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HomeMy WebLinkAbout066-360-010a u 4+-� - -- _- �- -- - - - - --- - - 66-36-10 KLEO MARSO W/S Nimshew Ridge R00' S of Ponderosa, Nimshe -mit z Permit ##2390-76E lect , e ch to existing site)MH-' ,ELEC . GAS b 1 �r � (q SUPPOR%TRUCTURE REQ. /U,U COMPACTION TEST REQ._ (%p 66-36-10 CONTR: English John MH Sales,'P Permit #3104-76MgI Issued 6, -11-76 66-36-10 Y Permit #3927-76B(2 decks/MH) 6P23f7� 66-36-10 contr: Sierra„Mobil.e Home Serv., Para. PritJ4-76B(new awnings/MH) 11 6F13', i PERMIT NO. 5034-76B PERMIT EXPIRES OWNER Kleo Marso CONTR. _ Sierra Mobile Home Service, Paradise LOCATION (A.P. 66-36-10 W/S Nimshew Ridge Rd., across from Ponderosa, ` I Nimshew 4 1 1. I r t ,It 1 Temp. Power Pole Called PG&E Temp. Elea Serv. ' Call�PG'ETemp. Gv. 'ailed PG&E JOB / FINALED '7 %+ (Date) (Signature) ..r { �- A � � ' _ j f � � .. COUNTY OF BUTTE — DEPARTD¢ENT,OF PUBLIC WORKS a BUILDING INSPECTION RECORD u BUILDING BUILDING (Cont'd) PLUMBING Setback / 2,-f4 —7 c. Firewall Soil -Piping FormsrN Parapets 1 t Floor Main g. Restroom Finish 2n Floor Footin Windows 3rd loor Stemwall Siding To out Slab Roof Sheathing ---.,'Water Pi a Piers Roofing 7 (, Sewer Garage Fdn. Vents Fixtures Footin s Stemwal I Garage Vents Insulation Water Htr. Heaters Slab Prov. for physically handicaDDed Appliances Carport Footin s Conformance of ex. structure Gas Piping & Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings /2-41-7 tY-1°- Footing ELECT I L Masonry Walls Thr t Rough Reinf. Steel — Final Fixtures Bond Beam FIRE SPRINKLEBSZ Motors Framina a,*-_ /2/& 7 G �� Test Water Htr_ Stucco Final Subpanels Mesh MEC CAL Grd. Fault Pro/ Scratch ' Heating Service Brown Cooling Temp. P le Finish Ducts Under round Interior Lath VentilatioK Pe anent Door Closer Final Final DATE l fo `7 U REMARKS OR CORRECTIONS /V/ it/ cal 6 A) !! N! 6 $ (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE DEPARTUENT OF PUBLIC WORKS %- 7 County Center Drive, - (koville, California 95965 Tel epht'ne: 534-4541 APPLICATION AND PERMIT ,�W3 _41-7� A/ UUu ur a representatives UI LIIC %,UUIIIy UI Butte io enter upon the above -me ned property for ins ction purposes. A X Date Signature of Permitee or A ent Receipt No. _/ s -/5a �/, 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 be paid. DIRECTORUBLIC WORKS BY Date BZ permit expires Date �o % BUILDING 71 Ir Owner�j.�,�+ , SQ. FT. OCC. BUILDING VALUATION a? O! Mailing Address Telephone No. Fireplace Contractor Total Valuatio ao r (p Mailing Address (o� ' Permit Fee Plan Checking Fee &/or Penalty Gk, ,CL, A Telephone No. &S ­ Permit Fee .- Building Address PLUMBING No. @ FEE PERMIT FILING FEE J$3.00 / 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. -� — / �. Z Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F6,- �re I Oration Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma p 60' R/W Im provements Lawn sprinkler system 2.00 Bldg. ans Recd .P-arCel-Approval Plans Approval Permit Fee NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL . No. @ FEE PERMIT FILING FEE $3.00 Main service 100 AMP OROR LESS5.00 Main service EA. ADD'L 100 AMP 2.50 SinSingle Family Duplex Mobil Home Others 9 Y ❑ P ❑ ❑ Main service OVER 600V 25.00 10o AMP OR Main service EA. ADD'L 100 AMP 1.00 0 AM NEW CONST.// DWELLING OCCUP. & OR ADONS. ( ACC. BLDGS. ) 20sgft NEW CONSTR. MULTI -OUTLET NON-RESID. BRANCH CIRCUITS)2.50ea NEW CONSTPOWER APPARATUS & NON.RESIR. D. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style O Y f zy ` 50 25C Ex. Occup(OUTLETS OR FIXTURES) BANL @1 1 FIXED APP LNS. OR Ex. Occup.(ouTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 � �� License No. Classification C C �_ Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ 1 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 TOT AL PERMIT FEE $ c2 UUu ur a representatives UI LIIC %,UUIIIy UI Butte io enter upon the above -me ned property for ins ction purposes. A X Date Signature of Permitee or A ent Receipt No. _/ s -/5a �/, 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 be paid. DIRECTORUBLIC WORKS BY Date BZ permit expires Date �o % 0 { e t3927 -76B ' i PERMIT NO. ' PERMIT EXPIRES 1, OWNER Kleo Marso CONTR. owner LOCATION (A.P. 66-36-10 W/S Nimshew Ridge Rd.,app.120.'S.of Ponderosa,' Nimshew y r s t 1• Temp. Power Pole Called G&E Temp. EI c. Serv. V PG&E s Serv. PG&E (Date) l (Signature) 1, , I Reinf. Steel Final I I Fixtures Bond Beam FIRE SPRINIkLERS I Motors Stucco COUNTY OF BUTTE — DEPARTMFENT OF PUBLIC WORKS BUILDING INSPECTION RECORD Subpanels BUILDING BUILDING (Cont'd) PL - MBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor StemwaII Siding To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings StemwaI I Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for physically handica ed Conformance of ex. r structure Appliances Gas Piping & Test Tem Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing 11\ ELECTR CAL Reinf. Steel Final I I Fixtures Bond Beam FIRE SPRINIkLERS I Motors Stucco Final Subpanels Mesh MECH NICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final DATA_gZ�--REMARKS O�R CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE —, DEPARI"MENT OF PUBLIC WORKS •} 7 County Center Driv, — Uroville, California 95965 Tel ed4torie: 534-4541 41�27-76 APPLICATION AND PERMIT ...cN icocnlciu v ca vi Lilt %.ULLIRy UI DUllc LU U111tt1 UPUll 111@ above-mentioned prop rty for inspection purposes. i X Date Signature f,Permitee or Agent 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. DIRECTOR OF PALIC WORKS BY -Date l�/J •� i (ding permit expires Date BUILDING go F Owner YSVSQ. FT. OCC. BUILDING VALUATION o 2LlC ,00 Mailing Address I S,4 Al J)elS0 //8 Telephone No. 3F7—o5'7/ Fireplace Contractor Total Valuation �, p 1 ' Mailing Address l�C/ Jv e--i� Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ 0 Building Address WIT ,VIAl SA 9,d Z"J PLUMBING No.1 @ I FEE PERMIT FILING FEE $3.00 PYO SLr l 0 E, 0 I= Ll e t -So q Each Trap 1.50 A G Z 14 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 // A. P. `ij" 9 — 3 Zoning &Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fe �a y'7 Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Parcel Plans Declaration Parcel Ma P 60' R/W Im rovements P Lawn sprinkler system 2.00 Bldg. Plan ss R� P a r c e Approval Plans Approval Permit Fee $ $ NEW ® ADDITION ❑ UTILITIES ❑ OTHER (1 ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 pa C_ Main service 1000 AMP ORV OR LESS5.00 Main service EA. ADD'L too AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service R 600V 1100EAMP OR LESS 25.00 Main service EA. ADD'L too AMP 1.00 NEW OCCUP. &) 2¢syft OR ADDNST ( ADWECCLBLDGLING S. 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) @SI< 100 Ex. Occu FIXED APPLNS, OR P• OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑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 TOTAL PERMIT FEE $ d ...cN icocnlciu v ca vi Lilt %.ULLIRy UI DUllc LU U111tt1 UPUll 111@ above-mentioned prop rty for inspection purposes. i X Date Signature f,Permitee or Agent 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. DIRECTOR OF PALIC WORKS BY -Date l�/J •� i (ding permit expires Date PERMIT NUMBER — B 2390-76 P � r E PERMIT EXPIRES 5/10/77 OWNER Kleo Marso +CONTR: owner { i LOCATION (A.P. 66-36-10 wls Nimshew Ridge Rd., 100' so. of Ponderosa Nimshew 147V 1^ 1` q-% s, • f r� c I 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 No B. Is there proper clearances around panels? Yes' No C. Is power supply cord or feeder assembly properly fused? Yes No D. Is continuity test satisfactory as per the following procedure? Ye`= No 1. De -energize electrical wiring system of the mobilehome at the. edestal. 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 ro.Qbiletlome supply conductor, including neutral. •.Y 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 to t'shall then be made between the grounding electrode and the chassis of the mobilehome. 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? 11. If everything okay, sign off card -and tag services. MOBILEHOME DATA Manufacturer and/or Namestyle Length Width Vehicle Serial No. P(-_1 / iet2 'x % d-- S tate Identification -No. Additional: Information or Comments: t MOBILEHOME INSTALLATION INSPECTION CHECK LIST 1: Is the mobilehome located -1 1-h required separation from lot lines and buildings and generally conform to plot plan? YesX 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 per approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes No 4. Is the mobilehome level? (Sec. 5088) YesNo_ 7V 5. I1o e than a single unit, are crossover connections properly installed? (Sec. 5088) Ye X No 6. Water A. Is flexible connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes No Test,- Does.H ter piping withstand working pressure or.50 lbs. air test? Yes No C. Ba' ow - If coach is not State of California approved, does station have backflow device and essure-relief valve? Yes No 7. Wast s and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? YesNo 74 B. Does ,it have minimum 4' per foot slope and is it properly supported? Yes No C. XAr any leaks detected in O drainage system after running 3 -gallons of water through each g fixture including washing machine standpipe?•Yes No D. If noe of California approved, does station have required trap and vent? YeNo 8. Gas iping 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 mobilehome gas line inlet without reductions other than the mobilehome connector. Yes_ X 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 411 appliance vents properly installed? Yes No DATE REMARKS OR CORRECTIONS ��-�- p` (r �� 76. �,� c,7�_.. �� `C4- COUNTY OF BUTTE Department of Public Works BUILDING INSPECTION RECORD Zoning Setback Forms Foundation Piers & Girders Fireplace Rgh. Plumbing V Bond Beam Lath & Plaster_ Rein. Steel Gas Piping & Test — Z Found. Vents Framing Plmg. Topout Rough Elec. Wtr. Htr. Furnace Kitchen Vent _ Firewall Garage Vents Sanitation & Water ELECTRIC GAS BUILDING Temporary 6 — 6 Temporary Cert. of Occup. Final Final '' Final DATE REMARKS OR CORRECTIONS ��-�- p` (r �� 76. �,� c,7�_.. �� `C4- _IR�"d'sDw+�i..i •,C'i.:�"`tX's''vr ".cY,•yV .'.:,.-...�.'." COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 4 C ERTIFICATE Of OCCUPANCY This mobilehome has been installed in accordance with the requirements of the California Administrative Code, Title 25, Chapter 5, under permit number for the following location: Owner -r C --- Owner's Address Mobilehome Mfg. '64 !--a -- a -� Model Year Insignia No. _ / 72`9�u 7 lb" serial No. ;-1l17/1// 7=•• Z It is hereby certified for occupancy at the above described location and may be occupied. Director of Public Works Date / /� y By/ THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED COUNTY OF BUTTE —JWMENT OF PUBLIC WORKS 7 County Center Drive r ovil-le, California 95965 A Tel ephorte: `541 APPLICATION AND PERMIT 3 76 " _2�0 authorize representatives of the County of Butte to enter upon the above-mentio ed property for inspect' pu oses. ate Signature of Perm+�iteee or Agent �^ Receipt No. / 9 (o I /7 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF/PUBLIC WORKS ilding permit �expir�esDat�eDa BUILDING Owner �� ® dA/ SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Fireplace _ Contractor eo;1 L 1S f,L !L4 Total Valuation Mailing Address � V o 0 Cz. dw-« � Permit Fee Plan Checking Fee &/or Penalty Aelephone !G!�}f�ls� No. Permit Fee $ Building Address PLUMBING No. @ FEE ' PERMIT FILING FEE $3.00 � � Is PhP'vl.3 qzw Each Trap 1.50 e losrn � �� Repair drainage or vent piping 1.50 Water piping 1.50 A j1K AA S HCrw Each gas water heater or. vent 1.50 A. P. No. (p - © Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fee W.C. Fire Dept. Fire Zone Use Permit Building sewer 5.00 EOA Parking Plans Parcel Declaration Parcel Ma p' 60' R/W ImprovementsLawn sprinkler system 2.00 %CPermit royal Plan - pproval Fee $ $ -Parcel NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 LL, d 01 • q9? f Main service io00o AMOR P LESSOR 5.00 Main service EA. ADD•L too AMP 2.50 Main service 1100EAMP oR LESS 25.00 Single Family ❑ Duplex ❑ Mobil Home ❑ Others El Main service EA. ADD'L 100 AMP 1.00 NEW CONST. OR ADDNS. ( ACCLBLDGLING OCCUP. &) 2¢Sgft NEW CONSTR. (MULTI -OUTLET NON.RESID. l BRANCH CIRCUITS) 2.50ea NEW CONSTR. (POWER APPARATUS & NON -REST D. SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: �c4-k3&- --ye 1-f Ex. Occup(OUTLETS OR FIXTURES)50 @25Q BAL 101 Ex. Occu FIXED APP LNS. OR P•(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 �r�Q'D (:�L PLfl­ , Mobile Home Facilities 15.00 �Misc. License No. �-lo ��C Classification C"�� 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. 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. @ I 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 above-mentio ed property for inspect' pu oses. ate Signature of Perm+�iteee or Agent �^ Receipt No. / 9 (o I /7 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF/PUBLIC WORKS ilding permit �expir�esDat�eDa COUNTY OF BUTTE — DEPAR-TMENT OF PUBLIC WORKS 7 County Center Drive -,,.1 rovi Ile, California 95965 Tel ep*one: 534-4541 APPLICATION AND PERMIT as5o �� ouu"or ze representatives UI the bounty Of Butte to enter upon the above mentioned roperty for inspection purposes. X_ Date Sign ure ofPerrm[itee or Agent / T Receipt No. + 015 -?r 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. 25XEC OR OF PUB ORKS By Date permit expires Date��� BUILDING Owner L C ��� SQ. FT. OCC. BUILDING VALUATION Mailing Address n, -i "1 e CSG u �i/9'• Telephone No. Fireplace - Contractor /t,, Total Valuation Mailing Address Permit Fee Plan Checking Fee&/or Penalty Telephone No. Permit Fee Building Address S N PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Wo 6P 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. --36 Zoning 8 Planning Gas piping system 1 - 5 outlets 1.5U Each additional outlet .30 Fe6efW. $.3Aauan I Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA PPlan arkin9 Declaration I Parcel Map 60' R/W I Improvements Lawn sprinkler system 2.00 ec Parcel Approval Plans Approval Permit Fee NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 180000 AMP ORV OR LESS5.00 S" Main service EA- ADD'L 100 AMP 2.50 r� Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service OVER e00V 100 AMP OR LESS 25.00 Main service EA. ADD'L too AMP 1.00 NEW CONST.DWELLING OCCUP. & OR ADONS. ( 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)@ZSC 104 Ex. Occup.( FIXED A OUTLETS P(RESID )REA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No.Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ SZS-b 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. XI 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 ouu"or ze representatives UI the bounty Of Butte to enter upon the above mentioned roperty for inspection purposes. X_ Date Sign ure ofPerrm[itee or Agent / T Receipt No. + 015 -?r 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. 25XEC OR OF PUB ORKS By Date permit expires Date���