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Home My WebLink About065-310-032n v H.'R. FISHER Permit 2833—'�2PyE cl� (utilities for mobile� home) 64-31-32 " Jill contr: Lloyd R. Roberts, Magalia Permit #3768-78B(new deck/MH) / ' 5�1 ^ _ ' . . ' . ./ 1 8 . � ' ~~ | ` � " ~ > ` � / e h ll i jjll!�Jlo 11 MA J J / ,�4 /*- : 5 ,,I-' � ✓', .12 1 /2'/7 a— K' t, f iaomi 'griggs REALTOR L AA INC. 338 VALLEY VIEW DRIVE PARADISE. CA 95969 (916) 877-1254 i No, l;- A> 1 �� a ♦ f 5� f iaomi 'griggs REALTOR L AA INC. 338 VALLEY VIEW DRIVE PARADISE. CA 95969 (916) 877-1254 i No, l;- A> 1 �� + March 31, 1981 F Naomi Briggs RE: Mobile Home Installation 338 Valley View Drive Permits Paradise, CA 95969 (AP 65-31-32) Dear, Naomi, - With reference to the above subject and your letter dated March 27, 1981,.Hutte County required a permit for a mobile home installation starting January 20,-1975. Any mobile, home installation prior,,.to that date did not require penits other,•than sanitation and mobile home utilities . - 6 C1 on ihe'�subject property, our records indicate mobile home utilities were installed in 1972, a private garage in 1978 and a mobile home deck In 1978. t Shouldgou have any further questions, please contact this office. y" Yours very truly, Clay Castleberry. Director of Public Works JFG:d� J.F. Glander Chief Building Inspector 's ..� . . . l ti FILE NO. BUTTE COUNTY (For Action 1, Public Works Dept. 2, 3) p (For Informotion,/) ' Director Dep. Dir. Sec. + Rd. & Br. Mtce. + Shop Equip. & Yards „ Ref. Disp. Bldgs. & Grds. r Bldg. Insp. Admin. D & C/Traffic Const. Rd. Des. Br. Des. Sur. &Loc. t " Mopping Drng./Permits Sub. Checking Right of Way + ..� . . . l ti FILE NO. BUTTE COUNTY (For Action 1, Public Works Dept. 2, 3) p (For Informotion,/) ' Director Dep. Dir. Sec. + Rd. & Br. Mtce. + Shop Equip. & Yards „ Ref. Disp. Bldgs. & Grds. r Bldg. Insp. Admin. D & C/Traffic Const. Rd. Des. Br. Des. Sur. &Loc. t " Mopping Drng./Permits Sub. Checking Right of Way X/1 PERMIT: 2833-72 PIPE FISHER, H.R. 15 Echo Glen Court Lot 116 Unit 1 PP (utilities for mobile home) Cia /V TiAId crs )t 'sn yrs 3 . 1y r'Q 7-0 P65 T Ta �T��i4i ZE ' o �2'73 ` �7_-D �-- COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 Telephone: 533-1230, Ext. 259 APPLICATION AND PERMIT C NI GJQIIta IiVCA ui tilt: wunty ui Out-tu to enter upun the ve abomentiOoned property for inspection purposes. X Date Signature of Permitee or Agent Receipt No. 111111h.-White-D.P.W. — Pink-Insp?ctn• _ (elaA rid-� lessor — 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 BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address — Fireplace Contractor Total Valuation Mailing Address Permit Fee Plar. Checking Fee &/or Penalty Permit Fee $ $ Building Address ---- -- -- PLUMBING No. @ FEE PERMIT FILING FEE J$2.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Eacl- gas water heater or vent 1.50 A. P. No. Zoning Gas oiping system 1 - 5 outlets 1.50 Each additional outlet .50 Fire Zone Fire Dept. Sanitation I Planning Building sewer 5.00 Plans Fees I W. C. R/W Encroachment Lawr sprinkler system 2.00 NEW ❑ ADDITION ❑ OTHER ❑ Permit Fee $ $ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (morethon 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 20bgL a Receps., switches & fix outlets 20025 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. Classification ❑ 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. 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 ,$$Permit InStrumentatio� r a Motion $0.07/$1000 Evaluation $ TOTAL PERMIT PERMIT FEE $ C NI GJQIIta IiVCA ui tilt: wunty ui Out-tu to enter upun the ve abomentiOoned property for inspection purposes. X Date Signature of Permitee or Agent Receipt No. 111111h.-White-D.P.W. — Pink-Insp?ctn• _ (elaA rid-� lessor — 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 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965Jj Telephone: 533-3.230, Ext. 259 v APPLICATION AND PERMIT ir BUILDING Owner )F1 /— 1S /11s: SQ.. FT. OCC. BUILDING VALUATION Mailing Address Fireplace Contractor Total Valuation Mailing Address .-� Permit Fee Plan Checking Fee&/or Penalty Permit Fee $ Building Address PLUMBING No. @ FEE / / —" G (p PERMIT FILING FEE $2.04 r Q0 Each Trap 1,50 _- �s— L C T� Repair drainage or vent piping 1.50 cr Water piping 1.50 15-0 Each gas water heater or vent 1.50 A. P. No. Zonin /� _� / g Gas piping system 1 - 5 outlets 1.50 —O Each additional outlet .50 Fire Zone Fire Dept. Panning Building sewer 5.00 , 00 Plans Fees —_ W. C. ` R/W Encroachment Lawn sprinkler system 2.00 NEW ADDITION ❑ OTHER ❑ Permit Fee $14-1 FJ �� E U ELECTRICAL No. @ FEE PERMIT FILING FEE J00 '$3.001 Main service incl. 1 meter IOD Additional meters, each 1.00 USE OF STRUCTURE . Single Family Duplex ❑ Others ❑ Sub -panel (12 or less) (more than 12) Range, dryer or water heater 1.00 O Oven, Cook -top or space heater 1.00 Light fixtures Receps., switches & fix outlets 20 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 00 License No. Classification I am exempt from the Contractors License Laws of the State of California. Permit Fee $ s77 Q WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor C—hi,h whch re I MECHANICAL No.1 @ FEE PERMIT FILING FEE $3.00 Heating ques every emp oyer 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. 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 Ye / 2. Signature of P itee or Agent Receipt No. �Q / �� _ White-D,P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant Cooling Ventilation Permit Fee $ $ State Fee for Strpng Motion nstrumentotion rogram $0.07/$1000 Evaluation $ TOTAL PERMIT FEE $ 00 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. /DIRECT911 OF PUBLIC WORKS By _Z� S' Date p0 I1 Building Permit Expires Date m P 1801-78B PERMIT N0. PERMIT EXPIRES ✓��/ Bud Fisher °OWNER CONTR. Lloyd. R. Roberts, Magalia LOCATION (A.P. 65-31-32 15 Echo Glen Ct., lot 116, P,P#l, Magalia T� n r� 3 4 'J K T, t Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E JOB ^� FINALED Cf. 1 7Q BU1 Setback Forms Main Bldg. Footings Stemwal l i Slab Piers Garage Footings Stemwa I I i Slab f Carport ;F Footings ` Slab f Patio Footings Masonry Walls Reinf. Steel COUNTY OF BUTTE -,,DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD G BUILDING (Cont'd) PLUMBING Firewall i Soil Piping Parapets 1 1st Floor Restroom Finish 2nd Floor Windows 1 3rd Floor Siding 0 i To out li Roof Sheathing Water Piping Roofing^ Sewer t Fdn. Vents Fixtures Garage Vents Insulation 1;' Water Htr. Heaters Prov. for phs cal y handica pedy ` Conformance of dr. structure Appliances Gas Pi in & Test Temp. Gas Final Sanitation FIIaEPLACE Final n FIRE SP Fix ELECTRICAL r-ramin v— Test Water Htr. Stucco Final Subpanels Mesh M CHANICAL Gird. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Under roun Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOMEUTILITf S ----------------- Elec. Service Elec. Pedesta Water Piping Sewer Gas Piping BI E [ME INSTALLATION -- - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DAT, REMARKS OR CORRECTIONS C�-13 7 (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 Teleptfone: 534-4541 10.1 �� APPLICATION AND PERMIT-�p authorize representatives of the County of Butte to enter upon the above -mention property for 'nsp do pu ses. Z � Date -2O Vate of Permitte7e or Agent Receipt No. U 3 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. D ECTOR OF PUBLIC WORKS By Date !3 Al milding permi expires _ es Date % BUILDING Owner /7`W/t � "Itex-_ SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. /� n Contractor GO �� 2. �0�� S Mailing Address ,, , 0 ® Fireplace Total Valuation �' , Telephone No. _�, Permit Fee Building Address oe Plan Checking Fee &/or Penalty - Permit Fee PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 A. P. No. ,s '-' 3 / - 3LWater Zoning & Planning piping 1.50 Each gas water heater or vent 1.50 F4 v ` 3zai4"WQ. Fire Dept. FireZone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans I Parcel Declaration Parcel Ma P 60' R/W Improvements p ovements Each additional outlet .30 Building sewer 5.00 131t1g-Plart. RBc'd Parcel A roval Pans Approval Lawn sprinkler system 2.00 NEW ADDITION E) UTILITIES OTHER permit Fee $ $ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 i Single Family Duplex E] Mobil Home Others Main service 800V OR LESS ' 100 AMP OR LESS 5.00 Main service EA. ADD -L 100 AMP 2.50 - Main service OVER 600V 25,00 100 AMP OR tE55 Main service EA. ADD'L 100 AMP 1.00 r OR ADDNST ACCLBLDGOC U . Y1 20sq ft 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: // 6e 4492/� �� ®4LM� NEW CES O, BRANCHMULTI.OT NON.R0NS ( BRANCH CIRCUITS) 2.50ea NEW CONSTR. (POWER APPARATUS .& NON-RESID. SINGLE OUTLET CIR. Ex. Occup{OUTLETS OR FIXTURES 5 L25 FIXED LNS Ex. Occup. (OUTLETSP(RESID)REA) 2.00 Temporary service 10.00 Mobile Horne Facilities 15.00 Q License No.�7 / c�+7 Classification Misc. Wiring 6.25 El I am exempt from the Contractors License Laws of the State of Cal ifomia. Permit Fee $ 2v $ Zt WORKMEN'S COMPENSATION INSURANCE 1 am awareof the provisions of Section3700 of the California Labor Code w.4ith requires every employer to be insured against liability for for 7��1. men's Compensation. ve placed on file with the County of Butte a certificate of 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 $ Eo ZC — authorize representatives of the County of Butte to enter upon the above -mention property for 'nsp do pu ses. Z � Date -2O Vate of Permitte7e or Agent Receipt No. U 3 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. D ECTOR OF PUBLIC WORKS By Date !3 Al milding permi expires _ es Date % COUNTY OF .J3UTTE DEPARTMENT OF PUBLIC WORKS r' 7 County Center Drive — ,OroviIle, California 95965 Telephone: 534-4541 /Vp APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned z7 property for ins ction purposes. lj. Date � •G / at/re*�P�e/mite�e^'o�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 have been paid. DIRECTOR OP"RUBLIC WORKS By Date �S� /— Building permit expires Date BUILDING Owner `% SO. FT. OCC. BUILDING VALUATION ei Mailing Address Telephone No. Fireplace Contractor C� '� _j Total Valuation Mai I i ng Address �� y� sem?/ Permit Fee i Plan Checking Fee &/or Penalty Te(,e hone No. Permit Fee $ Do� Building Address PLUMBING No.1 @ FEE PERMIT FILING FEE $1.50 Each Trap LJ'" Repair drainage or vent piping 1.50 Water piping 1.50 # — Each gas water heater or vent 1.50 A. P. �Q 3! ��/ Zoning & Planning Gas piping system 1 - 5 outlets 1.510 Each additional outlet .30 yes S tion Fire Dept. Fire Zone Use Permit Building sewer 5.00 EOA Parking Plans Parcel Declaration Parcel Ma 60' R/W P Im rovements P Lawn sprinkler system 2.00 B Plans c'd Parcel vol P nn T Approval Permit Fee $ $ NEW V ADDITION FUTILITIES ❑ OTHER ❑ ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 Main service 6001 OR LESS 5.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 2.50 Main service OVER 6001 25.00 100 AMP OR LESS Single Family&Duplex ❑ Mobil Home ❑ Others Main service EA. ADD'L 100 AMP 1.00 // NEW CONST DWELING OR A.D.S. ( ACCLBLDGS. OCCUP. &) 2¢sgft NEWCONSTR. MULTI -OUTLET NON -RESID. % BRANCH CIRCUITS) 2.50ea NEW C ON ST 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: Y �/' ten, v , e2 C L/� � Ex. Occup(OUTLETS OR FIXTURES) 109 Ex. ccu FIXED APPLNS. OR O 2.00 P• OUTLETS (RESID,) EA) Temporary service 10.00 �' .P,��j�/ r' Mobile Home Facilities 15.00 .'�� 7 r License No. / Classification - 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 Wo en'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 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 $ Z " authorize representatives of the County of Butte to enter upon the above-mentioned z7 property for ins ction purposes. lj. Date � •G / at/re*�P�e/mite�e^'o�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 have been paid. DIRECTOR OP"RUBLIC WORKS By Date �S� /— Building permit expires Date ,PERMIT NO. 3768-78B PERMIT EXPIRES OWNER H.R. (Bud) Fisher CONTR. Lloyd Roberts, Magalia LOCATION (A.P. 65-31-32 ) 15 Echo Glen Ct., Magalia . 1 1 i 1. i. 1; v - Temp. Power Pole Called PG&E Temp. Elea Serv. Called PG&E Temp. Gas Serv. Called PG&E /FINALED (Date) (Signatu SPRINKLERS t-rarning COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION- RECORD Water Htr. 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 l•'j.^ 'Z. Roofing Sewer Garage Fdn. Vents Fixtures Footings StemwaI l Garage Vents Insulation Water Htr. Heaters Slab Carport p Footings Prov. for physically handicapped Conformance of ex. structure n,1Temp. Appliances Gas Piping & Test Gas Slab Final Sanitation Patio FIREPI-Aa Final Footings Footing ELECTRICAL Masonry Walls Throat Rauah SPRINKLERS t-rarning 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 Final Final MOBILEHOME UTILITIES - - - - • - - - - - - - - - - - - - Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping OBILEHOME INSTALLATION - - - - - - - - - - - - - • 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.) CQUNTY OF, BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California ;��Rx2�`oo�•v,��8l� Telephone! 534-4541 /y APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspect' n purposes. x Date ign a of PermiteeQ'or Agent/ 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 F PUBLIC WORKS Z -6-7E By Date wilding permit expires Date 7—& — 7Z / BUILDING Owner /`/c5/lLp,✓�s SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Fireplace Contractor G A09094iW9: Total Valuation (o Mailing Address�� 7O Permit Fee Plan Checking Fee &/or Penalty T lephone No. Permit Fee $ Building Address C G �� PLUMBING No. @ FEE PERMIT FILING FEE $3.00 f /� f'�7� Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 nT Each gas water heater or vent 1.50 A. P. No. 9- — 3 Z. Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 FS� Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel a 60' R/W P Im rovements P Lawn sprinkler system 2.00 Bldge.P1'ans Re 'd Parcel proval 14ons Approval Permit Fee $ $ NEW ADDITION EJ ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 600V OR LESS 5,00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service OVER 25.00 100 AMPP OR LESS O Main service EA. ADD'L 100 AMP 1.00 �( NEW CONST. I DWELLING OCCUP. & OR ADONIS. ACC. BLOGS. 2�Sq ft 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 style of: AGO � ^��1� j� Ex. Occ Up(OUTLETS OR FIXTURES) 50 0 BAL� FIXED APPLNS, OR (OUTLETS S (RESID.) EA) 2.00 Ex. OccupTemporary Temporary service 10.00 Mobile Home Facilities 15.00 r� —/ 7 License NoQZ,Z�l-J Classification Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ MECHANICAL No. @ FEE WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code whic , requires every employer to be insured against liability forWor n'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. 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 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 inspect' n purposes. x Date ign a of PermiteeQ'or Agent/ 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 F PUBLIC WORKS Z -6-7E By Date wilding permit expires Date 7—& — 7Z /