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HomeMy WebLinkAbout066-300-0375 AP 66-30-37 PAUL WISE k J- F- 7`p 30 Heller Ct lot 62, PPC#/�, Magalia contr: Paul Reimel;"Parad se'jwo6rkshop. Permit# 3320-75B,P,E,M(new SF/��66-30-37 scontr: Paul 'Riemel., ParadiseTermit #4959�77B(new private 066-30-0-037 _A9 -2K2 ; ':WISE, .Paul ,�iii;'/ %Z /ir= piia 13764.Helle'r.F Court; . Mag (relocate fur.'nace/Del Johnson) e 1 O� cio c I= Icr,) Az J, -Li J 71 1 066-30-0-037 99-2822 WISE, Paul 13764 Heller Court, Magalia (relocate furnace/Del Johnson).-- Al It COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 PERMIT o. (Rev.12/96) APPLICATION AND PERMIT C,, ASSESSOR PARCEL NU (6-300-03+ ZONING 21 - BUILDING PERMIT OWNER( CAS TONE SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS/] J I aa4ael CONTRACTOR'S NAME (% TELEPHONE CONTRACTORS MAIUNG ADDRESS ' V CONSTRUCTION LENDER Fireplace LENDER's MaUNG ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. FilingFee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 00 0 to CIE- Energy Plan Checking Fee $ $ PERMIT FEE S LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SFX Duplex ❑ Mobilehome ❑ Other � SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each es water heater or vent 15.00 TYPE O WORK. New ❑ Addition ❑ Remodel ❑ U6lifies O sta . ❑ Other ❑ Describe Work: IN1 P`� Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G W @20.00 PERMIT FEE S �k ` " ELECTRICAL PERMIT Filing Fee 20.00 600V OR LESS Main Service .A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.POWER License Class Lic. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. C,7 I, as owner of the property, am exclusively contracting with licensed contractors (� to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO +000A 46.00NEW CONST. DWELLING OCCUP. OR ADDNS. ( a AcC. BLDs. SO 3.5QFT: T. NON -R610 MU LTI.OUTLET 97,50 APPARATUS 8 SINGLE Oun , CIR. Ex. Occu OUTLET OR FIXTURES BAL .so Ex. Occup. oUnEDrsA_(RS)ES D.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permitis issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) 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 workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. / X , .. i 1 /r r; i_ Date / !.w / / i / _ Signature of Applicant - .Q Owner - ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CO's" -TYPE / TOTAL FEE $ �.� , Cb HAZ. . D. F IMP FLOOD _. CDF PARCEL _ PD HD _ ISSU 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. q By , % Date PERMIT EXPIRES ON /a% —/ (P 'al 006 ate ReceiptNo. 8 6-4" WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT A L Jam/ COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-754 (Rev. 12/96) APPLICATION AND PERMIT C, ASSESSOR PARCEL NU D3-� Zo°- - BUILDING PERMIT OWNER L10 cam- TELEPHONE �3 -aa SO. FT. OCC. BUILDING VALUATION S .OWNERMAILING ADD ESS <is��^�/�••in " ''l. 6-(, 5 ab CONTRACTOR' NAME TELEPHONE CONTRACTOR'S MAULING AQUESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. —Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAIUNG ADDRESS Plan Checking Fee $ BUILDING ADDRESS Energy Plan Checking Fee $ PERMIT FEE $ LAT NO. SUBDIVISION'S NAME - PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF)( Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 1 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe �� Work: ,� ._ p ary" i"4 Ai6 l � Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 a00V OR LESS Main Service 20.AORLESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) 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 workers' compensation laws of California, and agree that f I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. �� l Date (p Si nature o Applicant - Owrfetractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service 200A TO 1000A 46.00 NEW CONST. ( DWEWNG OCCUP. SO OR ADDNS. DW: Acc. BLDS. 3.5QFr: NON-RESIDRANCHO IRCUITS T @7,50 POWER APPARATUS 8 SINGLE OUTLET CIR.20 @ 1.00 OUTLET OR FlxruREs Ex. Occu BAI_ @ .so Ex. Occup. aFun' A' DE'.- 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating X60 a5 t7� Cooling Hood 6.50 Ventilation PERMIT FEI: S Mobile Home Installation Fee $ Energy Inspection Fee $ Occ ,3 OGW.Z-TYPE TOTAL FEE $ 45, ob HAz. D IMP FLOOD CDF PARCEL _ PD HD SU This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicate • above for which fees have been paid. By 90&1&0 Date & PERMIT EXPIRES ON /o9 �tio'aOoi) (Da te Receipt No. CPEOGRI 5;dt WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD•APPLICANT 3 r PERMIT NO. 4959-77B y.. PERMIT EXPIRES OWNER Paul Wise Paul Riemel, Paradise CONTR. { LOCATION (A.P. 66-30-37 30 Heller Ct., lot 62, CC#4,M4plia { I Temp. Power Pole Called PG&E _ Temp. Elec. Serv.. Called PG&E.- Temp. G&E_Temp. Gas Serv. _ Called PG&E _ JOB FINALED •Y Motors T Mesh COUNTY OF BUTTE — DEPARTMFNT OF PUBLIC WORKS BUILDING INSPECTION RECORD Grd. Fault Prot. BUILDING BUILDING (Cont'd) PLUMBING - Setback Firewall Soil Piping Forms' Parapets 1st Floor Main Bldg. Restroom Finis 2nd Floor Footings Windows 3rd Floor Stemwall 7 Siding To out Slab Roof Sheathirk Water Piping Piers Roofing _ Sewer Garage Fdn. Vents Fixtures Footings Garage Ve is Water Htr. Stemwall Insulationif Heaters Slab Carport Footings Prov. for Ohysically handica ed Conform ce of ex. structurel Appliances Gas PipingTest Temp. Gas Slab Final 10 � Sanitation Patio FIREPL E Final Footings Footing 1 ELECTRICAL Motors T Mesh MECHAN tAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Tem►. Pole Finish Ducts Un Ie ground Interior Lath Ventllati n Pe � anent Door Closer FinalFina MOBILEHOMEUT LITIES------------------ Elec. S rvice Elec. Pedestal Water Piping 7 Sewer Gas Pipincf M21316EU,QMEI STA LATI N--------------Suppt Elec.CoAtinuity Water Piping Drain ge Gas Piping J DATE REMARKS OR CORRECTIONS (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 — 'Uroville, California 95965 Teleppone: 44-4541 APPLICATION AND PERMIT � 9f » authorize representatives of the County of Butte to enter upon the abov -men 'oned.,pr rty for inspection purposes. 7 X Date mnw�re of P IMItee or,. gent Receipt No. V` 7 0 d �( ` 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. DIREC R OF P ELIC WORKS 9 By �' d Date `/ 6 Building permit expires Date %w"f BUILDING pp Owner 14 L, \,rV t S e- SQ. FT. OCC. BUILDI G VALUATION C2 SAIP 3— 1 Mai I i ng Address ` Telephone No. Fireplace Contractor LA L, 4/ t+11 b' Total Valuation L Mailing Address W Permit Fee Plan Checking Fee &/or Penalty - r/P 4vrj 6 1 Teephone No. Permit Fee $ P Building Address �(�L,� PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 %, Z C `k Each Trap 1.50 n �i Repair drainage or vent piping •1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No.Gas Zoning 8 Planning piping system 1 - 5 outlets 1.50 Each additional outlet .30 F WIC/ I Fire Dept. I FireZone Use Permit Building sewer 5.00 EQA Parkin Parcel Plans Declaration Parcel Ma P 6 R/W Im r p ovem nts Lawn sprinkler system 2.00 Bldg.& ahs Recd Parcel Appr al Plan Approval Permit Fee $ $ NEW [:]ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 1000V OR 0 AMP ORLESS5.00 Main service EA. ADD'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home ❑ OthersMain ER 600V Main service 10 0 AMP OR LESS 25.00 service EA. ADD'L loo AMP 1.00 p� Y` V V �Vw• J % NEW CONST. I DWELLING OCCUP. & OR ADDNS. ACC. BLDGS. 20 sq ft NEW CONSTR. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS) 2.50ea ' ' 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 /r�-i�� ` \ ��) l� (✓ L— (�'1s') L,_biir Ex. Occup(ouTLETS OR FIXTURES)@L2iC BAL@1 FIXED ALN9_. Ex. Occup. ( OUTLETS PIRESID IKEA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. bb�7 Classification Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of Cali fomia. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code w ' h requires every employer to be insured against liability for frtpeTtgation. ave 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 $ $ 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 $ authorize representatives of the County of Butte to enter upon the abov -men 'oned.,pr rty for inspection purposes. 7 X Date mnw�re of P IMItee or,. gent Receipt No. V` 7 0 d �( ` 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. DIREC R OF P ELIC WORKS 9 By �' d Date `/ 6 Building permit expires Date %w"f PERMIT NO. NO. 0= t r Y/ E I r M IMI -I UTIL. ;PERMIT NO. PERMIT EXPIRES OWNER Paul. Wise 4 CONTR. ` Pau. Riemel, Paradise t LOCATION (A.P. 66 t -30-37 ) .... ', 30 Heller Ct., lot 62, PPCC#4, Magalia r� pry • St s . BE Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E X02 G i Temp. Gas Serv. r Called PG&E JOB :v� }� FINALED (Date a,,, (Si lure) r4 L COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD DATE REMARKS OR CORRECTIONS i 00, At (7La Of� �iloo A l BUILDING BUILDING (Cont'd) PLUMBING Setback � • Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish _ 2nd Floor Footings Windows % 3rd Floor Stemwal I Siding To out Slab Roof Sheathing Water Piping11 Piers YA 31,17 Roofing Sewer4,9 - Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. Stemwall Slab Prov. for physically handicapped Heaters ppliances Carport Footings Conformance of ex. structure Gas Piping & Te"st Temp. Gas Slab Patio Final FI E -LACE Sanitat' Final Footings Footing 1 AEf I TRICAL Masonry Walls Throat �` Rough Reinf. Steel Final Fixtures Bond Beam - FIRE SPRINKLER Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown CoolingTemp. Pole Finish Ducts Underground Interior Lath Ventilation Perma n Door Closer Final Final7A O A. DATE REMARKS OR CORRECTIONS i 00, At (7La Of� �iloo A l 4�7 �° 0 it -ep - County of Butte DEPARTMENT OF PUBLIC WORKS 695 Oleander Ave., Chico — 343-4211, Ext. 70 7 County Center Dr., Oroville — 534-4541 Skyway and Elliott Rd., Paradise — 877-3435 CORRECTION NOTICE ...................................................................................................................... Building or Property Address A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected.,. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. Date.............................. Inspector ................................................ Do Not Remove This Tog (400-4) 4�S �& G. Senior Citzens 1. Goal Crganize and coordinate a senior citzens Area. Accomplishments• Developed core group of six individuals tc Had 2 pot -Luck dinners, and have developed a li 2.Goal Increase activities and benefits for senic Accomplishments_ Talked with representative from certified supplimental health insurance for people over 6 Medi -Care. Preparing a written proposal for a THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH THE CURRENT ENERGY REGULATIONS. CALIFORNIA ADMINISTRATIVE CODE, TITLE 25. STATE OF;CALIFORNIA, IN THE BUILDING LOCATED AT: Heller Ct street o um er Tract No. �.0 Z EXTERIOR MALLS 3i11fiberglas Manufacturer O— C Thickness/Type R Value 1 1 CEILINGS Batts: Manufacturer Thickness R Value Bloom: Manufacturer O— C Thickness 8 3/4" No. Bags 26 Mt./Bag 2 5 SQ. Ft. Cyvered 1300 R Value 19 FLOORS Manufacturer V Thickness/Type ` R Value �I SLAB ON GRADE«., Manufacturer Thickness/Type R Value Width of Insulation Inches` FOUNDATION MALLS Manufactr Thickness/Type R Value ` GENERAL CONTRACTOR i�lLc. ,+�,idic�--L LICENSE NUMBER_ Br" TITLE DATE '—�.�` IN TIO CON7RAC QR . i cho l s on Insulation LICENSE NUMBER 2-12461 B 'TITLE Owner DATE 12/75", THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED.IN CONFORMANCE WITH THE CURRENT ENERGY REGULATIONS. CALIFORNIA ADMINISTRATIVE CODE. TITLE 25..STATE OF;CALIFORNIA, IN THE BUILDING LOCATED AT: Heller Ct --S rem— Lot NumbeF_Tract o. EXTERIOR WALLS 3 Z'If i b e r g l a s Manufacturer O- C Thickness/Type R Value 1 1 CEILINGS Batts: Manufacturer Thickness R Value Blown: Manufacturer O— C Thickness 8 3/4" No.e.g, 26 Wt./Bag 25 SQ: Ft. Covered 1300 R Value 19 FLOORS Manufacturer Thickness/Type R Value SLAB ON GRADE Manufacturer Thickness/Type R Value Width of Insulation Inches FOUNDATION WALLS Manufact er r Thf kness/Type R Value"" e GENERAL CONTRACT Q LICENSE NUMBER_ ZL-b 0 '1 '7 ' B TITLE 23 -DATE A,4 MSU S TZeC"�DATE' ONTRA QR g7icrh0 1 son Insulation LICENSE NUMBER .2 12 4 6 1 BfTITLE Owner12/75 COUNTY OF BUTTE — DEPARTMENT:OF PUB C ORKS 7 County Center grive — Orovi Ile, California 959 7_5' Telephone: 534-4541 / APPLICATION AND PERMIT v o w1i ­tllo 1LQ11Va UI LIM %1UUIIIy UI OUl1Q N CIIICI UIJUII LIM This permit is hereby issued under the applicable provisions of above-ment' roperty for inspection purposes. the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. X Date DIRECTOR OF P BLIC WORKS Signature.of Permit a or Agent BY Date. Y— q`" 7 I Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant ding permit expires Date BUILDING Owner . 1;L -% 1JIS'd: SQ. FT. OCC. BUILDING VALUATION /3 67 zao Mailing Address Telephone No. Vz V73' F el,s rj 40 ' Fireplace Contractor 1019 L42 /y Total Valuation r Mailing Address L/ /�` v Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ I / Building Address 1 BuilU /�� PLUMBING No. @ FEE PERMIT FILING FEE $3.00_pa �O -7/_ to �. v / �� L Each Trap 1.50 Q p Repair drainage or vent piping, 1.50 Water piping 1.50 / _4-0 Each gas water heater or vent 1.50 A. P. No.'" o -3'% Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Foe W. a t Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W Im r p ov,ements Lawn sprinkler system 2.00 . B I d Plans Recd Parcel A roval ans Approval Permit Fee $ $ Q NEW B ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 ,So Main service incl. 1 meterZOD ,ice ' ,z Additional mete'rs, each 1.00 Sub -panel (12 or less) (more t 2) �Q Single Family Er Duplex ❑ Mobil Home ❑ Others ❑ Ratllle, Conor Oven 1.00 Water Hater or Space He er 1 1.00 pa Light fixturesiele2opd2 6 R s„ s es & f i x oy�X s 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 styl``t(uL d, Ex Fan or F.A. Furn. Motor 1.00 Evap. cooler, g . disp. or W. 1.00 Z Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No.Z,6106% Classification �� r Misc. wiring ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ O 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. XI certify that in the performance of the work for which this ermit .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 3 Dy3 Heating Cooling Ventilation 2 �� Hood 2.00 Permit Fee $ $ O 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 $%l� a?0 o w1i ­tllo 1LQ11Va UI LIM %1UUIIIy UI OUl1Q N CIIICI UIJUII LIM This permit is hereby issued under the applicable provisions of above-ment' roperty for inspection purposes. the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. X Date DIRECTOR OF P BLIC WORKS Signature.of Permit a or Agent BY Date. Y— q`" 7 I Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant ding permit expires Date