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Home My WebLink About065-040-04065-04-2A. yQ James Burgess E/S Coutolenc Rd.,app.1000'N.of'Hupp Coutolenc Rd., Magalia contr: Triple"S" Custom Homes, Para. Permit#1379-77B,P,E(new single a family) 0 D� a 6.5-04-40. -- Contr: David C. Marler Per it.#3129'=83B,E(add dinning rm/SF) r i I (; i I 0 lk-. '1 1379-77B P i • PERMIT N0. ,E,;n1: PERMIT EXPIRES r , it OWNER James Burgess CONTR. Triple "S" Custom Homes, Paradise LOCATION (A.P. 65-04-2Vt Vh ) s E/S Coutolenc Rd.,app.1000'N.of Hupp Coutolenc Rd, Magalia' ' 6 YE- `u Temp. Power Pole Called PG&E Temp. Elec. Serv. 7 Cal led� G&E ' Temp . , i Serv. , / PG&E Called JOB - l N FINALED Z .. (Date) t• (Signature) i3 �5 � Mesh MECHANICAL Gird. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole -Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES Elec- Service Elec. Pedestal Water Piping Sewer Gas Piping OBILEHOME INSTALLAT12N -- - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING,,- LUMBING,Setback Setback Firewall Soil Pipin Forms Para ets1st Floor-- Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Piping 2 Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Stemwa l l Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for phsically handicap ed Conformance of ex. structure Appliances Gas Piping & Test Temp. Gas Slab Final ''' Sanitation Patio FIREPLAC Final 'T Footings Footing ELECTRICAL Masonry Walls Throat Rough 2 -'77 Reint. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Gird. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole -Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES Elec- Service Elec. Pedestal Water Piping Sewer Gas Piping OBILEHOME INSTALLAT12N -- - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) 1 1 V Fiber Glass Insulation BUILDERS INSULATION STATEMENT BLOWN INSULATION y Manufacturer's minimum thickness to provide the level of insulation resistance (R) Values as shown - R Values are determined in accordance with ASTM C-687 and C-236. Conforms to Federal Specification HHI-1030A. This insulation has been installed in conformance with the above recom- mendations to provide a value of R using bags of insula- tion to cover. square feet of area. Insulation Contractor Company BATTS AND BLANKET R INSULATION R INSULATION VALUE THICKNESS VALUE THICKNESS R-22 61/2" R-13 35/e" R-19 6" R-11 31/2" Builder (Sign) I Company Name _`,` ate Meets Federal Specification HHI-521E Fiber glass batts or rolls have been installed in accordance with the manufacturer's recommendation to provide an R -Value of '' in the ceiling, in the exterior walls, in the floor or crawl space perimeter. � ✓� Insulation Contractor (Sign) Builder (Sign) Company Name CSG -32-11-C cT• ig�/'�6�ss laev A45 4"'elo RTAIN TEED PRODUCTS CORPORATION. Company Name Date I ,-"vto4-w[ RD P.O. BOX 860, VALLEY FORGE, PA. 19482 Fiber Glass Insulation BUILDERS INSULATION STATEMENT BLOWN INSULATION Manufacturer's minimum thickness to provide the level of insulation resistance (R) Values as shown:_ R Values are determined in accordance with ASTM C-687 and L:-Z3ib- Conforms to Federal Specification 1 -11 -1I -1030A. This insulation has been installed in conformance with the awe recom- mendationto�pro_vide a value of R using — ags of insula- tion to cover --s area Insulation Cont L:ompany Name n) Builder (Sign) Company Name BATTS AND BLANKET Date R INSULATION R INSULATION VALUE THICKNESS VALUE THICKNESS R-22 61/2" R-13 35/e" Meets Federal R-19 6" R-11 31/2" Specification HHI-521E Fiber glass batts or rolls have been installed in accordance with the manufacturer's recommendation to provide an R -Value of /9 in the ng, I in the exterior walls, in the floor or crawl space meter. 24_9jj_e11__ Insulation Contractor (Sign) Builder (Sign) Company Name CSG -32-11-C Company Name Date IN -TEED PRODUCTS CORPORATION. P.O. BOX 860, VALLEY FORGE, PA. 19482 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT autnorize representatives of the county of tsutte to enter upon the above-mentioned property for inspection purposes. X t -2/ Date -_?—-2Z Signature�of^Perrmmmiitee/oorr 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 h been paid. DIREC OR OF PUBLIC WORKS By Date g- Li - 77 Building permit expires Date BUILDINGIr P Owner��^ �. SO. FT. OCC. BUILDING VALUATION QQ Mai I i ng Address V V6 Telephone No. Q Fireplace �D Contractor Total Val ion 00 Mailing Address ` Permit Fee zynpp Plan Checking Fee &/or Penalty A& t T lephone o Permit Fee $ Q $ Building Address C PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Q � A Q/e Aa Each Trap 1.50 Z,00 Repair drainage or vent piping 1.50 Water piping 1.50 _ Zoning Verifical♦io 0 11y Each gas water heater or vent 1.50 A. P. No. �� a"I" Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F .C. Sa n Fire Dept. Fire Zone Use Permit Building sewer 5.00 EOA Parking P ns Parcel Declaration P rcel Ma p 60' R/W Im rovements p Lawn sprinkler system 2.00 Bldg- Plans Rec'd arc I royal P I a s pproval Permit Fee $ $ NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE - PERMIT FILING FEE $3.00 500 Main service e00v OR LESS 100 . AMP OR LESS Main service EA. ADD'L 100 AMP 2.50 J Main service R 600V 1100EAMP OR LESS 25.00 Single Family DuplexO bil Home Others ❑ ❑ ❑ Main service EA. ADD'L 100 AMP 1.00 NEW CONST. DWELLING p & OR ADDNS, AGC. BLDG , D 2�tsgft 0 - ` ' NEW CONSTR, MULTI.OUTLET NON.RESID. BRANCH CIRCUITS) 2.50ea NEW CONSTR. POWER APPARATUS &) NON.RESID. SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name sty1w: A ��c�ri�lli JC^ en> 2 Ex. Occup(OUTLETS OR FIXTURES)50 @250 109 FIXED APPLNS. OR EX. Occup. (OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 �G��c�%� �_- Mobile Home Facilities 15.00 .I.r�y License No. _7/G k1J.S Classification /8 Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $4V71Q $ 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. ❑I certify that in the performance of the work for which this permit is issued I shall not employ any' person in any manner so as to become subject to the Workmen's Compensation Laws of California. PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit $ $ 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 -Fee N I-ZZ4 0 ffLlyz Al TOTAL PERMIT FEE $ L autnorize representatives of the county of tsutte to enter upon the above-mentioned property for inspection purposes. X t -2/ Date -_?—-2Z Signature�of^Perrmmmiitee/oorr 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 h been paid. DIREC OR OF PUBLIC WORKS By Date g- Li - 77 Building permit expires Date RESIDENT IAL PLAN`A'CHECKING GUIDE (S.F., DUPLEX, & MISC. ONLY) `~ Bldg. Permit # 1.77 5, 7 % OWNER �Ale" Y,13 i -e! S A.P. -# A. GENE RALn WAWA I I� � I V II 1. Zoning requirements (sideyards and parking Ivy F� G 2. Valuation. �1 by or Avehioeeb (iC� j j2.1 S MS $ -O }pyJ fUWACe LocATtoN B. PL PLAN Complete parcel size and dimensions. Lf0.0 S etbacks , s ideyards , easements, etc. �'"` �i� '� ��. -�"�f Pc rwciew ess 3. Other buildings or structures. - 4. Grading, fills, drainage. SV(b�11T �TlCx'1�11f�(Z.�Ajf�- �2 f0 U 1 JDA G O a-1 C. FL PLAN Complete to scale plan with dimensions. �equired windows for light and ventilation (Sec. 1405).— ,{, �-Required windows for second exit (Sec. 1404,) . /� _ ��Z )C . Z = 3& 2. Oaf/dvr4 Y4 Allowable glazing for energy requirements (20% mdxe per St to law). )6. Human pact glass (Sec. 5406) .St�. la�or. GtGdz��.r 6Tlis.r 3/0 e red room sizes, ceiling heights (Sec. 1407). G.F.C.I s in baths and exterior outlets (Sec. 210-81 Light fixtures, switches, receptacles, and exterior receptac a for maintenance of (�K:Dmechanical equi. 9. ocations of�tlear heater, eating & cooling equipmen other electrical or gas equipment, and plumbing fixtures. 4K6,Warage firewall, door size, and closer (Sec. 503(d)(4)). bi�:4941 - 3'0" exterior exit door (Sec. 3303d). ° 're lace location. 3. Smoke tectors (Sec. 1413). D. STPJJ RAL DETAILS foundation plan complete enough to construct building. _oor construction details complete enough to construct building. and wall construction details complete enough to construct building. Z:.Elevations .Roof construction details complete enough to construct building. -GL.OLLO QLL%A V4 Lt.O LL VVGL VLLG—OI W&.' LLL 1aG 1F, LaV. 6. Sufficient ata and details to satisfy energy insulation requirements (State law). E EOUS ITEMS TO LOOK OUT FOR . CCX ywood on exposed locations and overhangs. )4 2. airwa etails (Sec. 330 3 Gu c A. Bviek 0 --tone verie— Prober roof pitch for roof covering gWet�ua ties or bearing ridge beam. door or porch header sizes. a racing. walls and posts, etc. (Chapter 32).4//2 /7/V separation required including supporting r r PERMIT NO. 3129-83B, E PERMIT EXPIRES A4 OWNER JAMES BURGESS 4 4 CONTR. David C _ Marler { ASSESSOR PARCEL 65-04-40 1 gLOCATION 1566A Coutolenc Rd, Macra 1 ; a_ i y F; rr r • C� a }t v I •� r � t. Temp. Power Pole Called PG&E Temp. Elec..Service i� Called PG&E Temp. Gas Service Cal led PG&E JOB FINALED (Date) ^� Signature _ 3 � r a r r PERMIT NO. 3129-83B, E PERMIT EXPIRES A4 OWNER JAMES BURGESS 4 4 CONTR. David C _ Marler { ASSESSOR PARCEL 65-04-40 1 gLOCATION 1566A Coutolenc Rd, Macra 1 ; a_ i y F; rr r • C� a }t v I •� r � t. Temp. Power Pole Called PG&E Temp. Elec..Service i� Called PG&E Temp. Gas Service Cal led PG&E JOB FINALED (Date) ^� Signature _ 3 J = OK• 0..= Not OK = Not Applicable = Not Ready MOBILEHOMES MISCELLANEOUS . Date MOBILEHOME UTILITIES (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 2. Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/0 -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails - 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 5. Alum, Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat.or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. - Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Card -BI Date Date Card -BI Date _ POOLS (Plans) OK except N's 1. Setbacks -Easements , 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining _ 4. Electricity; MH Test -Crossovers -Breakers -Clearances 4. Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/0 to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card B-1 Date Card -BI Date Card -BI Date Card -BI Date Card B-1 Date Card -BI Date Card -BI Date Card -BI Date i J = OK r , 0 = Not OK - = Not Applicable RESIDENTIAL (Single and Duplex) ale = Not Ready Date UNDER 00 Plans OK exce t#'s Date FR Continued o grequirements-Setbacks-Easements 4 Pr rty Line Firewall & Openings tg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. -Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ft ., orches & Decks; Soils -Steel- / /" Ftg. Depth lywood on Roof Overhang -Attic Vents -Rafter Outriggers temwalls, Main; Steel-Blockouts-Wrapped-Slab 6. walls, Garage; Steel -Bloc kouts-Wrapped-Slab 53. Siding -Nailing -Veneer Stu Mesh -Drip Screed-Fdn. Vents-Underflr. Access Piers -Fireplace Ftg.-Steel 541' -Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. Plen s & Ducts; Clearance -Material -Support -Ins. , trders-SilIs-Anchor Bolts -Joists -Vents -Cripples Card -BI ate and -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date d -BI Date Date FINAL (Plans) OK except H's Card -BI KK�ate �y and -BI Date Date _ PLUMBING (Permit) OK except N's 14. Water Ht.; Vent -Access -Combustion Air 15. Water Pipe; Test & Anchors -Nail Protection 'delight Protection -Landings 57 moke Detector - learance-Comb. Air -Connector - In Garage; Above Floor -Ducts -Meeh. Protection 16. D.W.V.: Test-Fttngs & Anchors -Nail Protection ng _ Shower Pan; Test, First Floor -Tub Access 6 res & Tub Access __17. 18. Test Tub & Shower, 2nd Floor -Tub Access 6 lec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors -- 63. love; Clearances -Hearth Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 6§. Kit FmYt r3-°pp"nce;•Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date ec. utlets & Receptacles at Kit. Counter Date ELECT AL Permit OK except q's -67-'G3PJ§9-FTrFD'oor; Swing -Landing -Closer 687.-A-e-.Bvct-Ih Garage -Damper -- 2 yFc&Transformer ClearanceIns. Protection 2 �I .. Receptacles Spacing -Lights &Switches at Doors 69 WU utr Vents -Clearance -Comb. Air-Connector-P.R.V.- JR-tarage; Above Floor -Meth. Protections 7 Plb., Elec. & Mech. Equip. Listed for Location _ 2 Siz Boxes & No. of Conductors -Stapled 7 es in Garage; (G.F.I.)-Romex Protec. 2 Ro Installed Close to Edge of Studs & C.J. i 2 quip. Ground made up w/Mech. Fasteners -Bond Gas & Water 7 sulation-Fr5lT-CSoked in Attic es Guard Rails &Deck Construction -Post Caps - lance ircuits in a &Conductor Size 74. Fdn. Vents & Crawl Hole -Drainage & Wood -Earth Clearance Looked under Floor es _ 26. ubfeed S_Wire Size _ gga or AI-A.C. Wire Size / / ga. Cu or Al a4: 27. ange Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, _ sulated Neutral 'Yes 'j No _ 28. S rvice-Riser Conductors & Ground -Main Disconnect 75. Following instld.: Dr�ive/ es ❑ No; Walks es ❑ No; Planters ❑Yes L7 No 7 rown- tots nnect-Clrnces-Brkr. & Cond. Size -115V Outlet 7----_ -- 29. Eq ip. Clearances; Pane ls-Motors=Mech. Equip. -_ 30. Clothes Closet Light -Shower Light _- _ _ 78, ents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. - __- -__-.-.____ -- ____ . - _911 - - ----- -- Card B Date �0�/ Card -BI Date �- �.._____ _ _.._.... Card B -I Date Card -BI Date isconnect, Electrical, Plumbing 8 . F� rior Elec. Trim; G.F.I. Receptacle -Underground 8ve'V9,ritilation throughout House 8 �sS Protection Date MECHANICAL (Permit) OK except q's 8 . Corrections from Previous Inspections g Gas Test -Meters Tagged; Gas -Electric - - - Card -BI- Card -BI Date - 31. A.C. Ducts_ Insulation &SupportConnected-C/0 32. Vent -Fan; Exhaust above Insulation8frEnergy _33. Condensate_ Drain & Overilow; Size & Grade__ 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic -- - ---- - Date Card -BI _ - Date-- Date Card -BI Date F AMING(Plans) OK except q's to Grade -HD Approval Compliance Certificate -Other Certificates - - fir Card -BI Dat Card -BI Date Card- Date Card -BI Date Card -BI Date Card -BI Date Comments at Final: 3 ; Proper Material & Anchors 3? -Wal Is ; Studs -Nailing, Spacing & Bracing -Plates -Sound ng Walls over Girders &_F_loor Nailing 39 raft Stop in Walls (rat proof) 4 S; Furred Ceilings -Stairs -Chases -Tub 41. eader & Beam -Size & Bearing T 42ers=P'ost Caps -Anchors -Connectors 4 Cing. Joist-Rftr. Ties-Purlin-Root Brac.-Truss-Shthng.-Rfng. s or Type A Flue -Fireplace Throat 4 itic Access: Si_ze_& Romex Protection -Draft Stop -Ins. Baffles drm. Windows or Exiting Doors -Sill Hgt. & Dimensions arage Fire Protection Framing - - - (NOTE:Anentrymust be made each time youvisit jobsite) • �� .,� 1� 'I f � '� � p:' � .; N' y�,�' (i COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville,»Cadi'folll'ia 95965 - Telephone 916/534-4541 APPLICATI0k iN0 PERMIT PERMIT NO. i ASSESSOR PARCEL NU BER ZONING BUILDING PERMIT OWNER -JAMES OV96ESS TELEPHONE SO. FT. WC. BUILD ING VALUA ON OWNER'S MAILING ADDRESS CON ACTOR'S NA TELEPHONE (3731001 CO T CTOR'SOLIN A DRESS RO B �?* i Fireplace CONSTRUCTION LENDER UNKNOWN c Total Valuation $ - ado Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ aene+t7— 6X/,67^ it PC /LS — $�� ARCHITECT OR ENGINEER'S AILING ADDRESS Permit fee $ BUILDING ADDRESS C LE7l? C ` PLUMBING PERMIT Filing Fee 10.00 .SIv�O� Each Trap 2.00 Solar Water Heater 20.00 Water pipi 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qA w r e er ent 5.00 Gas pipin s em 1 - 5 outlets 5.00 USE OF STRUCTURE SF Duplex ❑ Mobi lehome ❑ Other SPECIFY Building iewer 5.00. Mobile Home I S I G I W 10-00e TYPE OF WORK New ❑ Addition Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: ZZY N 12aMW, L4 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2:50 NEW CONST. DWELLING OC & OR AODNS. ( ACC. BLDGS. I 2hdSgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Profession Code and my license is in full force and effect. License No. Classification rl� —/ ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR U TI.OUTL T 2,50 ea NON•RESID BRANCH CIRC ITS. NEW CONSTR. (POWER APPARATUS & NON•RESID. (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 200Sao FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID,) EA.) 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ 711 2 - Contractor MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. 5 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance ora Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shal I be deemed revoked. Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabil' ies, judgments, costs, and expenses which may in any way accrue against d County in consequence of t granting of this permit. �_ X Date `� -v —� Signature of Applicant — • Owner ❑ Contractor Agent ❑ An OSHA permit is required for excavations over 5' " deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ E,UE,26 3::1, TOTAL PERMIT FEE $ %D occUP. GROUP 3 TYPE OF CONST. ,^11 PARC PD H ISSU This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF P LIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS 19J -7 Dat - C Receipt No. (, WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT } •�'. i 1 is eUNIT vy ', -26 1042 TF T y a T o SUS' r ►�,, } Pepprri►r Cw. ara �r Irb�- r.:Av, �l +A' 14 DO It Z OAc v OO „ 1.19'2 4t a oe L" " t /14 84 It °h 6 0.lk q Ar r ;x« r s � :• 1 szo4r F 58 ayi. 744clao , t N. Z, 144 04 Jo or 14 COUTOLEJVCk5 qkft 46 Dds Z04 � « k o ,t �r i' a y'` w �'.�, � . .. • IN , 405.46 too, r/ w » <_ r « r" d At -04 IVO. 65 N^v Coun of (,t f � 74 Al r . L �� n.rrv•_ , b1�1!!Vy;M�I'�1M►!�f�A�+.'•S}t rrY ., ,.,. s, ;. .«er.. _Mw. • - ,:: - : . .nc,,.. a+o^.w-arc>•....0 �.--:.--..r+.y. � �� 20 , , ; .;lm '' , , '' L ��4�a V.'4 " 1, 4 , — 4 PAIR ' AM" 9, M 4 Rf 4t 1 f" AA