HomeMy WebLinkAbout066-060-01766-06-17 _
om Quinn
2 S Park`Dr'. , lot 1107," CC�f1,,-Maga.
cont :Tri V Const., Paradise
Permit 1 9-76P,E(util: MH)
ELEC . a
GAS' -
SUPPORT STRUC RE REQ. �p
COMPACTION TEST Q. /gyp
- 6 06-17
' contr: Kopp's Mobile ome'Se'V. Oroq
Per #5650-76MHI116
4 \
• . =ate ,-=�,�� ;
`
66-06-17
Contr. Ca Gass '
Permit 860-76P(gas .piping) MH
66=06`17__.._.- _
Permit #6026-76B'(new carport &' 2. deck '
s/MH) •
t
r
coi Fcloi O' cfli
PE�iMIT NP. 5149-76P,E
PERMIT EXPIRES
OWNER Tom Quinn
CONTR. Tri V Construction, Paradise
LOCATION (A.P. 66-06-17 )
295 S. Park Dr., lot 107, CC#l, Magalia
f
1
1
h Temp. Power Pol
Called PG&
Temp. Elec. erv. 7
Called G&E
),1�1i
Temp. s Serv.
C ed PG&E
J
INALED I ( A 1 7
(Date)
(Signat e)
Setba i
FormJ
Mai; Bldg.
o tin s
to wall
Slab
Piers
Gara e
Foo in s
Stem I
Slab
Carport
4,
Footings
Slab
Patio
Footings
Masonry Walls
Reinf. Steel
Stucco
Mesh
Scratch
Brown
Finish
Interior Latl
Door Closer
DATE
COUNTY OF BUTTE — DEPARTMENT .OF PUBLIC WORKS
BUILDING INSPECTWN RECORD
BUILDING BUILDING (Cont'd)
rewall Soil Piping
P ra ets 1st Floor
R stroom Finish 2nd Floor
�U
PLUMBING
willklows
3rd Floor
Sidi
To out
Roof h athing
Water Pi in
Roofln
Sewer
—76
Fdn. V is
Fixtures
Garage ents
Insulatio
Water Htr.
Heaters
Prov. for 4ysically
handicappem
Conformanc of ex.
structure
Final
Appliances
Gas Piping & Test
Temp. Gas
Sanitation
FIREPLACE
Final %i.
V
Footing
EL C
RI AL
Throat
Rough jl
Final
Fixtures
FIRE PRINKLERS
Motors
Test
Water Htr.
Final
'Subpanels
MEC NICAL
Grd. Fault Prot.
Heating
Service
Cooling
Temp. Pole
Ducts
Underground
Ventilation
Permanent
Final
Final -Ji
% �.
,4 REMARK$,OR CORRECTIDNS
(NOTE: An entry must be made on this form each time you visit the job site.)
r
COUNTY.OF BUTTE 4.1 r
DEPARTMENT OF PUBLIC WORKS 7 COUNTY'CENTER DRIVE,;,
OROVILLE, CALIF. 534-4541 +�l
CERTIFICATE Of OCCUPANCY'
This mobilehome has been installed in accordance with therequirementsy
of the California Administrative Code, Title 25, Chapter 5, under permit
number b.bb 6' ,^—for �`t�rh-e following location:
Owner
Owner's Address
Mobilehome Mfg - -r � Model' Yeae Z� s
Insignia No. ' �S y3 ' Serial No.
It is hereby certified for occupancy at the above described 'location and
may be occupied:
Director ofPublic
Works
' Date's J-7 13
Y
THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED
1P
9. Electrical
A.
Is
service large enoiigli to provide adequare amperage to„mobilehome (must equal rating; of
mobilehome with 1 ailfl.11'ilJnl 100 amp) anal other:; faciliti.e.on lot, i.e. , water pumps,
garage, cabana, erg:.:- Yes No
1i.
Is
ther,-� proper clearances around panels?� YeNo
C.
Is
power supply cord or feeder assembly properly fused? Yes X No
D.
Is
continuity test satisfactory as per the following procedure?. Ye s—No
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 Gluier lead to eaC h .W01 "'Cuuute SuP��ty cUYtuuctUY, lncliiullig Yleui fai.
5.
All nor. -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
te;L shall then be n.ade between r.he grounding electrode and the chassis of the
mobilehome. Upon satisfactory completion of theel.ectrical tests, the lot or site
service equipment may be approved for energizing.
T',;
job card si'ned by health Department. for water and sanitation?
1.1.. If everything o1:ay, sign off card and t.a services.
MOBILc:i'Oi"L DATA
Manufacturer and/or Namest:yle
Length! Width � t
Vehicle Serial No. e 9 sy.
State Identification No.
,.dititional Information or Comments:
ii0t31!,1?IiUii.l U4STALLATION INSPECTION CHECK LIST
1. Is the mobileh.omt� located ,_i required separation from lot lines and buildings and generally
conform to plot Ilan? YeS No_
r
2. notes the mobile -home have requirc.cl clearances above ground? (Sec.5085) Yes\ No
3. Are footin,s and supports properly sized, spaced, and braced as p r approved plans? (Note
possible variation at spring shackles.) (Sec. 5082 & 5083) Yes No
4. Is the mobilehome level.? (Sec. 5088) Yc No
5. If mo e than a single unit, are crossover connections properly installed? (Sec. 5088)
Yes No
5, Water
A. Isxi-ble connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566)
Y -es No
B. Test - Does'water piping withstand working pressure or 50 lbs, air test? YesNo4-_
C. Backfl.ow - If c is not State of California approved, does station have backflow device
and pressure -re valve? Yes No
7. Wastes and Drain
A. Is connection made with. Schedule 40 DWV and have flex connectors at each end? Yes No
B. Does it have minimum per foot slope and is it properly supported? Yes No
C. Are any leaks detected in drainage system after runnin -gallons of water through each
fixture including, ashing machine standpipe? Yes_ bio
D. If coach n State of California approved, does station have required trap and vent?
Yes No
8. Gas Piping d 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 mo ehome gas line inlet without reductions other than the mobilehome
connector. Yeso \ /
B. Test OK as per following procedure? Yes �/,Tdo_
1. Open all appliance connector valves.
2. Shut off appliance burner and pilot valves.
3. Air test with manometer to 10"-14" water column, or test with slope gauge (minimum
6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. 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
COUNTY OF BUTTE — -DEi ARTMENT OF PUBLIC WORKS
7 County Center Drive — Oroville, California 95965 ��
Telephone: 534-4541
4'
APPLICATION AND PERMIT
Ignature o Permitee or Agent �^
Receipt No. /
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Iding permit expires Date 9-1-2--27
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Fireplace
Contractor (�/
Total Valuation
Mailing Address �p /�
Permit Fee
Plan Checking Fee&/or Penalty
o
le hne No.
p ��
Permit Fee
Building Address
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
e/
Repair drainage or vent piping 1.50
ex r UnTng Verification On,,
Water piping 1-59- O—
Each gas water heater or vent 1.50
/1
A. P. No.
Zon
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
Fee
n
Fire Dept.
Fire Zone
Use Permit
Building sewer Q
EQA
Parking
Plans
Parcelcel
Declaration P
60' R/W
Improvements_Lawn
sprinkler system 2.00
BIdJ9kJaRs e d
d0 Parcel Approval
Plan pproval
^�
Permit Fee $ oC3
,5
NEW ❑ ADDITION ❑ UTILITIES OTHER ❑
ELECTRICAL No.1 @ FEE
PERMIT FILING FEE $3.00
Main service 100 AMP V OR ORSLESS 5.00 —
Main service EA. ADD'L too AMP 2.50
Single Family ElDuplex ElMobil Home Others ❑
Main service 1100EAMP OR LESS 25.00
Main service EA. ADD'L too AMP 1.00
SQ. FI. MINIMI UM
NEW CONST. DWELING
OR ADDNS. ( ACCLBLDGS.CCUP. &) 20 sq ft
NEW CONSTR MULTI -OUTLET
NON.RESID. BRANCH CIRCUITS) 2.50ea
EeR ..
.
NEW CONST(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:
— �✓ (S�
Ex. Occup(OUTLETS OR FIXTURES)gq@21
FIXED ALNS.
Ex. Occup. ( OUT ETS P(RESID )REA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No.Classification
Misc. Wiring 6.25
❑ I am exempt from the Contractors License Laws of'the State of California.
Permit Fee $ 02 `—'
$ "7S
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.
❑ 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 em
P employ y an y 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
State Laws relating to building construction, and hereby
authorize representatives of the County of Butte to enter upon the
above -me 'oned property for inspection purposes.
XDate
f
FEE TOTAL PERMIT
5--cand
$
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 0 BLIC WORKS
�
Ignature o Permitee or Agent �^
Receipt No. /
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Iding permit expires Date 9-1-2--27
COUNTY OF BUTTE — DEF'•ARTMENT OF PUBLIC WORKS
_ 7 County Center Drive — Uroviile; California 95965
Telephone: 534-4541
APPLICATION MW PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X AE'zCt (f . /�� Date /,0
Signature of Permitee or Agent
Receipt No. I
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
EW
permit expires Date �� ,7�
BUILDING
Owner O M A 5 G, 1 NAI
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Fireplace
Contractor /GO ,0 i0 '5 M,01511_011(iMC 5612,
Total Valuation
Mailing Address %/Q 51 ,g
Permit Fee
Plan Checking Fee&/or Penalty
/LQ - If
Telephone No.
Ira 1-5'z
Permit Fee
Building Address
PLUMBING No. @ FEE
PERMIT FILING FEE J$3.00
.� �. A��L %0L ��j�� /�•
Each Trap 1.50
Repair drainage or vent piping 1.50
l�/��'
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No. G(7 �/�j
Zoning $ Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
FeL4
W, n
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
ParkinDeclare
Plans
ion
IBldg.
Parcel Map
60' R/W
Improvements
Lawn sprinkler system 2.00
Plans Rec'd ✓
Parcel royal
Plans Approval
Permit Fee $
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER,K
ELECTRICAL No.1 @ FEE
PERMIT FILING FEE $3.00
A00— ��y9"
Main service 10000 AMOR L
P ORSLESS 5.00
Main service EA. ADO'L 100 AMP 2.50
Family F] Duplex ❑ Mobil Home Others ❑
Main service OVER 600V
100 AMP OR LESS 25.00Single
Main service EA. ADD'L 100 AMP 1.00
NEW CONST. I DWELLING OCCUP, a)
OR ADDNS, ACC. BLDGS. / 2¢Sgft
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:
Ex. Occup(OUTLETS OR FIXTURES)50 @2`
—.BAL.0109
Ex. Occu FIXED APP LNS. OR
p•(OUTLETS (RESID.) EA) 2:00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. _;i*207ti Classification C_ to
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
ermit is issued I shall not em an
p employ y person in any manner
so as to become subto 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
/ T GL 4 T 3060
TOTAL PERMIT FEE QO 1$3,0
O
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X AE'zCt (f . /�� Date /,0
Signature of Permitee or Agent
Receipt No. I
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
EW
permit expires Date �� ,7�
COUNTY"OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Uroville, California 95965
Telephone: 534,4541
APPLICATION AND PERMIT
,5 e460 -7(o
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Fireplace
Contractor �j
Total Valuation
Mailing Address o• �Cf Or
Permit Fee
Plan Checking Fee &/or Penalty
Telephone N
r
rPermit Fee $
Building Address
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00 .,
�• pv '
Each Trap 1.50
01"0" /0 7 C
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
�, O _ �+
A. P. No. �p
Zoning & Planning
Gas piping system 1 - 5 outlets 4--317 / QP -
Each additional outlet .30
Fe
&erttCaTtIIfT
I Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
Declaration
Parcel Ma p
60' R/W
Improvements
p ovements
Lawn sprinkler system 2.00
BI
Parcel Approval
Plans Approval
Permit Fee $
$
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
V OR LE
Main service 100 AMP ORSLESS 5.00
Main service EA. ADD'L too AMP 2.50
OVR 60
Main service 100E
EAMP OR LESS 25.00
Single Family ❑ Duplex ❑ Mobil Home Others ❑
Main service EA. ADD'L loo AMP 1.00
NEW CONST OR ADDNS. ( ACCLBLDGS.LING CCUP. &) 2¢Sgft
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:
Ex. Occup(OUTLETS OR FIXTURES) 50 BAL@1
FIXED APP LNS. OR
EX. Occup. OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. 2/630 & 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.
PI have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
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
$
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
/__--nX Date Off%
ignot re of Permitee or Agent
Receipt No. / � Y( Z
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.
D R CTOR OF PUBLIC WORKS
BY Date l0/ r/
gpermit expires Date �CA 1
Butte County
Department of Public Works
7 County Center Drive
Oroville-, California 95965
Attn: Darlene Denny
Dear Miss Denny:
Enclosed find a:check for $2.12 to'cover the printing
costs you discussed with Air. Quinn. Permit #6026-76.`
I understand this will -cover the cost of copying the
carport plan and the plot plan.
We appreciate your assistance in solving this seemingly '
major situation.
Sincere ours,
John H: Alston
a, 710 S. Park Drive .
-'Magalia,. Calif. 95954
1/24/77
00
4 '' Fit j't�e�{%`��/J '_•
r
Y
e
Yea _
u6l 9 Nd
s)I aline '0 )-iN0noo 30
PERMIT NO. 6026-76B
PERMIT EXPIRES l
OWNER TOM W. QUINN
,coNTR. owner
LOCATION (A.P. 66-06-17
t, 295 S. Park Dr., lot #1,,GQ CC#l, Mag.
ti
i
't
F;
i
,a
a
temp. Power Pole
Called PG&E f
Temp. Elea Serv.
Called PG&E
Temp. Gas Serv. .
Cal ed PG&E
oB 1,2,
FINALED
COUNTY OF BUTTE — DEPARTMENT`OF PUBLIC WORKS "
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont'd) PLUMBING.
Setback 0" (/
Firewall
Soil Piping I
Forms
Parapets
1st F loo I
Main Bldg.
Restroom Finish X,
2nd Floor I
Footings
Windows
3rd Floor
Stemwall
Sidin
To out
Slab
Roof Sheathing
Water Pi in
Piers
Roofing 14
Sewer
Garage
Fdn. Vents,
Fixtures
Footings
StemwaI l
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Carport
p
Footings ' 7-74P
Prov, for physically
handica ed
Conformance of fix.
structure
Appliances
Gas Piping & Test
Temp. Gas
Slab
Final r
Sanitation
Patio
FI PLACE
Final
Footings
Footing
ELECTFOC%1-
Masonry Walls
Throat
I
Rou h
Reinf. Steel
Final
x I 5=1whirac I
Stucco
Final
Subpanels
Mesh
MECHA'NJVL
Grd. Fault Prot. I
Scratch
Heating
Service I
Brown
Cooling
Temp. Pole
Finish
Ducts
Under ro d
Interior Lath
Ventilation
Penman nt
Door Closer
Final
Final
DATE REMARKS OR CORRECTIONS
/d-- /,L�W
n
/4 2 �, � � �/*, e, el
(NOTE: An entry must be made on this form each time you visit the job site.)
COUNTY OF451UTT'E — `dEP' AR`s MENT OF PUBLIC WORKS
7 County Center Dr!�'e. -Orgv,iIIe, California 95965
`- Telephone: 534-4541
APPLICATION AND PERMIT
0��C/
/y!
cNicacnLauvca Or ule wunty UI nutte tU enter upon the
ove-meid proper ori spection purposes.
G01 W'
is :,�Gea A./Gil?rG.a Date ��`
2—
Signature of Permi�teee or
Agent
Receipt No.
White-D.P.W. — Yell�v} — Pink- Spector — 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
ding permit expires Date
BUILDING
Owner ' C//
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
zpal �� "" 3
lephone No.
Fireplace
Contractor
Total Valuation 1770 6a
Mailing Address
Permit Fee
Plan Checking Fee&/or Penalty
Telephone No.
Permit Fee $.9�
OC
Building Address �`— S� �2
PLUMBING No.1 @ FEE
PERMIT FILING FEE J$3.00
/,f
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No. �. �(e .��
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
F04's'
Sart ion
Fire Dept.
FireZone
Use Permit
Building sewer 5.00
EQA
Park i Plans
Declarra ion
Parcel Map
60' R/W
Improvements
Lawn sprinkler system 2.00
Bldg. Plans Recdro
Parcel A yal
Plan pproval
Permit Fee $
$
NEW ADDITION ❑ UTILITIES ❑ OTHER ❑
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service 10000 AMP ORSLESS 5.00
Main service EA. ADD'L 100 AMP 2.5'50
�--�/
Single Family ❑ Duplex ❑ Mobil Home LZ]" Others ❑
Main service OVER 600V
100 AMP OR LESS 25.00
Main service EA. ADD•L 100 AMP 1.00
`
• /�S
NEW CONST. DWELLING OCCUP. &
OR ADDNS. ( ACC. BLDGS.NEWCONST) 2�sgft
NON-RESID R (BRANCH CIRCUITS) 2.50ea
NEW CONSTPOWER APPARATUS &)
NON_RESIR D. (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:
Ex. Occup(OUTLETS OR FIXTURES)@L@
BAL@1
Ex. Occup.FIXED APPLNS. OR
(OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. 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.
1:1 I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
JWI certify that in the performance of the work for which this
JW 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
E2O
Hood
Permit Fee $
$
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
TOTAL PERMIT FEE
$
cNicacnLauvca Or ule wunty UI nutte tU enter upon the
ove-meid proper ori spection purposes.
G01 W'
is :,�Gea A./Gil?rG.a Date ��`
2—
Signature of Permi�teee or
Agent
Receipt No.
White-D.P.W. — Yell�v} — Pink- Spector — 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
ding permit expires Date