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HomeMy WebLinkAbout064-340-003A.P. 641L-34_' FITZSIMMONS, C. C ?! ST 775 Sherwood Circle, Magalia CONTR: Pine Mount'an .ev_., Magalia Pemit 1485-72P* i��� (utility for mobile home)_ A.P . LOT BLOCK SUBDIV. C.C. FITSZIMMONS i75 Sherwood Circle, Magalia TYPE OF CONTR:. Ray N. Mun'Var Maga 'a PERMIT PERMIT NO. PLAN NO. DATE ISS Permit lg24-72P,E ,o (utilities for mobhome) A. P C.C. Fitzsimmons 75 Sh rwood Circle, Lot 77, P. #4 CON D.E. LeVasseur, Magali Pe it 3306-72 (new deck & s-t ps for mobile hom A.P. ` 3*.3 C. C FITZSIMMONS 75 Sh rwood Circle Lot 77, .P.#4, Magali CONT E.-LeVasseur-.,- Magalia Permit 3407-72B,E t (garage to be used with mobile home) I I PERMIT DESIGNATION: B -BUILDING DEPARTMENT OF P -PLUMBING T -TRAILER BUILDING AND SAFETY E -ELECTRICAL U -USE PERMIT TV - RADIO -TV ANTENNA V - VARIANCE S/W-SIDEWALK NOTICE S_ SIGN PERMIT REMARKS HM -HOUSE MOVING EP -ENCROACHMENT D - DEMOLITION 600. 1 31Va fl18 31Va 9IS 31Va vis 3. fl13 31Va cis NOIIVNDIS30 iM3HW(1N lIWM3d S7VAONd lb' snnrjNlvr7,7.a,rrw 1VNId SH313W S30NVIlddV V 33Mf11Xld NI•Honom 31Va fl13 31VO "CIS 31VO 913 31VO 913 31Va 9IS SM39Wf1N lIWM3d N itVn(),VIff4d 1VNId S1N3A V S30NVlld1dV 3NIl M3M3S 9Nldld M31VM 1S31 3Mf1SS3Md SV9 NI•H9(10M 31Va 'flIS 31Va 'DIS 31Va 91B 31VO 913 31Va '913 IM38W(1N lIW83d S7VAOMddV ;9A[la71lIS at1033V N01133dSN1 31Va cis 31Va '913 31Va • '913 31Va 91S 3A,Va '913 31Va 'cis 31Va '91S 31Va �JIS 31VO '91S 31Va 'fl IS 31Va '91S 31Va• • I '91S 0 m M> >O rm m0 O n ;� m y A mo I �� Dz m m m0 �� m mA =O z �z mA =O 0 3 z O Z m o Imm C q 0 O�> >wp z z Z�. 3 z m; z'1 S7VAOMddV ;9A[la71lIS at1033V N01133dSN1 COUNTY OF BUTTE , Department of Public Works BUILDING .INSRECTION -RECORD n 'Zoning Zoning Setback Z'�'�— 7L.L Forms Foundation Piers & Girders 'Fireplace , Rgh. Plumbing Bond Beam. Lath & Plaster Rein. Steel Gas Piping & Test Found. Vents Framing Plmg. Topout Rough Elec. Wtr. Htr. Furnace Kitchen Vent Firewall Garage Vents Sanitation & Water ELECTRIC GAS BUILDING Temporary Temporary Cert. of Occup. Final' Final Final DATE REMARKS OR CORRECTIONS` -, %-7L Gd-pk,;r17izc Td F -//a57=" • t a r i COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKSL�t 7 County Center Drive — Oroville, California 95965 Telephone: 533-1230, Ext. 259 APPLICATION AND PERMIT 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. Signature ofP nt/ee/or%Ag n� Receipt No. < White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant TOTAL PERMIT FEE 1� This permit is hereby issued under the aoclicabie pro\,si ms c.f the Butte County Code and/or resolutions to co tvortt above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By— Date7— -INii..-7 L Building Permit Expires Dated 73 r BUILDING Owner.. ,' , b SO. FT, OCC. BUILDING VALUATION Mailing Address i tf ,� •�� - it ti r r�+: S"+ Fireplace Contractor =✓j .i C.' �V . , "� t ,-4 . t,"'. • t Total Valuation Mai l i ng Address ✓ `1 0, -� ` �r, j..'- ; - Permit Fee plan Checking Fee 8/or Penal ty Permit Fee $ $ Building Address —,v a C PLUMBING No. @ FEE PERMIT FILING FEE j 52.00 , r;i> 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. 5`7 42k �O Zoning .z Gas piping system 1 - 5 outlets 1.50 Each additional outlet .50 Fire Zone Fire Dept.anitation` !'' Planning;,/'= Building sewer 5.00 Plans &/ Fees � W. C. ✓ R/W Encroachment Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ OTHER Z Permit Fee $ `� �'r• $ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 — t"Ci`l (,t't.c cJ Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) USE OF STRUCTURE Single Family 0 Duplex ❑ Others ❑ Range, dryer or water heater 1.00 �. r %.+ i ' '— ��, t • - Oven, Cook -top or space heater 1.00 Light fixtures 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 Misc. wiring License No.,=. s 59-C"' ; 2 Classification ❑ i am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's- Compensation. I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. ❑I certify that in the performance of the work for which this permit is issued I shat' not employ any person in any manner so as to become subject tc the Workmen's Compensation Laws of California. MECHANICAL No. @ T FEE PERMIT FILING FEE 53.00 Heating Cooling Ventilation Permit Fee $ $ 1 certify that I have read this application and stat'11e that the above Stote Fee For Str ng Motion Instrumentf_roaram $0.07/$1000 Evration luation $ 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. Signature ofP nt/ee/or%Ag n� Receipt No. < White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant TOTAL PERMIT FEE 1� This permit is hereby issued under the aoclicabie pro\,si ms c.f the Butte County Code and/or resolutions to co tvortt above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By— Date7— -INii..-7 L Building Permit Expires Dated 73 r COUNTY OF BUTTE — . DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 j 9C 1 Telephone: 533-1230, Ext. 259 APPLICATION AND'PERMIT ' BUILDING Owner SO. FT. OCC. BUILDING VALUATION Mailing Address D S17 5 G A Fireplace, Contractor N Total Valuation Mailing Address P G- Permit Fee Plan Checking Fee&/or Penalty A& Permit Fee $ $ Building Address tiil� 7 PLUMBING No. @ FEE PERMIT FILING FEE $2.00 i2 o 0 A Each Trap 1.50 'P y Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 /- n A. P. No. .� / - �n - 3 of Zoning A-,�-_ Gas piping system 1 - 5 outlets 1.50 O f. Each additional outlet .50 Fire Zone Fire Dept. r Sanitation Planning Bulrdling sewer 5.00 SOO Plans Fees' W. C'� R/W• Encroachment Lawn sprinkler system 2.00 NEW © ADDITION ❑ OTHER ❑ Permit Fee $ $O 1 E O ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 7� p0 C (� �� Main service incl. 1 meter 3 co 3,00 Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) USE OF STRUCTURE Single Family X Duplex ❑ Others ❑ Range, dryer or water heater 1.00 )—i0 A6, — Oven, Cook -top or space heater 1.00 Light fixtures Receps., switches & fix outlets _+ &M 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: ply N - V N IN Q 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 Misc. wiring (° 0 A H 06K t2P 47-w License No -& % 10 /! Classification ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ /400 $ /A 00 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 Fee $ - $ate 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 $Permit Fee for Inst umentati nrrpf a Motion $0.07/$1000 Evaluation $ TOTALr PERMIT FEE $�y J�l authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. Date Signature of Permitiittee ror' Agent 001" / Receipt No. q / White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow-Applicont 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 �- Z !i/ `Building Permit Expires Date -�� J f" COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Orovi Ile, California 95965 Telephone: 533-1230, Ext. 259 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 01 $ignoture ofnP'te%or%Ag nt Receipt No. `` White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -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 Dat Building Permit Expires Date_ '--73 '1 BUILDING Owner � C p as "�' . ob b SO. FT. OCC. BUILDING VALUATION Mailing Address C_% 3 Fireplace Contractor ?1 ry0 V k� ' I a R`� "•�% Total Valuation Mailing Address �--�� �� �o, Permit Fee Plan Checking Fee &/or Penalty Permit Fee $ $ Building Address' c? _ . ,�� C. PLUMBING No. @ FEE PERMIT FILING FEE ` $2.00 2,C,0 AIN )• �Q ,�. r �:._, Each Trap 1.50 `> ? 4 yi _ ,d. � Repair drainage or vent piping 1.50 Water piping 1.50 Z60 Each gas water heater or vent 1.50 A. P. No. 5- 9- . 7&0 ­ Zoning _Z Gas piping system 1 - 5 outlets 1.50 Each additional outlet .50 Fire Zone Fire Dept. � an✓l iT itation• ,, Plannin - Building sewer 5.00 Plans &./ / Fees V W. C. i✓T R/W I Encroachment Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ OTHER � Permit Fee $ 1 � $ . D �" ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (morethanl2) USE OF STRUCTURE Single Family Q/ Duplex ❑ Others ❑ Range, dryer or water heater 1.00 Oven, Cook -top or space heater 1.00 Light fixtures balrolo 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 Misc. wiring License No.27 7 _1:7Q'r - Classification ❑ i am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. I have placed on file with the County of Butte a certificate of LX 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 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 S$Permit Insi umentati nrrRn a anion $0.07/$1000 Evaluation $ TOTALt PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 01 $ignoture ofnP'te%or%Ag nt Receipt No. `` White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -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 Dat Building Permit Expires Date_ '--73 '1 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS ^o 7 County Center Drive — Oroville, California 95965 Telephone:. 533-1230, Ext. 259 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. A®9- 3 -77 to i notu a of ermitee or Agentt Receipt No. ��, 'g—y c White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -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 F_-2-7 Z Building Permit Expires Date.p`F-73 BUILDING Owner NJ SO. FT. • OCC. BUILDING VALUATION Mailing Address IJP ® i-4. S l F, DAllG 3 Fireplace Contractor R PN MV Total Valuation Mailing Address o, Permit Fee Plan Checking Fee &/or Penalty Permit Fee $ $ Building Address XPLUMBING .. No. @ FEE PERMIT FILING FEE • . $2.00 p v 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. ST-�_� y 3 vin _ y Zoning H Gas piping system 1 - 5 outlets 1.50 O Each additional outlet .50 Fire Zone Fire Dept. Sanitation I ing Bui ding sewer 5.00 �Od Plans ✓ Fees--` W. C'� R/W I Encroachment Lawn sprinkler system 2.00 NEW ® ADDITION ❑ OTHER ❑ Permit Fee $ 9150 $ 191-15`0 E O — ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 OD Main service incl. 1 meter 3 CP , 00 Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) USE OF STRUCTURE . Single Family M Duplex ❑ Others ❑ Range, dryer or water heater 1.00 INA v 1 L [ H 0 — Oven, Cook -top or space heater 1.00 Light fixtures Receps., switches & fix outlets 252 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: 1� N PA g 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 Misc. wiring License NoA, X7 10 /7 Classification A—! ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $//,&,o $V400 WORKMEN'S COMPENSATION INSURANCE I ammaware.of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. R-71 I have placed on file with the County of Butte a certificate of LA1 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 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 SjPermit Ini ute mentation n a Motion $0.07/$1000 Evaluation $ TOTALY PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. A®9- 3 -77 to i notu a of ermitee or Agentt Receipt No. ��, 'g—y c White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -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 F_-2-7 Z Building Permit Expires Date.p`F-73 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WOR f�D 7 County Center Drive — Oroville, California 95965 Telephone! 53'3-1230, Ext. 259 " APPLICATION AND PERMIT ouM.—U iaN!cachtattves UI the County or Butte to enter upon the abov mention property for inspectio urposes. X , Lri'9 1 Date / %� b 77_ Signature %of Permitee ® or Agent � Receipt No. _! �J'f `r/ _ White-D.P.W. – Pink -Inspector – Goldenrod -Assessor – Yellow -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 BWBLIC WORKS By ate 7 Z Buildi=gPeriit Expires Date /7 ? 75 BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address 0-1- '. n -� /z% Lisp v �S. Fireplace Contractor %7, — SJ ;(!� Total Valuation O Mai IingAddress hd, 0. oy- ��Jr'.7 Permit Fee Plan Checking Fee &/orPenalty ///iCx L%/9 t!'%i , � `f'�'—�f Permit Fee $ QU $ O Building Address '? '� o *77 PLUMBING No.1 @ FEE PERMIT FILING FEE $2.00 _ Each Trap 1.50 A119 4—'17A /3 45',s %i ��—�� � Repair drainage or vent piping 1.50 Water Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. �w ��%', Zoning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .50 Fire Zone Fire Dept. 10, � Planning Building sewer 5.00 Plans � Fees e� W. CLQ R/W Encroachment Lawn sprinkler system 2.00 NEW ADDITION ❑ OTHER ❑ Permit Fee $ $ _ ������� ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 0 IAC-147AI le A( Main service incl. 1 meter Additional meters, each 1.00 USE OF STRUCTURE Single Family ❑ Duplex ❑ Others Q Sub -panel (12 or less) (morethonl2) Range, dryer or water heater 1.00 p�Oven, '09 e,- Cook -top or space heater 1.00 Lig% fixtures a Re s., swi es & fix tlets () 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: pI - AZ_ V119SYA—, //Z eO,T/S'7- e D 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. Misc. wiring z License NQ&1 As Classification a ::�l ❑ i am exempt from the Contractors License Laws of the State of Cal ifomia. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ® I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not em p employ y an y person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEEPERMIT FILING FEE $3.00 Heating Cooling Ventilation Permit Fee $ $ I certifythat I have read this application and state that the above pp information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby 1_ Snstrurnentation- grrao^ion I $0.07/$1000 Evaluation $ TOTAL PERMIT FEE $ ouM.—U iaN!cachtattves UI the County or Butte to enter upon the abov mention property for inspectio urposes. X , Lri'9 1 Date / %� b 77_ Signature %of Permitee ® or Agent � Receipt No. _! �J'f `r/ _ White-D.P.W. – Pink -Inspector – Goldenrod -Assessor – Yellow -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 BWBLIC WORKS By ate 7 Z Buildi=gPeriit Expires Date /7 ? 75 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORK 7 County Center Drive — Oroville, California 95965 SO Telephone: 53i-,1230, Ext. 259 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above entioned property for inspection purpo es. X Date Oe Signature of ermitee or Agent �+ Receipt No. _% �—�� 6?/ W ite-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -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// -7- T-7 Building Permit Expires Date%/—Z�— 2 BUILDING OwnerSQ. if. C , i s' FT. OCC. BUILDING VALUATION Mailing Address 9C Fireplace Contractor Total Valuation Mailing Address (,7, i3p X 2" Permit Fee Plan Checking Fee&/or Penalty c /9c5 /may Permit Fee $ $ Building Address # _ .ate yPERMIT PLUMBING No. @ FEE FILING FEE $2.00 lee- 6P c5 0 17 Each Trap 1.50 "9 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. 5-9— : D-3 Zoning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .50 Fire Zone Fire Dept. Planning Building sewer 5.00 Plans Fees r/ W. C --_—J R/W Encroachment Lawn sprinkler system 2.00 NEW ADDITION ❑ OTHER ❑ Permit Fee $ $ G'' C S T.��S �•� �/ ��' 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) USE OF STRUCTURE Single Family ® Duplex ❑ Others Range, dryer or water heater 1.00 Oven, Cook -top or space heater 1.00 Light fixtures 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: D,,d , L, = k�,SS AZZR e�YST - 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 Misc. wiring F o Fox// AAS -_3 IYA&-,ga /A ?s 2S License No.�V6Z I / Classification 13"1 ❑ 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. 141 I have placed on file with the County of Butte a certificate of l� 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 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 a and State Laws relating to building construction, and hereby jtate Fee for Strp ng Motion Instrumentation Program $0.07/$1000 Evaluation $ 7 TOTAL PERMIT FEE $ O authorize representatives of the County of Butte to enter upon the above entioned property for inspection purpo es. X Date Oe Signature of ermitee or Agent �+ Receipt No. _% �—�� 6?/ W ite-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -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// -7- T-7 Building Permit Expires Date%/—Z�— 2