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PERMIT NO. 5342-76B
PERMIT EXPIRES Cr
OWNER Forrest Clark
CONTR. owner
LOCATION (A.P. 65-45-2
15 Snowberry, Magalia
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Temp. Pow Pole
Called G&E
Temp. E c. Serv.
Cal d PG&E
Temp Gas Serv.
alled PG&E
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COUNTY OF BUTTE — DEPARTMENT OF'PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING ` I BUILDING (Cont'd) I PLUMBING
y 1
Setback
Forms
Main BI
Footi
Stemv
Slab
Piers
rramni
Stucco
Door Closer
DATE
lo -la -76 N
(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 Drfvg: — Uroville, California 95965
Telephone: 534-4541 Yc�2 —76
APPLICATION AND PERMIT p�
nay vi uu uc av vil G1 uVVII my
above-mentioned property for inspection purposes.
X _C)—� _f ,k' l.,f C_ Dat
Signature of Permitee or Agent
�/
Receipt No. T t<
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�OFPUBWORKS
/uildinga
ate
permit expires Date ��
BUILDING
OwnerSQ.
FT. OCC. BUILDING VALUATION
Mailing Address
QG
Telephone No.
3
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee&/or Penalty
Telephone No.
Permit Fee $
—
Building Address
PLUMBING No. @ FEE
PERMIT FILING FEE J$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. No.
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
I-Tes
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Parcel el a
Declaration P
60' R/W
Im r
p ements
Lawn sprinkler system 2.00
��Plaanns
Bldg. aF'I ns Rec'd
�Par�r A4proval
Pans Approval
Permit Fee $
NEW � ADDITION ❑ UTILITIES ❑ OTHER ❑
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service 100 AMP OR00V OR LESS5.00
Main service. EA. ADD -L too AMP 2.50
Single Family ❑ Duplex ❑ Mobil Home Others
Main service 0 1 0 AMP VER OR LESS 25.00
Main service EA. ADD'L 100 AMP 1.00
NEW CONST. OR ADDNS. ( ACCLBL GOCCUP. &) 2¢sgft
NON.RESID CONSTR. ( BRANCH CIRCUITS) '2.50ea
NEW CONSTR. (POWER APPARATUS &)
NON RES,D. SINGLE OUTLET CIR.
i
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) BAL@1
Ex. QCCU FIXED APPLNS. OR
P'(OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No.Classification
Misc. Wiring 6.25
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.
�1 certify that in the performance of the work for which this
permit is issued I shall not employ any personin any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL No.1 @ FEEPERMIT
FILING FEE J$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
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TOTAL PERMIT FEE
$ %aZ
nay vi uu uc av vil G1 uVVII my
above-mentioned property for inspection purposes.
X _C)—� _f ,k' l.,f C_ Dat
Signature of Permitee or Agent
�/
Receipt No. T t<
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�OFPUBWORKS
/uildinga
ate
permit expires Date ��
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