWNERS "UNG ADDRESS 14595 CARNEGIE RD. MAGALIA CA 95954 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace A 1 500.0 LENDER'S MAILING ADDRESS Total Valuation $9-500.00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 54.00 ARCHITECT OR ENGINEERS MAIUNG ADDRESS Plan Checking Fee $ 32.00 BUILDING ADDRESS 14595 CARNEGIE RD. MAGALIA CA 9595 Energy Plan Checking Fee $ $ PERMIT FEE s 106.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.0023.00 USEOFSTRUCTURE SF EX Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat um water heater Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Xl Describe Work: WOODSTOVE RELOCATION AND ADDITION OF 2 6' X 20" SKYLIGHTS Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service AORLE:s 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. YI, as owner of the property, am exclusively contracting with licensed contractors to construct the project. I am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) 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 workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X to 6 — — d Z SI ture of Applicant - w er ❑ Contractor Agent An OSHA permit is require for excavations over 5'0"deep and demolition or construction structures over 3 stories in hei ht. Main Service 200A TO 1000A 46.00 NEW CONST. DWEWNG UP. SO OR ADDNS. ( a ACC. BLDS. 3.5¢FT. NNOONN•HO�-IO. MULTI. OUTLET @7.50 a �SINGLE �R AOUTLET CIR.PPARATUS zo Q ,.00 Ex. Occup. OUTLET OR FDCTURES SAL @ .50 Ex. Occup. owners .a 1 EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring23.00 PERMIT FEE $ MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 106.0 HAZ. D. FEES IMP I FLOOD I COF PARCEL PD HD ISSUE This permit is hereb issued under of the Butte Coun Code and/or indicated above for hich fees have (D�, PERMIT EXPIRE tP - the applicable provisions Resolutions to do work been paid. / �of rD7ate 4 ` ...- 3 ate Receipt No. WHITE-D.D.S.-B.D. CANAR SS R PINK -INSPECTOR GOLDENROD -APPLICANT )0 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signaftm Please complete and return this information at your earliest opportunity to avoid unnepessary delay in processing and issuing your building permit. No building permit will be issued until dais fication is received. 1 I personally plan to provide the major labor and materials for construction of the proposed property improvement: YES 0 NO O I HAVE J( HAVE NOT 13 signed an application for a building permit for the proposed WO& 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: Iplan topmo supervise, and NAME: CONTRACTOR'S LI ns of this work, but I have hi ie-naior work: following person to coordinate, ADDRESS: CITY: PHONE: ONTRACTOR'S L NSE NO. 5. I will provide some of work but I have contracted (hired) the owing persons to provide the work indicated: NAME ADDRESS PHONE TYP OF WORK SIGNED: PROPERTYOWNER. SOCIAL CURITY NUMBER: — D ATE: G – NOTE: This Owner -Builder Verification is required by Section 198.31 and 19832 of fie California Health and Safety Code. This verification must be eompkted /ud returned to our office before we are permitted to issue the permit OVER a OWNER BUILDER INFORMATION .1 Dear Property Ow-."': An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as -owner-builder" you are the responsible parry of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ♦ If you employ or otherwise engage any persons other than your immediate family. and the work (including materials and other costs) is 5300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. ♦ If you are an emplover, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the G.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1030 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. I!�m rely, el C. Vi ira, C.B.O. ger, Building Inspection NOTE: Tris Owner -Builder Information is required by Section !9810 of the Californla Health and Safety Code OVER ... ,I/ py /� F y PERMIT NUMBER - B 786 73B,P,E 4 P ti r E .y . i PERMIT EXPIRES ,TOWNER Vern Martin .,.,CONTR:. Schecker Const. Co., Paradise t LOCATION (A.P. 64-19-10 450 Carnegie Rd. Lot 260, P.P.#14, Magalia I COUNTY OF BUTTE Department of PUblA'c Works r. BUILDING INSPECTION' RECORD Zoning. •Setback ✓r 2-21 Forms r— Foundation _ Piers & Girders !_ Fireplace Rgh. Plumbing per.?�? Bond Beam Lath & Plaster Rein. Steel Gas Piping & Test Found. Vents '15"Vlm Framing _ Plmg. Topout S—Zq, ?3 �� Rough Elec. r�r Wir. Htr. 7• Furnace Kitchen Vent �/" % Firewall Garage Vents. g 7� Sanitation &Water ELECTRIC GAS BUILDING Temporary Temporary _ Cert. of Occup. Final r� % Final Final 171— DATE REMARKS OR CORRECTIONS 9-73 . �iAT�� P/�> C TO NOSE pja 13 Y S'£i�7�G z'/✓�/� Q/)` TO COvt � h/�S C O V, F04 /FOci"✓j7 f17 T�%S !> i Stift, N0 P.CoT �z�,✓ 0 COUNTY OF BUTTE — PEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT 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 represe of the County of Butte to enter upon the above. property r i spection purposes. X Date r 'g ure of Permiitee /o/ter Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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 OF BLIC WORKS By Date 7 2,V r1lding permit expires Date.................�.�� . BUILDING OwnerSQ. I&RAJ MAR -71 AJ FT. OCC. BUILDING VALUATION Z/0 D�s Mailing Address Telephone No. Fireplace Contractor C — C Q,1 -f7—, Total Valuation 3( -- Mai I i ng Address v Permit Fee Plan Checking Fee &/or Penalty Telephone No. b7, Permit Fee $ Building AddressPLUMBING No. @ FEE PERMIT FILING FEE $2.00 L. Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 G % A. P. No. � 7 " / 0 Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F V1rC. San ire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Parcel Declaration Parcel Ma p 60' R/W Improvements_ Lawn sprinkler system 2.00 �vPl�ans Bl dg.41ns Recdrova Plans royal Permit Fee $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER 10 ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service incl. 1 meter 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 L')6-6 ore Water Heater or Space Heater 1.00 Light fixtures ba�l df1�0 Receps., switches & fix outlets 2oT�2s CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of Califo nia B siness & 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 `6715 License No. � Classification Misc. wiring ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ 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. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. ®pI certify that in the performance of the work for which this ermit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. 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 authorize represe of the County of Butte to enter upon the above. property r i spection purposes. X Date r 'g ure of Permiitee /o/ter Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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 OF BLIC WORKS By Date 7 2,V r1lding permit expires Date.................�.�� . COUNTY OF BUTTE — PE.RARTMENT OF PUBLIC WORKS 7 County Center Drive —• Oroville, California 95965 Telephone: 534-4541 /A APPLICATION AND PERMIT 73� authorize representatives of the county of Butte to enter upon the abov n i d prope o spection purposes. Date Sigture 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 been paid. DIRECTOR OF PUBLIC WORKS pBuilding Date3— permit expires ate 7--7,P-751 BUILDING Owner SQ. FT. OCC. BUILDING VALUATION 3 ov .� / o -v Mailing Address �+d T may/ 4/d Telephone No. Fireplace Contractor Total Valuation a Mailing Address Permit Fee P I an Check I ng Fee &/or Penalty Telephone Aao7 Aa Permit Fee ^' $ Building Address d� PLUMBING No. @ FEE PERMIT FILING FEE $2.00 cr" G e < Each Trap 1.50 Lr Repair drainage or vent piping 1.50 Water piping 1.50 / sti Each gas water heater or vent 1.50 A. P. No. -- Zoning 8 Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F an' n Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W Im rovements P Lawn sprinkler system 2.00 Bldg. PIa�Rec'd I Parcel Approval Plans Approval Permit Fee $ /Ss" $ NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Q=' Main service incl. 1 meter 3 �' Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Single Family Duplex ❑ Mobil Home ❑ Others ❑ Ran:@I-, Cook -top or Oven 1.00 Water H ter or SpawcHeater 1.00 Light fixturesbU�(d(dl0�- R e sw s & fix pdats 78 Z�5 aCd CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of Cal iforni usiness & Professions Code under the name style of: 1-106d, Ex. FanorF.A. Furn. Motor 1.00 .-0 Evap. cooler, gar.60sp. or 9-W. 1.00 ,Z � 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 $ 3Z 8 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 $ f/� 3d authorize representatives of the county of Butte to enter upon the abov n i d prope o spection purposes. Date Sigture 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 been paid. DIRECTOR OF PUBLIC WORKS pBuilding Date3— permit expires ate 7--7,P-751 ` PERMIT NO. 4980-76B PERMIT EXPIRES OWNER Vern Martin CONTR. owner LOCATION (A.P. 64-19-10 ) 450 Carnegie Rd., lot 260, PP#14, Magalia Temp. Power Pole Called PG&E /ALED— (Datef) (Signature) COUNTY OF BUTTE — DEPARTMEINT OF -PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms 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 Stemwal l Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov, for physically handica a Conformance of ex. structure Appliances Gas Piping &Test Temp. Gas Slab Final $ Sanitation Patio FIREPLACE Final Footings Footing EL ECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRES RINKLERS Motors Framing_ �� 6 Test Water Htr. Stucco Final Subpanels Mesh ME HANICAL Grd. Fault Pro Scratch Heatino Service Brown Cooling Temp. Pole Finish Ducts Under roun� Interior Lath Ventilation Permanent Door Closer Final Final DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE .2' DEPARTMENT OF PUBLIC WORKS ► � 7 County Center DPh—="Uroville, 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. / �I X V IuC.t.ea .tate ! / Signature of Permittee or Agent Receipt No. / J /"1p Y 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 DIRECTOR OF U LIC WORKS BY Date ding permit expires Dates %% BUILDING Owner SO. FT. OCC. BUILDING VALUATION 7-2-7 ECA- (q Ll Mailing Address S^ Q C - o•ae bonee No //9"O. Fireplace Contractor Total Valuation 14 Mailing Address Permit Fee S — Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ S Building Address yS O PLUMBING No. @ FEE PERMIT FILING FEE $3.00 �% p / 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. lO� �9 �� Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F6Z_ btrL� Sa (o FireDept. Fire Zone Use Permit Building sewer 5.00 EOA Parking Parcel parcel a Plans Declaration P�� 60' R/W ImprovementsLawn sprinkler system 2.00 Bldg. P�ec'd Parcel `Approval Plans pproval Permit Fee $ $ NEW ❑ ADDITION UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 OR Main service ioo00 AMP ORSLESS 5.00 Main service EA. ADD'L too AMP 2.50 Main service OVER 00 AMP OR LESS 25.00 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD'L too AMP 1.00 NEW OR ADDNST ( ACCLBLDGS.LING CCUP. &) 2(tsgft NEW CONSTR. MULTI.OUTLET NON-RESID. BRANCH CIRCUITS) 2.50ea NEW CONSTR. (POWER APPARATUS &) NON -RES,D. 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 st le of: Y Ex. Occup(OUTLETS OR FIXTURES)@L�C BAL@1 EOFIXED APPLNS• OR x. ccuP• 2.00 OUTLETS (RESID.) EA) Temporary service 10.00 Mobile Home Facilities 15.00 License No. 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 Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. .rV I certify that in the performance of the work for which this ermit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 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. / �I X V IuC.t.ea .tate ! / Signature of Permittee or Agent Receipt No. / J /"1p Y 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 DIRECTOR OF U LIC WORKS BY Date ding permit expires Dates %%