The URL can be used to link to this page

Home My WebLink About065-410-01265-41-12 Ford i'jQ � ��.�� Jack Pyne Way, lot 108, PP 3� Magalia 1 Icontr: F sci Bros., Paradise r ermi.t �4525-77B,P,E,M(new single family) 5-41-12 Contr: Fisci Bros., Paradise Permit#372-79B(add'l deck) SF a -A01V11J/f 5-41-12 Con`r: Fisci Bros Ermt ##1983-79B �Par� ise 525-�j7) (s. -renewal/ 10-012 99-1,32 GOMEZ> ONDO 15001 JACK P Y AL CONTR: RELI P INST OOD STOVE I�}I} i 4 a r f..r t� I �j, �� '. w � � � �4. � � .- ., 1 � +" }, n,� �. s , rCOU NTY OF BUTTE ,� _.,..; �• . � �� Orovllle, Califomia GENERAL CLAIM r J CLAIMANT: Wood Heat & Spa ADDRESS: 6426 Skyway CITY & STATE: Paradise, CA 95969 DATE OF CLAIM: 09/02/99 IMPORTANT. SEE INSTRUCTIONS SMWI1 CLAIM I U UL-VAKI MtN/ Kt1La1V/NU UUUUS UK SERVICES ON REVERSE SIDE DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT Owner decided cancelled project.(AP#065-410-012, BP#99-1832, Receipt #273712, Dated 8/10/99, Owner: Arrnondo Gomez. Total amount paid $55.00 Retain refund processing fee $ 25.00 Retain building permit filing fee $ 20.00 Total amount to be retained $45.00 Total amount to be refunded $10.00 TOTAL $ 10 0( I, the undersigned, declare under penalty of perjury that the services or articles clai ed have been rformed. r delivered, and that this claim Is true and correct a: .stated. -5(f (� /v. w , , � Dated this �— day of, 1990 at l�C�; Calif. v — —"" 'Si nature o la ant I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles ified above bee performed or delivered and that there is a Budget Appropriation I I or Specific Board Approval I I (Check one) for the same. Dated this /7 day of s6' , 19 �at 02e 1/i�t e� Calif. rtment Nead or Authorized Deputy Dept. Code 440-002 Exp. Code 4210500 PAYABLE FROM CONSTRUCTION PERMITS FUND Dept. Code Exp. Code PAYABLE FROM FUND Dept Code Exp. Code PAYABLE FROM FUND DO NOT WRITE BELOW THIS UNE -AUDITOR'S USE ONLY DEPT. & SUB. PROD. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSS AMT. a Important Message W01=001mum"IMA ❑ Telephoned ❑ Wants to see you ❑ Returned your call ❑ Was here to see you P ❑ Please call ❑ Will call again ❑ URGENT Post -it® 7679-4 M 1993 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Or,.ville, California 95965 • Telephone (530) 538-7541 PERMITNO.NO. (Rev. 12/96) ia►PPLICATION AND PERMIT ASSESSOR PARCEL NUMBERp�/� ,{fos D�n U{Y�l' may, Y•P`_ ZONING BUILDINGPERMIT OWNER A✓'y-Y)on dc, c.>7 e Z TELEPHONE 873 -' 35-77 SO. FT. OCC. BUILDING VALUATION .OWNER'S MA ADDRESS 1�G01 T ck CONT CTOPP'S NAME /lAn(e 0,6A TELEPMONE a77-6751* CONTR ; 5 MA NG A4R SS l/p_ Z 1/O ♦ CONSTRUCTION LENDER Fireplace 1161 LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS Se -0l -,q i�iei e vVzz li Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDNISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.0023.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat um water heater Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New W`Addition ❑ Remodel ❑ Utilities ❑ .Inst/allation l❑ Other 13 Describe Work: ZNshi �� Woa c Stbtle Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G W @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 600VOR UES Main Service 2o.A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I 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 full orce and effect. 7 License Class Lic. No. -3z/3/2 OWNER -BUILDER DECLARATION I 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. 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 insuranc carr r and policy number are: Carrier 5fg--e 7 Policy Number �7,/ E r 177 3 ci (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) 131 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 forth ' - mply with those provisions. X Date Sig ature of Applicant - ❑ Owner ❑ Contractor ACgent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service TO 46.00 CCU000A NEW CONST. DWEWNO OCCUP. SO W: OR ADONS. a ACC. BLDS. 3.50FT, NpNgOp ' MULTI -OUTLET @7.50 POWER APPARATUS a SINGLE OUTLET CIR. OUTLET Esc, Occup. en0 @ 1. o FIXED APPLrJS. OR 5.00 Ex. Occup. ourLErs RESID. EA Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring23.00 PERMIT FEE t MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST.TYPEleo TOTAL FEE $ HAz. D. FEES IMP FLOOD I CDF PARCEL I PD HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By AM��ate PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. ate Receipt NO. WHITE-D.D.S.-B.D. ANARY-A SES R PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE Oroville, Califomia GENERAL CLAIM CLAIMANT: Wood Heat & Spa ADDRESS: 6426 Skyway CITY & STATE: Paradise, CA 95969 DATE OF CLAIM: 09/02/99 IMPORTANT: SEE INSTRUCTIONS SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES ON REVERSE SIDE DATE DESCRIPTION OF CLAIM DESCRIBE FULLY TO AVOID DELA AMOUNT Owner decided cancelled project.(AP#065-410-012, BP#99-1832, Receipt #273712, Dated 8/10/99, Owner: Armondo Gomez. Total amount paid $55.00 Retain refund processing fee $ 25.00 Retain building permit filing fee $ 20.00 Total amount to be retained $45.00 Total amount to be refunded $10.00 TOTAL $ 10 00 I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is true and correct as stated. Dated this day of , 19_, at Calif. Signature of Claimant I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or delivered and that there is a Budget Appropriation [ I or Specific Board Approval [ I (Check one) for the same. Dated this day of , 19_, at Calif. Department Head or Authorized Deputy Dept. Code 440-002 Exp. Code 4210500 PAYABLE FROM CONSTRUCTION PERMITS Dept. Code Exp. Code PAYABLE FROM Det Code Ex . Code PAYABLE FROM FUND FUND FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSS AMT. I PEi MIT NO. x+525=77B,P,E,M f " OWNER PERMIT EXPIRES W. Ford CONTR. Fisci Bros., Paradise LOCATION (A?P. 65-41-12 f 135 Jack Pine Way, lot.108, PP#3, Magalia , 7 % Temp. Power Pole u 1s Called PG&E �} �. .q N"., Temp..Ele0 Serv. Called PG&E% emp. Gas Se.r.v. cCal;led,P�G&E `� V J d' 10 M .I 4 JOB FINALED i 7 % Temp. Power Pole u sl Called PG&E �} �. .q N"., Temp..Ele0 Serv. Called PG&E% emp. Gas Se.r.v. cCal;led,P�G&E `� V JOB FINALED i THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH THE CURRENT ENERGY REGULATIONS, CALIFORNIA ADIIINISTRATIVE CODE. TITLE 25 STATE OF CALIFORNIA. IN THE BUILDING LOCATED AT: -135. Jack Pine Wav —�icree Coi um er Iract No. EXTERIOR WALLS' fiberglass Manufacturer .T - M Thlckness/Type ;Lit R Value CEILINGS Batts: Manufacturer Thickness R Value Blown: Manufacturer Amer i g a r d Thickness 5 No. BagsWt./889_AL_ sa. Ft. covered 14 6 8 - R value 10 ' = _ FLOORS 321f Fiberglass Manufacturer JAM Thlckness/Type R Value ll SLAB ON GRADE Manufacturer Thickness/Type R Value Width of insulation Inches FOUNDATION WALLS Thickness/Type R Value mq �ippu LICENSE NUMBER A TOD 6 ITIE� ef��Ec i DATE 0 17, ON TNSULATIONLICE14SE NUMBER 212461 .` ITLE Owner DATE 4 /78 - COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS' 4 4 BUILAING INSPEC-fih RN= _BUiLDING BPIDING (Cont1d) PLUMBINGA Setback Firewall -?o Soil Piping WPAW =2�227 (L /(�=�11 ;�_A, FormsParapets Y: ( list Floor Main Bldg Restroom Finish 2nd Floor FootingsWindows 3rd Floor Stemwal I /* Siding -Topout Slab Roof Sheathina Water Piping -I- Piers J0 Roofing Sewer GarageFdn. Vents t" Footi gs 101 1 31 Garage Vents --- Fixtures Water Htr. Sternwall Insulation yano k7— Heaters V Wce, U Slab Prov. for ph sically Appliances Carport handica pe.1 ce o Conformance Gas Piping IL 'Test Footings structure Temp. Gas Slab Final 5 17"s Y.11 Sanitation Patio 7 -FIREPLACE Final Footings Footin ELECT [ICA Masonry Walls Throat- r.� ? Reinf. Steel Final fO _iFIxfures Bond Beam FIRE SPRINKLERS Motors Framina Test Water Htr. Stucco Final Subpanels Mesh 114ECHANICAL Grd. Fault Prot. Scratch Heating Service V Brown -Cooling 7 /-.1,/ 1 V Temp- Pfolet Finish l t I Ducts 17,e I b Underground Interior Lath Ventilation .9 - N 41. 1, Iq CA :� I//— Permanent Door Closer t"7PY Final Final MOBILEHOME UTILITIES -------- ---------- Elec. Service Elec. Pedestal Water Piping Sewer 'Gas Piping )ME INSTALLATION -/ ------------ Support Elec. Continuity Water Piping Drainage Gas Piping DATE —REMARKS OR CORRECTIONS lop f-0,3 IP41u- ;, ,0,, 0, l��a�� opt k7,1 �� C112 7 po� At of 4� /Zld r- ly (NOTE: An entry must be made on this form each time you visit the job site.) 40' .7".. COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 /f r Telephone: 539-4541 APPLICATION AND PERMIT a / dutnurize representailves OT ine l;OUnty Oi tSUiie io enter upon ine above-mentioned property for inspection purposes. Date C O Signature of Permitee or Agent Receipt No. "13.304 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 F PUBLIC WORKS C 40�/ ilding permit expires Date BUILDING Owner �O 1 SQ. FT. OCC. BUILDING VALUATION Mai I i ng Address Telephone No. Contractor /SG Mailing Address �O �% Fireplace Total Valuation A9iiP&g]/S Telephone No. " Permit Fee Cj Building Address` •— Plan Checking Fee&/or Penalty Permit Fee ftp BSc PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 /�. ,[d iUG ,ll(�jL//S► Repair drainage or vent piping 1.50 A. P. No. PEP—/ Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 Fpees' P_rf5 •Sar�Aatibfi Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 -etd-g 'PT ns Rec'd I Plans Approval Lawn sprinkler system 2.00 ___Earcel_Approval NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Permit Fee $ $ ELECTRICAL. No. @ FEE 1 r PERMIT FILING FEE $3.00 00V OR LE Main service 10000 AMP ORSLESS 5.00 Single Family LJArJ Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD•L 100 AMP 2.50 Main service OVER 25.00 100 AMPP OR LESS O Main serv.lce EA. ADD'L 100 AMP 1.00 NEW OR ADDNST % ACCLBLDGS.LING CCUP. S) 2�sgft CONTRACTORS LICENSE LAW I am licensed under the,provisions of Chapter 9, Div. 3, of the State of ornia Business & Professions Code under the name style Ofj� • 0 n NEW CONSTR. BRANCH CIRCUITS) NON-RESID ( BRANCH CIRCUITS) 2.50ea NEW CONSTR. POWER APPARATUS B NON-RESID. SINGLE OUTLET CIR. Ex. OCCUD(OUTLETS OR FIXTIIRES B L@; EX. Occup. ( FIXED APPLTS JRE S. OR OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 //�� ` License No.�te 44,, 6 i Classification 6 W Misc. iring 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. rVI 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 L2.00 Hood 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 $ �O dutnurize representailves OT ine l;OUnty Oi tSUiie io enter upon ine above-mentioned property for inspection purposes. Date C O Signature of Permitee or Agent Receipt No. "13.304 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 F PUBLIC WORKS C 40�/ ilding permit expires Date COUNTY OF EUTTE� — DEPARTMENT OF PUBLIC WORKS ` • ;, 7 County Center Drive Uroville, California 95965 ' Tel ephpne: 53d4541 APPLICATION AND PERMIT y�57� authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 11 X �v'-- Date 3 1-77 ature ofrPermiittee or 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 DIRECTOR 0 PU IC WORKS By Date�7—� - �L— G B ing permit expires Date l / �� -71 BUILDING Owner . OCC. BUILDING VALUATION 0a Q �� tF Mailing Address Telephone No./��(K oU . (C ' Contractor l C �j �1 V j . aflaation ?.S n Mailing Address Permit Fee 3 — Plan Checking Fee &/orPenalty M &,� C J e o. Telhone — ifta� Permit Fee Building Address PLUMBING No. @ FEE PERMIT FILING FEE $3.00 ,/ �--- Each Trap 1.50 (��^ �r 76 Repair drainage or vent piping 1.50 Water piping 1.50 FIT_ Y Each gas water heater or vent 1.50 ^0 �� C] l �l Z° A. P. No. ! Zon'+� r Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fe W C I 1 on' Fire Dept. FireZone Use Permit Building sewer 5.00 EQA Parking Plans arcel Declaration Pa I Ma p 60' R/W Im rove nts p Lawn sprinkler system 2.00 BI ��y Recd' rcel Approval Plans pproval Permit Fee $ ELECTRICAL No. @ FEE , NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ 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 :. Main service OVER s O 25.00 100 AMP OR LESS Single Family Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD'L 100 AMP 1.00 _SQ. FORMOBILES NEW CONST. ( DWELLING O 2�sgft OR ADDNS. ACC. BLDG 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 Bu ' ess & Professio Code under the name style of: �zs Ex. Occup(OUTLETS OR FIXTURES) BAL21a FIXED ALNS. Ex. Occup. ( OUTLETS P(RESID )KEA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 lassification License No. Classification-&—l' ET am exempt from the Contractors License Laws of the State of California. Permit Fee $ 53 ut MECHANICAL No. @ 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 h 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 3 r Heating G Cooling ' Ventilation Hood 2.00 Permit Fee $ 1 $13 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby L ho Dt V - o2 s� TOTAL PERMIT FEE 2c authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 11 X �v'-- Date 3 1-77 ature ofrPermiittee or Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been DIRECTOR 0 PU IC WORKS By Date�7—� - �L— G B ing permit expires Date l / �� -71 P � 10A COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS .y 7 County Center Drive - Oroville, California 95965 Tel e$hone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. -� Date Z,;'_4 J Signature off�PPerrmitee or Agent Receipt No. lez;L 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. RECTO PUBLIC WORKS By Date permit expires Date BUILDING Owner al, SO. FT. OCC. BUILDING VALUATION Mai I i ng Address Telephone No. Contractor OELE (F Mailing Address 0 ,:,3q7 Fireplace Total Valuation 6P,4/r1 6 Telephone No. Permit Fee rOd Building Address yr7 3 `' /&Z ctl Plan Checking Fee&/or Penalty Permit Fee (JQ7-3-3 PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 %-07— lO(F- Pir' 3 /M,q6-,4A00 Repair drainage or vent piping 1.50 A. P. No. �p� �� r<�— ,/�'�-- �l ZZOnin'& Planning Water piping 1.50 Each gas water heater or vent 1.50 F 6eRi�a�ieR Fire Dept. FireZone Use Permit Gas piping system 1 - 5 outlets 1.50 EOA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 Bldg. Parcel A rovol Plans Approval 2.00 Lawn sprinkler systemweI NEW ❑ ADDITION UTILITIESW OTHER �` Permit Fee $ $ 46-1- rezS'> > eP ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 Single Family ®' Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service OVER 600V 25.00; 100 AMP OR LESS Main service/ EA. ADD•L 100 AMP 1.00 OR ADDNSNEW T DWEACCLBLDGS.LING CCUP. Y) 22sgft CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of Celj�nia Business &Professions Code under the name style of: z NEW CONSTR BRANCH CIRCUITS) NON.RESID. (MULTI BRANCH CIRCUITS) 2.50ea NEW CONSTR. (POWER APPARATUS d NON-RESID. SINGLE OUTLET CIR. Ex. Occup {ourLETs OR FIXTURES g L� Ex. Occup ( FIXED APPLES. OR • OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No._C�&D 6�?_ Classification 6- 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. Iool I have placed on file with the County of Butte a certificate of 4� 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 above-mentioned property for inspection purposes. -� Date Z,;'_4 J Signature off�PPerrmitee or Agent Receipt No. lez;L 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. RECTO PUBLIC WORKS By Date permit expires Date