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Home My WebLink About066-240-04666-24-46 Fred WohlWichita '� *10MCMi. 95 Wichita r. oMagalia contra Tri V Const., Paradise Permit 1 63 77P,E(ut�§A . ,MH) ELEC . p GAS 7 SUPPOR STRUCTURE REQ. Ajo COMPACTION TEST REQ. AJ p • /' 66-24-46 ontr: Cal-Gas, Paradise- Permit #909-78P(gas i p ping) MH 66-24-46 CEntr: "Car�'e11�pBros;'-Chico P rmit #1216-78MHI Issued ahzlzzof 66-24-46 ---� Permit # 283-78B(new carport & deck/ MH) �••� 0079 j N u 0 W& 6� 41 j'" 1283-78B Pi ERMIT NO. t PERMIT EXPIRES 0-Slonvo OWNER Fred Wohlau -CONTR.- owner LOCATION (A.P. 66-24-46 ) 95 Wiclrita "Dr, , lot 251, CC#4, Magda a s t " r I 4 44 . Si Temp. Power Pole Called PG&E Temp. Elec. Serv. ,r Called PG&E A Temp. Gas Serv. Called PG&E aj JOB — —7 FINALED (Date) (Signatur A— _ Setback Forms Main Bid Footin Stemw, Slab Piers Garage Footin Stemw+ Slab Slab Patio Foot i COUNTY OF BUTTE — DEPARTMENT,OF PUBLIC WORKS. s' - BUILDING -BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Firewall Soil Piping Parapets 1st Floor Restroom Finish 2nd Floor Windows 3rd Floor Siding To out Roof Sheathing Water Piping Roofing Sewer Fdn. Vents Fixtures Garage Vents Insulation Water Htr. Heaters Prov, for phsically handicapped Conformance of ex. structure Appliances Gas Piping & Test Temp. Gas Final Sanitation FIREPUCE ACE Final Foo anal FIRE SPRIN Fixtures Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOMEUTILITIES ------------------ Elec_ Service Elec. Pedestal Water Piping Sewer Gas Piping E O E INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS q [3 (NOTE: An entry must be made on this form each time you visit the job site.) ELECT COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive —., Oro�,ille, California 95965 Telephone! 534-4541 APPLICATION AND PERMIT authorize representatives of the county of Butte to enter upon the above-mentioned property f inspection purposes. n / q D X� L�� Date LI '�Q Signature ofPermitee or Agent / Receipt No. r 7V. I Fr 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 PXIBLIC WORKS By Buil ding tPermit expires Date BUILDING Owner SQ. FT. OCC. BUILDING VALUATION �o J Z0 Mailing Address %`S ��Lf A� / lephone3 Contractor W t �� Mailing Address Fireplace Total Valuation O Q Telephone No. Permit Fee /(0_ Building Address Plan Checking Fee &/or Penalty Permit Fee (0 CffT4- 2 PLUMBING No.1 @ FEE 12-; j CC7 PERMIT FILING FEE J$3.00 Each Trap 1.50 r4 V f"9- Repair drainage or vent piping 1.50 A. P. No. (a `T Zoning & Planning Water piping 1.50 'Each gas water heater or vent 1.50 F s C. a nn FireDept. FireZone Use Permit iping system 1 - 5 outlets 1.50 EQA Parking Parcel Plans Declaration Parcel Map 60' R/W improvements additional outlet .30 Building sewer 5.00 Bldg. ns Recd Parcel A roval Plans Approval Lawn sprinkler system 2.00 NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ Permit Fee $ ELECTRICAL No.1 @ I FEE PERMIT FILING FEE $3.00 Single Family Duplex ❑ Mobil Home Others ❑ ❑ Main service 600V OR LESS t00 AMPORLESS 5.00 Main service EA. ADD'too AMP 2.50 f A I� �' OVER 600V Main service 100 AMP OR LESS 25.00 Main service EA. ADD'L too AMP 1.00 NEW CONSDWELING OOR ADDNST ( ACCLBL GS.CCUP. B� 20 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: NEW CONSTR MULTLOUTL T NON.RESID ( BRANCH CIRCUITSI 12.50ea NEW CONSTR. POWER APPARATUS 9 NON.RESID. (SINGLE OUTLET CIR. Ex. occuo(OUTLETS OR FIXTIIRES 5 L� Ex. QCCU FIXED APPLNS. OR P•(DUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 1 am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $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 / $ ! Q authorize representatives of the county of Butte to enter upon the above-mentioned property f inspection purposes. n / q D X� L�� Date LI '�Q Signature ofPermitee or Agent / Receipt No. r 7V. I Fr 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 PXIBLIC WORKS By Buil ding tPermit expires Date r. e 1 6305-77.P E PERMIT NO. j- PERMIT EXPIRES Fred Wohlau DOWNER CONTR. Tri V Const., Paradise LOCATION (A.P. 66-24-46 95 Wichita Dr., lot 251, CC#4, Magalia * 4 ' 7 {� t !r . I i% 1 t f, t Temp. Power Pole 1' Called PG&E Temp. Elec. Serv. ` Called PG&E emp. Gas Se It Called PG&E OB FINALED (Date) (Signature) 61 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 'n'+ for the following location: I,tAA Owner Owner's Address n Mobilehome Mfg. h, A Model Year i k Insignia No. Serial No. It is hereby certified for occupancy at the above described location and may be occupied. Directorof Public Works of Date '�. e" ' �i By \I /��i 7`J A/ 1 THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED White - Owner, Yellow - Installer, Pink - D.P.W. COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) Set ck ewall S i PLUMBING rormq Pa ets 7 t Floor Mai Bldg. Rest om Finish 2n Floor Fo ins Windo 3rd k0or Stem all Siding To out Slab Roof Shea)blng Water PI i Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings StemwaI I Garage Vents Insulation NHeaters Water Htr. Slab Carport Footings V Prov. for ph sical handica ed Conformance of ex. structure V Appliances Gas Piping & Test Temp. Gas Slab A Final Sanitation Patio REP ACE Final Footin s Footing EL&CTRIdkL MasonryWalls Throat Rou h Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLEFk Motors Framing Test Water Htr. Stucco Final Sub anel Mesh MECHANICAL Gird. Fa t Prot. Scra h Heati q Servic tjrqwn Coo ng Te/no. Pole F ish D is der round In rior Lathentilation/Permanent oor Closer Final Inal MOBILEHOME UTILITIES ..... ----- Elec. Service - Elec. Pedesta} Water Piping I = I Sewer �' Gas Piping ;21 ,MOB ILEH2W11M§1&LL&1= V-------- Support Elec. Contin" ity' 5_ j. Water Piping - 3 Drainage Gas Piping DATE REMARKS OR CORRECTIONS 0 7- qj (NOTE: An entry must be made on this form each time you visit the job site.) hH 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- No_ 3. Are footings and supports properly sized,'spaced,'and braced as 7p 'approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes_ No 4. Is the mobilehome level? (Sec. 5088) Yes No 5. If more than a single unit, are crossover connections properly installed? (Sec. 5088) Yes -No- 6. fNo 6. Water A. Is flexible connector of adequate size,and properly installed (1/2" ID m1n.)? (Sec. 5566) Yes_ZNo_ B.. Test - Does water piping withstand working pressure or 50 lbs. air test? Yeses No_ 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 k" per foot slope and is it properly supported? Yesl No C. Are any leaks detected in drainage system after running 3 -gallons of water through each fixture including washing machine standpipe? Yes No D. If coach is not State of California approved, does station have required trap and vent? Yes ` No 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 mobpehome gas line iiilet 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 with soapy water. , / C. Are all appliance vents properly installed? Yes b/ No 9. Electrical A. Is service large enough to provide adequate amperage -to mobilehome (must equal rating of mobilehome with a minimum of 100 amp) and other facilities on lot, i.e., water pumps, garage, cabana, etc.? Yes '-f No B. Is there proper clearances around panels? Yes /No C. Is power supply cord,or feeder assembly properly fused? Yes_L/No_ D. Is continuity test satisfactory as per the following procedure? Yes r1 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 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 Length Y� Width_ Vehicle Serial No. 6 S d State Identification No. Additional Information or Comments: COUNTY OF -BUTJTE- — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - proville, California 95965 Tel ephohe: 534-4541 APPLICATION AND PERMIT 4�jl VL-.— 77 c', auuwllcc Nlcaenfat ves UI the bounty of butte to enter upon the above -hie Toned pr�opertyy for inspection purposes. Date, Signature of Permi tee or gent Rec ipt No. ' /13 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 Pld'9hIC WORKS BYDate B l lding permit expires Date BUILDING • Owner (A.) 61`1 L A (,/ . SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Fireplace Contractor Total Valuation Mailing �Address 'L/�/� � ` Permit Fee Plan Checking Fee &/or Penalty dL��CtS '" lephone No 7 - S'� Permit Fee Building Address PLUMBING No.1 @ I FEE PERMIT FILING FEE $3.00 /, W /7-4 Jho.' Each Trap 1 1.50 LD T . gt e Repair drainage or vent piping 1.50 6� C,1 tIO Zenfing Verification QW)l Water piping G7 Each gas water heater or vent 1.50 A. P. No. -z 7 ylp _ ,e Zo Gas piping system 1 - 5 outlets 1.50 additional outlet 30 Flies C. Sa -ori Fire Dept. Fire Zone If -Each Use Permit Building sewer .5-.W I EQA PPlanarking s Declaration eZ 60' R/W Improvement Lawn sprinkler system 2.00 B f �P.hjrin3 Recd Parcel Ap roval Plans prov000al Permit Fee $ - $ NEW ADDITION ❑ ❑ UTILITIES OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 100 AMP OR00V OR LESS5.00 Main service EA. ADD'L 100 AMP 2.50 ^� Single Family ❑' Duplex ❑ Mobil Home C9 Others ❑ Main service 1100EAMP OR LESS 25.00 Main service EA. ADD•L 100 AMP 1.00 SQ. FT. MINIMUM ' CONSDWELING OC CUP. &\ 20sq ft oR ADDNST ( AC ON/CCLBLOCS. NON-RESID R (BRANCH CIRCUITS)) 2.50ea' EOR MOBILES NEWCONSTR. POWER APPARATUS & NON .RESID. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: - /' ` e t c-" Ex. Occup(OUTLETS OR FIXTURES) 50 @@1 BAL@1 APPLNS. OR Ex. OCCU Occup.( (OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. 3o 2- 7 0 Classification Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ �S - $ 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. Q_2ertify that in the performance of the work for which this I 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, _.i. _ Vt:'V d-5— TOTAL PERMIT FEE $ 3.n auuwllcc Nlcaenfat ves UI the bounty of butte to enter upon the above -hie Toned pr�opertyy for inspection purposes. Date, Signature of Permi tee or gent Rec ipt No. ' /13 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 Pld'9hIC WORKS BYDate B l lding permit expires Date COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT w ,• - I, vwo u L e -OwlLy VI Duce w enter upon [ne above-mentioned property for inspection purposes. p X Date C�r 7 0 ignature 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.. DI =.CF PUBLIC WORKS By Date /78' -BditAg permit expires Date BUILDING Owner�� U SO. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Fireplace Contractor C& (, S. Total Valuation /2 vMai I i ng Address C) T Permit FeePlan Checking Fee &/or Penalty [2 e hone No. q S • Permit Fee $ Building Address PLUMBING No.1 @ I FEE PERMIT FILING FEE $3.00 — (^, %� f Ci F{ %} Each Trap 1 1.50 h VV G Repair drainage or vent piping 1.50 ( Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. - Zoning 8 Planning Gas piping system 1 - 5 outlets -4- / Each additional outlet .30 Fee. 4.ao"aUew Fire Dept. Fire Zone Use Pen -nit Building sewer 5.00 EGA Parkin PlanBldg-dens4]ec'd Declaration Parcel Map 60' R/W Improvements Lawn sprinkler system 2.00 Parcel Approval Plans Approval Permit Fee $ i NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 00V OR L Main service 100 AMP ORSLESS 5.00 7f'�� . Main service EA. ADD'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home ❑ Others ❑ OER 600V Main service 100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 ' NEW DWELLING OR ADDNST ( ACC. BLDGS. OCCUP. &� 2¢sgft NEW CONSTR. MULTI -OUTLET NON-RESID2.50ea 'NEW C0N5TR.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) BALE'1 Ex. Occup. ( OUT ETS P(RESID )REA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No.--; / 6 L((3 Classification Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. I have placed on file with the County of Butte a certificate of .ur 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 J2.00 Hood 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 $ ' w ,• - I, vwo u L e -OwlLy VI Duce w enter upon [ne above-mentioned property for inspection purposes. p X Date C�r 7 0 ignature 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.. DI =.CF PUBLIC WORKS By Date /78' -BditAg permit expires Date OUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS �► � 7 County Center Drive - Uroville, California 95965 Telephone: 5'34-4541 APPLICATION AND PERMIT w!�FIVQVr—k Vw Ui tile %,Uun1Y UI auiic 1u enter upon the above-mentioned property for inspection purposes. r/ X Date ��O 7 d Signature ofkermitee g t Receipt No. d elh2 White-D.P.W. — Yellow -Assessor — Pink-I�nsppector — 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 UBLIC WORKS BY Date �'�%-� ding permit expires Date 3" 7� BUILDING Owner t- `o d �� 1 C.+t SQ. FT. OCC. BUILDING VALUATION Mailing Address a m Telephone No. 97 - 09 31 Fireplace Con tracto �,j_(� O oV4 g,- a ,� Total Valuation Mai I i ng Address 3 o y. a J �,,� A,� Permit Fee Plan Checking Fee &/or Penalty Telephone No. cF cr Permit Fee p Building Address V �� (,� ; GiL �'.�•�, e,. PLUMBING No. @ FEE PERMIT FILING FEE $3.00 cx. Each Trap 1.50 %ZpRepair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 ,, .� `, - Q_b q(0 A. P. No. "C' Zoning 8 Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F�/s "C/" -SaFti-tatiea I Fire Dept. FireZone Use Permit Building sewer 5.00 EQA Parking Plans DePa a ion IBldg. Parcel Map 60' R/W Improvements- Lawn sprinkler system 2.00 PI s Recd I Par ZIA_Pp rovaI PI Permit Fee ,$ ADDITION ❑ UTILITIES ❑ OTHER X NEW ❑ ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 s- 6001 OR LESS Main service 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2,50 Single Family ❑ Duplex ❑ Mobil Home 0 Others ❑ Main service OVER 6001 25.00 10o AMP OR Main service EA, ADD'L 100 AMP 1.00 0 AM NEW CONST. f DWELLING OCCUP. & 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)(s 2@5Q BAL@1 Ex. Occu (( FIXED APPLNS. OR P.(OUTLETS (RESID•) EA) 2.00 Temporary service 10.00 r Mobile Home Facilities 15.00 License No. 31 O 4aCDClassification Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of Cal ifomia. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. �I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not em p to an employ 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 I ,e c..L-Q mac` TOTAL PERMIT FEE � , cI --= w!�FIVQVr—k Vw Ui tile %,Uun1Y UI auiic 1u enter upon the above-mentioned property for inspection purposes. r/ X Date ��O 7 d Signature ofkermitee g t Receipt No. d elh2 White-D.P.W. — Yellow -Assessor — Pink-I�nsppector — 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 UBLIC WORKS BY Date �'�%-� ding permit expires Date 3" 7�