HomeMy WebLinkAbout065-172-00165-172-1
Ernie Henton
14694 Wood Dr., lot 3.56, F19 Sub, Maga.
-COnt.r- Malcolm
Permit' #,P�.,,
Hall Magalia
5834-80BEk
family) (new sin le
it
NAIL )01 03-34..5..
JENNIFER
14694 WOOD �DR�tGALIA VXA
CONT: GREENE &N ROOF
G
RE ROOF,
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065-172-001: ✓03-3457'
NAIL, JENNIFER
14694 WOOD DR, MAGALIA
CONT: GREENE & SON ROOFING
RE ROOF
1
COUNTY OF•RUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING -DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7,541 IT NO.
(Rev. 12/96) APPLICATION AND PERMIT �
ASSESSOR PARCEL NUMBER& - /^ % - 0 W ^ /
I V&,} J,G
ZONING
BUILDING PERMIT
OWNER
ME r /
SO. FT. OCC. BUILDING VALUATION
(
OWNER;! Z L7 ESS / ,UDC , . `�L� �f i, e,'R'S
NAE
CM � 4 / M� SD ' I
\
,TE F10NB.� t /V
/..
COfRAC70" 3RE53`P
I/NR.I1. 'kC C i o
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filen Fee
$ 20.00
Permit Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDING ADDRESS ' l' / 1G� J
Energy Plan Checking Fee
$
J
$
PERMIT FEE
$ J
IAT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF 000ODuplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
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 ❑ �Re-mmodel ❑ Uli/liittie ❑ Installation ❑ Other ❑
Describe Work: 1 `'G (� Vp %�i
c r �i'i I C�ti�,fJ 7 f In ) e. S
Gas piping stem 1 - 5 outlets
15.00
Buildingsewer
15.00
Mobile Home I S I G W
@20.00
PERMIT FEE
S
J
ELECTRICAL PERMIT
Filing Fee 20.00
OOOVOR UE
Main Service zo.A OR LESS
23.00
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 ull forc and effect.
License Class � —" 9* Lic. No.
OWNER -BUILDER DECLARATION
1 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 ..S 9� 44 n/Cf
Policy Number - 0Py2 3 U'7
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 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.
F
X Date /J- 7-403
Signature of Applicant - ❑ Owner;I10-Contractor ❑ Agent,
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Main Service 200A TO tOaoA 46.00
NEW CONST. DW
."NG OCCUP. SO
OR ADDNS. ( a ACC. S.3.50FT.
NEW
fpf}galp, T.MUL IJ ciRLET 97,50
POWER APPARATUS
a SINGLE OUfLEr CIR.
Ex. Occup. OurLET OR FxruREs 20 p ,.00
BAL @ .50
Ex. Occup. OunF°s-Ro .) E 5.00
Temporary Service
23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE S
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
Dcc
CONST. TYPE
TOTAL FEE $ 55.
HAZ.
D. FEES IMP
7D
I CDF
I PARCELr7
ISSUE
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which,fees have
, (,� )
By J// ttt / % 1
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
I f _ _ J
Date / )
f
Date
Receipt No. �/ �� I' S
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center DriveOroville, California 95965 • Telephone (530) 538-764 , _2)q lT NO.
(Rev.12/96) ' APPLICATION AND PERMIT ' "��
ASSESSOR PARCEL NUMBERO / • /� ^
/f��s /Vly//
ZONING
BUILDING PERMIT
OWNERe�nl
f
T E
SO. FT. OCC. BUILDING VALUATION
.OWNERS (, D S T \OD r
W
j�
CO � R'S NAME
�& -�l
♦RAOjORS p�JNQ ADD E$S•� _ - � �� I /� � ��
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
FlinFE1e
$ 20.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Permit Fee
$
Plan Checkin Fee
$
BUILDING ADDRESS '1
O V
Energy Plan Checking Fee
$
$
PERMIT FEE
$ -L2
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 1 20.00
USEOFSTRUCTURE
SF 0016uplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
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 ❑ Utilitie ❑ Installation❑ Other ❑
I `' 4I �
Describe Wo k: e � �� /��
W 1 �� l►�
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
@20.00
PERMIT FEE
S
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service •Gov OR LESS
2o0A OR LESS
23.00
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 u11 force and effect. y�
License Class `� __ Lic. No. -2 /.,,%p��
OWNER -BUILDER DECLARATION
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.
❑ 1, 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
46,00NEW
CONST. DWE= OCCUP.
OR ADONS. ( a ,ems.
SO
3.5¢FT:
NON-R6ID T. MULTI -OUTLET
@7,50
POWER APPARATUS
a sINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FIXTURES
BAL 9 10
FIXI
Ex. Occup. ourlEt°Ts Ao .°EA
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE
S
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' co ensation insurance Carrie and policy number are:
Carrier
Policy Number
(The above sections need not be completed if the per it is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 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 'th those provisions.
X Date
Signature of Applicant - ❑ Owner ac or ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height. I
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEiE $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $
HAZ.
D. FEES IMP
FLOOD
CDF
PARCEL
I PD
HD
ISSUE
This permit is hereby issued under
of the Bu a County Code and/or
indicate ab ve for whiSh.4ees have
- ( ) L_
By °
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
-
Date )/
Date
Receipt No.
WHITE-D.D.S.-B.D. CANARY-ASSESSOIR PINKINSPECTOR GOLDENROD -APPLICANT I
PERMIT NO. 5834-80B,P,E;M-
PERMIT EXPIRES d/
OWNER Ernie Henton
Malcolm Hall, Magalia
CONTR.
ASSESSOR PARCEL 65-172-1 /
' P
LOCATION 14694 Wood Dr., lot 356, FH Sub, f
Magalia
P
•a
t - �
' Temp. Power Pole
Called PG&E
o
Temp. Elec. Service
i
Called PG&E /% /• 3 '�l .l�G�/s 1.�1i�� 6�/C.0
Temp. Gas Servi
Cal ledPG&�
JOB FINA ED.(Date) 313&)
Signature
..
J OK
O = Not OK -
- =Not Applicable MOBILEHOMES MISCELLANEOUS
= Not Ready
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.-Rig.-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. Y N
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date
Date Card -BI Date
MOBILEHOME INSTALLATION (Plans) OK except N's
1. Zoning Requirements -Setbacks -Easements
Card -BI
Date
Date Card -BI Date
POOLS (Plans) OK except tt's
1• Setbacks -Easements
2. Footings; Size -Spacing -Marriage Line
• .2. Solrs', 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 -I
Date Card -BI Date
Card -BI
Date Card -BI Date
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
• n/1 kAA an•
0
T_� �_ - 41V01;5.e d
C$
AxJ'04n 40
AAA
JUL x,
w:a
J = OK
0 = Not OK
- = ot Ready ble
N
*-_ Not Ready RESIDENTIAL )Single and Duplex)
Date
UNDERFLOOR Plans OK except #'s
Date FRAMING Continued
1. Zoning,uirements-Sett wim-FaeewepiaI
roperty Line Firewall & Openings
2.
F ., Main; -St - le - / /" Ftg. Depth
Ext. -One 3' -Check Garage -3rd story, 2 exits
3.
F ar SBile=S I- / /" Ftg. Depth
oer tairs; Width -Headroom -Rise -Run -Landing -Fire Protection
4.
Ftg., Porches & Decks; Soils -St el- / /" Ftg. Depth
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
5. Ste IIs, Main; Steel to is rapped -Slab
Siding -Nailing -Veneer
6. Stem Is, G -e; el-61ockouts-Wrapped-Slab
ucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access
7.
- la Ftg.-S
Glazing Area -Glass Protection -Skylights -Plastic
8
D- Fi gs Tes - way C/0 -Sewer Test
_.14.-ftear Walls; Nailing -Bolts
9.
as Pipe; Size -An
10. Water Pipe; ors egulato ervice Tes wi '
11.
Electric; Underground
12.
Plenums & Ducts nce-Material-Support-Ins.
13.
Girders -Sills Anc of -Joists-Vents-Cripples
Card -BI •L Date Card -81 Date
Card -BI Date / Card -BI Date
Card -BI Date Card -BI Date
Card -BI 5L
Date I Card -BI tj L Date %ft,
Date FINAL (Plans) OK except N's
Card -BI l Date 7 Card -BI Date
Date
PLUMBING (Permit) OK except q's
xt. Steps -Door & Sidelight Protection -Landings
Smoke Detector
14.
Water Ht.; V nt-Ac ss -Combustion Air'c!l.
rnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
15. Water e; Te An rs-Nail Protection_
16.
D&A-�; Tbs-_Ftt Aac-Nail fiction
!9L § room Exiting
17.
Shower Pan; Test, First Floor -Tub Access
• ,G.F.l. & Bath Fixtures & Tub Access
18.
Test Tub & Shower, 2nd Floor -Tub Access
W.- Elec. Trim & Subpanel; Breaker Sizes -Labels
19.
Gas Pipe; Size & Anchors
Stairs & Rails
Fireplace or Stove; Clearances -Hearth
Ar-Elec. Outlets at Wood Panel; Int. & Ext.
Card -BI
IL,
Date j Card -BI Date
Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI
Date Card -BI Date
Alec. Outlets & Receptacles at Kit. Counter
Date
N14,
ELECTRICAL Permit OK except N's
141� Garage Fire Door; Swing-Land in -Closer
--@@-'A.C. Duct in Garage -Damper
20.
Fixture & Transformer Cleance- s. Protect' n
Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
21.
Elec. c tacles Sp n Lfg is & Swi es at Doors
p Elec: & Mech. Equip. Listed for Location
22.
Size 8AY<es & N9. of nd ctors-S ed'.
„
. Elec. Receptacles`in Garage; (G.F.I.)-Romex Protec.
23. Romex In a Clos o of S s & .J.
_Edge
Equip. Gr Mrs-Bonds&Waterade_ w.
Z20 -Insulation -Foam -Looked in Attic S-14"24.
.. �* i &Deck Construction -Post Caps
25.
2 ApplinCircuits-6 Kitch & ConductorSize
4 dri. Vents Crawl Hole.Door-Drainage & Wood -Earth Clearance
Loo under Floors
26. Subfeed Wire Size /:r-_/ ga. Cu or AI-A.C. Wire Size /� / ga. Cu or AI
27.
Range Circ. /gyp / au or Al Oven Circ. / / ga. Cu or A1,
Insulated Neutral es ❑No
75. Following instld.: Drive •E}IY ss ❑ No; Walks ❑ Yes.@4.No;
Planters ❑Yes �1J0
28.
Servi is Conductors & Ground -Main Disconnect
76.Ash
29.
Equip. C rant s; Panels-Motors-Mech. Equip.
. ect
t-Clrnces-Brkr: & Cond. Size -115V Outlet
30.
Clothes C et Light-Shower+Light
Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
'•"Wale Well; Disconnect, Electrical, Plumbing
xterior Elec. Trim; G.F.I. Receptacle -Underground
Card B -I
Date l� + , Card -BI Date
ntilation throughout House
Card B -I
Date Card -Bl- Dates-
Glass Protection
Date
y
MECHANICAL (Permit) OK except N's
rrections from Previous Inspections
. Gas Test -Meters Tagged; Gas -Electric
31.
A.C. Ducts; Insulation & Support,
85. & Se Con -C/0 rade=HO'Approval
32.
Vent Fan; Exhaust above Insulation
Energy Compliance Certificate -Other Certificates
33.
Condensate Drain & Overflow; Size & Grade
..
-34.,
Furnace -Vent; Access -Comb. Air -Return Air,Vent-115V outlet
35.
Atti ccess & Platform if Furnace in Attic
F
Card -BI Date Card -81 ' Date
C�ardrd-Bl n
-
�
Date Card -BI Date "'�
Card -BI Date -r; Card -BI Date
Card -BI /
Date- Card -BI - Date
Card -BI Date ' Card -BI Date '%
Co ent t Final:
Date FRAMIG ns) OK except H's
36.
37.
Sil groper Material & Anchors
Wall uds-Nailing, Spacing & Bracing -Plates -Sound
R sVIC
k
_
38.
Beari Walls over Girders & Floor Nailing
`•
_
39.
Draff Stop in Walls (rat proof)
_
40.
Fir t s; Furred Ceilings -Stairs -Chases -Tub
41.
He r , Beam -Size & Bearing
lQA
42.
ptt-Post Caps-Anchors-Connpctors
Ha ff
Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Ring. _
irepjate Ties or Type A Flue -Fireplace Throat
45.
46.
Att cess; Size & Romex Protection -Draft Stop -Ins. Baffles
BdrK Wi ws or Exiting Doors -Sill Hgt. & Dimensions
47.
Gara Fire Protection Framing
(NOTE: An entry must be made each time youvisit jobsite)
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Orovi Ile — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
BUILDING OR PROPERTY ADDRESS
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
Inspector
COUNTY OF BUTTE ',. '
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive., Orovi Ile — Phone: 534-4541
Skyway and Elliott Road; Paradise— Phone: 872-2961, Ext. 57
CORRECTION NOTICE
BUILDING OR PROPERTY ADDRESS
A routine Inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when sprrection of work is completed. If you have any question pertaining to this
matte/, or need additional explanation, 'Please contact this office immediately.
r tlrVIA Ail
f
Lin-,
Inspector Date
OdTr, . . f.
Rod LIP
Dare
To
........ FF&wv as
......Necessary action
......Prepare reply
......Comment
......Note and return
......Note and file
......Investigate
......Signature
......Confer
......As requested
......For information
......Per telephone
conversation
R11TTF COUNTY
��OIFi f�
T al«✓
0
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS P RMIT O. 0
7 County Center Drive - Oruville, California 95965 - Telephone 916/534-45
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
(o — /,I:)- - 6 •
ZONING�11
Ti
BUILDING PERMIT `JJ
OWNER -
tiNl� �v ��„7o
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
z a
OWNER'S MAILING ADDRESS
37
CO TRACTOR'S NAME
L
TELEPHONE
vo
; T
CONTRACTOR' MAILING 4CDRESS
-104
CO TRUCTION LENDi` a-
�Cr1
UNKNOWN
Fireplace S'0
Total Valuation $
LENDER'S MAILING AD RESS
Permit Fee $ -? —
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Penalty $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee $ —
BUILDING ADDRESS a1 V, .
PLUMBING PERMIT Filing Fee JV.00
C Q'Z
Each Trap 2.00 / U-
Repair drainage or vent piping 2.00
Qaq(& -
Water piping
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Each qas water heater or vent 2.00 S
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
SF Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer S
Lawn sprinkler system 2.00
TYPE OF WORK
New N Addition ❑ Remodel ❑ Utilities ❑ InstallationC Other ❑
Describe work:
Permit Fee $
Contractoru-r-rL-1-,'
ELECTRICAL PERMIT Filing Fee X13.00
Main service 100 AMP OR1 OR LESS5.00 S
,Z
Main service EA. ADD'L 100 AMP 2.50NEW
CONST DWELING 0
OR ADDNS. ( ACCLBLDGS cV 20 sq it 0 �-
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the Businesss0
and Professions Code and my license is in full force and effect.
License No. �`fl (�
� � CIaSSIflCatlOn ___
El 1, 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
NON.RESID R BRANCH CIRCTITS 2.50 ea
NEW CONSTR. (POWER APPARATUS 91
NON-RESID. SINGLE OUTLET CIR.
@ ac
Ex. Occup( OUTLETS OR FIXTURES BAL@12Q
EX. OCCU FIXED APPLES. OR
p•(DUTLETS (RESID) EA,) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 6.25
Permit Fee $ r
Contractor K t[,;.1
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a 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 shall be deemed revoked.
MECHANICAL PERMIT FiIingFee 10.00
Heating
Cooling
Hood 2.00
Ventilation
permit Fee $ , 23
Contractor L.s '
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.
1 also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequ nce of the granting of this permit.
X Date ivy �p�`�I
�l `� l j
Sig ture of Applicant — Owner 0 Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Land Development Fee $
TOTAL PERMIT FEE $ i 2�
OCCUP. GROUP
I TYPE OF CONST.
PARC
PD ND
ISSUE
This permit is hereby issued under the applicable provi-
sions of the Butte County Code and/or resolutions to do
work indicated above for which fees have been paid.
DIRECTOR F UBLIC WORKS
r,-
By Date
PERMIT EXPIRES Date �-
z. Y•� I/ ,
Receipt No.
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
RESIDENTIAL
ENERGY CONSERVATION STANDARDS
CONSTRUCTION COMPLIANCE CERTIFICATE
THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN
INSTALLED IN CONFORMANCE WITH CURRENT ENERGY CONSERVATION REGULATIONS
AT Wood. MaQalia
(location)
BUILDING PERMIT NO. A. P. N0.
THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS:
(Check each item or write N/A if not applicable)
INSULATION:
GLAZING:
Slab Edge.
NA
Single Glazed
NA
Fdn. Walls
NA
Special (Insulated)
NA
Floors (Z- 1 t
CERT. & LABELED WDS.
b1&k 2S hon
R-19
& SLIDING DRS.
NA
Ceiling/Roof
R-22.,
WEATHERSTRIPPED DRS.
NA
Ducts
NA
BACK DAMPERED FANS
NA
Circulating Pipes__
INTERMITTENT IGNITION DEVICES
NA
APPROVED HEATER
NA
CERT. APPLIANCES
NA
APPROVED WTR.HTR.
NA .
I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED
IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO
THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED.
Insulation Applicator Name HAWKINS INSULATION COMPANY INC.
Signature of'
(pie se print)
Insulation Applicator
State Contractors
License No. 378407
General Contractor/Owner Name._eZ ,,, l/ L Z,
Signature of (please print)
General Contractor/Owner ,e��✓�i^ Date
State Contractors
License No. 9 9
C
THIS CERTIFICATE MUST BE ON FILE WITH THE BU ILD ING DEPARTMENT PRIOR TO
REQUESTING•FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION
WITHIN THE ..DWELLING.
RESIDENTIAL
ENERGY CONSERVATION STANDARDS
CONSTRUCTION COMPLIANCE CERTIFICATE
THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN
INSTALLED IN CONFORMANCE WITH CURRENT, ENERGY CONSERVATp�')O,ryN REGULATTONS
/)T F
(location,)
BUILDING PERMIT NO. :-5�-3 `4- e; A.'P. NO.6
THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS:
(Check each item or write N/A if not applicable)
INSULATION:
Slab Edge. LVZ±
Fdn. Walls
Floors A
Walls /Z-//
Ceiling/Roof
Ducts LV*
Circulating PipesI --
APPROVED HEATER
APPROVED WTR. HTR. jiz S
GLAZING:
Single Glazed /✓c
Special ( Insulated)
CERT. & LABELED WDS.
& SLIDING DRS./ ? 5
WEATHERSTRIPPED DRS. %' +►,
BACK DAMPERED FANS
INTERMITTENT IGNITIO' DEVICES iU
CERT. APPLIANCES Y.e 5
I
I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED
IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO
THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED.
Insulation Applicator'Name_ G4/(,0fiI r/q //
Signature of �
(ple se print)
Insulation Applicators
State Contractors
License No. S `l `S—
i
General Contractor/Owner Name %�' G2=_®"� Ge G•� /� ��
(please print)
Signature of _
General Contractor/Owner Date 2 —.2-6 f" �
State Contractors
License No. 3 q
THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO
REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION
WITHIN THE DWELLING.
if
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