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HomeMy WebLinkAbout065-340-01965-34-19 CARL FOSS - ` 1210 Wood Dr , Maga.1/Ii<9 2 lot 44 F'I� I.�' � � �_---� � �-1� 'PERMIT NO. 2036�79B,E PERMIT EXPIRES Byrd Robinson OWNER CONTR. owner 'LOCATION (A.P. h5-34-19 ) � Wood Dr., lot 34i, SDO#2, Magalia POT' 1p ' c y 11 't i< k Temp. Power Pdle Called PG&E ,6 Temp. Ele/Serv. Called PG&E p Temp/as Serv. " I Called PG&E r �OB FINALED�11 1A (f::) , (Date) C. (Signa ure) V 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 StemwaII Siding To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Stemwa I I 5-14 •'1 Garage Vents Insulation Water Htr. Heaters Slab Car ort p Footings Prov. for physically handica ed Conformance of ex. structure Appliances Gas PI in &Test Temp. Gas Slab Final Sanitation Patio FIREP CE Final Footings si4—?tj _ Footing I A I ELECTRICAL Masonry Walls Throat Rou h Reinf. Steel Final Fixture wT Bond Beam FIRE SPRIkKILERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MEC NICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer FinalFinal \V MOBILEHOME UTILITIES ------------------ Elec. Service n Elec. Pedestal Water Piping Sewer Gas Piping E OME INSTALLATION - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORK TIONS —/L I,J�VS;Zelf 14�e_ /v7 . /.✓ AfILI So Q 7si' .v_41ZIta/ �l ez�l (NOTE: An entry must be made on this form each time you visit the job site.) `I COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive =-�; Oroville, California 95965 TeMphone: 534-4541 �O / APPLICATION AND PERMIT C(� BUILDING Owner Y2,4 .5 CW SQ. FT. OCC. BUILDING VALUATION Mailing Address W Oo a .ate 8C� G S Telephone No. a0 Contractor �1„t Mailing Address Fireplace Total Valuation ena Telephone No. Permit Fee 6lc� Building Address Plan Checking Fee&/or Penalty Permit Fee oto PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 2 A. P. No. G "' / "-1 Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 F,Ws I Vk'5 I Sa n Fire Dept. I Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Par ing Parcel Plans Declaration Parcel Map 60' R/WImprovement Each additional outlet .30 Building sewer 5.00 Bldg. ans Rec'd Parcel A -11- Plans IpproVal Lawn sprinkler system 2.00 NEW ADDITION ❑ UTILITIES ❑ OTHER �. Permit Fee $ $ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 ©O Main service SS 100 AMP OV OR RSL_SS5.00 Single Family ❑ Duplex ❑ Mobil Home Others Main service EA. ADD'L 100 AMP 2.50 /O Main service OVER 600V 25.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 1.00 NEW 1 OR ADDNST ACCL I S UP 4/ 20sq ft O ' 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: NEW CONSTR. (MUL I.OUTL T 2.50ea NON-RESID BRANCH CIRCUITS NEWCONSTR. /POWER APPARATUS 9 NON -RESID. (SINGLE OUTLET CIR. Ex. OCCUD(OUTLETS OR FIXTI1RES B L@; FIXED APPLNS, OR Ex. Occup.(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $'1-3,ityo $ MECHANICAL No. @ FEE COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor PERMIT FILING FEE Heatinq 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. 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 &04k F R Date —10-. Sig ature of Permitee or Agent Receipt No. e.2 33 �0 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Cooling Ventilation Hood 1 1 2.00 Permit Fee $ $ Land Development Fee $ TOTAL PERMIT FEE $ (p� This permit is hereby issued under the applicable provisi s of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIR,R OF LIC WORKS By 4 Date Building permit expires Date COUNTY OF BUTTE DEPARTMENT 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: W90 Aq Owner /fFL /--ass Owner's Address Mobilehome Mfg.p...� ;"7 Model Year Insignia No. 0 34'/ 1 > ' / L Serial No. It is hereby certified for occupancy at the above described location and may be occupied. Director ofPubli Works s Date _�� t % By GC�La THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED PERMIT NO. 3805-7.7MHI. PERMIT EXPIRES fh 2 OWNER CARL FOSS L CONTR. Gene Schmitt MH S r LOCATION (A.P. 65-3!X-19 ) 1400 Northwood -Dr., Magalia PP#1 lot 54 `l a./0 X100 0 AV n S p0 z` 7- 4073Y • i Temp. Power Pole Called PG&E Temp. Elec. Serv. �7t � S— 7 7 ? Called PG&E 9'/ 72 .QT rib Mbyrn ) Temp. Gas Serv. Called PG&E JOB . FINALED (Date) f Q-- (Signaturf/- • r PLUMBING ICA L Mesh COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD Gird. Fault Prot. BUILDING BUILDING (Cont'd) Heating 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 Stemwal I Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for phsically handica e. Conformance of ex. structure Appliances Gas Piping & Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing Masonry Walls Throat Rou h Reinf. Steel Final Fixtures Bond Beam _ FIRE SPRINKLERS Motors PLUMBING ICA L 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 =E ME INSTALLAL10N - - - - - - - - - - - - - - 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.) 9. Electrical A. Is seivicc large erlottglt to provide ;-.tdequar_e amperage to mobilehome. (mu'$t equal rating of mobilehome faith a.atln.Ll:ium of 100 amp) anal other faciliti. !s on lot, i.e., water pumps, -wage, cabana, etc.',' Yes &--' No B. Is ther--� proper clearances around panels? Yes �-No_ C. Is power supply cord or feeder assembly properly fused? Yesf1_ D Is continuity test satisfactory as per the folloviing procedure? Yes "- No 1. De -energize electrical wiring syste:;1 of the mobilehome at the pedestal. 2. Make sure that fire 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 le., -id of a test instrument to the mobilehome grounding conductor and app.L"y tLie Otu.e'i 1.eau %U eailt iii.� uulCliuuie supYiy Cun.luctoi, 111iliiulYtg Yleotrcll: 5. A1.1 nor. -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 to<;t shall then be made between �.hc grounding electrode and the chassis of the 1110bilehome. Upon satisfactory completion of the dectrical tests, the lot or site service equipment may -be approved for energizing. 0 T:; job card si.-ned by health Department for water and sanitation? 1.1.. If everything (A<ay, sign off card and tag- services. 'MOBILEIJO---!E DATA Manufacturer and/or Namestyle LengthL_ Width A-- Vehicle Serial No,. State Identif.ication 'No. Adel i t ional Infoz-na t a on or Comments: 2iUB7i,C'IiUt'1E INS`I'ALLATIDif INSPECTION CHECKLIST 1. Is the. mobilehome 'located with required separation from lot lines and buildings and generally conform to plot plan? Yes0_ 2, Docs the mobilehome Have required clearances above ground? (Sec.5085) Yes '-�No 3. Are foot.in,s and supports properly sized, spaced, and braced as per approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yesk__ No_ 4. Is the mobilehome level.? (Sec. 5088) Yes L- No 5. If more than a single unit, are crossover connections properly 'installed? (Sec. 5088) Yes � No y: 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 ," per foot slope and is it properly supported? Yes' No C. Are any leaks detected in drainage system after running -gallons of water through each fixture including Leashing machine standpipe? Yes N 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`__�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 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 /No I LIE COJNTY„OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — . Uro4ilie, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT SignatureJ%/ Yer�tee �r Agent By Date Receipt No. / ��/ White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant BZing permit expires Date BUILDING Owner 4.I SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Fireplace Contractor S :5 Total Valuation Mailing Address Permit Fee' Plan Checki ng Fee &/or Penalty 1 31ep. &,- 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 r . Each gas water heater or vent 1.50 A. P. No. r 3 LS Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet 30 Fees W.C. ire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W Improvements P Lawn sprinkler system 2.00 Rs ec d Parcel proval Plan proval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 ./ ZO /`t Main service 600V OR 000 AMP ORSLESS 5.00 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service 00 AMP OR LESS 25.00 Main service EA. ADD•L too AMP 1.00 NEW CONS. DWELING OR ADONST ( ACCLBLDGS.OCCUP. &) 20sgft NEW CONSTR, MULTI -OUTLET NON.RESID. ( BRANCH CIRCUITS) 12.50ea 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: CkA)h r���%M / T% lY% /I /9 �/� Ex. Occup(OUTLETS OR FIXTURES) 50 BAL21 09 FIXED APPLNS, OR Ex. Occup. (OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 / License No._3%02,3�2,3 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 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. @ FEEPERMIT FILING FEE J$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 authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X>�-�e �t�c �c Date 7-� 9_`' c d ^� TOTAL RMIT 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 }JBLIC WORKS A ) I SignatureJ%/ Yer�tee �r Agent By Date Receipt No. / ��/ White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant BZing permit expires Date 4 /'v SS BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville,.CA. . PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name: S ,S 2. Installer's name: .cJ SCI -1,W T 7— 01 3. Is the site currently under permit? Yes / ✓/ No (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? ----------------------- l �Amps 6. What is the mobilehome site service rating? --------------------- / Amps 7. What is the mobilehome site circuit breaker rating? ------------- / O (0 Amps.'. 8. Is there any other electric load to be served by the mobilehome siteservice? --------------------------------------------------- Yes / / No (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? ----- ----------------- - _ (in.) 10. What is the t e of as service.? ----- type ---------------------- -- Natural / / LPG. -/ --i 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. S/Z ti k R 0 R E S7- Setup Model No. /2762 Year -1,22 Width 02(ft.) Length ..I D (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). . ... .. i . 14—. Single .., . a Center Center Support Support Footing Sizes Locations (in.) ......° in. in. in. •02� � � SJx� p ;FE' in. ..(in.)(in.) .. . z_x3g (in.) (in.) 's %',If center piers are other than drawn above, draw in locations, spacing, and dimensions. Footings-- (check . one) .1. Wood : either pressure treated or :..... : fdn. ; grade . . ' 2.:Concrete pad. 3. Other, -specify Supports (check one) /77`�1. Concrete block 2. Concrete piers LL 3. Steel piers 4. Other, specify i x Footing Siical zeort C3 -n. in. T?x COUNTY OF 13UTTE - DEPARTMENT OF PUBLIC WORKS • 7 County Center Drive, / z OroviIle, California 95965 � �f Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the abANo. roperty for inspect'on purposes. p 7C X Date 6 Per/mitee or Agent Re7[�� 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. DIRECTO 0 PUBLIC WORKS tt'' By Date -- ?7 �, L( - 7e (ding permit expires Date �- BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address Az_25Z5.A111J_e 23e ) 1054 elephone No. Fireplace Contracto Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ Building Address Q PLUMING No.1 @ FEE PERMIT FILING FEE $3.00 a9 irv 1.50 G rainage or vent piping 1.50 Water piping 1.50 J, Each gas water heater or vent 1.50 A P `j 19, Zoning ng & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 s lrje Saaiion Fire Dept. FireZone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W Improvements P Lawn sprinkler system 2.00 Bldg. 121s. —R.ee=d Parcel Approval Plans Approval Permit Fee $ ()p $ Oc NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER �j ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 >= Main service 100 AMP OROR SLESS 5.00 Main service EA. ADD'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service OVER 600V 00 AMP OR LESS 25.00 Main service EA. ADO'L too AMP 1.00 NEW OCCUP. &) 2¢sgft OR ADDNST ( DACCLBLDGLING S. 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: Ex. Occup(OUTLETS OR FIXTURES) �04 FIXED APPLNS. OR Ex. Occup. (OUTLETS(RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. psilMECHANICAL 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. ❑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. 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 $ 70 authorize representatives of the County of Butte to enter upon the abANo. roperty for inspect'on purposes. p 7C X Date 6 Per/mitee or Agent Re7[�� 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. DIRECTO 0 PUBLIC WORKS tt'' By Date -- ?7 �, L( - 7e (ding permit expires Date �- COUNTY OF BUTTE► — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT �� 96-77 authorize representatives of the County of Butte to enter upon the above -mention d property for //inspection purposes. Xh Date fig nure�off Permitteee� or Agent Receipt No. /'�/J ZGiZX 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 id. DIRECTOR 0 P BLIC WORKS BY Date� Build' permit expires Date �`�- 7 BUILDING Owner �/ SQ. FT. OCC. BUILDING VALUATION Mailing Address e7phon�. // Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee&/or Penalty Telephone No. Permit Fee $ Building Address l /� _/ PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 GdJ ✓Z Each gas water heater or vent 1.50 A. P. Pt' / Zoning 8 Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 es .' . Se:t-WfaT Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans I Parcel Declaration Parcel Ma P 60' R/W Improvements provements Lawn sprinkler system 2.00 �ll�q-P�vrts-I�ea'd Parcel Approval Plans Approval Permit Fee $ $ NEW❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 O A'/ �-• 100 AMP OR LESS 5.00 Main service 6001 OR LESS 6� Main service EA. ADD'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service 10 0 AMP VER OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW CONS. DWEL-ING O OR ADONST ( ACCLBLDGS.CCUP. &) 20sgft NEW CONSTR. MULTI -OUTLET NON.RESID. BRANCH CIRCUITS) 2.50e' a 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: Ex. Occup(OUTLETS OR FIXTURES)L'� BAL�1 Ex. OCCUP•(FIXED APLNS. OR 2•00 OUTLETS (RESID.) EA) Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 ' ® 1 am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ s 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.1 @ FEE 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 $ C authorize representatives of the County of Butte to enter upon the above -mention d property for //inspection purposes. Xh Date fig nure�off Permitteee� or Agent Receipt No. /'�/J ZGiZX 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 id. DIRECTOR 0 P BLIC WORKS BY Date� Build' permit expires Date �`�- 7