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HomeMy WebLinkAbout066-410-028- AP 66-41-28 ;.+.SEPARD Charles ~� 150 Ishi Dr., unit 2, Indian Mead. PO ot 29, Rx MIN Magalia �contr: Charles Hancock, Paradise ermit d# 2434-74P,E (util, MH) P6'G 4 1 - 2-8 • CHARLES E. SHEPHARD 150 Ishi Dr., lot 29, Magalia ermit## 3732-74B (2 decks, MH)F»�-1'16'76- AP 66-41-28 CHARLES SHEPPARD 150 Ishi Dr. , lot 29.,-. "I-nd:Mead:42' cantr ACRO-LUMZ,_ Oroville 1 Permit## 4254-74B (2 awni gs, MH) AP 66-41-28 ',�..A Permit# 1479-75B, E_(gar.Age- M�ii)-G - � ? r N C PERMIT NO: 1 7,5 ,E P J E }l M FMH UTIL. PERMIT NO. z PERMIT EXPIRES ;,OWNER Charles Shephard CONTR. ;LOCATION (A.P. 66-41-28 150 Ishi Dr., lot 29, Magalia { D� t Temp. Power P le Called P &E Temp. Ele . Serv. Calle PG&E Temp. as Serv. r C Iled PG&E INALED (D te) (Signa(ure) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback'Setback'VJ6 Firewall Soil Piping Forms Parapets 1st Floor Mai Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Sidinq To out Slab Roof Sheathing 6 Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. Stemwall Slab Prov. for physically handicapped Heaters Appliances Carport Footings Conformance of ex. structure Gas Piping & Test Temp. Gas Slab Final Sanitation Patio FIRE LACE Final Footings Footing ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRE SP NKLERS Motors Framing �Ez 7t; Test Water Htr. Stucco Final Subpanels Mesh MEC ANICAL Grd. Fault Prot. Scratch j Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final o DATE REMARKS OR CORRECTIONS �• r _ 1* 1 COUNTY OF BUTTE 'DEPARTMENT OF PUBLIC S Z 7 County Center Drive i arovilie, California 95965 7F_ Tel epNone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. ( �% X to Signature of Permitee or gent Receipt No. % White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR PUBLIC WORKS By Date euil(ding permit expires Date ................... BUILDING Owner S — SQ. FT. OCC. BUILDING VALUATION 0d Mailing Address v P Telephone No. y Fireplace Contractor AZ&Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ $ d o Building Address S 2PLUMBING No.1 @ FEE PERMIT FILING FEE $2.00 D O Z 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.Gas -- ��—� Zoning 8 Planning piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fe San' n Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parc j Ma P 60' R/W Improvements p ovements Lawn sprinkler system 2.00 Bldg. Plan Recd Parcel Approval ans Approval Permit Fee $ $ NEW ® ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Single Family ❑ Duplex ❑ Mobil Home Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures bal d10 Re s., switcZes & fix ouVets 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: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ < MECHANICAL No. @ 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 oas to become subject to the Workmen's Compensation Laws of California. 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 $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. ( �% X to Signature of Permitee or gent Receipt No. % White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR PUBLIC WORKS By Date euil(ding permit expires Date ................... e � 54 • Y PERMIT NO. 4254-74B P E , M )MH UTIL. 'PERMIT NO. PERMIT EXPIRES d "�v� 7— —7 OWNER Charles Charles Sheppard f'CONTR. ACRO-LUME, Oroville 4 LOCATION (A.P. 66-41-28 ) 150 Ishi Dr., lot 29, Magalia j - 1 Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E JOB FINALED (Date) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS r BUILDING INSPECTION RECORD UILDING BUILDING (Cont'd) PLUMBING �- Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. Stemwall Slab Prov. for physically handicapped Heaters Appliances Carport Footings Conformance of ex. structure Gas Piping & Test Temp. Gas Slab Final Sanitation Patio IVFIREPLACE Final Footings Footing ELECTRICAL Masonry Walls Throat Roucih Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final DATE REMARKS OR CORRECTIONS —1 ' f COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WOR S 7 County Guenter Dl'ive Orofille, California 95965 ��✓fff Telephone: 534-4541 / APPLICATION AND PERMIT r2� / authorize representatives of the Cp0ty of Butte to enter upon the above-mentioned pr=nat X D 7 ignature of Permittee or nt Receipt No. �(0 3 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 aoove for which fees have been paid. DIRECTOR 0 PUBLIC WORKS By Date I; ellding permit expires Date ...............1.... BUIL NG Owner -SQ. FT. OCC. BUILDING VALUATION Mailing Address ` J� -- Lf Telephone No. 'R77— q4`5 7 Fireplace Contractor N Total Valuation 1 Mailing Address f-" C, . ('J L V Permit Fee Plan Checking Fee &/orPenalty QB U 1LL J; !i 1 a - Telephone No. Permit Fee $ ©—() $ Building AddressPLUMBING ^_s No. @ FEE PERMIT FILING FEE $2.00 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. — �/ Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F s Lol So on I Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel p 60' R/W Improv ents Lawn sprinkler system 2.00 g. Plans Recd Parce Approval Plans Approval Permit Fee $ NEW ❑ ADDITION ® UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Single Family ❑ Duplex ❑ Mobil Home ® Others ❑ Range, Cook -top or Oven 1.00 =JZF.0 r• ti v 7�� _ Water Heater or Space Heater 1.00 Light fixtures bat 610 Receps., switches & fix outlets b (025 �. — A0 L4 C le ie, o 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:4-Water ceo �1 C_ Hood, Ex. Fan or F. A. Furn. Motor 1.00 Evap. cooler, gar. di sp. or D.W. 1.00 Air conditioner or heat pump pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification C`61 Misc. wiring ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ MECHANICAL No. @ 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. F]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.$ PERMIT FILING FEE $3.00 Heating Cooling Ventilation 42.00 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 authorize representatives of the Cp0ty of Butte to enter upon the above-mentioned pr=nat X D 7 ignature of Permittee or nt Receipt No. �(0 3 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 aoove for which fees have been paid. DIRECTOR 0 PUBLIC WORKS By Date I; ellding permit expires Date ...............1.... } PERMIT NO. 3732_74B P E M MH UTIL. PERMIT N0. PERMIT EXPIRES OWNER Charles E. Shephard CONTR. LOCATION (A.P. 66-41-28 ) 150 Ishi Dr., lot 29, Ind.Mead.#2, Magalia I , % Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E k r r JOB FINALED (Dat ) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING .SetbackFirewall Soil Piping Forms — Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Gara a Vents Water Htr. Stemwall Slab Prov. for physically handicapped Heaters Appliances Carport Footings Conformance of ex. structure Gas Piping & Test Temp. Gas Slab Final 2gaL --- Sanitation Patio FIREPLACE Final " Footings Footing ELECTRICAL Masonry Walls Throat Rou h Reinf. Steel Final Fixtures Bond Begm FIRE SPRINKLERS Motors FramingTest Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final DATE REMARKS OR CORRECTIONS COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WO 'r 7 Count] Center. Y Drive ' = Oroville, California 95965 Telephone: 534-4541 / v� APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. Date Signature of Permitee Agent Receipt No. �/ ;)- 7 0 — 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 P BLIC WORKS By Date 42_-Z -7Z B1,Iding permit expires Date...................y.:�.0 BUILDING Owner % �r SQ. FT. OCC. BUILDING VALUATION Mailing Address � �G. ,� " T lephone Fireplace Contractor Total Valuation Mai I i ng Address Permit Fee 40 U Plan Checking Fee &/or Penalty Telephone No. Permit Fee Building Address �' oe PLUMBING No. @ FEE PERMIT FILING FEE $2.00 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. .- ( Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fees W.C. Sa ill V' Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA I Parking Plans Parcel Declaration Parcel Ma p 60' R/W Im rovements p Lawn sprinkler system 2.00 Bldg. fans Parcel proval Plans Approval Permit Fee NEW ❑ ADDITION ❑ UTILIT,IES ❑ OTHER Q ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Single Family ❑ Duplex ❑ Mobil Home ®Others ❑ Range, Cook top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures bal'10 Receps., switches & fix outletsHm 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: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring I am exempt from the Contractors License Laws of the State of California. Permit Fee $ MECHANICAL No. @ 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. —14 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. 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 relatinq to buildinq construction, and hereby PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ TOTAL PERMIT FEE $ G� authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. Date Signature of Permitee Agent Receipt No. �/ ;)- 7 0 — 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 P BLIC WORKS By Date 42_-Z -7Z B1,Iding permit expires Date...................y.:�.0 e _v 1 r PERMIT NO. ' 1 �l. - P E M MH UTIL. `PERMIT NO. 2434-74P.F 1�1 4� PERMIT EXPIRES ,',OWNER Charles Sheghard �,CONTR. Charles Hancock, Paradise 1�. «LOCATION (A.P.. 1 66-41-28 - 150 Ishi Dr., Indian Neadows##2, lot 29, Magalia fb ti at i� Temp. Power Pole Called PG&E Temp. E-lec. Serv. Called PG&E Lb V Temp. Gas Serv. Called PG&E JOB r, l FINALED _ (Date) ignature ��- COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Pi p in Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr., Stemwall Prov. for physically Heaters Slab handicapped Appliances Carport Conformance of ex. Gas Piping & Test — Footings structure Temp. Gas Slab Final Sanitation Patio FIREPLACE Final 7) — l _) Footings Footing ELECTRICAL Masonry Walls Throat Rou h Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prof. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final ^ d DATE REMARKS OR CORRECTIONS 17 °lam - 0 COUNTY OF BUTTE — ,-DEPARTMENT OF PUBLIC WORKS 7 County Center Drli;A `'OroviIle, California 95965 ��� Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X /0— J ,/11=, :;_ . Date ��Signature of Permitee or Agent Receipt No. —� 2���� 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. DkRICTORAF _Pu6LIG 4ORKS ByA���Date I-- / L Building permit expires Date .......... ....../.....`.� BUILDING Lol Owner SQ. FT. OCC. BUILDING VALUATION r Mailing Address • C Telephone No. Fireplace Contractor 944 Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty � Telephone N Permit Fee Building Address, 11 PLUMBING No. @ FEE PERMIT FILING FEE $2.00 0 Js 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. — 7 Zoning &Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F s Senile"eR- FireDept. FireZone Use Permit Building sewer 5.00 EQA Parking Plans I Parcel Declaration Parcel Ma p 60' R/W Improvements p Lawn sprinkler system 2.00 Bldg. Plans Recd I Parcel Approval Plans Approval Permit Fee F6 $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Single Family ❑ Duplex ❑ Mobil Home Others ❑ Range, Cook -top or Oven 1.00 �� Water Heater or Space Heater 1.00 Light fixtures bal dio Receps., switches &fix outlets 20 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: „ C&Mobil Hood, Ex. FanorF.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Home Facilities 5.00 Temp. Power Pole 5.00 ccll / License No_ _lr> 5o Classification Misc. wiring ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ MECHANICAL No. @ 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. PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 1 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 $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X /0— J ,/11=, :;_ . Date ��Signature of Permitee or Agent Receipt No. —� 2���� 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. DkRICTORAF _Pu6LIG 4ORKS ByA���Date I-- / L Building permit expires Date .......... ....../.....`.� COUNTY OF BUTTE — DJEPARTMENT OF PUBLIC WO S 7 County Center Dr -W, ' Oroville, California 95965 Telephone: 534-4541 )APPLICATION AND PERMIT � �SV_1--2V 1196 Signature of Permitel(or Agent ✓ p � :2 / � By Date. Recei t No. White-D.P.W. — Yellow -Assessor — Pink-Inspector—Goldenrod•Applicant B ding permit expires Date..........................'.75..... BUILDING Owner �o� SQ. FT. OCC. BUILDING VALUATION Mai I i ng Address Telephone No. Fireplace Contractor Total Valuation Mai I i ng Address Permit Fee Plan Checking Fee &/or Penalty elephone No. Permit Fee $ $ Building Address -0 'Z PLUMBING No. @ FEE PERMIT FILING FEE $2.00 t P 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. �� , — /C �n� % Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F W a n Fire Dept. FireZone Use Permit Building sewer 5.00 O� EQA Parkin arcel Parcel Ma Plans Declaration P 60' R/W Improvements Lawn sprinkler system 2.00 f� Cbs Recd '9 Ncc ,g a9,"F a 1' Rppr�ooy Plan praval Permit Fee $ $ NEW [JADDITION ❑ UTILITIES OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 3 j Main service incl. 1 meter Cj Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Single Family ❑ Duplex ❑ Mobil Home ® Others ❑ Range, Cook -top or Oven 1.00 Soo SQr ��,c/ Water Heater or Space Heater 1.00 Light fixtures boIN 10 Receps., switches & fix outlets r CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of Ca 'fo is Business & Pro s' s Code under t name style of: i Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 _Z 6 Temp. Power Pole 5.00 License No. �. Classification _,27 Misc. wiring ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ MECHANICAL No. @ 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 Wor`kmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. certify that in the performance of the work for which this 2permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. PERMCT 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 authorize representatives of the Cou of Butte to enter upon the above-menti.omd property for i ec on purposes. )�_ZZ,L to TOTAL PERMIT FEE $ 5 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 PABLIC WORKS Signature of Permitel(or Agent ✓ p � :2 / � By Date. Recei t No. White-D.P.W. — Yellow -Assessor — Pink-Inspector—Goldenrod•Applicant B ding permit expires Date..........................'.75.....