HomeMy WebLinkAbout066-060-012.�
66-06-12
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So.Par'
ParadisePermitCOMPACTION TEST REQ..
'/��37P4-78B,E(util MH)
GAS
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Contr: SOS MH Ser, Paradise
Permit #4794 78MHI
66-06-12
Contr: Cal Gas, Paradise
pErmit
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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 5, under permit
number for the following location:
Owner ifs .�
Owner's Address �4�
r
Mobilehome MfgModel Year
Insignia No: �� Serial No ,
It is hereby certified for occupancy at the above described location and
may be occupied.
DateBy
Director of Public Works
a
THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED
White - Owner, Yellow - Installer, Pink - D.P.W.
r
PERMIT NO. 3764-78P,E
PERMIT EXPIRES
OWNER Charles Baskins
=s
CONTR. Tri -V Constr., Paradise
LOCATION (A.P. 66-06-12 )
345 So. Park Dr., Lot 112, PPCC#1, Magalia
_ r
ti
Y
r
t
o
Temp. Power Pole
Called PG&E
Temp. Elec. Serv.
Called PG&E ' �L �`tn
Temp. Gas Serv. ✓
r' —�7 /p -�
Called PG&E ����� s �a��/ - 70 .l
f
JOB s— / 8
FINALED a
(Date)
(Signature)
V
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING BUILDING .(Cont'd) PLUMBING
aefqaCK
I wall
S I Piping
Form
ara is
1 t Floor
Mal Bldg.
rRestroFinish
2n loor
Foons
indows
3rd loor
Stem II
din
To out
Slab
Roof Sheath
Water PI n
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footin s
Stemwal I
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Carport
Footings
Prov. for physically
handicaped
Conformance of ex.
r' structure
A (lances
Gas Piping & Te t
Temp. Gas
Slab
Final
Sanitation -
Patio
FIREPL CE
Final
Footings
Footing
ELEC ICAL
Masonry Walls
Throat
Rouah
Motors
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 0, Gas Piping
BI E OME INSTALLATION-' - - - - - - - - - - SupportElec. Continuity
Water Piping QiL ZDrainage Gas Piping
DATE REMARKS OR CORRECTIONS
41_
(NOTE: An entry must be made on this form each time you visit the Job site.)
9. Electrical
A. Is service large enough.to provide adequate amperage to mobilehome (must equal rating of
mobilehome with a minimum.of P 1 amp) and other facilities on to , i.e., water pumps,
garage, cabana, etc.? Yes 41 No
B. Is there proper clearances around panels? Yes No_
OIs power supply cord or feeder assembly properly fused? Yes_ No,
D.' Is continuity test -satisfactory as per the following procedure? YesZNo_
1. De -energize electrical wiring system of the mobilehome at the pedestal.
2. Make sure that the 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'lead of a test instrument to the mobilehome grounding conductor and
apply the other lead to each mobilehome supply conductor, including neutral.
5. All non-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
test shall then be made between the grounding electrode'and the chassis of the
mobilehome. ,Upon satisfactory completion of the electrical tests, the lot or'site
service equipment may be approved for energizing.
10. Is -job card signed by Health Department for water and sanitation?
11. If everything okay, sign off card and tag services.
MOBILEHOME DATA
Manufacturer and/or Namestyle
Length, e (p y Width -
Vehicle. Serial No.
State Identification No )6 S" 5rb`
Additional Information Comments:
Y
MOBILEHOME INSTALLATION INSPECTION CHECK LIST
1. Is the mobilehome located wit required separation from lot lines and buildings and generally
conform .to plot plan? Yes No
2. Does the mobilehome have"required clearances above ground? (Sec.5085) Yes N
3. Are footings and supports properly sized, spaced, and braced as p approved plans? (Note
possible variation at spring shackles.) (Sec. 5082 & 5083) Yes No
4. Is the mobilehome level? (Sec. 5088) Yesj',�No_
5. If mor than.a,-single unit, are crossover connections properly installed? (Sec. 5088)
Yes No
6. Water
A. Is fle ble connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566)
Yeso
'B. Test - Does water piping withstand working pressure or 50 lbs. air test? Yes 9 --Io
C. Backflow - If cnot State of California approved, does station have backflow device
and pressure-re0f f lve? 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 4" per foot slope and is it properly supported? Yes'` No
C. Are any leaks detected in drainage system after running 3- llons of water through each
fixture including washing machine standpipe? Yes No
D. If coachi State of California approved, does station have required trap and vent?
Yes No)k
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 mobil ome gas line inlet without reductions other than the mobilehome
connector. Yeso
B. .Test OK as per following procedure? Yes L' No
1. Open all appliance connector valves.
2. Shutoff appliance burner and pilot valves.
3. Air test with manometer°to 10"014" water column; or test with slope gauge (minimum
® 6oz.-maximum 8 oz.) calibrated.in tenth pound increments. Test for 10'mn. 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
J I I
. COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965
• Tel epf�rie: 534-4541
APPLICATION AND PERMIT
An
authorize presentatives of the t;ounty of t3utte to enter upon the
above -m Toned property for inspection purposes.
I /m? X tl�
X Date
Signature of Permitee or ge t
Receipt No. 7
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 06IPdBLIC WORKS
By [C. �� - Date 7_(,.-7J;1`
ding permit expires Date . 7— !o - 71f
BUILDING
Owner
SQ. FTi OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Contractor
Mailing Address �Z
Fireplace
Total Valuation
e hone N�
Permit Fee
Building Address "` ��
Plan Checking Fee &/or Penalty
-
Permit Fee
'tt4, c.
PLUMBING No. @ FEE
o Z Lf •
PERMIT. FILING FEE $3.00
Each Trap 1.50
Zoning Verification my
Repair drainage or vent piping 1.50
//� rr ^,
A. P. No. lD �D 2 S'
�` r-
zo
Water piping
Each gas water heater or vent 1.50
F
Wtcr.-,
i ept. Fire Zone
Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking
Plans
Parcel
Declaration
Parcel p
60' R/W
Improvements
Each additional outlet .30
Building sewer 5-86- %
Bldg Wen. Recd
Parcelt4proval
Plans.Approvol
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ UTILITIES OTHER ❑
Permit Fee $
$
ELECTRICAL No.1 @ FEE
PERMIT FILING FEE $3.00
Main service 600V OR LESS ^ _
loo AMP 5.00
- �--�/ -
Single Family Duplex Mobil Home Others
9 Y ❑ P ❑ Lam" ❑
-L 00 ALES
Main service EA. ADD'L 100 AMP 2.50
500 SQ. FT. MINIMUM
FOR MOBILES
Main service IIER 00 AMP 600
R LEss 25.00
Main service EA. ADD't 100 AMP 1.00
NEW CONST. ( DWELINGOR ADDNS. ACCLBLDGS.CCUP. S) 20sgft
CONTRACTLET
TORS 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 BRANCH CIRCU
NON -CONS ( BRANCH CIRCUITS) 2.50ea
NEW CONSTR. POWER APPARATUS 9
NON.RESID. .SINGLE OUTLET CISR
EX. OCCUD(OUTLETS OR FIXTIIPEs 1 BAL21
FIXED APPLINIS
Ex. Occup.(OUTLETSiiRESID.)REA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00 T 5_7::-
License No. 3d 2 i®1 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.
❑I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
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
$ 5`Q
authorize presentatives of the t;ounty of t3utte to enter upon the
above -m Toned property for inspection purposes.
I /m? X tl�
X Date
Signature of Permitee or ge t
Receipt No. 7
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 06IPdBLIC WORKS
By [C. �� - Date 7_(,.-7J;1`
ding permit expires Date . 7— !o - 71f
a � '
CQUNTY BUTTE — DLP4RTMENT OF PUBLIC WORKS
7 County Center Drive ` Oroville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
vfmo_;�p __
aumonze represenlaiives or me 1;ounry or tsulie io enter upon me
above-mentioned property for inspection purposes.
X
Date �� ^
Signature of
PermCitee or Age
Receipt No. 1,5 `5 f3
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 fo hich fees hav been paid.
ri. DI EC PUB IC WORKS
BY - �_72,f
Building permit expires Date
BUILDING
Owner I -A (),elE BAS kIAJS
SQ. FT. OCC. BUILDIN ALUATI
Mailing Address
Telephone No.
Contractor SaD•s �'vllJQlLE til6 /4L.ES
Mailing Address K/J5LE,e R019 -V
Fireplace
Total Valuation
p
p 7591.9
T� Jl1_0 % al1/
Permit Fee
Building Address 345 SO , ,
�K ��
Plan Checking Fee&/or Penalty
Permit Fee
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
pp
I -VT ��0l2 pPGG �6Rt.��}
Repair drainage or vent piping 1.50
A. P. No. �(p—Q�"! a�
Zoning & Planning
Water piping 1.50
Each gas water heater or vent 1.50
F
Sam"a4=
I 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
B ec'd ParceI.Ar oval
Plans pprovaI
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
Permit Fee $
$
_
& 166
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
00V OR L
Main service 100 AMP ORSLESS 5.00
Single Family ❑ Duplex ❑ Mobil Home Others ❑
Main service EA. ADD'L 100 AMP 2.50
OV AMP OR LESS O
Main service OVER e 25.00
Main service EA. ADD'L 100 AMP 1.00
NEW CONST DWELLING
OR ADDNS. ACC. BLDGS.CCUP. Y) 22sgft
CONTRACTORS LICENSE LAW
1 am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
Y
NEW CONSTR MULTI -OUTLET
NO N.RESID BRANCH CIRCUITS) 2.50ea
NEW CON ST R. POWER APPARATUS B 4
NON-RESID. (POWER
OUTLET CIR.
EX. OCCUD(OUTLETS OR FIXTIiRES BAL@1
Ex. OCCU FIXED APPLNS. OR
p. UrTLETS (RESID.) EA) 2.00
Temporary service 10.00
.Mobile Home Facilities 15.00
License No:124!9 4' Classification G/
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.
'1"Fiave placed on file with the County of Butte a certificate of
® Workmen's Compensation Insurance.
r -1I 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 $
$
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
Land Beveimment ee 11114 T
$ 30 cod
TOTAL PERMIT FEE
$ 6�G
aumonze represenlaiives or me 1;ounry or tsulie io enter upon me
above-mentioned property for inspection purposes.
X
Date �� ^
Signature of
PermCitee or Age
Receipt No. 1,5 `5 f3
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 fo hich fees hav been paid.
ri. DI EC PUB IC WORKS
BY - �_72,f
Building permit expires Date
oil
V
COUNTY OF 43U'TTE — DEPARTMENT OF PUBLIC WORKS ^�
7 County Center Drive - Oroville, California 95965 17
' Teleptlon : 534-4541
APPLICATION AND PERMIT
aulnunce ruplubelluILIVub Ur 11110 t,,Uunly UI 6UL110 LU 10n110r upun the
above-mentioned property for inspection purposes.
,f
X X + Date
$i nature of Permitee or Agent
t3
Receipt No. - �0
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.
—< IRECTOR OF PUBLIC WORKS
BY Date /� z�-%9
W
B -?76 y-��
1 es permit expirate
BUILDING
Owner C ,
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Contractor 6 � �,j`�
Mailing Address /190zflyxO
Fireplace
Total Valuation
nG /f�
/C d/
Telephone No. s
Permit Fee
Building Address -
Plan Checking Fee &/orPenalty
Permit Fee
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00 p
Each Trap 1.50'
Repair drainage or vent piping 1.50
A/ P. ®�_/
Zoning & Planning
Water piping 1.50
Each gas water heater or vent 1.50
es
Sani-tet'te,
FireDept.
FireZone
Use Permit
Gas piping system 1 - 5 outlets p
EQA
Parking
Plans
I PaicelEach
I Declaration
I Parcel Map
60' R/W
Improvements
additional outlet .30
Building sewer 5.00
Bd
Parcel Approval
Plans Approval
Lawn sprinkler system 2.00
NEW ❑ ADDITION UTILITIES ❑ OTHER,0
Permit Fee $ p
.$ d
�2 I ' _7
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
00V OR L
Main service 100 AMP ORSS 5.00
Single Family ❑ Duplex Mobil Home ® Others ❑
Main service EA. ADO'L 100 AMP 2.50
Main service OVER 600V 25.00
100 AMP OR LESS
Main service EA. ADD•L 100 AMP 1.00
NEW CONST. ( DWELING
OR ADDNS. ACCLBLDGS.CCUP. 910\ 22 sq ft
/
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�
�/G
NEW RESID, BRANCH CIR T
NON-RESID. BRANCH CIRCUITS 2.50ea
NEW CONSTR. (POWER APPARATUS.8
NON-RESID. SINGLE OUTLET CIR.
Ex. OCCUD{OUTLETS OR FIXTURES) g L@;
FIXED APPLNS. OR
x.ccup•�OUTLETS (RESID.) EA) 2•00
Temporary service 10.00
Mobile Home Facilities 15.00
// / i -�
License No.7//k Classification
Misc. Wiring 6.25
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$
MECHANICAL No. @ 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.
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
Land Development Fee
$
TOTAL PERMIT FEE
$ G
aulnunce ruplubelluILIVub Ur 11110 t,,Uunly UI 6UL110 LU 10n110r upun the
above-mentioned property for inspection purposes.
,f
X X + Date
$i nature of Permitee or Agent
t3
Receipt No. - �0
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.
—< IRECTOR OF PUBLIC WORKS
BY Date /� z�-%9
W
B -?76 y-��
1 es permit expirate
RESIDENTIAL
�L
r 66-06-123850-90B,P,E
CONN,- Darrell
13770 South Park Dr,-Magalia
Contr: Paul Belleveulle
( garage with bath)
,1
t
JOB FINALE
Signature
1
J=OK
O=Not OK
Not
= Not Readyable MOBILE HOMES
Date -
MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support Sketch
3. Sewer; Location -Test -Fall -C/O Concrete
4. Water; Location -Test -Easement Needed (Sketch)
5. Electricity; location-Clearences-Grnd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap: / /"L"ft.
/ /"Nat. or/ /"L"ft./ /"LPG
7. Utility Clearance
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements -Setbacks Easements
2. Footings; Size -Spacing -Marriage Line
3. Gas; MH Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
5. Drain; MH Test -Fell -Flex Connector
6. Water; MH Test -Regulator -Connector
7. Water and Sewer Connected -C/O to Grade -HD Approval
8. Gas and Electricity Tagged
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
MISCELLA
Date DECKRrdbVERS, CARPORTS tans OK except #'s
�.-Zorooequirements-Setbacks-Easements
ootings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks; Gridsrs and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rttrs.-Coonectors
Shthg.-Rfg.-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. C rports; Windows -Doors
I ctric
r S' - nchor -Stu 4 -Trusses
iding; . ailing -Veneer -Stucco -Mesh
1 ; Shthg-Roofing
t.; Ste s -Do rs-Landings
Date Card B-1 Date % %/ Card B-1
Date - Card B-1.7 Date Card 8
Date POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distances-GFI
5. Elec.; Pool Lighting; 15 volts-GFI
6. Elec.;Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Main in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
J=OK
O = Not OK
- = Not Applicable
' = Not Ready RESIDENTIAL (Single
& Duplex)
Date
UNDERFLOOR (Plans) OK except #'s
Date
FRAMING (Continued)
1. Zoning -Setbacks -Easements -Flood -Slope
45. Hangers -Post Caps -Anchors -Connectors
2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Rfng.
3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
47. Fireplace Ties or Type A Flue -Fireplace Throat clearance
4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth
48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
5. Stemwalls, Main; Steel -Bloc kouts-Wrapped
49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
6. Stemwalls, Garage; Steel- Bloc kouts-Wrapped
50. Garage Fire Protection Framing
6a. Hold Downs and Special Anchors
51. Property Line Firewall & Openings
7. Slab; Steel -Wrapped
52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits
8. Piers -Fireplace Ftg.-Steel
53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers
10. Gas Pipe; Size -Anchors
55. Siding -Nailing Veneer
11. Water Pipe; Test -Anchor -Regulator -Service Test
56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
12. Electric; Underground
57. Glazing Area -Glass Protection -Skylights -Plastic
13. Pienums & Ducts; Clearance -Material -Support -Ins.
58. Shear Walls; Nailing -Bolts
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
59. Insulation -Walls -Ceilings
15. Insulation
60. Infiltration -Walls -Windows
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PLUMBING (Permit) OK except #'s
Date
Card B-1 Date Card B-1
16. Water Htr.; Vent -Access -Combustion Air -Baffle
Date
FINAL (Plans) OK except #'s
17. Water Pipe; Test & Anchor -Nail Protection
61. Ext. Steps -Door & Sidelight Protection -Landings
18. D.W.V.; Test -Fittings & Anchor -Nail Protection
62. Smoke Detector
19. Shower Pan; Test, First Floor -Tub Access
63. Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
20. Test Tub & Shower, Second Floor -Tub Access
21. Gas Pipe; Size & Anchors
64. Bedroom Exiting
65. G.F.I. & Bath Fixtures & Tub Access -Spa
Date
Card B-1 Date Card B-1
66. Elec. Trim & Subpanel; Breaker Sizes & Labels
Date
Card B-1 Date Card B-1
67. Stairs & Rails
Date
ELECTRICAL (Permit) OK except #'s
68. Fireplace or Stove; Clearances -Hearth
22. Fixture & Transformer Clearance -Ins. Protection
69. Elec. Outlets at Wood Panel; Int. & Ext.
23. Elec. Receptacles Spacing -Lights & Switches at Doors
70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
24. Size Boxes & No. of Conductors -Stapled
71. Elec. Outlets & Receptacles at Kit. Counter
25. Romex Installed Close to Edge of Studs & C.J.
72. Garage Fire Door; Swing -Landing -Closer
26. Equip. Ground made up w/Mech. Fastners-Bond Gas & Water
73. A.C. Duct in Garage -Damper
27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI
74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.
In Garage; Above Floor-Mech. Protection
28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga.
Cu or Al
75. Plb., Elec. & Mech. Equip. Listed for Location
29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al.
Insulated Neutral 0 Yes 0 No
76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection
77. Insulation -Foam -Looked in Attic 0 Yes
30. Service -Riser Conductors & Ground -Main Disconnect
78. Guard Rails & Deck Construction -Post Caps
31. Equip. Clearances Panels-Motors-Mech. Equip.
79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth
Clearance Looked under Flocr 0 Yes
32. Clothes Closet Light -Shower Light -Spa Light
33. Smoke Detector
80. Following instid.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No;
Planters ❑ Yes ❑ No
81. Stucco; Brown -Finish
Date Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
82. A.C. Unit; Disconnect, Electrical, Plumbing
Date
MECHANICAL (Permit) OK except #'s
83. Vents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to
Openings
34. A.C. Ducts Insulation & Support
84. Water Well; Disconnect, Electrical, Plumbing
35. Vent Fan; Exhaust above insulation
85. Exterior Elec. Trim; G.F.I. Receptacle -Underground
36. Condensate Drain & Overflow; Size & Grade
86. Ventilation Throughout House
37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet
87. Glass Protection
38. Attic Access & Platform if Furnance in Attic
88. Corrections from Previous Inspections
89. Gas Test -Meters Tagged; Gas -Electric
90. Water & Sewer Connected -C/O to Grade -HD Approval
Date
Card B-1 Date Card B-1
91. Energy Compliance Certificate -Other Certificates
Date
Card B-1 Date Card B-1
Date
FRAMING (Plans) OK except #'s
Date
Card B-1 Date Card B-1
39. Sils, Proper Material & Anchors
Date
Card B-1 Date Card B-1
40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound
Date
Card 8-1 Date Card B-1
41. Bearing Walls over Girders & Floor Nailing
Comments at Final:
42. Draft Stop in Walls (rat proof)
43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub
44. Headers & Beam -Size & Bearing
each time you visit job site)
(NOTE: An entry must be made
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.
®"g®
ASS 5 O AR EL NUMBER
—� —1
ZONING
RT -1
BUILDING PERMIT
OWNERf
DARRELL CONN
TELEPHONE
873-0302
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
CONTRACTOR'S NAME
Paul Belleveulle
TELEPHONE
872-9476
CONTRACTOR'S MAILING ADDRESS
5090 Warnke Drive, 6k4-ee, �y�a, �
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
Filing Fee
$ 10.00
LEA4Neg MAILING ADDRESS
Permit Fee
$ 62.50
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
31.25
Energy Plan Checking Fee
E$.
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
13770 SQuth Dr, Magalia
Permit tee
$ 103.75
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
31 2.00 6.00
Solar or heat pump water heater
1 20.00
LOT NO.
112
SUBDIVISION NAME
PPCC#1
PARCEL MAP
Water piping
1 5.00 5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome❑ OtherBuilding
b CIFY
Gas piping system 1 - 5 outlets
5.00
sewer
j 5.00 5.00
Mobile Home I S I G W10.00e
TYPE OF WORK
New ®X Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work: garage with bath
4
Permit Fee
$ 26.00
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 100 AMP ORV OR LESS10.00
Main service EA. ADD -1- too AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
rL`L/1 I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.SINGLE
License No. U7_ Classification
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OR ADDNS. � ACC. BLDGS. I OCCUPM
2�vtsq ft 12.00
NEW CONSTIRMULTI-OUTLET
NON-RESID BRANCH CIRCUITS)
2.50 ea
POWER APPARATUS &)
OUTLET CIR.
Ex. OCCU p(OUTLETS OR FIXTURES
.20050C
20@3D¢
FIXED
Ex. OCCUp. OUTLETS PIRESID IREA.)
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00
Permit Fee
$ 99 nn
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Coolin g
Hood
3,00
Ventilation
Penult Fee
$
Contractor
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.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, c sts, and expenses which may in any way accrue
a I t sai u y i co ence of the granting of this permit.
r
K Date r
Signature of Applicant — Owner ❑ Contractor & Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST TYPE
AL
TOTAL FEE $
q PARK
FL
PAR PD
'
Iss
Th;s permit is nereby issued under
sions of the Butte County Code and/or
work indicated above for which fees
DIRECTOR OF PUBLIC
B
P IT EXPIRES Date
the applicable provi-
resolutions to do
have been paid.
WORKS
Date �� '�Y — f-
fZ—Ii — C1
Receipt
Receipt No.
YELLOW-ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
iF7
:t .
COUNTY OF BUTTE - DEPARTMENT.OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE' OROVILI . CALIFORNIA 96966 - TELEPHONE; 916/638-7641
PERMIT APPLICATION DATA SHEET
Permit No._
OWNER 10n C ^'ry A. P. No. U 6 1 L
Proposed Building UseGillglze _G& - dc, Building Inspector C - Date
1
At time of permit�application, 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, signed by preparer of plans ........
3. Complete plans in duplicate/triplicate, signed by preparer. of plans ..
4. Complete engineered plans and calcs, `with wet signature on plans . .
5. Hazardous Material Form .......................................... `
6. Energy Design Compliance and supporting documentation .........
7. Statement of Intent for Non -Heated and AC Buildings ...............
8. Engineered truss details and layout in duplicate (required prior to plan check)
9. Mobilehome installation data including manufacturer's installation
instructions.......................................................
10. Fees of $ ........................
11. Chico Urban Area fees paid .......................................
12. Park fees paid ....................................................
,13. School District fees paid ..............
14. Sanitation approval from Health Department
15. City of Chico plumbing permit .....................................
16. Plot plan and business license approval from City of
(see City for other requirements)
17. Planning approval for (A) Use: (B) Parking: ......
18. Improvements may be required. Contact Land Development Section DPW
•.19. Driveway permit (construction approval required, prior to occupancy)
^'' Pre-Inspec. request to
20. Pre -Inspection for required .. • Building Inspector (Date)
Contractor's license information (No., Name Style, Classifications ...
2 Certificate of Workmans Compensation Insurance ..................
Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) .....
24. Recorded copy of Agricultural Acknowledgment Statement .........
25. Letter of signature authorization ...................................
26.
27.
When you issue the permit, process as follows: Mail to owner. Mail to contractor.
Telephone and hold for pickup at W office. A Deliver w./inspector.
Other All) ; I IJ A
Copy of Haz-Mat form sent Health Dept. Fire Dept. _Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submitted prior to permit issuo
1. Index permit for above items No.
2. Additional items required:
ircle new item not checked above).
Contractor, designer, owner,
was advised of above required
data
by_phone_—nail—counter by—..date—
y
..date_Contractor,
Contractor,designer, owner,
was advised of above required
data
by_phone_mall_c unter by
date_
tans checked by
Date
PI
s approved by
Date
•Sets of plans on hold in File cabinet --AHPfolder
Copy—DPW
I
TO Buildinv Department
�,= .
FROM: ..Environmental Health
SUBJECT: Sanitation Clearance
-P
�)-7-70 5, at -X Z2
owner Location AP
Plan Approved for: Sewaqe Disposal Water Supply
Hold final for: Water Supply
Final clearance O.K. for:
Clearenge for bedroom mobile home Other
NOTE * * *
VI
Water Supply
aE-:/
16 A-�(2 -T-jn4iari ate
7 Uvuni' Uunler Uilve - Ulovllle, Galilornia 95965 - Telephone: 916/538-7541 1i Ilv.
APPLICATION APID PERMIT
Ya _ 06 _ Zorr
/N ER - I f3U1LD114G PERMIT
�P(ZReI<— Con TELE?PHONE SO. FT. OCC. BUILDINl3 VALUATION
INER'S MAI ING ADORfiS3 3 �3
3� o Sa u (� P�sZ �i►2 . o 72 0
�rrv�L. �ct_L�•TEc.11LLE
.ONTRACTOn'tl MAILING ADDR
So90 WA41z1�1<� Q,
:oN3TnuCT1oN LEr•IDan
N o Ns
ENOER'! MAILING AOOn ESS
11%111 l �g�o/1 ¢Nnia
I•-An`ciili€c i•`ori•eFriiigearir3"iiXiCiNo i►D`nite
-nuif:nit-4iiAAnnn
N
/377c S,0%J r Atzk I
LOT NO.SUBDIVISION NAME PARCEL MAP
III- I40cc t:1
USE OF STRUCTURE
SF ❑ Duplex❑ Mobllehome❑ tl Cila/z/S G
P E CI FY
TYPE OF WORK
New® Addition❑ Remodel❑ Utilities[:] Installation❑ Other[:]
Describe work: GR24'1&E WITH 134T+ -
Fireplace _ 1
Total Valuetlon
IS
Filing Fee
Permit Fee
Plan Checking Fee
Erlorgy Plan Checking Fee
Penalty
Permit fee
PLUMBING PERMIT
Each Trap
Solar or heat pump water heater
Water piping
Each qas water heater or vent
Gas piping system 1 - 5 outlets
Building sewer
Mobile Home S r; w
Permit Fee
Contractor
ELECTRICAL PERMIT
Main service 100v. oft LESS
00 AMP O11 LESS
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
®!EW
I am licensed under provisions of Chapt. 9. Div. 3 of the Business
and Professions Code and my license Is In full force and effect.
License No. -4C'$Z`4'1 Classification _13
ElUon
I, as the owner, or my employees will! wages as their sole compen-
cation, will do the work,and the structure Is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ 1 am exempt under Sec. , Business and Professions Code
for this reason
Main service EA. ADO'L loo AMP
NE w CoI14T. / O w EL L IN r..' O CCU P.
only l ACC, BLOCS. I
CONST–R,-TII-C T.UUtLET
NON.RESID BrIANCH C111 CytTS
F•OWER AUr PA It ATOS A
(SINGLE OUTLET CIR.
Ex. Occup OUTLETS OR FIXTUnES
Ex. Occup. OTLET9'iRelsl �,)
Temporary service
Mobile Home Facilities
Misc. Wiring
Permit Fee
WORKMEN'S COMPENSATION INSURANCE
I declare under penally of perjury (check one):
❑ The permit Is for $100.00 (valuation) or less.
I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
Contractor
MECHANICAL PERMIT
Healing
iL
M
S
$
$
S
Flling Fee
2.00
_ 20.00
5.00
_ 5.00
5.00
5.00
10.00 e
S
Fi l ing Fee
10.00
2.50
10.00
o LTI
2.50 ea
Io ngnr "--
eALe Jo
2.00
10.00
15.00
15.00
s
77
FI Iing Fee r 10.00
of Consent to Self -Insure. Cooling
❑ I shall not employ any person In any manner so as to become subjectrHl"oSo�d�
to tire W. C. laws of California.:�:]
3.00
Notice to Applicant: If after making this statement, should you become subjectenll Ionto the W. C. provisions of the Labor Code, you must forthwith comply will suchermit Feeprovisions or this permit shall be deemed revoked. ontractor
I certify that I have read this application rind state that the above Information
Is correct. I agree to comply to all County Ordinances and Stale Laws relating
to building construction, and hereby authorize representatives of the Countyol
Butte to enter upon Ilia above-mentioned property for Inspection purposes.
I also agree to save, Indemnify and keep harmless the County of Butte against
ell liabilities, judgments, costs, and expenses which may In any way accrue
3ga�t said C unly In c nseq a ce of the granting of this permit.
Date 11—�a a
Signature of Applicant — Owner ❑ Contractor `ac' Agent ❑
Nn 0SI1A permit is required for excavations ever 5'0" deep and demolition or construct.
on 61 structures over 3 stories in height.
Mobile flome Installation Fee $
Energy Inspection Fee i $
OCC CONST TYPE
TOTAL. FEE $
HA2 CUA PAItK SCHL FLOPAR PO HDISSUE
Inls permit Is nereby Issued under the applicable provl-
slons of the Butte County Code and/or resolutions to do
work Indicated above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
iecetpl No. 713 SSI BY Date
rfflTt-o.P•w.. TE1.1_ow-Aset3son• rill K-IN'Irt C tort. C0Lntnnon•Ar•rLICAHt P -nMIT EXPInES Dnle
1
This sel of plans end s`pecificafions MUST be
kept in the job at all times and it is unlawful to
`make any changes or alterations on same with•
out written permission from the Department of
Public Works, County of Butte.
Qiti �F
SIO%—All Materials & Workmanship Shall Be In
Accordance wi-$ Recognized Good practices and
bf a qual:lt prescribed for the Specified use in the
Unifors;i hui!dingf Plumbing & Mechanical Codes oni
Phe National Electrical Code.
A setback of 5 ft. from the
property lines and a setback of
50 ft. from the road
centerline shall be clear of
structures or equipment ox§fPt /� /
for a 2 ft- owe Ove", Nib Y —/Z
CMZ- OFAU- Lk-,
Diq R,tZ (^ �, o1�►J
_f':3,1 ryr :,f.. q. .�v:'t .i?'tet:• ::�; TY� - ,:�: �C ,f,,
•��/�Ygi��/'� � Y \3
(� ` S y is :'3'."� •.
VS
PERMIT NO. 5875-78B
PERMIT EXPIRES
OWNER Laurie Baskins
CONTR. owner
LOCATION (A.P. 66-06-12 ,
345 So.Park Dr., Magalia
1
y�
d
i
s
�i
kyr
M
F�F
7
i.
it
y�
° Temp. Power Pole,
Called PG&E
t .Temp. Elea, Serv.
y
I Called PG&E
Temp Gas Serv.
talled PG&E
/�OINAL
/
ED
(Date)
(Signature)
btucco
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RE"GORD
Subpanels
BUILDING BUILDING (Cont'd)
PLUMBING
Setback
Firewall
Soil Plpin
Forms U
coyParapets
1st Floor
Main Bldg..
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
Stemwall
Siding
To out
Slab
Roof Sheathing
A, Water Piping
Piers
Roofing.
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Stemwall
Garage Vents
Insulation
Water Htr.
Heaters "
Slab
Carport
Footings
Prov. for phsically
handica ed
Conformance of ex.
structure
Appliances
Gas PipingTest
-Tem . Gas
Slab
Final ZZZ
Sanitation
Patio
. FI EPLACE
Final
Footing
Footing
ELECTRICAL
Masonry Walls
Throat
Rou h
Reinf. Steel
FinalFixtures
R -A 91-
-...r ..........�. --
.. _ .. _
btucco
Final
Subpanels
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
MRS16EHOME INSTALLATION - - - - - - - - - - - - - - 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.)
COUNTY OF. ATE — DEPARTIMEN"f OF PUBLIC WORKS
7 County Center Drive e. Oroville, California 95965
Telep+l4bne. 5t4-4541
APPLICATION AND PERMIT
autnorize represemaiives or me c;ouniy or tsuiie io enter upon me
above-me,ntioned;x-cWrtyJPr purposes.
//�.;rfnitee
�ar��
Date
Signal e oReceipt No. • 2
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 F UBLIC WORKS
7,0r,
BY Date
/'—!
B I lding permit expires Date p
BUILDING
OwnerSQ.
FT. OCC. BUILDING VALUATION
IeC
Mailing Address
, Lf
•
Telephone No.
'
Contractor
Mailing Address
Fireplace
Total Valuation Z
Telephone No.
Permit Fee
Building Address
Plan Checking Fee&/or Penalty
Permit Fee
pd
t�
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
Repair drainage or vent piping 1.50
A. P. O. - y
Zoning 8 Planning
Water piping 1.50
Each gas water heater or vent 1.50
F sS
ation
Fire Dept.
FireZone
Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking Parcel
plan Declaration
Parcel Map
60' R/W
Improvements
Each additional outlet .30
Building sewer 5.00
Bldg. PIa ec'd
Parcel A roval
Plans Approval
Lawn sprinkler system 2.00
NEW ADDITION ❑ UTILITIES ❑ OTHER ❑
Permit Fee $
$
7Ldy� — N leN _
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service 600V OR LESS
MSS 5•00
100 AMP OR LE
Single Family ❑ Duplex ❑ Mobil HomePN Others ElMain
service EA. ADD•L 100 AMP 2:50
Main service 100 A MP e0oORv LESS 25.00
100 A
Main service EA. ADD•L 100 AMP 1.00
NEW CONST. DWELING
OR ADDNS. ACCLBLDGSCCUP. 6) 22sgft
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
le of:
NEW CONSTR BRANCH CIR T
NON.RESID (MULTI BRANCH CIRCUITS) 2.50ea
NEW CONSTR. POWER APPARATUS6,1
NON.RESID. SINGLE OUTLET CIR.
Ex. OCCUp(OUTLETs OR FIXTI-RES g L 1� OC
Ex. Occup. 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
'rulsi 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 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
$ O
autnorize represemaiives or me c;ouniy or tsuiie io enter upon me
above-me,ntioned;x-cWrtyJPr purposes.
//�.;rfnitee
�ar��
Date
Signal e oReceipt No. • 2
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 F UBLIC WORKS
7,0r,
BY Date
/'—!
B I lding permit expires Date p
E
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