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Home My WebLink About066-040-013or— AP -04-13 E.V. LOENEN S25 Cascade Dr., lot 1�.9. PPCC 1 contr: Duane Hotovec, aradis Permit# 4966-74P,E(util:, MH) f9/�2,17 AP 6,6-04 1 E.V. LOENEN 225 Cascade Dr. lot 169, PPCC#1 contr: Duane H ovec, Paradise Permit# 5131-7 B(deck & awninp.MH 66-04-13 CONTR: J. & F Builders, Mag is -7 � Permit #2617-76B,E(new ga e & cover walkway) r • iy.. CAA - 66-04-13 t Fa aadlock //—/O 77` 225 Cascade, t._169, CC#l, Magalia , contr: Don Darby, Magalia { Permit #5314-77B(new awning/MH) E o - � 6 f� .,�, �. rt PERMIT NO. 5314-77B PERMIT EXPIRES " g OWNER Faye Tadlock CONTR. Dori Darby, Magalia LOCATION (A.P. 66-04-13 ) 225 Cascade, lot 169, CC#11 , Magalia t � ' 1 Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E f Temp. Gas Serv. Called PG&E JOB t FIINALED (Date)_ (Signature) J Setback Forms Main Bldg. Footings Stemwal I Slab Piers Garage Footings Stemwa I I Slab Slab Patio Footings isonry Walls Relnf. Steel Bond Beam COUNTY OF BUTTE — DEPARTI ENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Firewall Soil PI in Parapets P g 1st Floor Restroom Finish 2nd Floor Windows 3rd Floor Siding To out Roof Sheathing Water Piping Roofing Sewer Fdn. Vents Fixtures Garage Vents Insulation Water Htr. Heaters Prov. forph sically handica ed Conformance of ex. structure A (lances Gas Piping &Test Temp. Gas Final 4 0 ' Sanitation FIREPLAC Final Flxtur FIRE SPRINKLERS I Motors ELECTRICAL 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 BI E ME INSTA LATION - - - - - - - - - - - - - - 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.) Owner Mailing Addres) Contractor Pt Mailing Address Buildina Address COUNTY OF BUTTE\ — DEPARTMENT OF PUBLIC WORK �. 7 County Center Drive — Orp.viIle, California 95965 /%// -�/7 Tel ephofie: 534-4541 6J/ / / APPLICATION AND PERMIT lAllii,7/ V Telephone No. IF tv // 1 /Ig hone pN�o. I3 3 '- -7 <� G A. P. NO. z ` Zoning & Planning F s Fire Dept. Fire Zone Use Permit EQA Parking Parcel Parcel Ma Plans Declaration p 1 60' R/W Improvements Bldg. ins Recd Parc pproval PI royal PP NEW � ADDITION ❑ UTILITIES ❑ OTHER I-1 Single Family ❑ Duplex ❑ Mobil Home Others ❑ J r f `1%t—C.IC- 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: 0 AV / BUILDING SQ. FT. OCC. BUILDING VALUATION 1 2 Fireplace Total Valuation 'I— Permit I- Permit Fee Plan Checking Fee &/or Penalty Permit Fee PLUMBING Nt PERMIT FILING FEE Each Trap Repair drainage or vent piping Water piping Each gas water heater or vent Gas piping system 1 - 5 outlets Each additional outlet Building sewer Lawn sprinkler system Permit Fee Wiring ELECTRICAL PERMIT FILING FEE Main service io00o SLESS MECHANICAL AMP OR Main service EA. ADD'L 100 AMP Main service OVER 600V Ventilation 100 AMP OR LESS Main service EA. ADD'L 100 AMP CONST. NEWC OR ADDNS. DWELLING OCCUP. Ik ACC. BLDGS NEW CONSTR. /-UL II -OUTLET N 0N.RESI D, l BRANCH CIRCUITS. NEW CONSTR /P(1WFri eoo no nr. . EX. Occup(OUTLETS OR FIXTUR EX. Occup• ( FIXED APPLNS. OR OUTLETS (RESID.) E Temporary service Mobile Home'Facilities License No.,I.lo? 7 y' (?Misc. Classification Wiring ❑ 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. �( 1 have placed on file with the County of Butte a certificate of Y� 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 PERMIT FILING FEE Heating Cooling Ventilation Hood Per 't F 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 -me 'oned pro for inspection purposes. Date — 7 Signature of Permitee or A nt Receipt No. 1 �i White-D.P.W. _ Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant FEE $3.00 1.50 1.50 1.50 1.50 1.50 .30 5.00 2.00 FEE $3.00 5.00 2.50 25.00 1.00 22sq ft 2.00 10.00 15.00 6.25 FEE $3.00 TOTAL PERMIT FEE Is J 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 LIC WORKS By Date 7 - 7 Buil Ing permit expires Date �'' -7- 7 �S' .a .d PERMIT NO. 2617-7`6B,E. PERMIT EXPIRES OWNER Van T.oenen & Tadlnck CONTR. J. &T Builders, Magalia LOCATION (A.P. 66-04-13 235 Cascade Dr., lot 169, PPCC#l, Magalia e L' 5✓ i' Temp. Power P e Called? E Temp. E'le . Serv. Call PG&E Temp. as Serv. Iled PG&E J B INALED (Date (Si rnature) i R COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING Setback Forms Main Bldg. Footings StemwaI I Slab Piers Footings (� ` Stemwa I I Slab Carport Footings Slab Aoiio Footings isonry Walls Reinf. Steel Mesh Scratch Brown Finish Interior Lath Door Closer DATE BUILDING (Cont'd) Firewall Restroom Finish Windows Siding tt' // Roof Sheathing�o Roofing Fdn. Vents Garaqe Vents e Prov. for physically c_,,. handicapped Conformance of ex. FIREPLACE Footin PLUMBING Soil Piping 1st Floor 2nd Floor 3rd Floor Water Piping Sewer Fixtures Water Htr. Heaters Appliances Gas Piping & Test Temp. Gas Sanitation Final ELECTRICAL Final Fixtures FIRE SPRINK ERS Motors Test Water Htr. Final Subpanels MECHAINJICAL Grd. Fault Prot. Heating Service Cooling Temp. Pole Ducts Underground Ventilation Permanent Final Final k V —/ EMARKS OR CORRECTIONS e-, f=ate,---9C��-c. � �.► c.�;�� ivy Ste, iv" 3 N-ee) (NOTE: An entry must,be made on this form each time you visit the job site.) L PERMIT N0. 5131-74B — .) P E M i -I UTIL. PERMIT NO. PERMIT �X IRES OWNER E.V. Loenen a, CONTR. Duane Hotovec. Paradise 134 0 •L-OCATION (A.P. 66- ) f; 225 Cascade Dr., lot 169, PPCC#1, Magalia t �i 13tJj.� A 1• Temp. Power Pole A Called PG&E t Tenp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E JOB FINALED (Date s t (Signatu ) I COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING _ BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms r f 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 Garage Vents Water Htr. StemwaII Prov. for physically Heaters Slab handicapped Appliances Carport Conformance of ex. % Gas Piping & Test Footings structure Temp. Gas Slab Final . Ei Sanitation Patio FIREPLACE Final Footings Footing LECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRES INKLE,RS Motors Framin �� Test % Water Htr. Stucco A Final Subpanels Mesh MECH , CAL Grd. Fault Prot. v Scratch Heating Service Brown Cooling 4//— Temp. Pole Finish Ducts Under round Interior Lath Ventilation �; Permanent Door Closer Final Final j DATE REMARKS OR CORRECTIONS .��- COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 j Telephone: 534-4541 / 7-- APPLICATION AND PERMIT 76 authorize representatives or the County of Butte to enter upon the above-mentioned pro erty for inspection purposes. e Date "11-/8 - 7 C, Signature ermit a 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 paid. DIRECTR OF PUBLIC WORKS By—.—Date /�^ 49 Building permit expires Date BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address j Z J A -P_ 7 Z Telephone No. Fireplace Contractor �% 8��(�L Total Valuation Q Cap Mailing Address / !/ ��,L Permit Fee Plan Checking Fee &/or Penalty T ephone No. 7 --oz— Permit Fee ' Oo Building Address ,a� _ 6r PLUMBING No. @ FEE PLUMBING FILING FEE $3.00 e 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. N -O —�� Zoning 8 Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fe VW. Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking( Plans ParcelParcel Decl Ion Ma P 60' R/W Provem Im is Lawn sprinkler system 2.00 Bldg. Plans R c'd Parcel Appr of Plans Akpproval Permit Fee $ $ NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 3.dVo �/51,e1t6 — ,d lq-cl_ ertl 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 1100EAMP OR LESS 25.00 Main service// EA. ADD'L 100 AMP 1.00 NEW CONS.DWELING OR ADDNST C ACCLBLDGSO.0 2Tsgft 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* ��/! / ,E/�,/ C�� Ex. Occup(OUTLETS OR FIXTURES)@ BAL@1 EX. OCCu FIXED APPLES, OR P• OUTLETS (RESID,) EA� 2•00 Temporary service 10.00 Mobile Home Facilities 15.00 License No_2-!7t?3/G-.Classification_ �� l / 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. ❑ 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 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 TOTAL PERMIT FEE $3 authorize representatives or the County of Butte to enter upon the above-mentioned pro erty for inspection purposes. e Date "11-/8 - 7 C, Signature ermit a 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 paid. DIRECTR OF PUBLIC WORKS By—.—Date /�^ 49 Building permit expires Date COUNTY OF BUTTE — DEPARTMENT OF PUBLI' 7 County Center DriGe — Oroville, California 95965 KelephiAd: t34-4541 APPLICATION AND PERMIT BUILDING Owner Mailing Address r Telephone No. Contractor Mai I i ng Address G6 lephone No. 14 77- Building Address 77 .4Z, t- d c-- e- q /9"!5r /) p CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State Ca,fornia Business & P�roff4esions Code under the name style License No. 23 -fY,03 Classification 1 am exempt from the Contractors License Laws of the State of California. 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. Thave 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 authori \representatives of the County of Butte to enter upon the above mentioned property for inspection purposes. VX Date e 9/ Signature of Per itee or Agent Receipt No. /2(1-6 S3 White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant SQ. FT. I OCC. I BUILDING VALUATION Fireplace Total Valuation Permit Fee Plan Checking Fee &/or Penalty Permit Fee PLUMBING PERMIT FILING FEE Each Trap Repair drainage or vent piping Water piping Each gas water heater or vent Gas piping system 1 - 5 outlets Each additional outlet Building sewer Lawn sprinkler system Permit Fee ELECTRICAL PERMIT FILING FEE Main service incl. 1 meter Additional meters, each Sub -panel (12 or less) (morethan 12) Range, Cook -top or Oven Water Heater or Space Heater Light fixtures Receps., switches & fix outlets Hood, Ex. Fan or F.A. Furn. Motor Evap. cooler, gar. disp. or D.W. Air conditioner or heat pump Water pump Mobil Home Facilities Temp. Power Pole Misc. wirinq FEE $2.00 1.50 1.50 1.50 1.50 1.50 .30 5.00 2.00 Permit Fee $ MECHANICAL No. @ FEE PERMIT FILING FEE J$3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ I TOTAL PERMIT FEE 1$ A-1 ley 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 OFAJBLIC WORKS By `� Date / o 73 Buding permit expires Date ................ :. e- 76 A. P. No. - Q — /3 Zoning & Planning Fe Sa3t�on Fire Dept. Fire Zone Use Permit EQA Parking Plans Parcel Declaration Parcel Ma p 60' R/W rovements Improv Bldg. Plans Recd Parcel 4,pproval Pl&rs Approval NEW ® ADDITION ❑ UTILITIES ❑ OTHER ❑ Single Family ❑ Duplex ❑ Mobil Home Others ❑ w All A/6, CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State Ca,fornia Business & P�roff4esions Code under the name style License No. 23 -fY,03 Classification 1 am exempt from the Contractors License Laws of the State of California. 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. Thave 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 authori \representatives of the County of Butte to enter upon the above mentioned property for inspection purposes. VX Date e 9/ Signature of Per itee or Agent Receipt No. /2(1-6 S3 White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant SQ. FT. I OCC. I BUILDING VALUATION Fireplace Total Valuation Permit Fee Plan Checking Fee &/or Penalty Permit Fee PLUMBING PERMIT FILING FEE Each Trap Repair drainage or vent piping Water piping Each gas water heater or vent Gas piping system 1 - 5 outlets Each additional outlet Building sewer Lawn sprinkler system Permit Fee ELECTRICAL PERMIT FILING FEE Main service incl. 1 meter Additional meters, each Sub -panel (12 or less) (morethan 12) Range, Cook -top or Oven Water Heater or Space Heater Light fixtures Receps., switches & fix outlets Hood, Ex. Fan or F.A. Furn. Motor Evap. cooler, gar. disp. or D.W. Air conditioner or heat pump Water pump Mobil Home Facilities Temp. Power Pole Misc. wirinq FEE $2.00 1.50 1.50 1.50 1.50 1.50 .30 5.00 2.00 Permit Fee $ MECHANICAL No. @ FEE PERMIT FILING FEE J$3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ I TOTAL PERMIT FEE 1$ A-1 ley 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 OFAJBLIC WORKS By `� Date / o 73 Buding permit expires Date ................ :. e- 76 i .a MH Util.4966-74P.E PERMIT N0. O. P E M MH UTIL. PERMIT NO. PERMIT EXPI ES A9 OWNER E.)Pkoenen CONTR. Duane Hotovec, Paradise LOCATION (A.P. 66-04-13 ) 225 Cascade Dr., lot 169, PPCC#1, Maga. . .t 1 Temp. Power Pole Called PG&E Tem Elec. Serv.ej::Q_jgW Called PG&E Temp. Gas Serv. Called PG&E JJOB FINALED /z A" /I i i ENGLISH JOUN MOBILE HOMES 5400 C1ark,Roa& Paradise, California Butte County Building Inspection Paradise, California. Re: F. Tadlock, Lot 169 Country Club #1 Magalia, Calif. 56X24 Key Biscayne Ser.# 60681 Pd 6-0 54"13 Gentlemen; Please be advised that the above captioned Mobile Home was delivered and installed on December 17 and 18; 1974, Very truly yours, Frank Bardenheier Installation & Service Manager -': �� - � C - .._ .... � ., . rr . _ C _ ... .. ��_ .. . • _ Jam.. �._.'' : .�. .: _ ' • w .. J... .. ` �. .. .... � y I` � .� k. • _ .^ � - .� �� .. J l ' � Scratch Heating Service C,* C� Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final DATE REMARKS OR CORRECTIONS / 1h Aoo-z c COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUI DING 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 Roofing Sewer Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. Stemwall Slab Prov. for physically handicapped Heaters Appliances Carport Footings Conformance of ex. structure Gas Piping & Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service C,* C� Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final DATE REMARKS OR CORRECTIONS / 1h Aoo-z c ,, r COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive , — �OroviIle, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT dutnuriz epresentatives of the Uounty of t3utte to enter upon the abov en ned property for inspection purposes. X i Iate G /; Signature of Permit 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 paid. DIRECTOR OF UBLIC WORKS BY Date ufiding permit expires Date................C��'.:">a. BUILDING Owner �, t�E E SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Fireplace Contractor J &G Total Valuation Mailing Address f �� C—LUd t9.4>� Permit Fee Plan Checking Fee &/or Penalty visa Tele phone�2 o. �-2�G Permit Fee $ $ Building Address $ C'IV,li PLUMBING No. @ FEE PERMIT FILING FEE $2.00 dd 0— --=,-L/ Each Trap 1.50 O Repair drainage or vent piping 1.50 Water piping 1.50 SQ Each gas water heater or vent 1.50 / A. P. No. to ep" —(��y _ Zonin n Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F W S i 1i'n Fire Dept. Fire Zone Use Permit Building sewer 5.00 , Q� EQA Parking Plans Parcel Declaration Parcel M P 60' R/W Improvements p ovements Lawn sprinkler system 2.00 g. Plans Recd I Parcelprovol Plans pproval Permit Fee $ $ r J NEW [JADDITION ❑ UTILITIES OTHER [JPERMIT ELECTRICAL No. @ FEE FILING FEE $3.00 3, Main service incl. 1 meter 6Q Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Single Family ❑ Duplex ❑ Mobil Home Others ❑ Range, Cook -top or Oven 1.00 S� Azz Lu L �L Water Heater or Space Heater 1.00 Light fixtures ball (d10. Receps., switches & fix outlets Z E.UTJ25 10110 CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of ��-a-i.vl fornia Business Profess •ons Co a under the name style of: _ Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar, lisp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No.oC, 7 7�� Classification Misc. wiring ❑ 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 men's Compensation. ve placedon file with the County of Butte a certificate of W�0,,,r,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 Coolingorkmen's 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 cc $ i V( dutnuriz epresentatives of the Uounty of t3utte to enter upon the abov en ned property for inspection purposes. X i Iate G /; Signature of Permit 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 paid. DIRECTOR OF UBLIC WORKS BY Date ufiding permit expires Date................C��'.:">a.