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9
PERMIT NO. 4302-77P,E
PERMIT EXPIRES 9&
Raymond E. Bean
OWNER
CONTR. owner
LOCATION (A.P. 65-19-55 )
S/S Greenwood Dr., app.425'E.of Holmwood Dr.,
lot 450, FH Sub, Magalia -
;i
r
i
Temp. Power. Pole
Called PG&E
Temp. Elec. Serv. )-6
Called'PG&E Y
Temp?Gas Serv.
Called PG&E
JOB
FINALED Z 0 7
(Date)
(Signature)
• v
9. Electrical
A. Is service large enoktgli to provide adegLlar_e amperage to mob'i.lcflame (must equal rating of
mobi_leliome (dith a :: inh-:um of 1.00 amp) an -0 other faciliti_Eis on lot, i.e., water pumps,
,"araoe, cabana, erc.'- Yes ,,/No_
B. Is ther,-� proper cicarances around panels? Yes__Z�o_
C. Is power supply cord or feeder assembly properly fused? Yes V 1\'o_
D. Is continuity test satisfactory as per the following procedure? YesV 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 ]sad of a test instrument to the mobilehome grounding conductor 'and
app Ly LLi- oLL,.ei Icau to eac1i Tt)UU1_.LCllulllt siipply cui►uiictor, inCliiutng YLEi1i'rdt.
5. All nor. -current, carrying metal parts of the• mobilehome (aluminum siding, gas line,
water. Iine), 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
te.:;L shall then be mace between she grounding electrode and the chassis of the
riobilehome.. Upon satisfactory completion of the electrical tests, the lot or site
service equipment may be approved for energizing.
D), Is _;ob card si ned by health Departmeat.for water and sanitation?
1. l.. If everything olray, sign off card and tag services.
'NOBILEI'10 E DATA
Manufacturer and/car Namestyle
Length Width
Vehicle Serial No.
State Identification No.
D.ddttional Infoinnar..ion or Comments:
'M0BTk'EH0ME' D617&LATIQU INSPECTION CHECK LIST
1. Is the mobilehome located wi.i_li required separation from lot lines and buildings and generally
conform to plot plan?. Y<!cr. j/ No
?. Dori the mobilehome have. required clearances above ground? (Sec.5085)
Yes `✓ No
3. Are footin.;s and supports z PP properly sized, spaced, and braced a.., p/er-'approved plans. (Note
possible variation at spring shackles.) (Sec. 5082 & 5083) Yes t/ No
4. Is the mobilehome level.? (Sec. 5088) Yes V No_
5. If more than a single unit, are crossover connections properly installed? (Sec. 5088)
Yes No
5. Water
A. Is fle i.ble 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? Yeses 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
B. Does it have minimum ," per foot slope and is it properly supported? Yes e--1�10
f:. Are any leaks detected in drainage system after running/3gallons 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 !/ No
B. Test OK as per following procedure? Yes-LIZNo
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
6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without
drop.
4. Connect: gas meter to mobilehome with connector, turn. on gas, test connections with
soapy water.
C. Are all appliance vents properly installed? Yes Y No
COUNTY1OFsBUTTE
DEPARTMENT OF PUBLIC WORKS 1 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 y �iG 7— for the following location:
{ / s
Owner
Owner's Address
Mobilehome Mfg. Model Year 7
Insignia No. n, ' r % , .2 / Serial No.
It is hereby certified for occupancy at the above described location and
may be occupied.
Date
Director of Public Works
By
THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED
Maf Bidg.
Fo tin s
Ste all
Slab
Piers
Garage
Footings
Stemwa I I
Slab
Carport
Footings
Slab
Patio
Footings
sonry Wall;
Reinf. Stee
ICOUN-fY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont'd)
ewall Sol ripen
1s loor
2nd loor
3 rd F I 3r
To out
Water Pepin,
Sewer
Fixtures
Water Htr.
Heaters
Appliances
Gas Piping
Temp. Gas
Sanitation
Final
Rest om Finish
Windo
Siding
Roof She in
Roofing
Fdn. Vents
Garage Vents
Insulation
Prov. for physical ,
handicapped
Conformance of ex.
E
Final \
FIRE'SPRINKLE
Test
Mesh Jr MECHANICAL
Scra h Heats
B n Coo g
Lrior
D is
th ntllation
er Inal
MOBILEHOME UTILITIES ---------- r*:)----- Elec. Service ?--5a-7
Water Piping Sewer Q —7
M0816EMOME INSTALLATION - - - - - - - - - - Support -
Water Piping Drainage
DATE REMARKS OR CORRECTIONS
XV `
Fixtures
Motors
Water Htr
Subpanell
Grd. Figilt Prot.
Servs
T mD. Pole
VJFInaI
{i Elec. Pedestal
Gas Piping 5
Elea Continui
Gas Piping
(NOTE: An entry must be made on this form each time you visit the job site.)
PLUMBING
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 -County Center Drive UroviIIe, California 95965
Telephone: 534-4641
APPLICATION AND PERMIT
7 7
n
authorize representatives of the County of Butte to enter upon the
above-mentioned property forinspection purposes.
X Date K-4-2
Signat a of Permitee or Agent
Receipt No._T1(11Ts �5
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.
DIREC OF PU LIC WORKS
By Date
permit expires Date ,�-��
BUILDING
OwnerSQ.
1z rM el rvD I
FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Fireplace
Contractor , Q-0 1 114Total
Valuation
Mailing Address D L-.a-pvU•L
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
L Z
Permit Fee $
Building Address
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
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. Ng.
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet 30
F
99. Sartit5+144p
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA Parkin arkin
Declare ion
Parcel Map
60' R/W
Improvem nts
Lawn sprinkler system 2.00
BI Ions Recd
Parcel Approval
Plan pprovol
Permit Fee $
$
NEW ADDITION ❑ UTILITIES ❑ OTHER ❑
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service 1100 AMP OR00V OR LESS5.00
Main service EA. ADD'L 100 AMP 2.50
Single Family ❑ Duplex ❑ Mobil Home Others ❑
Main service OVER 1100 AMP OR LESS 25.00
Main service EA. ADD'L 100 AMP 1.00
_
NEW CONST. DWELLING OCCUP. &
OR ADDNS. ( 2¢sq ft
ACC, BLOGS. )
NEW CONSTRMULTI-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
style of:
/�
Cce yrs // 48,Za!�'T�
Ex. Occup(OUTLETS OR FIXTURES) BAL@1
09
Ex. Occup.FIXED APPLNS, OR
(OUTLETS (RESID.) EA) 2.00
Temporary service 110.00
Mobile Home Facilities 15.00
License No. 3/® 1i Z DClassification
Misc. Wiring 6.25
❑ 1 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.
ave -placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
I to an certify that in the performance of the work for which this
ermit is issued I shall not em
p employ y 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
State Laws relating to building construction, and hereby
4-$-
TOTAL PERMIT FEEand
authorize representatives of the County of Butte to enter upon the
above-mentioned property forinspection purposes.
X Date K-4-2
Signat a of Permitee or Agent
Receipt No._T1(11Ts �5
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.
DIREC OF PU LIC WORKS
By Date
permit expires Date ,�-��
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS
7 County•Center Drive, Oroville,- CA.
PHONE: 534-4541
MOBILEHOME INSTALLATION SHEET
1.
Owner's name: f<a_U ll.,1
2.
Installer's name:
3.
Is the site currently under permit? Yes _
No
(If yes,.furnish permit number
) OR
_.
Js the s.irte ari;existing site? Yes / /
No
(If yes, furnish two (2) plot plans.)
4.
Will the mobileRome be located at.least 5 ft. away
from septic tank
and -leach -fields and
clear of all setbacks and easements? Yes
No 7-7
(If no, clarify
)
5.'�
What is the mobilehome electrical rating? -----------------------
Amps
�o
6.
What is the mobilehome site service rating? ---------------------
Amps
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) (Amps)
9. What is the mobilehome site gas pipe size? ---------------------- 3�y (in.)
10. What is the type of gas service? ------------------------------ Natural / / LPG
11. What is the gas pipe length from meter or tank to the mobilehome? (ft.)
12. What is the mobilehome gas demand? ------------------------------ (BTU)
(This information not required if pipe length less than 6 ft. on natural gas
or less than 50 ft. on LPG.)
MOBILEHOME SUPPORT DATA
Mobilehome Mfr. !a- Setup Model No. '3-73 Year
Width Z_(ft.) Length _� U (ft.) Expando Size ft.x ft.
(Draw support details below)
On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation
manual and structural setup sheets (if not on file with the County of Butte)..
Sin le ������� 2 otin s (check one)
a7�0 �J2 9 Sle-Y ��� 1. Wood either
ress e t t d
/e v� / `,., p ur rea e or
Center Center Sup ort & bl /`-e fdn. grade.
Support Footin izes;
Locations in.) *2. Concrete pad.
_—_I I _._.._ x __.! ; / 3-yOther, specify
Cf�:)-(�:� (n.)(in.j
Super (check one)
d�11. Concrete block
_ x ; / / 2. Concrete piers
(ft)..
(in.)(in.)
3. Steel piers
4, ther, spec'fy
in.
F -i ��in.
x
(in.)(in.)
i_ x 1
(in (in.)
*If center piers are other than drawn above,
draw in locations, spacing, and dimensions.
6kx Z9, Tical Sup
Footing Sizeort
(in )(in.)
f Max. Pier
Spacing
(ft.)(in.)
',,.)Max
.
Overhang
in.
F -i ��in.
x
(in.)(in.)
i_ x 1
(in (in.)
*If center piers are other than drawn above,
draw in locations, spacing, and dimensions.
6kx Z9, Tical Sup
Footing Sizeort
(in )(in.)
f Max. Pier
Spacing
(ft.)(in.)
',,.)Max
.
Overhang
/s COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 7
�7 """"77
Telephone: 534-4541 L/ —77 /
APPLICATION AND PERMIT /
-••.-• •- •..,.. ...........� v...a , a ,c vuLiri y vi OUlla lU Clllel UPUII Ine
above-mentioned property for inspection purposes.
X Date
Sig elre of Permitee or Agent
/
I/ L L�
Receipt No. 6
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 OYF UBLIC WORKS
�Hing permit expires Date
BUILDING
Owner
F 1
SQ. FT. OCC. BUILDING VALUATION
14M
Mailing Address ',
C, lie
T41 phone No.
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
PI an Checki ng Fee &/or Penalty
Telephone No.
Permit Fee
Building AddressPLUMBING
tiv./a "_e_n
No.1 @ I FEE
PERMIT FILING FEE J$3.00
_
Vale-
Each Trap 1.50
"Iynwroa "Olt AA '�
Repair drainage or vent piping 1.50
l-* 2 t t1v/ lfiy
Water piping 1.50 fl
Each gas water heater or vent 1.50
�T-Gas
Z
piping system 1 - 5 outlets 1.50
Each additional outlet .30
F sSa
Ion
Fire Dept.
Fire Zone
1 -
Use Permit
Building sewer 5.00
EQA
Parking
Plans IBldg.
Declare ion
Y�rc�l a 6 R/W
Improve ents
Lawn sprinkler system 2.00
P4,r1re.d
P3ar�cel pprova
Plans pproval
Permit Fee
NEWADDITION
❑ ❑ UTILITIES OTHER ❑
ELECTRICAL No. @ FEE
-
PERMIT FILING FEE $3.00
Main service 600V OR LESS
100 AMP OR LESS 5.00
Main service EA. ADD'L 100 AMP 2.50
Single Family ❑ Duplex ❑ Mobil Home Va" Others ❑
Main service OVR 110.V 100E
EAMP OR LESS 25.00
Main servlce EA. ADD'L 100 AMP 1.00
NEW CONST.DWELLING OCCUP. &
OR ADDNS. ( ACC. BLOGS. ) 2¢sgft
NEW CONSTR. MULTI -OUTLET
NO N.RESI D. BRANCH CIRCUITS) 12.50ea
N E WC ON5T R. 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
style,of:
Ex. Occup(OUTLETS OR FIXTURES) BALFIXED
A@1
Ex. Occup.(OUTLETSP(RESID )REA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6..25
X I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$2
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.
NA 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 1 2.00
Permit Fee
1 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
anthnri>o ren race.. +♦I...,� ..s •.,, n...._... _. n...._ ._ __.__ ..
TOTAL PERMIT EE
-••.-• •- •..,.. ...........� v...a , a ,c vuLiri y vi OUlla lU Clllel UPUII Ine
above-mentioned property for inspection purposes.
X Date
Sig elre of Permitee or Agent
/
I/ L L�
Receipt No. 6
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 OYF UBLIC WORKS
�Hing permit expires Date
NOTE Materials &s Workmanship
shall Be: in
:Accordance with .�Reco^,naed 6o ed Specified use in 'tFie `
nd,This set of .plans and specifications MUST be
' of a.c{uaGfY, prescrrbed.,f�r #he' Sp . i � Dept, on the job at ell times. and it is unlawful tc
;Ufliform Builsfing, Plum'oing Mechaniodl Codes anis male any chant^y-or;alterafions on same withoi�:
Code•
}he cit'ionar ffectrical - Kiritten :permission ,front the. Department of
- Iic Work;; County of. Butte:
R(yw
Se is $, stem and location
F .;
j s ,The $# Setback shall be 5 ft fro , g► tha Y .
side prioperty'#in, and 5Q =,ft frci +the � e as per
to. .b
centerline -of the tcad; permiftin5 a.maxi _ ..:- utte County hlealth .Dept: • Re=-
MUM of o'2 ft. eave overhang but entirely quirements.
out. of all,easements.. t'
�OZI. i 001 - 008 ?09:' .Ob 1 HOZ:.; :..
a-- -
conn .�
ect
¢ _ gated w' ithirt s haler
tto
-- - - l ; o#i the
to ons ; ..
thiKd
#side t 'e..edr HOZ
_ _._..r-. .. ..... _...._. lef
da= f thi
(� on 'the n -
�(road; si a rr�obile
.. j
� e
---:c�-:,,,:•�- "---- . .� ;-� --• peto
c
t
,
_. _-- ' - -•.__ _. .. _ �. n / _. •�^'� 1. !: � ... .. .. .;.
... --- :.... ir.� 4001
BUTTE COUN:I.Y
_..:......, . y1 BUILDLNG.,.DEPARTMEN:iOZI
:'::'
pD
_. / ,0v
PERMIT NO. 4038-75B
figg;
9 P
E
M
l
°:MH UTIL.
PERMIT NO.
E l
T PERMIT EXPIRES
OWNER Raymond Bean
�i
CONTR.
OCATION (A.P. 65-19-55
4150
�A�Greenwood Rd., Magalia
a
Temp. Power Pole
Called PG&E _
Temp. Elec. Serv..
$ Called PG&E _
Temp. Gas Serv. _
Called PG&E _
/JOB
FINALED
COUNTY OF BUTTE — DEPARTMENT"6F PUBLIC WORKS
BUILDING INSPECTION RECORD `
UI DING BUILDING (Cont'd) PLUMBING
Setback
Firewall
Soil Piping
Forms
Parapets
1st Floor
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
Stemwall
Sidina
To out
Slab
Roof Sheathing
Water Piping
Piers
Roofing ew
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Garage Vents
Water Htr.
StemwaII
Slab
Prov: for physically
handicapped
Heaters
Appliances
Carport
Footings
Conformance of ex.
structure
Gas Piping & Test
Temp. Gas
Slab
Final
Sanitation
Patio
FIREPL CE
Final
Footings
Footing
ELECTRICAL
Masonry Walls
Throat
Reinf. Steel
Final
Bond Beam
FIRE SPRINKLEF
Framing
Test
Stucco
Final
Mesh
MECHANICAL
Scratch
Heating
Brown
Cooling
Finish
Ducts
Interior Lath
Ventilation
Door Closer
Final
DATE
REMARKS OR CORRECTIONS_
�/, �� .Xi , fp4t.0 44 A-10-
Rough
Fixtures
Motors
Water Htr.
Subpanels
Grd. Fault Prot.
Service
Temp. Pole
Underground
Permanent
Final
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC W'OR '' 4103 7J
it 70Dou ty Center Drive — Orc?ill,e, C?lifornia 95965
Telephane:534-4541
APPLICATION AND PERMIT
BUIL NG ,
GO
Owner
SQ. FT. OCC. BUILDING VALUATION
Ce;d 00
Mailing Address �
,Telephone No.
Fireplace
r
Contractor —
Total Valuation
Mai I i ng Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee
Building Address
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
14 44-1 C 1A
Repair drainage or vent piping 1.50
$
Water piping 1.50
Each gas water heater or vent 1.50
A. P. NO. ids— - SJ'�
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
F
Vt! SO t'on
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
'Parking Parcel
Plans eclaration
Parcel a P
60' R/W
Im r
p ove nts
Lawn sprinkler system 2.00
Bldg. Pla ec'd
Por pproval
P ns proval
Permit Fee $
NEW ADDITION ❑ UTILITIES ❑ OTHER ❑
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)
-
Single Family ❑ Duplex ❑ Mobil Home ❑ Others ®
Range, Cook -top or Oven 1.00
C—_
4
Water Heater or Space Heater 1.00
Light fixtures b0
�2
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
Mobil Home Facilities 5.00
Temp. Power Pole 5.00
License No. Classification i
Misc. wiring
I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$
i
$
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.,
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. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.001
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 representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X Date
Signature of Permitee or Agent
Receipt No. /3 Yl 0 7
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 -PUBLIC WORKS
By _ Date. _f
Bu' ding permit expires Date�i'!''i�'