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'P': r ... •. .. ,. .:ir ..: J.,.. .. ,� r :,.. ... .. rr %i , .7). - 1 WORT r.: I`•4 � @ COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPE�CTION� ECORD BUILDING BUILDING (Cont'd) PLUMBING Seloack I kirewall Sntl ininn Nti Roof Finish t-ootincls x Garage Vent Stemwa I I Insulation Slab Prov. for ph sic Ily irport handicapped Conformance of ex rootings Slab Patio Footings Masonry Wall Rel Stucco Me9J ,F[Ref LACE Footing Throat Final 'FIRE SPRINKL Test Final MECHANICAL Heati 1st loor 2nd Nloor 3rd FI or To out Water PI in Sewer Fixtures Water Htr. Heaters Appliances Gas P 1ping & Test Temp. Gas Sanitation Flnal EL Fixtures Motors Water Htr. Subpanels Grd. Fault rot. Service Tem Pole Un rground erior, Lath V nIllation P anent oor Closer if Inal F 1161 MOBILEHOME UTILITIES -------'----------- Elec. Service Efec. Pedestal -00 $^ �� •� Water Piping _ – Sewer —/ Gas Piping ^ DMILEH IN I --------------Support T_ Elec.Continuity _ Water Piping Drainage �j O Gas Piping Q DATE REMARKS OR CORRECTIONS Ct D�4 l �iS£K Z Sal i.✓7� W y�.✓�l ti (NOTE: An entry must be made on this form each time you visit the job site.) 'MOBILEHOME.INS TALLA'fIbN-INSPECTION CHECKLIST Is the mobilehome' wit required separation from lot°lines and .buildings and generally' conform to plot plan?' Yes,_ No_,` Does the mobilehome have required clearances above ground? (Sec, 5085) Yes. No ��� Are footings a`nd supports properly sized spaced, and braced as pe approved plans _ (Note' ;p V Iossb.le.variaton at spring'shackles.)'(Sec. 082 & 5083) Yes_ No `- ((� Is the mobilehome 'level? '(Sec. 5088) Yes_ No_ lJ �q ' jeIf more han a single unit, are crossover connections properly installed? (Sec'. 5088) . Yes No . Water A.. Is flex" e connector of adequate -size and properly installed (1/2",'ID'min.)? (Sec. 5566) YeS . �C,o— B.' Test-Does.water piping withstand working pressure, or, 50 lbs:air test? Yes Baw' If.coach is not State of California approved, does'station have --backflow device an�ssure-relief valve? -Yes— No— Wastes and -Drains A.' Is connection made with. Schedule, 40 DWV And have flex connectors at each end? Yes 1 ---"No B. Does it have minimum" per foot slope and is it properly supported? Yes o C. Are any leaks detected in drainage system after running 3-ga ons of water through•each i, fixture including washing machine standpipe? .Yes,_ No If V 's not State of Californiaapproved, does station have required trap and vent? Yes , Gas.Piping and Gas Vents J 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`l'east as large as the mobile e gas line iril..et withopt'reductions other -than the mobilehome connector, Yes No— Test OK as per following procedure? Yes C No l0 0 en all,appliance connector valves. P - a PP -. 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 ineter'to mobilehome with connector,. -.turn on gas, test connections with soapy .water. C. Are all appliance vents properly installed? 'Yes__IZ No a Electrical' A. Is service large .enough to provide adequate amperage, to mobilehome (must equal rating gf mobilehome with a minimum of 0O "amp)I'and other- facil`iti'es on ;lot, i.e. , water pumps, garage, cabana, etc.. Yes v No B. Is, there proper. -clearances around panels? Yes No ' C. Is power supply cord or feeder assembly`prop'erly`fused? Yes No A �J No �rls continuity test satisfactory as per the following procedure,. Yes. 1. ,De -energize electrical wiring system';of .the mobilehome at the pedestal. 2. Make"sure that the power supply cord or feeder assembly conductors, includ.ing:neutr`al 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:',., All non-current, carrying metal parts of the mobilehome (aluminum siding, gas line, water line),"in'cluding fixtures and`Fappl'iantes, 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,toI the site service equipment. A further continuity test shall then be made between the+grounding electrode and the ,chassis of the moliilehome. 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? �D 11. If everything okay, sign off'card and tag',services. MOBILEHOME DATA Manufacturer and/or Namestyle Length .' 6:f Width Vehicle Serial No. State Identification No. Z Additional Information or Comments: 4bo,4 4�o Zeo"A 1)t c t4 4 A, &,V I Jr, 3 3._ COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER.DRIVE OROVILLE, CALIF.. - 534-4541 CERTIFICATE OOCCUPANCY This mobilehome has been installed in accordance with. the requirements of the California Administrative Code, Title 25, Chapter 5, under permit number `7rf1r- ✓[) for the following location: %//') %Alla: /ice Owner—/ Owner's Address Mobilehome Mfg. A/J'� _ Model(%( F_1 A 4 AV Yes' %� ' Insignia Nog Serial No�Y/AA' a ' It is hereby certified for occupancy at the above described location and may be occupied. DirectoPublic Works Date ��. 71— S% ] By THIS CERTIFICATE IS VOID WHEN White -Owner, Yellow -Installer, Pink D.P.W. TED 1' V COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 695 Oleander Avenue, Chico — -Phone, 343 -4211 , Ext..70' 7 County Center Drive, Oroville — Phone 534-4541 Skyway and Elliott Road, Paradise. — Phone 877-3435 f : CORRECT16311, NOTICE BUILDING OR PROPERTY ADDRESS R� A routine inspection indicates that the following violations of County Ordinan6 exist at the above address -and should be corrected. Please notify this office when correction of work is completed. It you have any question pertaining to this matter, or needadditional explanation,. please contact this office immediately. V. 5 r��• (1O Vd:vs h4 ! T5 `� County. of Butte -DEPARTMENT OF PUBLIC WORKS 695 Oleander Ave., Chico — 343-4211, Ext. 70 7 County Center Dr., Orovllle — 534-4541 • . Skyway and Elliott Rd., Paradise — 877,-3435 tQRRE0169:46TICE .........:....................:............................:............................................................ Building or P jlerty Address. A ro te✓ inspection` 0teates that the following- violation ount Qr fiance a the above address and shouldjr ected. Please nod this office correction Tof `,work f you have. any -ques erwaini r, or, need additional explanatj`.' please contact this office immedd((iiaat�tel . ..4; . .. ................................... ................ ... t .......:...... ...:w....f�....r�....... _ ............ .......... ........ ...................... .............................................. .,R ............................................................. ...................... ........... ....... ..............: :....... ,.. �:............................................ :...... .............. ..� Date.............................. Inspector........................................................ . Do Not Remove This Tag (400-41 I i dF t. 1 F, -,.� ; , .•`E.>�+ •.• •. . I� `''r�"ty�. a 1r7. C.OUJNTY O.F BUTTE DEPARTMENT,OF' PUBLIC WORKS PERMIT' O.� E ; 7 County Center Drive-.Orovilfe California 95965 •Telephone 916/534-4541,. APPLICATION�'AND. PERMIT .a ,ASSE SO ' PA .y ELN, BER >: _1( ZO��gII BUILDING P T.'. /"0,' v OWN "• - TELE'P-HONE - 4 ._ OWNER'S MAILING ADDRESS `-C - •A ..TO .. " SO.,'FT. OCC - BUIL'DIN VALUATION . .. ... tl _ , ME TELEPHONE'ayr_^ NT_R ATOS. MAI L I N G" DDR ESS 'ssaL :A R�° P .c�U P,9A�Is c a ,C O NSTR U CTI O N`L EN D ER, - _NOWN Fireplace Total Valuation;' - - ' 'L'ENDER'S'MAI LING ADDRESS` - *. Permit Fee $ �ARCHITE-CT-0R.EN GINE�ER .. ARCHITECTS OR• -ENGINEER'S MAIL"I,NG ADDRESS - L`ICENSE N_O. Pian Checking'^Fee• / , "� $? - Penalty --- $- p; 1. Permit fee` $ BUILDING ADD ES - - IOD�-Ll/I�t/ " PLUMBING. PERM IT •- } . FiiingFee •r3.00 �t 2. N. 'Each Trap 2.00 R epa)r d,[ainage orAvent pipings . ' , 2 00. 4 r�� Water piping LOT SU,BbPVISION-NAME - - PARCEL MAP.' ''Each qas .Water heater -or vent - .:2.00 - Gas piping;system'1'- 5`outlets R USE OF STRUCTURE." SF❑ Duplex, Mo¢tlehome®Other S .i SPECIFY ; `.Building_ -sewer ;Lawn sprinkler system 200 i- d� t '.P .. ,- " .TYPE OF WORK New Addition ❑ =Remodel `• Utilities ❑ I'nst lation Mother �s-r �bI D.escri.be work:' / �+�y i '• L Pc-ems3s�8iJ _ 5 { ° Permit Fee $ Contractor t' '' ELECTRICAL Filing Fee 3.00• Main service �o°o AMP ORSL•ESS• 5.00 ,service '�'• - _' - �` j - - • - Mann EA•,ADD,'L 100 AMP:. 2.50r NEW CONST. / D,WELLING �OCCUP•h+ ORADDNS: (ACC, BLDGS. .- - , 2,tSq ft y CONTRACTORS -LICENSE LAW I ,deClafe Under:penalty Of peri Ury (Check One):' - _ [�: I .am` licensed urider.provisions of Chapt 9 rDiv. 3 of the Business ;and,-Professions'"Code and m license ts` iw`full 'force and Y�, License No.,7 6 7 6W Classif i'cation e �o'� as the owner, or.m eiri to ees'with wages as their. sole com en 0 X� p..Y 9 p. saiion; will do the work; and the' -is noCinterided• or offered for sale. .(Sec.7044),: 7 I,. as the owner,' am exclusively' contracting with: Licensed contract ors. (Sec. 7044) ❑, I am'exeMot under Sec. ;:Business and Professions Code • for this -reason~ .;NEW FCINSTa T.I-OUT.LE,.T ANO N:'ESID_n BRANCH'CIRC TS: ..2:50 ea . NEW C'ONSTR (POWER, APPARATUS &,1'-. NON-RESID'! SINGL•EOUTLET CIR. / z - .-' 50@25q! Ex.'Occup (:OUTLE;T S'oR FIxTUREs BAL@1 - i FIXED"A'P,PLNS,OR -Ex...Occup.(OUT LETS.(R ESIDi) EA.)- 2. �; , -•Temporary,service y, b "' 10 00, - Mobile Home -Facilities 15:00 ' . Misc. Wiring ti 4' . 6.25 , Permlf-Fee, w'r -$ Contractor MEC HANICAL,•PERMIT Filing Fee 3:00'`.'' WORKMEN'S;COMPENSATION INSURANC�EE' I declare under.penalty;'of perjury (check one): xi -The permit„is for $100:00"(valuation)•"or less:',= 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,no_t employ any person Inrany, manner so.as to become subject- .:fo:the W. C. laws of California: Notice to.Appllcant If after making this statement,.should you -become subject •to the -W. C. provisions;of the Gabor Code, you, must•forthMth;,comply with such. piovisions.Or this permit shall be deemed revoked: , "'. Heating _ Coo l -rid .Hood 2.'00l `Ventilation,' .'Permlt.Fee $ ' -;Contractor ' - •-` h certify that I',have=read this application and -state. hat'the'above information: -.is correct::.0agree to comply to.all County Ordinances' and State Laws relating to•building construction, andherebyauthorize representatives of the.Countyot -Butte-to enter upon the,, above=mentioned, property for, inspection purposes:' b also agree to'save,. indemni•f y'and keep harm less the 'C un t ys *of'Bu Re against.'. all liabilities,•'judgments_, .cbsts_and. expenses which -,may my any. way accrue agains aid,County, i' 'c erica of'the giabtirig;of this permit:' X Date ' Z Owner Contractor �• Agerif'❑ O . $ignaiure'of,Applicant7ir _;AnOSHA permit is .refor, excavations over 5' '"cle'ep and demo, itlon ot: consrrucr of structures overs:i'n height.: Mobile Homel,ln'stallation Fee ... $ .QQ. ' ''Land'Developmenefee `I $ " •TOTALRERMIT F -,'EE $: . 5,O'; Qo . Occup. GROUP. P. TIPS OF, 6ON ST PARCEL PD HD ISSUE This' permit is --hereby. issued under sions',of.the'Butte County,. Code• and/or work indicated above for which DIREC OF PUBLIC By r ."P IT EXPIRES Date the appli6able-pro'vi- resolutions to' do -fees have been paid: .WORKSon Date' f [;Rec4)pi INo . WHITE;D.P.W•, � 7ELLOW-ASSESSOR, PIN K .INSPECTOR, GOLDENROD-APPL I CANT .. • ^�,. � '�� ��. x�.; r, r •'��+- "t yh5.. J�,_. ',i •..S t �} T F� , e• •.•y.. S i._ '��,� .l � ,.i t .^S ,� ra' ,-`..:7 r? � f •.;t. . ro a �.". 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T - ` I Y �,4 t ,� f:. -lot -'t,'tr•1 i .. r J i iJ 'i. � rs s...�•v !� - r r�- t 'r` i�^ ,. t. ,F... r- .stiff � i. _f ,i+ € �',tt �' `t. ."J '6'�-i Y �;r`.4 'f' i" -�. �.r' t _�1� '_"r. �3 -} .. •.�; i r t 0i z: 14 r i') .a�.-- t. .,.+ r• ;.ro?t' 1,y. t :?f �,• - ty d rI ...7 e `.. t .- .. t iY f r{S , + � c, r NN ♦ 4 t - K... xt..`• r So a� t f i�.F _ i � -fib _ _ �...•' � t v .' r mot ,.•T. t jw. ,.Y'+' ry y1i. ,1.' 11 K .t i r ._4S. .rt ,+ r 70 W too WY Z' 41 ' jt �'� �,+' � �•. r er.. G� - "w ,r. r ^d. t 4 ��.. � .t � rt� - � � t..• u•• F I ` k„ 'l'>{ tV�' g a r is +v i"' ' i E+• -YL �. '' ^',�--t -�, dk `; 07 .t k mot h�. ,.r t _k.• �, x ,`� �: �y � • b .rte ' ; I i __ t. • w. r t^ • � ,..o- .�'' ��' d '•j�: '� r' µ �. � F-. 9�t •' _ tRG..� .4. 4 - i + � f. 1 Tt .. '.'i l � M' i;� �• ' #• ii • 1 Y♦ r � ..�� t , s"�*:'. k AW � 'L J .`�, - �.: •:e. .._� .fixVOL, ;do; :`f - �. � �f� ..t., y Y-,�.. 5 T �. i�_ ? �. c _•S' ,�,„ r .,tet ti . w ; d i ,„s. fr P.'”- +` �`!'�.fi F r, #':?-' ? _=i 7 ' _t L�. S �.� r?:"`• i :.hr s,_ tr ��„r.. f-. �• � ,F. t' :''°- _r r'i e, 9 ?•- .t '�f -� ,tf',.c 4.' �. �;- "�t. It �:a. .{+rf rrt �.d i �,' 4.-. .s �r Mp A :' .b - r 1 - �[ S �'1 :1 +'• ,�,,. _ I3 fs 4. i^ Jam. ,C .. c , N •'' i'!.;R -x� _ t ;,'h:.s� i r',r`c rti..f'. ,;r '� w (' • � �+ ,� � •.4. y }^� 3h�_.•i' it ; ? .1zr, t ..t ; ->. : View .� •:�.. ; �� . ASSESSOPAR'C EL NUMBER '^ l`J•.',3 _ ,. .. ZONING Rid.'( - -- '-,�, ,y,•Y .,.{.. BULL•DING P,ER - .. O ER .; e (LIL ` a .P '. TEL"EHONE ,.: -SO , T -0CC. B ING,VALUATION F 'O WNER'S MAI LI -ADDRESS - rSS� 'CON7R AC TOR S!N AME - ,,. t+ ` �.. TELEPH E 77:76 COUNTY OF BUTTE DEPARTMENT OF'PUBL'IC WORKS FERMI 'CONT 'AL O_ R'S MAI I G. AD REST •i _ _ 7. .CONSTRUCTION LENDER. :.•" '. `Total . 7 County Center.Drive=l�roville Califonia`;95965 - Telephone 91'6%534-4541 .. t'NO Valuation LENDER'S MAI LING :ADDRESS, w. Permit. Fee $ �. . 1 APPLICATION -AND PERMIT �. LICENSE NO. U Penalty' $ ., ARCHITECT. OR EN GINEER',S MAILING:ADDRESS Permit fee $ - B U IL DI N G. A D D R E SS - - .. �- PLUMBING PERMIT "• Filing Fee 3.00 qE6ch a�©; C14L ul✓N:' Trap , `; 2 00 ' Repair drainage or vent piping 2.00.' .' Water piping io �V LOT.N0.. .. 9'(0 SUBDIVISION NAME - .- C L u .PARCEL MAP - . ASSESSOPAR'C EL NUMBER '^ l`J•.',3 _ ,. .. ZONING Rid.'( - -- '-,�, ,y,•Y .,.{.. BULL•DING P,ER - .. O ER .; e (LIL ` a .P '. TEL"EHONE ,.: -SO , T -0CC. B ING,VALUATION F 'O WNER'S MAI LI -ADDRESS - rSS� 'CON7R AC TOR S!N AME - ,,. t+ ` �.. TELEPH E 77:76 i �r - '»� 'CONT 'AL O_ R'S MAI I G. AD REST •i _ _ 7. .CONSTRUCTION LENDER. :.•" '. `Total UNKNOWN.FlreplaCe - Valuation LENDER'S MAI LING :ADDRESS, w. Permit. Fee $ �. ,ARCHITECT OR ENGINEER .,., LICENSE NO. ',Plan Chef king Fee $ Penalty' $ ., ARCHITECT. OR EN GINEER',S MAILING:ADDRESS Permit fee $ - B U IL DI N G. A D D R E SS - - .. �- PLUMBING PERMIT "• Filing Fee 3.00 qE6ch a�©; C14L ul✓N:' Trap , `; 2 00 ' Repair drainage or vent piping 2.00.' .' Water piping io �V LOT.N0.. .. 9'(0 SUBDIVISION NAME - .- C L u .PARCEL MAP - "Each qas water heater or vent mo - Ga s.pi'ping''system;l -5 outlets' ' " USE OF STRUCTURE :, SF ❑ -Duplex❑ Mobilehome) Other „SPECIFY Building sewer' Lawn sprinkler system 2 00 ' _ TYPE -OF WORK.. New ❑ Addition ❑ • 'Remodel ❑,. Uti lities LnStal lation ❑„-. Qther ❑ Describe work: Pe.rm&Fee .. $ :. ,:, • .13 - Contractor; ELECTRICAL PERMIT:'. 'Filing Fee'•, ,3:00'. Main. service 100°o AMP•ORSLESS 5.00'` - - Main service EA;'A'DD'L 100,AMP 2.50 aS� NEW CONST. DWELLING OCCUP,'-& .. OR ADDNS. ACC, BLDGS. - 2c Sq•ft • CONTRACTORS LICENSE LAW I declare under.penalty, of perjury. (check one): "4 - - ” I -am. liven sed•.under provisions of Chapt 9, Div. 3.•,of.the Business• and Professions <Code and: my license is in •full force_' and.effect.: / License No: Z7�00 95- Classification ❑ I, as the.owner, or my employees with wages, as their sole comp en -Temporary sation, will do the work,and,the structure is not intended proffered- for sale. (Sec. 7044) '_ ❑- .1, 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 Ft U�TLourLEr 2,50 ea NON':RESID BR -ANC` CIRC ITS. -. NEW CONSTFZ POWER. APPARATUS & NON-RESID•,�-rSINGLE{OUTLET CIR, k�` —Ex. Occup OUTLETS OR FIXTURES g L'0¢ FIXED APPLNS. OR Ex. Occup.( OUTLETS'(RESIDJ EA.�._ ': 2.00 service-, .10:00 Mobile'Home Facilities 15:00 %J Misc wI`ring .a%.25 ' N- Permit Fee, $ Contractor-, MECHA.NJCAL PERMIT .. .FilingFee WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury' (check one)',,' The permit is for $100.00 (valuation) or less. Ek- I have placed ,on file:wiih the. County of.Butte. Building Department " a Certificate of Workmen's .Compensation Insurance or. a Certificate of Consent to Self -Insure..' D1. shall,not'employ any person in any.:manner so as to become ,subject f 1.to the W. C' laws of California. ?Notice .to`:AppIIcant: If 'after. making, statement,' hould you become;subject to the W'�C: provisions of the Labor•Code,"you must forthwith cbmply,wi.th`such provisions or this permit shall be deemed revoked. Heating Cooling: 1 Hood 2:00 Ventilation ` Permit`Fee $ . ,Contractor,' I certify that _1 have read this application and state that the above information is correct. l agree.to comply to•all-County.Ordinarices and State, Laws relating to building'.construction, and hereby'authorize,representatives -of the Countyot Butte to enter upon ttie above-mentioned property foc inspection purpo,s'es. "'' I also-agree.to save,*inde nify and keep'harmlessl'the:County of Buite:against all liabilities, judgmen osts, and expenses whi'c'h. may in any way',accrue st said County in equence ofAhe granting of this permit. (? ^1 �� _ c Date' o 7.nure (,Applicant Owner Gonrractor, Agent ❑° An OSHA'.,perrnit is required for.ezcavutions' over 5'0 ,deep:and'demolltlon or�Onsrr„cr von of structures over 3 -stones. In height Mobile Home Installation Fee $ Land' Development Fee ti: $ �..— ». . TOTAL .PERMI<T'FEE - $� ;' ` 73 OCCUP, GROup, TYPE OF CONST:' PARCEL' ✓ . PD H ISSUE p� Thi's permit is•hereby issued under the applicable provi- sions of the• Butte County Code, and/or;_ resolutions to;'do work indicated above. Vfor which fees Have' been paid:: "r 'DIREC OF PUBLIC.WORKS -- By �. P IT -'EXPIRES Date /// . Receipt No. 9:3�-` '. WHITE-D.P. W., .7EL LOW -ASSESSOR', PINK I NSPECTOR,. GOLDEN RO'D-APPLICANT - �.. y-1 e k.-, �.7r- ,,y ,.ip. .c r ..d'f..; i r-. Li „L SS to ai x< e,.}, .r } L, ,q 4. ' r ?Y S s c� x As,r s� £ ..f - fir- 7 5' I . a' 14 z ,T F t, k �4,r ...�+-•p ✓.. J^ me—n - 7 .a .r . , ti v S. 44 i '� .i ., . r.7 -,� ,.}i, t s. a -t Zq}5. �c ;J �. ir.rz > , . .+.� ° . •rte" n hi >, " t r ` �...F : " tib' 4; y j y k _ r - ••� _ ` y� r k J. � ;Y - .- It "� f Orf ar 1Z'" j �. `' tfi 4l s,..,� `w Y �r r ; tE,, 't \\ 1- u u � �. L r "Kh4 fi• I '� a i r.t.i � �' tt,.tt. <t, b „ r kno _.� f i "''c ¢ t r a� gf t'.? *" \ , k..' } + E aT a r,',h T h;.� 9 s - '! t jr s� + ": ) }.. n , ; ,:+ 5 .: r+ k -" r %4„_�� =`t-� v ; i r4 ai {"+ t .a' t•. 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'd _ x ..- . 4 - T\5, Ar' ` d_ 4.'�� ., ie .. z M r .xu,liv , "It: ..d. °�e'}4 ,. ., 1 .,u,7an. I�fi T" v "{ J� *'�^.3 iw„ �`�—•�z '" : ^'ri i ,v ... ,�-,—_.�� . •s a,; . � fia� r „ - A �- r •J -. fir,. ... '.. ��, 1 t'� n '�•v. ., .. } r, . r COUNTY OF BUTTE DEPARTMENT OFJPUBLIC WORKS P. R IT NO x5' �7.Coun,ty.Center Drive- Oroville, Califgrnia 95965 _-'Telephone 916/53444541 ' APPL-ICATIONAND PERMITZO `A SSE SO R'PARCEL NUMBER 'I N,G K)✓" , ' . ,4.., ;BUILDING PERMIT' , M'` • ,•, �O NER,".>rv_ I• .J, y- —. •. :-.TEb.E .HONE,. ' S SO FT.., •-OCC BUILDING'-VALUAT ON 4,0 W NE R'S MAILING ADDRESS`,' p COTRACTR4O,;,* NAME ICON-`RACTO YAIUING �DD RESS Yvvpp ^ t . � ',. CONSTRU-CTIONLENDER' µ: - , UNKNOWN''-' Fireplace, Total Val,uatlon $ I-L,ENDER',S MAILING ADDRESS - :.t Permit- Feer A$ -ARCHITECT OR.jENGINE.ER - LICENSE NO.' A CHIT CT OR'ENGINEER S MAILING .ADDRESS a- . f, �' PIan`Ch'ecki Ig.,Fee ,P.enalt `Permit fee' $ • BUILDING' ADDRESS-' - 0 'CAL' air _ - - -` PLUMBING PERMIT. F.ii'ingFee 3.00 ' . Each Trap' 200 Repair drainage or.vent piping ,Water pjping `+LOT `NO. �•., SUBDIVISION NAME. " F -' '" .- -.. [ P A.RC EL,M AP.. ,Each pas water heater or vent . 2.00-11 Gas piping system 1 --5 outlets t Oi [ • 'USE OF STRUCTURE- SF-❑ Duplex ❑ Mobi lehome Other ` '.SPECIFY.- Buil sewer.- ding .Lawn sprinkler system: 2.00 •TVPE OF-WO.RK :New❑ Addition❑.. Remodel❑ l)tlJrties❑. Installation❑, Other' Describe-work:` V —A/Main Permit. Fee Contracto`r.: ,ot` ECk7RICAL PERMIT Filing Fee 3:00 service 100 AMPSS OR; LESS5.60' - Main service -.EA ;-ADD'L 1.00 AMP . 2.50 NEW CONST./ DWELLING'OCCUP,&` OR ADDNS.. ` ACC. BLDG'S.- - :/ . ?0 Sq ft _ - A CONTRACTORS LICENSE L.AW�h C { .,' _ I decfare'under, enalt of perjury p �' p J y ,(Check One): , T ` -f •-:,! .. '� ❑ ;,I:am•Iicen'sed under.:provisions of Chapt. 9, DIV. 3 Of the ,BUSIneSS; -and Professions Code and -my 'license is in full force:'andeffect - License. No:,'�/ /��� Classification 'r'•�- 2 / I, astthe owner; or m em lo. ees:with wa es'as (heir sole com en= ❑ ' ` Y P Y 9 P. sation',h ill do,`tbe work, and the structure is not. intended or offered' for sale (Sect -J044) ❑, I,; as the owner,. am` exclusively contracting, with, Ifcensed contract `ors: (Sec.•7044) ❑ I am exempt under Sec: Business ind:Professions.Code for this reason' N'EW'CONSTR TI.OUTLET - ---NO.N:RESrD •. BRANCH,CIR.GU ITS - 2.50 ea NEW CONST R./ POWER APPARATU , �.�NON-R ESI D"'\\SINGLE OUTLESCIR.� , EX. OCCUp�OUTLETS OR FIXTURES. 50@BAL ; FIXED APPLNS ,OR • >� EX. .00CU p.�OUTLETS'(RESIDJ EA, MO t Temporary service Mobile'Home Facilities 15.00 ' Misc. Wiring Permit Fee. $ Contractor �''MECHANICAL'PERMIT Filing Fee; -400- WORKMEN'S COMPENSATION INSURANCE'_.'' I declaee.;under penalty'of; perjury (check, one):. - .t, Tne'.permit is for -$100.00 (val,uation)�or- less.' ,� l 'have `ptd-on-Ji-le with.thel-County` pf Butte,'Building'Department acea ,Certificate of Workmen's. Compensation Insurance or a;Certifieate of Consent to Self.=Insure: ❑I ,shall not employ any m person any manner•so -as to become' subject to. the W. C. laws of{California. NoticeAo' Applicant:' If after making this statement;- should,you-become subject to the W',C.'provisidns ofthe'Labor Code, you must forthwith comply with such provisions;orahis pernlit shall be deemed revoked. `'. - Heatln g . .•�Cooiing Hood 2.00 Ventilation - penult' Fee': e$ -Contractor I certify that f have read this'applic tiony'and state `that the.above information. correct. I' agree to -comply to al.l County Ordinances-and;.State Laws relating. t6 -building construction; and hereby 'authorizerepresentatives of the,Countyot Butte to enter upon the above=mentioned.property for inspection purposes... `I also agree t0 save, 'i ndemnify , and keep harmless'the County of:Butte'against' all liabilities, judgments; costs,: -arid expenses.'which may in a'n'yway accrue 'against said County in co'nsequenc'e ofthe,granting of this _permit , X_��� Date ���� Y, Applicant_'- .. 'Owner.❑ Contractor ❑' .Agent ❑; ' An OSHA a permit' is required for'excavatians over 5'0 deep and demolition or construct `.ion of structures'o-v�e�r.p3 stories rri;height M66ile Home'Installation Fee..:is Land Developnient,Fee $ TOTAL: PERM LT FEE $ -O_CCUP'. CROUP- 1 ' TYPE 'OF CONST. - PARCEL PD95UE `'• `•' This permit is hereby issued .under the applicable provi- signs of the Butte County Code -and/or, resolutions to.-Ad work indicated above for which: fees;'halve been paid: DI TOR OF PUBLIC WORKS ./��/,, By ate �/ I V . RMIT XPIRES Date."' Receipt No L J Y' b:Ort WNITE-D.P.:.W.YELLOW-ASSESSOR, P,INK,-INSPECTOR GOLDENROD -APPLICANT. - ' :,�. u '_-'k' .4. ,rR, ?'� a, r? Y 41N.. ...` P 'YT,S N.r ni 1: ^)' . ro.'.y:� IU''^1 .,"?r _ , , ,,. 4 5 ., .L. -' - c ,-' 0'r -.' c 1 , Y' .? J" - u s f , ,{f i\" ." f[L ;° xS 1. ``p Y �C d i�9 Lr i _ 'a 9,1 i �' ' '�`.r. �i �l� Q :• '/1. I :�-., j h )I:r +�, Yaf \ X1.7 �t.k 1 tri 17 1' y ^ tl' - L ," V _ { r , L. ; I ." C •� it f S . �} FY 1. I dr . i ' 1 i .� , r . Y R , t 1, ` a * �. .. , _ z.- } r t r{ ,ry " t,� r � ' r- - - _ 5 1* , , ' s c , ..b - �' tt. .,.T ...y ` 't Y.. _ - Ks .-,� , lea �- _ a .4.,* -4 a f: y . I I- E + ti '+ 7r* I ., , , :_ ,� .i 1. 35 ,� i. (11 ,� ,� ,,. �.. 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IM a..,, yx ( x.- 11 x' 'I -y1. _ 't 7 .�'�r "�'J'� ,:1 ''x ,. t �' s '4 i, k.' -� r,1 ( < r S. ✓ / '�.r rh Ile /I�`T` `rhe hl ,�{ - 1; - �; fir` 4 }' * 11 ". 1 b:i•4-t ..t _ •r ` !. t. 1r Yt/ '' f:"t i F. i.F _ .� ,� '-r`i i�r. F 3 S ^t^ _ ` �,'.a _•. ' r' -. y - r Q i &" r + r� �'ol�. .: - d ,I t fly l` <Yr '- Ei' l �,.+. t I.f' `Y'. , �} r +� i a i+�„ P s.� f I. n 1-N 6iidis A -War' NOTE., Workmanship ip ancej,: WM Reco 6d'' Gor)d.''P C; Icesl"in , M use;, a ucfify.�, crib6d lro,�T,f 6 "Aarm', Building, Pluming & M a har n�j% C6desT,.,�6i fhe. Nei+ a ty,C connections 0- CCbA4- fili on a .-be �I�hln .3 A ft. of the- bil 'h irib-Ier he mo le 0. PIC direct{y t behind'dr'withih -tF e. r ar .'haff 6fj he roa 5,4 ce__ rdh oi:m e. Mobi ,. � ✓ � c=:1'BR cy__ � ; � . �� ' 0,�, ols MB A b f >�A Perm', Of 0. OQ1 ot "zoo M LE o 10� 7- lee 'A oc C N PC G7 _A�e4 7 o A'getback 'f Sff ,from es -.4 -th z orn rTy lines an j,14pp 'N' d a setback '50ft.� fron�-th �of 'r6'a'd, e 7. /11/_ AIIAZ AP/161 centerline' shall be 'I' c earof Mpf. *10dures or eqb1pM ent eic' eave anr Y C q.rh -1 ar a? xes. x, 7 &�n4 7-e:� �.g A_ L p e� e, Acewd q . ,4a' , Ui C'bw, A A a Deparf mer bl ft -at I rth6 &8f p Vi 4111KAt, io -P, W s V� . t I kV ..... .. LT Wit RMIN in: M - .l?. il.: is t • .. _ f BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS -�- 7 County'Center Drive., OrovAle, CA. PHONE: 534-4541 ;.M6BILEHONE INSTALLATION SHEET 1. Owners name: 2. Installer's .' name: ✓�.(?��/E�.. �o,�/ .��r��' S .�/// �. 3. Is, the site currently.•.under permit? Yes / / No (If yes,, furnish permit number_ ) OR Is the site an existing site?. Yes // No (If yes, furnish two (2) plot plans.) 4. Will the 'mob ilefome be located at'least 5 ft. away from septic tank and*leach fields and . .-clear-of all setbacks. and easements? Yes , No :F (If no, clarify ) 5. What is' the mobilehome electrical rating? ----------------------- /Qp Amps- . 6. What is the mobilehome site service rating? ------------------=-- Amps. 7. What is the mobilehome site. circuit breaker rating? -------- Amps 8. Is.there'any other electric load to be served•by the mobilehome 'site service? ------ --------------------------------------------- . Yes No /-./ (If yes, identify the load..and size,:. (Load)' (Amps) 9. What is the mobilehome .site. gas pipe size? ---------------- -------�' (in..) 10. What is`the',type of gas service?,---------------------------- Natural LPG i. 11. What is the gas pipe length from meter or tank to the mobilehome? 2.5 (ft.) 12. What is the mobilehome gas demand? ----------------'------ ------- (BTU). (This information not required if pipe length'le'ss than 6 ft. on natural,ga6 or, less -than 50 ft. on LPG.) MOBIDEHOME SUPPORT DATA If other than single wide,-. Mobilehome Mfr.Q'A4 [/S. �,�/Q : furnish Setup Model No. 6 C� /�/ year -Width 2U (ft.) Box Length �. 1 9' g (ft.) Tagalong or Expando Size ft. x ft. (SHOW SUPPORT DETAILS BELOW) On all mobilehomes manufactured after -October 7, 1973, furnish manufacturer's installation manual and structural setup sheets (if not on file with the.County of Butte). All center su worts measured from front of mobileh u les otherwise specified. r Footings (check one). �1 Single " ` ® 1. .Wood either pressure treated or foundation grade. (ft.)(in:) (in.) (in.) 2. Other (specify) Center support Center support locations* footing sizes Supports (check one) ® 1: Concrete b -lock. 2. 0th r (.spe� fy) (ft.)(in.) (in.) (in.) rS���''G (ft.)(in.) 1'. I ". (ft.)( (in.) �< ---Tagalong or Expando,' ( show support details. .(in.) (in.) (in.) (in.) *If center piers are other than drawn above, draw in -locations., spacing, and dimensions. /t Z - x �l -- Typical Support `( in.) (in.) Footing Size J -- Max. Pier Spacing -- Max. Overhang t.) (in.) .BUTTE COUNTY UtI.DING DEPARTMENT" 40PP.O n, z� Z d F- J = OK _ O = Not OK . - = Not Applicable RESIDENTIAL (Single and Duplex)_ = Not Ready Date UNDERFLOOR Plans 'bK except #'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property.L(rie,Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- •/ /" Ftg. Depth 49. Ext., Do6rs-One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs;.Width-_Headroom-Rise-Run- Land ing-Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /'' Ftg. Depth 51. Plywood.on Roof. Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Sid ing-Nailing=Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing,Area-Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear,Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test-Anchors-Regulator-Seryice Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date_ Card -BI Date Card -BI Date - Card -BI Date Card -BI Date Card -BI Date , Card -BI Date Card -BI Date Date FINAL., Plans ,OK except N's Card -BI Date Card -BI Date Date PLUMBING (Permit) OK except N's 14. Water Ht.; Vent -Access -Combustion Air 56. Ext._Steps=Door & Sidelight Protection -Landings 57. Smoke: Detector. 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nall Protection 59. Bedroom.Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath,Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. 63. Stairs & Rails Fireplace.or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. FW. &'Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Date Card -BI Date ELECTRICAL Permit OK except q's 66. 67. Elec. -Outlets & Receptacles at Kit. Counter Garage -Fire -Door; Swing -Landing -Closer 68. - A.C. Ductin Garage -Damper 20. 21. Fixture & Transformer Clearance -Ins. Protection Elec. Receptacles Spacing -Lights & Switches at Doors 69. Wtr. V bovClearance-Comb. Air-Connector-P.R.V.- In Garage; -Above Floor-Mech. Protection 70. Plti t Elec'A-Mech. Equip. Listed for Location 22. Size Boxes & No. of Conductors -Stapled 71, Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 23. Romex Installed Close to Edge of Studs & C.J. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. 73. Insulation -Foam -Looked in Attic ❑Yes Guard Rails &Deck Construction -Post Caps 25. 2 Appliance Circuits in Kitchen &Conductor Size 74. Fdn:,Vents&t.Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under=Floor ❑ Yes _ 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or AI, Insulated Neutral ❑Yes El No 75. Follow,ing instld.: Drive [I Yes E] No; Walks [I Yes ❑ No; Planters,`.'❑Yes El No 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco;, Brown -Finish 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77, A.C. Unit ;,Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light 78. Vents„-Above;Boof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. Water Well; -Disconnect, Electrical, Plumbing 80. Exterior-Elec.-Trim; G.F.I. Receptacle -Underground Card B -I Date Card -BI Date 81. Ventilation throughout House Card B -I Date Card -BI Date 82. Glass -Protection Date - MECHANICAL (Permit) OK except #'s 31. A.C. Ducts; Insulation & Support 83. _ Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 85. Water-& Sewer Connected -C/O to Grade -HD Approval _ 32. 33. _Vent Fan; Exhaust above Insulation Condensate Drain & Overflow; Size & Grade 86. Energy'Compliance Certificate -Other Certificates 34. Furnace -Vent; Access -Comb. Air -Return Air Vent-115V•outlet 35. Attic Access & Platform if Furnace in Attic - Card-BI Card -BI Date, Card -BI Date Date, Card BI Date Card -BI Date_ Card -BI Date Card -BI Date Card -BI Date Card -BI _ :Date.' ',;,";: Card -BI Date Date FRAMING Plans OK except N's Comm ents`atJFina fi 36. Sills; Proper Material & Anchors 37. 38. Walls: Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls_ over Girders & Floor Nailing_ 39. Draft Stop in Walls (rat proof) ' 40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. 42 43. 44. 45. Header & Beam -Size--& Bearing Hangers -Post Caps -Anchors -Connectors CIng. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. Fireplace Ties or Type A Flue -Fireplace Throat Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles �" ^ -" 46. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing - (NOTE: An entry must be made each time you visit,,job,site)'_k; J = OK 0 = Not OK — = Not Applicable = Not Ready MOBILEHOMES ' MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except N's Date , COVERS, CARPORTS, ETC. (Plans) OK except a'.s 1. Zoning Requirements—Setbacks—Easements 1 g Requirements—Setbacks—Easements 2. Soils; Special MH Support—Sketch 2 ootings Size—Depth—Spacing—Connectors 3. Sewer; Location—Test—Fall-C/0—Concrete s; Girders and/or Joists—Decking—Bracing—Stairs—Rails 4. Water; Location—Test—Easement Needed (Sketch) 4. Wood Awn.;'Posts—Beams—Rftrs.—Connec.—Shthg.—Rfg.—Bracing_ 5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete 6. Gas; Location—Test—Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG - 5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures 6. Carports; Windows—Doors 7. Utility Clearance 7. Elea Card -BI Date Card -BI Date Card -B Date Card -BI Date Card=Bl Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except q's 1. Zoning Requirements—Setbacks—Easements Card -BI Date Date Card -BI Date POOLS (Plans) OK except N's 1. Setbacks—Easements 2. Footings; Size—Spacing—Marriage Line 2. Soils; Compaction—Structure Stability 3. Gas; MH Test—Demand—Valve—Connector 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining 4. Electricity; MH Test—Crossovers—Breakers—Clearances 4. Elec.; Receptacles and Lighting; Distances—GFI 5. Drain; MH Test—Fall—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI 6. Water; MH Test—Regulator—Connector 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed 7. Water and Sewer Connected—C/0 to Grade—HD Approval 7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater 8. Gas and Electricity Tagged 9. Exits; Insp.—Sketch B. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghig. Boxes—Enclosures—Panel boards—Ins. to Main in Conduit 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test—Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date a i { : COUNTY OF'BUTTE - DEPARTMIENTbF PUBLIC WORKS ERMIT'NO '7 County Center Drive - Orovij.le, Califorriia 95965 - Telephone 916/534-4541 'APPLICATION AND PER :A,SSES P=� L NUMBER _ i ZONIN �./ -- BUILDING PER .o/ OO owNE / �.- ELEPHONE SQ. FT. OCC. BUILDING VALUATION ow - ' OWNER'S MAI LLN ADDRESS n 41 'CONTRACTOR'S NAME , TELEPHONE .CONTRACTOR'S MAILING -ADDRESS ". CONSTRUCTION LENDER UNKNOWN - Fireplace Total Valuation $ 119 LENDER'S M AI LING ADDRESS"- _ � ', � ., � Permit Fee $ 0 0 - ARCHITECT OR,ENGINEER _ .LICENSE NO. Plan Checking Fee :_ $ _ �O O Penalty $' ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ 0. Q 0 BUILDING ADDRESS d� 2 - PLUMBING PERMIT.. - Filing Fee 3.00 Each Trap 2.00 Repair drainage or vent piping -2.00 / ej Water piping �T NO. SU.BDI VISION N'A&1E•;. - I.PAACEL MAP Each qas water heater or vent 2.00 ' Gas piping system 1 -'5 outlets USE OF STRUCTURE SF ❑ Duplex F-1 Mobilehome;❑ Other iii SPECI FY Building sewer Lawn sprinkler system ' E2.0:0 TYPE, OF WORK New AddftionEl Remodel ❑ • Uti lities!❑ Installation ❑ Other ❑ ..Describe work: f Permit Fee' $ Contractor. ELECTRICAL PERMIT FiiingFee 3.00 ' Main -service 1000V OR 0 AMP ORSLESS 5.00 Main service EA. ADD'L 100 AMP '2.50 NEW CONST. DWELLING CCUP.& OR ADDNS. (DWELLING BLDGS. 2Q Sq ft - - -, CONTRACTORS LICENSE LAW declare Under penalty Of perjury "(Check One): • - - - ❑ . I am licensed under_ provisions of Chapt. 9, Div. 3 of the Businesss0 and Professions Code amy _nd• license is.in full force and effect.. fff� /LiCense'No. 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) 'am;ezempt under Sec. ,,Business and Professions Code for this reason NEW CONSTR I -OUTLET RA NON-RESID BNCH CLRC ITS 2.50 ea NEW CONSTR.. POWER APPARATUS & NON-RESID. ( SINGLE OUTLET CIR, @ 259• Ex. Occup(ouTLETs OR FIXTURES BAL @109 FIXED APPLNS; - Ex. Occup.(OR OUTLETS (RESID:) EA.1- 2.00 -Temporary. service10.00 -Mobile Home Facilities 15.00 Misc. Wiring 6.25 Permit, Fee $ Contractor MECHANICAL PERMIT FiIingFee 3.00 ,WORKMEN'S COMPENSATION INSURANCE declare under penalty of perjury. (check one): ❑ The permit is for $100,00 (valuation) or less.' El 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.' rLJ� 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' tolthe W. C. provisions of the Labor Code, you must forthwith comply with such provisionsor this permit shall be deemed. revoked. Heating Cooling Hood -2.00 Ventilation permit Fee $ Contractor I certify that.,,) 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 Countyof Butte to enter upon'the above-mentioned property for inspection purposes. .l. also agree to, save, indemnify' and, keep harmless the County of Butte against•. all liabilities, judgments, costs,.and.expenses which may in any way accrue ag ins t said cunt 'n. nseg4 ce-of the granting of this permit. X Date 3 Signature of Applicant —' Owner Contractor ❑ Agent ❑ An OSHA'permit is required for excavations over'5'6" deep and demolition or construct- ion of structures over 3 storiesinheight. Mobile Home Installation Fee $ Land Development Fee $ TOTAL PERMIT FEE $ 0, p Occup GROUP _� TYPE OF CONST. PARCEL PD HD 55� This permit is hereby issued under sions' of•the Butte County Code. and/or work indicated above for which '' DIRE R.OF PUBLIC BY P MIT EXPIRES Date the applicable'provi- resolutions to do fees have been paid. WORKS Date v� Receipt No ���IU WHITE-D.P.W., YELLOW -ASSESSOR, PINK-INSPECTOR,"GOLDENROD-APPLICANT A A'' i:y;irie t f • ..4 . - -. - .. Y . {,.-• ..;u ! .- . -,� , ,� .� '+. 'f'`t �� �.2 r 9` : d .. - r , f ',it a . !t Z Jan 'W svo mjw - - a - - IJ 4,115 = Von oil QT ori#en permisst. Norks, County Ijf pgpnrFment of Pu Y � t 1 - ft from the es n a setbd! f k L Li t, U. r ? Fr 1< ti's , _ ram pr i r i�is.set of puns and ept on ori#en permisst. Norks, County Ijf pgpnrFment of Pu Y � t 1 - ft from the es n a setbd! f _k L gC¢r� 4h76/ �Ar r �0 44s oa/ 0 �• °ofi4 c''%dc3c f�cy r. r ? Fr 1< ti's , _ _k L gC¢r� 4h76/ �Ar r �0 44s oa/ 0 �• °ofi4 c''%dc3c f�cy r. j It oK�l as L% t'> i T a +" n14cfln 7 Ads— :ProVicle fr^ .? �' VJ X20 it+i k' "` ,�f r ; x.75. �sz.' ea `'• ..yy►► ��r r � �r7 ?�t �.� :7 r, ' 7il U i s. • I 1r S SJ Yin; a - ( �sn. 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