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HomeMy WebLinkAbout065-100-009Q AP -65-10-09 - GORDON PATTERON w/s Skyway, 250'�V. of DeS bla Mkt. , DeSablac Permit'# 3009-75B,''E(garage) d — Gµ1 Da% &e 65=10-09 GEOERGE BE_C - R NG { 9 Someway, Magalia Contr: Towne Mobile Home SEr, Pai A (MHI/existing site).},//7a'' 74�A1-41 Issuedi✓iOL..4178 0/� A /iK• p y 7� 65-10-9 Contr: Cal Gas, Paradise PErmit #4417-78P (gas piping) MH.. j l a s 1 LM MOBILEHOME INSTALLATION INSPECTION CHECK LIST 1. Is the mobilehome located wi 9 Zrequired separation from lot lines and buildings and generally conform to plot plan? Yes— No 2. Does the mobilehome have required clearances above ground? (Sec.5085) Yes No_ 3. Are footings and supports properly sized, spaced, and braced as pgr approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes,/_ No 4. Is the mobilehome level? (Sec. 5088) Yes !! No_ 5.* If mor than a single unit, are crossover connections properly installed? (Sec. 5088) Yes r/ No 6. Water A. Is flexible connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes ✓No B. Test - Does water piping withstand.working pressure or 50 lbs. air test? Yes �� No C. Backflow - If coach is not State of California approved, does -station have backflow device and pressure -relief valve? Yes— No 7. Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes `�No B. Does it have minimum 4" per foot slope and is it properly supported? Yes 41-�`No— C. Are any leaks detected in drainage system after running 3 -gallons of water through each fixture including washing machine standpipe? Yes— No— D. If coach is not State of California approved, does station have required trap and vent? Yes No 8. Gas.Piping and Gas Vents ,A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum mobilehome connector not more than 6 ft. long? Note: All piping is to be at least as large as the mobilehome gas line inlet without reductions other than the mobilehome connector. Yes I/ No_ t t/ B. :Test OK as per following procedures Yes No 1.- Open all appliance connector valves. 2. Shut off appliance burner and pilot valves. 3. Air test with manometer to 10".-14", water column or test with slope gauge (minimum 0 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without drop. 4. Connect gas meter to mobilehotge.with connector, turn on gas, test connections with .soapy water. C. Are all appliance vents properly installed? Yes No 9. Electrical A. Is service large enough to provide adequate amperage -to mobilehome (must equal rating of mobilehome with a minimum of 100 amp) and other facilities on lot, i.e., water pumps, garage, cabana, etc.? Yes_ No B. Is there proper clearances around panels? Yes No C. Is power supply cord or feeder assembly properly fused? Yes No_ D. Is continuity test satisfactory as per the following procedure? Yes_ No_ 1. De -energize electrical wiring system of the mobilehome at the pedestal. 2. Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected. 3. Switch all breakers and switches in the mobilehome to the "on" position. 4. _Connect one lead of a test instrument to the mobilehome grounding conductor and apply the other lead to each mobilehome supply conductor, including neutral. S. All non-current, carrying metal parts of the mobilehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. 6. Upon completion of the above procedure, the power supply cord or feeder assembly conductors shall be connected to the site service equipment. A further continuity test shall then be made between the grounding electrode and the chassis of the mobilehome. Upon satisfactory completion of the electrical tests, the lot or site service equipment may be approved for energizing. 10. Is job card signed by Health Department for water and sanitation? 11. .If everything okay, sign off card and tag services. MOBTLEHOME DATA Manufacturer and/or Namestyle c T 1v� Length 6 Width i Vehicle Serial No. State Identification No. 6 Additional Information or Comments: � � e COUNTY OF BUTTE DE;?ARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of the California Administrative Code, Title 25, Chapter 51 under permit number for the following location: A , Owner– Owner's wner Owner's Address Mobilehome Mfg. M. < < Model Year r Insignia No.—' - t Serial No. r It is hereby certified for occupancy at the above described location and may be occupied. Director. of Public Works r Date By f/ THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED White - Owner, Yellow - Installer, Pink - D.P.W. PERMIT NO. 4178-78MHI existing site PERMIT EXPIRES OWNER GEORBE BECKERING CONTR._Towne Mobile Home Ser, Paradise LOCATION (A.P. 65-10-09 ) 9 Someway, Magalia 's r F e ' 4 tl I _ 7 � _ F• i. b' }. S Temp. Power Pole Called PG&E Temp. Elea Serv. Called PG&E i Temp. Gas Serv. Called PG&E OB i, FINALED (Date) (Signature) i COUNTY OF BUTTE — DEPARTMENT 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 Stemwall Garage Vents Insulation _ Water Htr. Heaters Slab Carport Footings Prov. for ph sical,ly handica ed Conformance of ex. structure _ Appliances Gas PI In &Test Temp. as Slab Final Sanitation Patio FIREPLACE Final Footings Footing _ ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final _ Subpanels Mesh MECHANICAL _ Grd. Fault Prot. Scratch Heating Service Brown Cooling _ Temp. Pole Finish Ducts Underground Interior Lath Ventilation _ Permanent Door Closer I Final Final MOBILEHOME UTILITIES - - - - - - - - - - - - - Elec- Service Elec. Pedestal Water Piping. Sewer Gas Piping a' E OME INSTALLATION Support Elec. Continuity Water Piping _ -7 Drainage Gas Piping DATE REMARKS OR CORRECTIONS cy (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE —' DEPAPTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the a®1�li mionepro�ertr ' s c 'o purposes. is at D e Signature of Permiteeor Agent '?F f� Receipt No. I Z'Z White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRE T R OF PUBLIC WORKS By GVH D a B' a g permit expires Date 7 L 7/'? BUILDING e Owner � SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Contractor e4L, Mailing Address 0 . 07C 0 - Fireplace Total Valuation flJ� �t lh� e J Permit Fee Building Address PIanCheckingFee &/orPenal ty Permit Fee PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Ll ' Repair drainage or vent piping 1.50 A. P. No. (,I-, t C° Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 Fe. NLjd ma ion Fire Dept. FireZone Use Permit Gas piping system 1 - 5 outlets dt"Sf1 EQA Parking Pians Parcel Deciaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 ans ec Parcel Approval Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Permit Fee $ t3 $ j ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 SinSingle Family Duplex Mobil Home Others 9 Y ❑ P ❑ ❑ Main service EA. ADD -L. 100 AMP 2,50 Main service OVER 11 00V25.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 1.00 NEW CONS. DWELING O OR ADDNST V ACCLBLDGS.CCUP. 4� 20sq tt CONTRACTORS LICENSE LAW 1 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 TLET NEW RESID.CONSTBRANCHMULTI-OCIRCUITS NON-RESID. BRANCH CIRCUITS) 2.50ea NEWCONSTR. POWER APPARATUS 8 NON -RESID. SINGLE OUTLET CIR, Ex. Occup{OUTLETS OR FIXTIIRES 6 L1� Ex. QCCU FIXED APPLNS. OR p• OUTLETS (RESID.) EA) 2,00 Temporary service 10.00 Mobile Home Facilities 15.00 I' License No._ 12- Classification Misc. Wiring 6.25 ❑ 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. 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 Land Development Fee $ TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the a®1�li mionepro�ertr ' s c 'o purposes. is at D e Signature of Permiteeor Agent '?F f� Receipt No. I Z'Z White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRE T R OF PUBLIC WORKS By GVH D a B' a g permit expires Date 7 L 7/'? COUNTY OF BUTTE Department of Public Works 7 County Center Drive .Oroville ----- 534-4541 ELECTRICAL INFORMATION FOR DE -RATING MOBILEHOMES Owner Location � Mobilehome Installation Permit No. FILL IN INFORMATION FOR ITEMS 1 THRU 10 Watts 1. Width Z 62 x Box Length x 3= 7(9 0 2. 2 Kitchen Appliance°Circuits ................. = 3,000 � 0 3. 1 Laundry Circuit .......................... _ 1,500 4.' 5 n z 3 v Ovens .......... .. e...w. . ........... = - MoD Cook Stove Top .. Z. ................... = 7M t75. t �- 6. Hot Water Heater ............................. =ice /1/05 �5.... c............. I �' 14410 7. 7. Dishwashe�Disposal . _ 8. Clothes Dryer ................................ 9. Other (specify, i.e., motors, exhaust ans, etc ) Sub -total - Watts ..... 9 First 10,000 watts @ 100% ............................... = 10,000 Remaining ' watts @ 40% 10. Air Conditioner$. watts @100%.. = ) Largest Demand = Central Heat System �— watts @ 65%.. = ) TOTAL DEMAND WATTS REQUIRED ............. /M- "Demand Watts Required" 230 ...... _ 'AMPS De -rate Mobilehome to ............. ........... (� AMPS. r BU TTE CoujqTY 6 ""'LVING DEPARTMENT APPROVED COUNTY OF ¢UTT.5 — 'DEPARTMENT OF PUBLIC WORKS 7 County Center Drive 5 le, California 95965 Telephone: 534-434-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. .1 X DateZE!7-715 Signature of Permitee or Agent Receipt No./_,M!7J '7 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 f which fees have been paid. ^ E OF PU IC WORKS Date Building permit expires Date BUILDING Owner 2 �� • dO SO. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Contractor j Mailing Address 11f64 Zr �� Fireplace Total Valuation J ee hone a.7 Permit Fee Building Address Plan Checking Fee&/or Penalty Permit Fee PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each TraD 1.50 Repair drainage or vent piping 1.50 A. P. o. b - D- 17 Zoning &Planning Water piping 1.50 Each gas water heater or vent 1.50 es -*e. Fire Dept. Fire Zone Use Permit Gas piping system 1 -5 outlets 1.50 EQA Parking Parcel fans Declaration Parcel Ma P 60' R/W Im rovements P Each additional outlet .30 Building sewer 5.00 dg. Plans Recd . Parcel royal ns Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Permit Fee $ $ ELECTRICAL No. @ FEE r £ PERMIT FILING FEE $3.00 Main service 600V OR LESS too AMP OR LESS 5.00 Single Family Duplex Mobil Home Others ❑ P ❑ ❑ Main service EA. ADD100 AMP 2.50 Main service OVER 600V 25.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 1.00 NEW OR ADDNST'L ACCLBLDGS.OCC UP. 4� 2¢sgft 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 Sty�lQ✓..Qf: r T 1 NEW CO I T � BRANCH CIRCUITS/ 2.50ea NEW CONSTR BRANCH CIRCUITS) NEW CONSTR (POWER APPARATUS .&, NON -RESID. SINGLE OUTLET CIR. Ex. OCCUD(OUTLETS OR FIXT11RES B L� EX. OCCUp. FIXED APPLNS. OR OUT LETS (RESID.) EA) 2•00 Temporary service 10.00 Mobile Home Facilities 15.00 / License No. �.r1SZ16 Classification C`G 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. permit is issued 1 shall not employ any person in any manner RoI certify that in the performance of the work for which this as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No @ FEEPERMIT 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. .1 X DateZE!7-715 Signature of Permitee or Agent Receipt No./_,M!7J '7 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 f which fees have been paid. ^ E OF PU IC WORKS Date Building permit expires Date This set of plans and specifications MUST be ,- kept on the job at all times and it is unlawful to ma!:e any changes or clter; #sons on same wifhoui . writiren permissionprom tl;e Department of Pub- lic Works. -County of Butte. The. Set ack shall be 5 ft. from the side property line and 50 ft. from the centerline of the road, permitting a maxi- mum of a 2 ft. eave overhang but entirely ou# ow all ea �ments. All utility connections shall be located within 4 i �. os±tside the rear third section of the mobile home on the Loft Ima_dl side of the mobi6 homes 91 Cl y q1i8-�8 BUTTE. COUNTY BUILDING DEPARTMENT APPROVED . W/t I ___ BUTTE COUNTY -DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name :g C �P_(S 49- � eX f 2. Installer's name: R.1,E 7© 3. Is the site currently under permit? Yes 7717N 01*�, (If yes, furnish permit number ) OR Is the site an existing site? Yes / / No (If yes, furnish two (2) plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and 'easements?- ' Yes / / No ( If no, clarify ) 5. ' What is the mobilehome electrical rating? ----------------------- / f�d Amps —� 6. What is the mobilehome site service rating? --------------------- ��� Amp 7. What is the mobilehome site circuit breaker rating? ------------- Amps 8. Is there any other electric load to be served by the mobilehome site service? ---------------- :=-- -------------------------------- Yes / / No (If yes, identify the load and size: (Load) ps) 9. What is the mobilehome site gas pipe size? ----------------- ---- �/ <j' (in.) 10. What.is the type f gas service? ----------------------- ---- Natural // LPG 11. What is the gas pipe length from meter or, tank to th mobilehome? _3z� (ft.) 12. -What is the mobilehome gas demand? ------------------------------ Z ,►UU (BTU) (This information not required if pipe length loss than 6 ft.o n tuppral gas or less than 50 ft, on % LPG.) t_� 4, MOB ILEHOME-.VDATA If other than single wide, g Mobilehome Mfr./�s a IF furnish Setup Model No. L 0,6- 8 Year Width_(ft.) Box Length (ft.) Tagalong oho Size(9 ft. x 7i d ft. (SHOW SUPPORT DETAILS BELOW) On all mobilehomes manufactured a?ter October 7, 1973, furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of Butte). All centersupports measured from•front of mobilehome unless otherwise specified Single Footings (check one) �1. Wood either pressure treated or foundation grade. I A. [ n V I (ft.)(in.) (in.) (in.) 2. Other (specify) Cent r support Center support Alu_ to ations-� footing sizes Supports'(check one) . D (in.) � j� N, 2 PKA Concrete block. F6x3o I Ej 2. Other (specify) (in.) (in.) <---Tagalong or Expando, show support details, (fit.) (in.) (in.) (in.) t- X)43 -- Typical Support (in.) (in.) Footing Size ft.)(in.) in. in.. -- Max. Pier Spacing (ft.) (in.) BUTTE COUP f Y BUILDING DEPARTMENI AD Max. OeThPR O,/ (ft.) (in.) (in.) (in.) PROVED (ft.)(in. ) vt, Cud *If center piers are othertan rawn above, 'draw in locations, spacing, and dimensions. /� .I .i PERMIT NO. 3009-7513,P,E t� P 3 E i c+ M °MH UTIL. jPERMIT NO. i! a PERMIT EXPIRES /W _ .OWNER Gordon Patterdon th 'CONTR. �I :LOCATION (A.P. 65-10-09 ) Aq;TS171,jay, 2501 N. of DeSabla Mkt., DeSabla 1 1r I .. 9 Iv Temp. Power Pole Called PG&E Temp. Elec. Serv. ;. Called PG&E rTemp. Gas Serv. Called PG&E JOB FINALED (Date) (Signa ure) COUNTY OF BUTTE — DEPARTMENT OF'PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING I BUILDING (Cont'd) PLUMBING Setback DATE Firewall Soil Piping ; Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding v"Y T To but Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Gara a Vents Water Htr. StemwaII Slab Prov. for physically handicapped Heaters Appliances Carport Footings Conformance of ex. structure Gas Piping & Test Temp. Gas Slab Final Z $" Sanitation Patio FIREPLACE Final Footings Footing EL CTRICAL_ Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beaml FIRE P INKLERS Motors Framing Test V Water Htr. Stucco Final A Subpanels Mesh kfECNANICAL Grd. Fault Prot. Scratch Heating Service 7 - Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final -7 ",a— Z DATE , REMARKS OR CORRECTIONS �� ,( COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WO\KS �® 7 County Center Drive- -r OroviIle, California 95965 Tel ephorie: 534-4541 �i APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date Signature of Perm tee or Agent Receipt No. / 3-3r 61 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. 4 DIRECTOR OFBLIC WORKS By Date tiding permit expires Date "��-�� BUILSING Owner .� _ SQ. FT. OCC. BUILDING ALUATION i . CJ S Mailing Address �. , _ AZA10 Telephone No. 7f Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ 1411 Building Address �� ,� (. �,/� `� PLUMBING No. @ FEE PERMIT FILING FEE' $3.00 kelea Y. <3 tl /= Each Trap 1.50 g C" Cv Repair drainage or vent piping 1.50 Water piping 1.50 - i4 A Each gas water heater or vent 1.50 A. P. No. _ s a - o Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F s F� W+ S a ion FireDept. FireZone Use Permit Building sewer 5.00 6� EQA Parking Plans Parcel Declaration Parcel Ma p 60' R/W Im provements Lawn sprinkler system 2.00 Bldg. Plbrfs Recd Porce pprovalWar-, s Approval Permit Fee $ 6 �L NEW Q, ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 CI Main service incl. 1 meter >© p Additional meters, each 1.00 - Single Family ❑ Duplex ❑ Mobil Home ❑ Others ® Sub -panel 02 ods) (more than 12) Range, Cook -top or Oven 1.00 Water Heateir or Space Heater 1.00 r QQ Light fixtures y %2 — Re0b., swit,,?I s & fix outles 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 4 Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring Q I am exempt from the Contractors License Laws of the State of California. Permit Fee $ r0 6 $ �, I 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. j� 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 the Workmen's Compensation Laws of California. MECHANICAL No. @ =EE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above I 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. X Date Signature of Perm tee or Agent Receipt No. / 3-3r 61 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. 4 DIRECTOR OFBLIC WORKS By Date tiding permit expires Date "��-��