Loading...
HomeMy WebLinkAbout065-530-0210 Bob Hedrick NIS Coutolen Rd 7/ 0 m': f ti rram - 'RR u der gas gall, Perm'9B,P ,M(new s- ng1 _ fam y> • I Ro art Hedrick S Coutolenc Rd.,app.600'N _ of^D6o r ,, Grade Rd., Magalia • � Permit �k482-80B,P;E, (;)iwle mily)C � ff 'A'065'530-'021'W,.& #98:11867.3 p t IE it}u 4 atV I i �HEADRICK;?..ROBERT^°;r�i� 1522Ei"COUTELENC;RD �MAGALIA,fx,;�:t >n i L 'ROOFING`CO J ;RER00 F ` ,•065, r99�2126 Pte ° 4 HEDRICK,�Rober Co #,15226, �tolent (changefiwoodfstovtori gas) Conti °,,Wood*AHeat'& Spa, Reliance.. ; I 1 ' 0 �lc, a 1 '^?M"..9' ��1+',:.'\•4�'.�'C-�" "�w.��iAe�l1��� ._f.." x'Y".i.� WtK��+w� f - x4064;53= COUNTY OF BUTTE- DEPARTMENT,OF`DEVELOPMENT SERVICES- BUILDING DIVISION 7 County Center Drive • Oroville, Californias 95965 • Telephone (530) 538-7541 PERMI NO. (Rev. 12/96) APPLICATION AND PERMIT Cl ASSESSOR PARCELN MBER w X30 O ZONING BUILDING PERMIT 1 OWNERLEPH ON E �- )3b5 SO. FT. OCC. BUILDING VALUATION .OWNERS MAILING ADD ESS qq z www CONTRACTOR'S NAME) �� , ♦ Aa TELEPHONE - CONTRALTO S MAILING ADDRESS p t CONSTRUCTION LENDER U LENDER'S MAIUNG ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER^! r ` ? LICENSE NO. —Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS n i Energy Pian Checking Fee $ $ ri ac- . ,CAd PERMIT FEE $ LOT NO. SUBDNLSIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF X Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump,water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 16.10 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Describe Work: 0 A /Y1[I � t4{ � . � � � s c O )-t tin-11��C �CZ.C� �i Irl.- Gas piping system 1- 5 outlets 15.00 Building sewer 15.00 Mobile Home S [GLW @20.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 600VR LE Main Service 200A OR LESS 23.00 CA 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 force and effect. License Class Lic. No.+- OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contrectors�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. ❑ I am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. SO OR ADONS. ( a ACC. BLOS. 3.5QFT; P1ON.ROSID.' MULTI -OUTLET 97,50 a SOWER OUTLET ICIC APPARATUS. OUTLET OR FIXTURES 20 O 1'00 Ex. Occup.BAL @ .50 FlXED APPLNS. OR Ex. Occup. ouTLETs RESIO. EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring23.00 PERMIT FEE $ 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. ❑ 1 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 insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred doliars ($100) or less.) 'O' 1 certify that in the performance of the work for which this permit is issued, I shallTOTAL 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 forthwith comply with thoseprovisions. 1 7�f'� X Date { j Signature of Applicant - 0 Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEI: $ Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE FEE $ 14A2. D FE IMP FLooD CDF PARCEL ..► PD HD ISSUE This permit is hereby issued under the applicable provisions Code and/or Resolutions to do work of the Butte above indicated above for which fees have been paid. for By 7�%��^ .. .,w Date PERMIT EXPIRES ON 9'-1-'5_-,-_2Q00 pate Receipt No. „2 " 8 •00 WHITE-D.D.S.-B.D.' CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE "a _ t BUILDING DIVISION t • DEPARTMENT OF DEVELOPMENT SERVICES' - t 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530)'538-7541 / CORRECTION NOTICE PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. r� COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SFERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephon0) 538-754 PERI No. (Rev. 12/96) APPLICATION AND PERMIT C/ 9� '191? / ASSESSORPARCELN B530—pa I ZONIN 5 BUILDING PERMIT OWNER {�EGb5 U SO. FT. OCC. BUILDING VALUATION .OWNERS MAIUNG D$E$S L'C)— CONTRA OR' NAME • TELEPHONE CONTIRMS MAILING ADDBESS •LC^. rX1�•+�,AC— CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADORESS Energy Plan Checking Fee $ PERMIT FEE S LAT NO. SUBDNIS IONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF X Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 /5-.00 New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Describe Work: Gas piping system 1 - 5 outlets 15.00 16. 00 Building sewer 15.00 Mobile Home IS G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 600VR LE Main Service zo.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 force and effect.PSINGLE License Class Lic. NO. 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 Main Service 200A TO 1000A 46.00 NEW CONST. DwELUNo Occup. OR ADDNS. Ow=c* BLDS. so 3.50FT: NO RAONSTID MULTI -OUTLET @7,50 6 OUTLET OWER APPARATUCIR.S OUTLET OR FDLTURES Ex. Occup.SAL. 20 @ 1.00 @ .w FIXED Ex. Occup. o� (RRM.oEl 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE S 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. ❑ 1 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 insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) 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 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 fo with omply with those r isions. X Date _ / / Signature of Applicant - caner ❑Contractor ❑Agent An OSHA permit is required for excavations over 5'0" deep and demolition or constructionCJ�-l:[�o of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ �, 3 CONST. TYPE T TAL FEE $ HAz. D FE IMP FL000 CDF PARCEL — Po HD SUE This permit is hereby issued under of the Butte County Code and/or indicate bove for which fees have By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date �,1l Date Receipt No. 'sb ' WHITE-D.D.S.-B. D. CA -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT ;��� � -rr tom, ....... _ - �,-,.....--....,•�y�.7p.4?a.::;•!��1�.nji17�%"i.'�.'P�c�toi.�Jlk�[lisp'�L;iaPrdE'�'.zr•„+,.-.�^z-a. _-'Tw`�"�":ra'7'�c'.iy . r • , ; 065 u 530-02N' -,—v— 1867 . f t HEADRICK ; .ROBERT f "� ,—' 4 ^'15226 COUTELENCRD - MAGALIA P% fid, `y'ALL`'ROOFING CO. �w REROOF� COMP, tr ` f 40 er r i 1 . f • - fix• 4 ' COUNTY OF BUTTE - DEPARTMENT OF,DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7.54,1 r pr P•gMIT NO. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER /� �� ` 4l U ZONING BUILDING PERMIT OWNER f� r'v TELEPHONE SO. FT.r. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS e /w c k1 CONTRA OR'S NAME N C TELEPHONE l�72 CONTRACT,RS "(.MIUNG AD,Qw /•/J1 (/S 7 CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ I ARCHITECT OR ENGINEER LICENSENO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 2.2 /? t �� Energy Plan Checking Fee $ A#°/ :,t PERMIT FEE $ LAT NO. SUBDIVISIONS NAME ^' PARCEL -MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE / SFr Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation O Other Describe Work: /( �I:JO ( II` r Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 E00V ORLESS Main Service 200" OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION 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 ful� for a and effect.`7 I License Class If- Lic. No. . / Ll Li 1 ) OWNER -BUILDER DECLARATION 1 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 contracti g with licensed contractors to construct the project. © 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO lOooA 46. NEW CONST. DWa ACC. ELLMUP. SO IG OCCUP.so OR ADDNS. ( BLnS. 3.50FT. pjpNp°Ip. MULTI -OUTLET 97,50 POWERLE "PPARATUS a SINGOLmET CIR. 20 @ 1.00 Ex. Occup. OUTLET OR FIXTURES BAL @ .so Ex. Occup. ourLEEDrs AEsl6.oen 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S 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. O 1 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 insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) 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 workers' compensation laws of California, and agree that if should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. G X .. L `' Date '1 Signature of -Applicant - ❑ Owner fZContractor ❑ Agent t An OSHA permit is required for excavations over 60" deep and, demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ -+IAZD.�� '-'IMP "-FLOG -CDF -PARCH- PO'- HD ISSUE 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. By Date PERMIT EXPIRES ON � Date y y r s -' Receipt No. r„ � WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT (Rev. 12/96) COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7 MIT NO. APPLICATION AND PERMIT �� (0 ASSESSOR PARCEL NUMBER /� /r3 b ZONING BUILDING PERMIT OWNER / ,7e�- `„ TELEPHONE SO, FT, OCC. BUILDING VALUATION . OWNERS MAILING ADDRESS JIO ¢•/ CONTRA O9 S ME L CP TELEPHONE IV 7- 0.3/T CONT TRRS 1UNG �3ADA, SS J1610 �C �✓ ��� CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $J ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS /J v !j 1 _/J �'�f Energy Plan Checking Fee $ $ • PERMIT FEE $ LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ,R -'Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Describe Work: e_ Y Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W 920.00 PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.00 Main Service ooA oA'.ss 23.00 LICENSED CONTRACTOR'S DECLARATION 1 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 f e and effect. License Class — � Lic. No. s Ll � DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 1, 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. EX I am exempt under Sec. Business and Professions Code for this reason Main Service TG 46.00 NEW CONST. DWWELLING OCCUP. SO E CCU OR ADDNS. b ACC. S. NON-R.,.T MULTI.OUTLET @7,50 POWER APPARATUS 8 SINGIE OUTLET CIR. 20@ 1.00OWNER-BUILDER Ex. Occup. OUTLET OR FIXTURES BAL p .w Ex. Occup. OuTEIeTs RM ,G�, 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE $ 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. O 1 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 insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) 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 workers' compensation laws of California, and agree that if I should become subject to the workers' compen tion provisions of section 3700 of the Labor Code, I shall forth ith comply i e provisions. Q Date " 1 Signature of Applican - O Owner Contractor ❑ Agent An OSHA permit is required for excava 4ns over 60" deep and demolition or constructionle of structures over 3 stories in height. r" MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee I $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ suE 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. By r..i✓ Date c PERMIT EXPIRES ON Date Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT Yr. PERMIT NO. 482-80B,P,E,M i' PERMIT EXPIRES Mel Robert Hedrick OWNER CONTR. owner LOCATION (A.P. ) N/S Coutolenc Rd., app.600'N.of Doone Grade Rd., Magalia ' 1 i! . F�. Temp. Power Pole- 0 4 Called PG&AE e! Temp. Elec. Serv.8 Called PG&E — r— Temp. �Gas Serv. _ Ctied PG&E JOB /10 FINALEDl 13 (Date) (Signature) I A. P L U M B I N G Check List ❑ Permit ❑ Underfloor Stage ❑ D.W.V.: .(1) Sizing. (2) Materials. (3) Fittings. (4) Grade & Support'. (5) Cleanouts & Accessibility. (6) Clearances. (7) Rough -in Locations. ❑* (8) Wrapping. (9) Test - including "Ts". (10) Additional test not required.* ❑ Water: (1) Sizing. (2) Materials. (3) Support. (4) Test. (5) Wrapping. (6) Dissimilar metals. (7) Service regulator installed or not required.* ❑ Gas: (1) Sizing. (2) Materials. (3) Support. (4) Log Lighter. (5) Wrapping. ❑ Framing Stage (Top Out) D.W.V.: (1) Size. (2) Vent Area & Termination. (3) Materials. (4) Fittings. (5) Grade & Support. (6) Cleanouts. (7) Traps. (8) Nail Protection. (9) Plumbing Access. (10) Toilet Clearances..(11) Shower size. (12) Shower Pan Test. (13) Vents - turns, horiz., runs, loop, wet, etc. ❑* (14) Additional 2nd floor test not required.* ❑ Water: (1) Pipe Test. (2) 'fixer Valves. (3) Support. (4) Roof drains. ❑ Gas: (1) Size. (2) Materials. (3) PR Valve Drain. - ❑ Water Heater: (1) Vent. (2).Loca.tion: (3).PR Valve Drain. ❑ Final D.W.V.: (1) Connected to sewer system. (2) Special systems. ❑ Water: (1) Water Source. (2) Shut-off. (3) Anti -siphon Valves. ❑ Gas: (1) Test. (2) Connectors. ❑ Water Heater: (1) Location. (2) Accessibility. (3) Clearances. (4) Stability. (5) 18" Garage Floor. (6) Mechanical protection. (7) Combustion Air. (8) Draft Diverter. (9) Vent Connector.. (10) Vent. (11) Shut-off and connector. (12) PR Valve & Drain. ❑ Fixtures: (1) Approved. (2) Stability. (3) Clearances. (4) Trapped. (5) Connections. (6) Cross -connections. (7) Dishwasher Air Gap. A W 5/79 M E C H A N I C A L Check List ❑ Permit ®Underfloor Stage ❑ Underfloor Supply Plenum:- (1) One-story. (2) Clearances. (3) Combustible° material. (4) Insulation and vapor barrier. (5) Access. (6) Catch receptacles and registers. (7) Fire -stopping. (8) Boots. (9),Supply' ducts. (10) Gas lines and plumbing cleanouts. ® Ducts: (1) Size. (2) Materials. (3) Support. (4) Fittings. (5) Wrapping. (6) Insulation. (7) Clearances - ground, crawlspace, cleanouts, plumbing, etc. ❑ Combustion Air: (1) Size. ❑ Refrigerant Piping: (1) Material. (2) Support. (3) Fittings. (.4) Insulation. ❑ Framing Stage ❑ Heating: (1) Approved appliances. (2) Accessibility.:(3) Clearances. (4) Combustion air. ❑ Vent and Connector: (1) -Approved. (2) Size. (3) Clearances. (4) Cap. (5) Termination. ❑ Ducts: (1) Materials. (2) Size. (3) Support. (4) Fittings. (5) Insulation. (6) Fire Damper. ❑ Refrigerant Piping: (1) Material. (2) Support. (3) Fittings. (4) Insulation. (5) Condensate drain.' a J Final ❑ Heating: (1) -Accessibility. (2) Combustion air. (3) Safety controls. (4) Electrical connection. (5) Fuel shut-off. ❑ Cooling: (1) Accessibility. (2) Support. (3) Controls. (4) Pressure -.relief valves. (5) Class 2 refrigerant. 5/79 (dash) - = OK 0 = Not OK X = Not Applicable (blank) = Not dealt with RESIDENTIAL (Singis and Duplex) yet �r Date UNDERFLOOR Plans OK exe 1 hi's Date FRAMING (Continued) 1. Zoning requirements-Setbacks_Easements 48. Property Line Firewall & Openings 2. Fig., Main; Soils-Steel-Elec. Grnd.- " Ftg. Depth 49. Ext. Doors --One 3' -Check Garags-3rd story, 2 exits -_ 3. Ftg., Garage; Soils -Steel- " Fig. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils --Steel- " Ftg. Depth S. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 6. Stemwails, Garage; Steel�-BIockouts-•Wrapped-Slab 7. Piers -Fireplace Fig. -Steel 51. Plywood oo Roof Overhang -Attic Access-tdafter Outriggers 52. Siding-Nailing-Venee,^ _ 53. Stucco Mesh -Drip Screed-Fdn. Vents-•Lnderflr. Access _ 54. Glazing Area -Glass Pro' ectlon-_Skylights^_-Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test. 9. Gas Pipe; Size -Anchors 10. Water Pipe: Test -Anchors -Regulator -Service Test 11. Electric; Underground _ 55. Shear Walls; Nailing -Belts - d -- 12. 13. Plenums & Dusts; Clearance -,Material -Support -ins. ' Girders-SIIIs-Ancher Bolts-Joists--Vents-Cripples Card -Bt Card -81 Date Card -Bt _ Date. Date Card -BI Date Card -BI Card -BI Date Card -81 Date Date Card -81 Date Card -BI ;Date Date Card -81 Dato' FINAL Plans OK except q's Date PLUMBING (Permit) OK except #'s 14. Water Ht.; Vent -Access -Combustion Zr 15. Water Pips; Test & Anchors -Nail Proieetion 16.. D.W.V.; Test-oFttngs & Anchors -Nail Protection 17. Shower Pan; Test, First Floor -Tub Access 18. Test Tub & Showe, 2nd Floor -Tub Access 19. Gas Pipe; Size & Anchors - 56. 57. . 58. 59. 60. _ Ext. Steps -Door & Sidelight Prulectiorb-Landings Smoke Detector Furnace; Vents -Clearance -Comb. Air-Conwtar- In Garage; Above Floor--Ducts-Mech. Protection Bedroom Exiting - G.F.I. & Bath Fixturev & Tub Access Elea. Trim & Subpane_I;_ Brealcov Sizes-Labcala _61. 62. 63. Stairs & Rails Fireplace or Stove; Clearances4learth _ Card -BI Card -BI Date Date Card -BI Date Data Card -BI Date ELECTRICAL Permit OK except k's 64. Elec. Outlets at Wood. Panel: Int. & Ext. 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -=Cooking Clearance 66. Elec. Outlets & Receptacle%at Kit. Counter 67. 66. Garage Fire Door; String-Landing-Closor^ A.C. Duct in Garage -Damper _ 20. 21. Fixture & Transformer Clearance -Ins. Protection Elec. Receptacles Spacing -Lights &Switches at Doors 69. Wtr. Htr.; Verim-Clearance-Comb. Air Court:4ctor-P.R.V.-- In Garage; Above Ffoor-- tech. Protection 70. Plb., Elec. & Mach. Equip. Listed for Location 22. Size Boxes & No. of Conductors -Stapled 71, Elec. Receptacles in Garage; (G.F.i.)-Romex Protec. 23. 24. 25. Romex Installed Close to Edge of. Studs & C.J. Equip. Ground made up w/Much. Fasteners -Bond Gas & Water 2 Appliance Circuits In Kitchen &Conductor Size 72. Insulation -Foam -Looked In Attic ❑Yes 73. 74. es_ Guard Raillss&DDeck Construction -Post Caps Fdn. Vents Crawl fate Door -Drainage & Wood -Earth Clearance Looked under Floor C3 Yes 26. 27. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral ❑Yes ❑No 75. Following instid.: Drive ❑ Yes C]No; Walks C)Yes E]No; Planters ❑Yes ❑No; Creating Drug, Problems . ❑ Yes QNo 28. Service -Riser Conductors & Ground -Alain Disconnect 29. Equip. Clearances; Panels -Motors -Meth. Equip.77. 30. Clothes Closet Light -Shower Light 76. Stucco; Brown -Finish A.C. Unit; Disconnect-Cirnces•-Brkr. & Cond. Size -115V Outlet 78. Vents Above Roof; Plbg.--Appliance.-Firepl.-Clearance to Opngs. 79. Water Well; Disconnect, Electrical, Plumbing Card B-1 Date Card -BI Date 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground 81. Ventilation throughout House 82. Glass Protection ' 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric Card B-1 Date MECHANICAL 31. Date. Card -BI Date (Permit) OK except k's A.C. Ducts; Insulation & Support_ r 85. 86. Water & Sewer Connected -C/O to Grade -HD Approval Energy Compliance Certificate -Other Certificates 32. Vent Fan: Exhaust above Insulation 33. 34. 35. Condensate Drain & Overflow; Size & Grade Furnace -Vent: Access -Comb. Air -Return Air Vent -115V outlet Attic Access & Platform If Furnish in Attic Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI. Date Card -BI Date Date FRAMING(Plans) OK except q's Comments at Final: 36. Sills; Proper Material & Anchors 37. Malts; Studs -Nailing, Spacing & Bracing -Plates -Sound a4 OZ 38. Bearing Walls over Girders & Floor Nailing 39. Draft Stop in Walls (rat proof) 40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. Header & Beam -Size & Bearing 42. Hangers -Post Caps -Anchors -Connectors 43. Clog. Joist-Rltr. Ties-Purling_-_Roof_Brac.-Truss-Shthng.-Rfng. 44. Fireplace Ties or Type A Flue -Fireplace Throat 45. Attic Access; Size & RomeR Protection -Draft Stop -Ins. Bartels 46: Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing ' _-' Eli ID 1-� f-� L -- r.- neinr. azeei COUNTY OF BUTTE — DEPARTMENT -OF PUBLIC WORKS • BUILDING INSPECTION RECORD t 1 Fixtures BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soll Plping r d d Ori l' Forms Parapets 1st Floor Final Main Bldg. Restroom Finlav 2nd Floor Footings Windows 3rd Floor Heating Stemwall Siding To out xD Slab n Roof Sheathing Water Pi in Ducts Piers Roofing Sewer Ventilation Garage Fdn. Vents Fixtures Final Footings Stemwall Garage Vent Insulation i Water Htr. Heaters Elec. Service Slab Carport Po Footings Prov. for ph sica handicapped Conformance of ex. structure Appliances Gas Piping Temp. Gas & Test Slab Final ! 13 Sanitation Support Patio 717 12Z FIREPLACE Final Drainage Footin s ootin G' O� ELECTRICAL Masonry Walls -*Throat . Roueh neinr. azeei Final 61/(,.at 3"H Fixtures Bond Beam FIRE SPRINKLERS Motors Framing 1 Test 7 Water Htr. Stucco Final I Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole 4A, 89N Finish Ducts PA -14^0 Underground Interior Lath Ventilation 1 1 4. Permanent IV Door Closer 1 131 Final Final 1,3 'I, MOBILEHOME UTILITIES ------------------ Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping E ME INSTA L TION - - - - - - - - - 7 - - - - Support Elec. Continuity Water Piping Drainage Gas Piping in 9 DATE REMARKS OR CORRECTIONS S�- A/j 11itp LA,., IM Cy id O za (NOTE: An entry must be made on this form each time you visit the job site. / ,' E R.S E T HCOMPANY i!e LICENSED CONTRACTOR Phone: 342-4764 P.O. Box 628 — Durham, California 95938 INSULATION (Batted or Blown)Date q I V 19 TO THIS IS TO CERTIFY THAT INSULATION HAS. BEEN INSTALLED IN CONFORMANCE WITH THE CURRENT ENERGY REGULATIONS, CALIFORNIA ADMINISTRATIVE CODE, TITLE 25, STATE QF CALIFORNIA, IN THE BUILDING LOCATED AT: "Street Lot Number Tract No. EXTERIOR WALLS 1A ` Manufacturera, `� Thickness/Type R Value CEILINGS Batts: Manufacturer ,�.,{{ Thickness '^ R Value (�^/�) Blown: Manufacturer�LL\Thickness `�' No. Ba1gs�]� Wt./Bag Sq.. Ft. Covered — R Value ) FLOORS Manufacturer Thickness/Type R Value SLAB ON GRADE Manufacturer Thickness/Type R Value Width of Insulation Inches FOUNDATION WALLS 'Manufacturer Thickness/Type R Value GENERAL CONTRACTOR_ BY JJ INSUL 44TION CCJNTRACTO LICENSE NUMBER TITLE DATE �� L)ICENSENUMBE TITLE ��`'��� DATE SAVE ENERGY - INSULATE! ( DATE) ACCEPTED H SETH OMPANY- 12 (Authorized, Representativ RESIDENTIAL ENERGY CONSERVATION STANDARDS CONSTRUCTION COMPLIANCE CERTIFICATE THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN INSTALLED IN CONFORMANCE WITH CURRENT ENERGY CONSERVATION REGULATIONS AT S72? % Ca-u�o 44� a (locat' n) BUILDING PERMIT NO. 's�2^ A. -P. NO. S'��I%-2. THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS: (Check each item or write N/A if not applicable). INSULATION: Slab Edge../� Fdn. Walls Floors !� Walls Ceiling/Roof Ducts L -- Circulating Pipes APPROVED HEATER Zi' APPROVED WTR.HTR. i� GLAZING: Single Glazed Special (Insulated) �l CERT. & LABELED WDS. �1 & SLIDING DRS. WEATHERSTRIPPED DRS. BACK DAMPERED FANS INTERMITTENT IGNITION DEVICES I-- CERT. `CERT. APPLIANCES I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO THE COMPLETENESS OF THIS CERT�/IF�`ICATE AS SUBMITTED. Insulation Applicator Name (please print) Signature -of Insulation Applicator State Contractors License No. General Contractor/Owner Name ` %�� A:pIA? r rL Signature of (p ase print) General Contractor/Owner `� c Date �e �o State Contractors License No. THIS CERTIFICATE MUST BE ON FILE WITH THE BU ILD ING DEPARTMENT PRIOR TO REQUESTING FINAL INSPECTION AND SHALL BE POSTED INA CONSPICUOUS LOCATION WITHIN THE -DWELLING. t I COUNTY OF BUTTE — bEPAR°7MENT OF PUBLIC WORKS e 7 County Center -Drive '- Oroville, California 95965 4f, A Telephone: 534-4541 —v APPLICATION AND PERMIT 1 Owner gap Mailing Address Jas Contractor Mailing Address 67 JI;Wi Tele hone No. Telephone No. Building Address �j� C 0 A.. P. No. �� ,Zoning & aP'1'nning Fps Sa° In Fire Dept. Fire Zone Use Permit EQA Parking Parcel Parcel 60' R/W Im rovements Plans Declaration P Bldg. P ans Recd Parcel A proval Plans roval NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ Single Family IV Duplex ❑ Mobil Home ❑ Others ❑ 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: License No, 1 am exempt from the Contractors License Laws of the State of California. Permit Fee WORKMEN'S COMPENSATION INSURANCE MECHANICAL PERMIT FILING FEE I am aware of the provisions of Section3700 of the California Labor Heating /(T�yyt ,I/1 Code which requires every employer to be insured against liability for Workmen's Compensation. Classificat _ BUILDING i A1, SQ. FT. I OCC. I BUILDING VA UA ION Fireplace I 17 0tc� Total Valuation .CU ELECTRICAL No. Permit Fee FEE PERMIT FILING Plan Checking Fee &/or Penalty $3.00 - Permit Fee 100 AMP ORV OR LE LESS5.00 PLUMBING No.1 @ FEE PERMIT FILING FEE, Main service Each Trap (t0 k( Repair drainage or vent piping 1.50 1.00 Water piping 1.50 O Each gas water heater or vent 1.50 NEW CONST. N[IN.RRESIM_ Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Building sewer 5.00 Lawn sprinkler system 2.00 Permit Fee W '4), I BAL@102 EX. OCCU FIXED APPLNS. OR P• OUTLETS (RESID.) EA) .CU ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 ,CSL` Main service 100 AMP ORV OR LE LESS5.00 Main service EA. AOD•L 100 AMP 2.50 Main service OVER 600V 100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NE W OR ADDNST ( DWEACC B P 4) 22 sq ft Z5-, 7; NEW CONST. N[IN.RRESIM_ M LTI.OUTL T BRANCH CIRCUITS) 2.50ea EX. OCCUD(OUTLETS OR FIXTIIRES) W '4), I BAL@102 EX. OCCU FIXED APPLNS. OR P• OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 0 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. 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 �, , e Date —�'"�� Signature of Permitee or Agent Receipt No. L � 50 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant @ I FEE $3.00 3 r00 Cooling 61:L 'r— ' I I 14f 100 Ventilation Hood 2.00 �O Permit Fee $ (5i� Land Development Fee $ -�Q 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 UBLIC WORKS By Date�`� Building permit expires Date a;z_ 7L s COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS — BUILDING DIVISION ...,,.".� 7 County CentDrive — OrAill'e; Caliiornia 95965 — Telephone 534-4541 PERMIT APPLICATION DATA SHEET t / Permit No. OWNERc�c-G� A.P. No. -- C/Ss Proposed Building Use Permit fee based upon: Complete Coact Price 1, DPW Valuation.:' Oth r (explain) Building. Inspector C ___ ��_� _ - Date /z 1 At time of permitv�a00fication, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted................................................................... 2. Plot plans in duplicate/triplicate............................................................... 3. Complete plans in duplicate/triplicate................................................... 4. Complete engineered plans and calcs..................................................... 5. Plans with Energy Design Compliance Statement ............................ 6. State Energy Forms No. .................... 7. Statement of Intent for Non -Heated & AC Buildings ................... 8. Fees of $ 9. Letter of signature authorization ............ k..... ............... 0. Sanitation approval from �1-�j�J` `'�-F Health Dept.... 11. Planning approval for ........... 12. Certificate of Workmen's Compensation Insurance ........................ 13. Contractors License Information (no., name style, classification) ............................... 14. Improvements may be required. Contact Land Development Section of Dept. Public Works (see addressbelow)................................................................................................. 15. Pre -inspection for required. Pre-inspec. request to bldg. inspector (date) 16. Other When you issue the permit, process as follows:- `Mail to owner Mail to contractor. ii Telephone_ X75? r7 3 and hold for pick-up at ,O -*4j-4-d- I office. Deliver w/inspection. Other Applicant ll�,�f� Date Copy of plans sent Health Dept., Fire Dept., Other Date_ During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at time of appl;ca ion, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by dans cnecKea Dy_ Plans approved by OTHER: Coov/DPW Telephone Mail Other Date Date Do: Building Department, E'rom: Environmental Health Subject: Sanitation Clearance /d el c C r� Owner Plans Approved for: Hold final for: Final Clearance O.K. for: .� Location Sewage .Disposal Water Supply \_� ',rater Supply ie;er .Supply Clearanee for bedroom mobil Other ClearaAce -for addition. of Zote * �.. 4 ,lan, ia te Of alJutk OROVILLE, CALIFORNIA GENERAL CLAIM CLAIMANT: Robert E. Hedrick ADDRESS: 1401 Del Mar Lane CITY & STATE: Anaheim, CA. 92805 IMPORTANT: DATE OF CLAIM: April 4, 1979 SEE INSTRUCTIONS ON REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT Decided not to build. (Permit Appin. #702-79B,P,E,M Receipt #186413 - AP 58-48-21) _ ----- 1 00 Building permit fee 48. - $ Retain 1/3 of fee ------- 49.33 - Amount of refund due ---------------$ 98.67 Plumbing permit fee ----- $ 21.00 Retain filing fee ------- 3.00 Amount of refund due ---------------$ 18.00 Electrical permit fee --' $ 44.00 Retain filing fee ------- 3.00— - — --� i Amount of refund due ---------------$ 41.00 Mechanical permit fee --- $ 13.00 Retain filing fee ------- 3.00 Amount of refund due --------------- 10.00 total Permits Fees Refund Due ------$167.67 Land Development Fee Refund Due ---- 5.00— -- ---- -- ------------------- TOTAL. REFUND DUE$192.67 $192:67 TOTAL $1921.67 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. Datedthis .................................. 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 de- livered and that there is a Budget Appropriation or Specific Board Approvals (Checkone) for the same. Dated this Al=k................ day of . ril 19 79 at Oroville Calif. Department Head or Authorized D eputy Dept. Exp. Code............................................ Code ................................................PAYABLE FROM...............................................................................,............ FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY VENDOR CODE DEPT. & SUB. PROD• SUB. OBJ. CLAIM NO. INVOICE NO. INVOICE DATE DISC. GROSS AMOUNT ENCUMB. SUB -DIST. i Ir INSTRUCTIONS to.•.CIAIMUTS All claims ag 'nst the county must be itemized, giving dates and character of se vice rendered or work- performed; quantities,, de- scription and unit ices of articles furnished or delivered. Claims must be certified by the claimant, and submitted to the De- partment head for approval. Upon approval the_ Department head will forward claim to County ' Auditor -for-payment. procedure. Do not file with the County Auditor first. Claims should be presented to off icials• for. Apptoval- immediately upon completion of services iequested or material ordered. Claims are paid every Tuesday; however, same must be approved by officials and in Auditor's off ice'before..pteceedingWednesday noon. Compliance with above will expedite payment of claim, failure to do so may delay payment considerably. Q-7 t n�i 0-1 t '0 I t N t N NIQ CIO �`�1 M _ COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 • Telephone: 534-4541 APPLICATION AND PERMIT autnonce represenranves or the county or tsutte to enter upon the above-mentioned property for inspection purposes. X���� Date Signature of Peerrmitee or Agent Receipt No. /a z Yl 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. DIRECTOR OF PUBLIC WORKS By Date Building permit expires Date BUILDING e77Owner O60�lG/l SQ. FT. OCC. BUILDING VALUATION x".24 Mailing Address DI -j�.� � *,K)a- 26 Telephone No. g/ 14 W 0.40d-47 4".z 9" 4)d Contractor Mailing Address Fireplace Total Valuation p� 3m -7 C.. 00 Telephone No. Permit Fee I LJAI 00 Building AddressPlan oG c,fpG� Checking Fee &/or Penalty Permit Fee Cv 7 , etO . PLUMBING No.1 @ FEE• PERMIT FILING FEE J$3.00 3,OC> Each Trap 9 1.50 13,56 aJ� Repair drainage or vent piping 1.50 �.-. A. P. No. " 7 0 — z% j� Zoning 8 nning Water piping 1.50 1 4J-0 Each gas water heater or vent 1.50 1 es Sanitation Fire Dept. Fire Zone Use rmit Gas piping system 1 - 5 outlets 1.50 1 a� EQA Parking Plans Parcel Declaration Parcel Ma 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 Bldg. P s Recd Parce roval Plan pproval Lawn sprinkler system 2.00 NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ permit Fee $ .Z)• $ �1 6C 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 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 le of: style Main service OVER e00v 100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW CONS. DWELING 0 OR ADDNST ( ACCLBLDGS.CCUP. 20sgft NEW RES10, BRANCH NON-RESID � BRANCH CIRCUITS 2.50ea NEW CONSTR. (POWER APPARATUS B NON-RESID, `SINGLE OUTLET CIR. EX. OCCUD(OUTLETS OR FIXTI1RES1 BAL@@ICO Ex. OCCU FIXED APPLNS. OR p• OUTLETS (RESID•I EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 toI am exempt from the Contractors License Laws of the State of California. Permit Fee $ q Y, 410 $ be 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 y� 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 $,b Heating i 01- l.A4 Cooling Ventilation Hood 2.00 o'Zsb� Permit Fee $ 13.&C> $ % G{ 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 „13700 $ :,6-, zX TOTAL PERMIT FEE $ �J autnonce represenranves or the county or tsutte to enter upon the above-mentioned property for inspection purposes. X���� Date Signature of Peerrmitee or Agent Receipt No. /a z Yl 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. DIRECTOR OF PUBLIC WORKS By Date Building permit expires Date