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HomeMy WebLinkAbout066-070-020E/ �T�•';.:1-`.-i--.'`. .'^Y_-..-..+�+, •, .'+^r,. --. t��.r�..!.^'.+."`-S„”` "4P.:�'�--+""'rry,n,r}"..r y n;� �r' �'„'L'ww...�T�-e, ,r, 7 � _ - r- .. .. -- '�-� .. r , '' ... - L- r ^: :,+ _. : �'" ,,,,,t.1i��:..+.— . +wtiyn:�,..7. �; •'_:a��, '-'d +,— ,w .,. `—j.r.+..'s� � , z.. AP 66-07-20 L: R. HAY % /I4��a��7S ' �> 7 S' Park .•Dr:;--lo,,-l4l—;-PPCC#1 \ contr: Fuller Const., Magalia r }} ` V fPermit# 4268-74?, E (ut il, G C fCJ ' -a t. ELEC. GAS y SUPPORT. 8TRUCTURE REQ.'_if /v JL COMPACTION TEST REQ_ AP 66-07-29 Permit 4959-75MHI CONTR: Kentwoo -MH Sales,. Chico 0 ISSUED " �a 66 07-2 , 01, 4 { E CONTR: Upstate Awning;. --Sacramento ' ' Permit #2Aj �ciB(new covered deck/MH) - ` 66-07-20 Permit ��5532- 8B(new open' deck/MH) o } \� Yh i I .t �` �� �I � O � . i 1 �b 5532-78B r PERMIT NO. � PERMIT. EXPIRES "OWNER L. R. Hay CONTR. owrte r a LOCATION (A.P. 66-07-20 141 So,Park Dr., lot 141, CC#l, Magalia i, Temp. Power Pole Called PG&E Temp. Elea Serv. Called PG&E . Temp. Gas Serv. / Called PG&E Y ,losr2.9 FINALED (Date) (Signature) COUNTY OF BUTTE —DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDI G (Cont'd) PLUMB G Setback — Firewall Soil PI In Forms V, Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding Topout Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Stemwall Garage Vents Insulation Water Htr. Heaters Slab Carport Footings r pehysically handicalp Conformance of ex. structure Appliances Gas Piping & Test Temp. Gas Slab Final Sanitation FIREPLACE Final Footing ELECTRI L Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRE SPR KLERS Motors Framing — Test Water Htr. Stucco Final Sub aneIs Mesh MEQAANICAL 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 M2016EUOME INSTALLATI - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping wDATEREMARKS OR CORRECTIONS 11` ��d!'a�� .Ol�r�po�1Cl/ /�pT!-(i/ C£•Y�� Cc% �L�c�/C (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE" — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Orovi'lle, California 95965 Telephoqe' 534`4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date Signature of Per to or gent 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. DIRECTO. OF P LIC WORKS BY Date Bilding permit expires Date G' 2,f' 7 BUILDING Owner SO. FT. OCC. BUILDING VALUATION d f Mailing Address G one No. Contractor Mailing Address Fireplace Total Valuation G Telephone No. Permit Fee Building Address Plan Checking Fee&/or Penalty Permit Fee ,5 PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 / A. P. (��p 07- a10 Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 FIVS S rIn aVb n Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EOA Parking arcel Plans Declaration Parcel Map 60R/W ' Improvements Each additional outlet .30 Building sewer 5.00 Bldg. ,ns Rec'd Parc p royal Plon provol Lawn sprinkler system 2.00 NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ permit Fee $ $ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 8001 OR LESS 100 AMP LESS 5.00 Single Family Duplex Mobil Home Others 9 Y ❑ P ❑ ❑ -L Main service EA. ADD'L 100 AMP 2.50 A � (� Main service OVER s O 25.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 1.00 NEW CONST. ( OR ADDNS. ACCLBL GSLING CCUP. 2� 20sgft 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 of: styleOccup. NEW CONSTR.S'.. -OUTLET ID (MULTI BRANCH CIRCUITS) 2.50ea NEW NEW CONST R. POWER APPARATUS B CO NON-RESID. SINGLE OUTLET CIR. Ex. Occuo{OUTLETS OR FIXTIiPES 50@, �1@! Ex. FIXED APPLNS. OR P• OUTLETS (RESID,) EA) 2•Q0 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. .10 I•have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. �j71 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 Development Fee $ TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date Signature of Per to or gent 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. DIRECTO. OF P LIC WORKS BY Date Bilding permit expires Date G' 2,f' 7 t ; NO. ',,P E RM 2619"76B PERMIT'EXOIRES `;OWNER L. R. Hay 'CONTR. Upstate Awning, Sacramento "LOCATION (A.P 66-07-20 270 S. Park Dr., Magalia j 0 zi, j Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E OB FINAL ED (Datej/ I (2 0 (Signat COUNTY OF BUTTE — DEPARTMENT SOF, PUBLIC WORKS" a BUILDING INSPECTION=•RECORD ' BUILDING BUI ING (Cont'd) PLUMBING Setback Firewall Soil Piping j Forms Parapets 1st Floor Main Bldg. Restroom Finl h 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheat4ng Water Piping Piers Roofing Sewer Garage Fdn. Ven Fixtures Footin s Garage V nts Water Htr. Stemwa I I InsuIatl6 Heaters Slab Prov.f phy Confor ante of ex. sically Appliances Carport n ed Gas Piping & T t or Footings struct a Temp. Gas Slab Final S Sanitation Patio 47FIR LACE Final Footin s v1 ` Footing ELECTRICAL . Mas6hiy Walls Throat Rou h Reinf. Steel Final Fixtures Bond BedA FIR SPRINKLERS Motors Framing L Test Water Htr. Stucco Final Subpanel Mesh MECHANICAL Grd. Fah Prot. Scratch Heating Service Brown Cooling Temd. Pole Finish Ducts Und r round Interior Lath Ventila on Pe anent Door Closer Final Final DATE• �j REMARKS OR CORRECTIONS 9,0( ea C,/ . c 9 C� (NOTE: An entry must be made on this form each time you visit the job site.) v I - COUNTY OF BUTTE — 13EPARTMENT OF PUBLIC WORKS ' 7 County Center Drive — Urovi lie, California 95965 Telephone: 534-4x41 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date Signature of Pe mitee or Agents Receipt No. IC160e; Av 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 bee paid. DIRECTOR F UBLIC WORKS B'0? Date—Z� i ng permit expires Date 77 BUILDING Owner SO. FT. OCC. BUILDING VALUATION Mailing Address 70 �Q � J O f B 1" 2-6- ITL(A 1 Telephone No. 1Fireplace 11.1 Contractor "1 Total Valuation 00 Mailing Address C, �/ r ` /7 �I� Permit Fee Plan Checking Fee&/or Penalty � ele on N h � Permit Fee Building AddressPLUMBING �� �� 2 ' No. @ FEE PERMIT FILING FEE $3.00 Nprcrvcl A (74t't 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. (o v / Zoning 8 Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fees W.C. <Sa i 0 Fire Dept. Fire Zone I Use Permit EOA Parking Plans Declaration I Parcel Map 1 60' R/W Improvements Building sewer 5.00 Lawn sprinkler system 2.00 Bldg. Plans Recd Parcel proval Plans i0provol Permit Fee NEW ® ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 i/ '� Main service 600°o AMP ORV OR LESS5.00 Main service EA. ADD'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service OVER 600V 100 AMP OR LESS 25.00 Main service EA. ADD'L too AMP 1.00 NEW CONST. DWELLING OCCUP. & OR ADDNS. ACC. BLDGS. ) 2Ssgft NEW CONSTR. MULTI.OUTLET NON -RES ID. ( 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: '"dJ /� !' 1 / 1- A 4 � F to /V //t/ 6 Ex. Occup(OUTLETS OR FIXTURES)@�C BAL@1 Ex. Occup. FIXED APP LNS. OR P• ( OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 FE ❑ 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 Cod Cod which requires every employer to be insured against liability for orkmen's Compensation. I have placed on file with the County of Butte a certificate of Compensation Insurance. Iermit is issued I shall not employ certify that in the performance of the work for which this P p 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 and State Laws relating to building construction, and hereby TOTAL PERMIT FEE�' �Z authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date Signature of Pe mitee or Agents Receipt No. IC160e; Av 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 bee paid. DIRECTOR F UBLIC WORKS B'0? Date—Z� i ng permit expires Date 77 MH Util. PERMIT NO. 4268-75PyR r^ F P r M MH UTIL. PERMIT NO. t: PERMIT EXPIRES OWNER L. R. Hay .CONTR. Fuller Construction, Magalia LOCATION (A.P. 66-07-20IM ) S. Park Dr., lot 141., PPCC#1, Magalia F q . I i Temp. Power Pole i. Call d PG&E t? Elea Serv. 49 - ailed PG&E n a Te p. Gas Serv. Called PG&E G JOB FINALED C/ O (Date) I_ (Signature) 14. COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING 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 Gara a 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 . d 7�_ J Footings Footing ELECTRICAL Masonry Walls Throat Rou h Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Sub anels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath i Ventilation Permanent Door Closer / Final Final DATE I/ q117 Z G a G� REMARKS OR CORRECTIONS - 9. .Electrical A. Is service large enough to provide adequate amperage to mobilehome (:rust equal rating bf mobilehome with a minimum of 100 amp) and other facilities on lot, i.e., water pumps, garage' cabana,_etc.?: Yes No B. Is there proper clearances around panels? Yes -X No C. Is power supply cord or feeder assembly properly fused? Yes X No D. Is continuity test satisfactory as per the following procedur7ee?' YesNo 1. De -energize electrical wiring system of the mobilehome at the pe estal. 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 grouid�ng 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 theelectrical 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 ,`��it. Length Width . Vehicle Serial No./ State.Identification No. Additional Information or Comments: TfOBILEH01IE INSTALLATION INSPECTION CHECK LIST I.. -Is the mobilehome located with ired separation from lot lines and buildings and generally conform to plot plan? Yes_�i lV" 2. Does the mobilehome have requ.i-re-d clearances above ground? (Sec.5085) Yes No 3. Are footings and supports properly sized, spaced, and braced as per approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes -X No 4. Is the mobilehome level? (Sec. 5088) Ye .p X No 5. If more than a single unit, are crossover connections properly installed? (Sec. 5088) Yes No 6. Water A. Is flexible connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yeses No B. Test - Does water piping withstand working pressure or 50 lbs, air test? Yesy No i C. Backflow - If coach is not State of California approved, does station have backflow device. and pressure -relief valve? 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" per foot slope and is it properly supported? Yea sNo C. Are any leaks detected in drainage system after runnin 3 -,gallons of water through each fixture including washing machine srandpi.pe? .Yes No D. If coac-h_is not State-of-Cal"iforiiia approvzd� does station have required trap and vent? Yes No 8. ('as--p—.�1rn..-T g—an4—Gas-Ven t 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 mobilehome gas line inlet without reductions other than the mobilehome connector. Yes No B. Test OK as per following procedure? Yes No 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 %.7ith soapy water. , C. Are all appliance.vents properly installed? Yes No. ' COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS • 7 County Center Drive . — • OroJille, California 95965 Tel �phorie: 534-4541 APPLICATION AND PERMIT X959-�s authorize representatives of the County of Butte to enter upon the above-mentioned roperty for inspection purposes. Oi� 1 Date' C� Signal a of Permitee orAgent Receipt No./ 3<e _74 � • 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. DIRECT -OR OF PUBLIC WORKS -z S BY Date BvH tl q permit expires Datez5% G BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mai 1 i ng Address ' Telephone No. Fireplace Contractor Cly v© . y �� Total Valuation Mai I i ng Address Permit. Fee PI anChecking Fee&/or Penalty Telephone No. Permit Fee Building Address PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 ��7I ho S ^ 21.0 /� 6 7 l,4 Repair drainage or vent piping 1.50 Water piping 1.50 'CIAI- Each gas water heater or, vent 1.50 /� A. P. No. %— z Zoning & Planning Gas piping system 1 - 5 outlets ,1.50 Each additional outlet ' . .30 Fees 38lTrfaitt7ri I Fire Dept. Fire Zone F Use Permit Building sewer 5.00 EQA Parking Plans. Parcel Declaration Parcel Ma p 60' R/W Improv e ents prov Lawn sprinkler system 2.00 Bldg. ane Rec'd Parcel A rovaI Planspproval Permit Fee $ ADDITION ❑ UTILITIES ❑ OTHER �y NEW F]U ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 P i /C) Main service incl. 1 meter �,. 75 - Additional meters, each 1.00 Sub -panel (12 or lees) (more than 12) Single Family ❑ duplex ❑ Mobil Home Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures bal070 Receps., switches & fix outlets CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California B siness & P of ssion Code under the name style %Jof•' C)a r Hood, Ex. Fan or F. A. Furn. Motor , 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 22 License No. 7-7S4�J 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 for W rkmen'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. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $t3 I certify that I have read this application and state that the above information is correct. I agree to comply to all County OrdinancesTOTAL and State Laws relating to building construction, and hereby PERMIT FEE $C� authorize representatives of the County of Butte to enter upon the above-mentioned roperty for inspection purposes. Oi� 1 Date' C� Signal a of Permitee orAgent Receipt No./ 3<e _74 � • 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. DIRECT -OR OF PUBLIC WORKS -z S BY Date BvH tl q permit expires Datez5% G COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WQRKS 7 County Center Drive — Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT ` authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X ` ' Date Signature of ermitee or Agent r Receipt No. -Z 77 :Z d 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.. DIRECTOR F PUBLIC WORKS BY Date_ i (ding permit expires Date _ 7 BUILDING t ' • Owner L SO. FT. OCC. BUILDING VALUATION / Mailing Address 3 1,�//�� o S 40 Cl 0 Li Telephone No 8— O O t ` Fireplace Contractor ` (� Total Valuation Mailing Address Permit Fee PlanChecking Fee&/orPenalty cS TelS No / SI eOCn� Permit Fee , Building Address / �� S-0 k �,� 1 V @. PLUMBING No. @ FEE, ?,, PERMIT FILING FEE $3.00 pp LV / C Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 /0"0,V Each gas water heater or vent 1.50 A. P..No. %� —Q % —"�j> �in o Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fo Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking 51ans Parcel Declaration Parcel Map 60' R/W Improvements Lawn sprinkler system 2.00 � (�S BI 11 nac'd Parcel Approval PI s Approval Permit Fee $ $ �' NEW ADDITION ❑ UTILITIES OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 1,,llV Main service incl. 1 meter 44: X 3, 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 7 SJofl& e- a_0 Water Heater or Space Heater 1.00 Light fixturesb20(d2 Receps., switches & fix outlets 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: . Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap, cooler, gar. disp. or D.W. 1.00' Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 S.Wi Temp. Power Pole . 5.00 License N4=VT1 %7—s Classification Misc. wiring ❑ I am exempt from the Contractors License Laws of the State of Califomia. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE —,PERMIT 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. E]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 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. 1 agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT FEE t $ OG authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X ` ' Date Signature of ermitee or Agent r Receipt No. -Z 77 :Z d 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.. DIRECTOR F PUBLIC WORKS BY Date_ i (ding permit expires Date _ 7