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HomeMy WebLinkAbout069-090-026. -' .. i-!� Mary A . Roge s ��� /��� /,� 12 Hangin Tree Ct. , lot 3, ��2A,Orw1. Permit �� 22-78P,E(uti � � ; ' ELEC. ` GAS- SUPPO RUCTURE REQ.�� COMPACT � TEST �. ��a �///� ntr: Orovil � Trailer S 1-^a es, Oro. Pemit ��6962-"'r8� Issued /a ��r7� �TVQ- G V contra Hones Mobile Home Serv., Oro. Permit ��1050-79B(new awnings &deck/MH moi__. _ e 4 i . -' .. i-!� Mary A . Roge s ��� /��� /,� 12 Hangin Tree Ct. , lot 3, ��2A,Orw1. Permit �� 22-78P,E(uti � � ; ' ELEC. ` GAS- SUPPO RUCTURE REQ.�� COMPACT � TEST �. ��a �///� ntr: Orovil � Trailer S 1-^a es, Oro. Pemit ��6962-"'r8� Issued /a ��r7� �TVQ- G V contra Hones Mobile Home Serv., Oro. Permit ��1050-79B(new awnings &deck/MH moi__. _ e cril, ff M PERMIT NO. 7221-78P,E t /j PERMIT EXPIRES Mary A. Robers OWNER CONTR. owner 34-66-26 LOCATION (A.P. ) 12 Hanging Tree Ct., lot 43, KR#2A, Oroville Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. f Fet,. Called P JOB /r FINALED (Da ) (Signature) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING 7 BUILDING (Cont'd) PLUMBING etback Fir all Soil I in F ms Para is 1 stV Ioor In Bldg. Restro Finish 2nd Noor ootin s Windows 3rd FI r St wall Siding To out Slak Roof Sheathlba Water PI in Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Stemwal l Garage Vents Insulation Water Htr. Heaters Slab Carport Footings A Prov, for physically handica ed Conformance of ex. structure Appliances Gas Piping &Test Temp. Gas Slab Final Sanitation Patio fIREPL CE Final Footin s Footing E ECTRICA Masonry Waill Throat Rou h Reinf. St el Final Fixtures Bond B96M FIRE SPRINKLEE& Motors Framina Water Htr. Stucco l Subpanel Med MECHANICAL LHea Grd. Fah Prot. Sc Itch i Servicwn ng T p. Pole finish s der round erior Lath V ntilation ermanent oor Closer final final MOBILEHOME UTILITIES --------------•--- Elec_ Service _ Elec. Pedestal Water Piping . , % Sewer —� .� Gas Piping s" i I E 3ME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity --% Water Piping —7 Drainage Gas Piping DAT€ ��-�7REMARKS OR CORRECTIONS 4M /y(6 j'63 cA4D o2 �D S. i9 /V'(� �' 01-i7p� _ '� p�Z p .� CID ( �7q�(Z (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 OROVILLE, CALIF. - 534-4541 .t 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. -7 for the following location: /2 1111•il-161- SFA Owner dYI✓Ir1-� � /16 c;e S Owner's Address .5Arr1 F� Mobilehome Mfg. R E1ki1 ;V_ Moder Year 7k Insignia No. 0 04 f Serial No. It is hereby certified for occupancy at the above described location and may be occupied. G Director of Public Works Date 7 ' / $ �: ,1YL�r J, By I THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED White - Owner, Yellow - Installer, Pink - D.P.W. MOBILEHOME INSTALLATION INSPECTION CHECK LIST 1. Is tie mobilehome"located with required separation from dot lines and buildings and generally conform to plot plan? Yes-&,-'No- 2. es No2. Does the mobilehome have required clearances above ground? (Sec.5085) Yes v No 3. Are footings and supports properly sized, spaced, and braced as pe approved plans? (Note possible variation at spring shackles.) (Sec.55082 & 5083) Yes No 4. Is the mobilehome level? (Sec. 5088) Yes &I - No_" 5. If mor�than a single unit, are crossover connections properly installed? (Sec. 5088) Yes l No_ 6. Water A. Is fle . le connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes No_ / .B. Test - Does water piping withstand working pressure or 50 lbs. air test? Yes, No Eackflow - 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? Yes -•'1 No C. Are any leaks detected in drainage system after running3-g ons of water through each fixture including washing machine standpipe?..Yes Nom A p 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 mobilehome gas line ihl'et without reductions other than the mobilehome connector. Yes �o / B. Test OK as per following procedure? Yesv No Open all appliance connector valves. 42! Shut off appliance burner and pilot valves. 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. Connect gas meter to mobilehome with connector, turn on gas, test connections with soapy water. C._ Are all appliance vents properly installed? Y.esad No 9. Electrical A. Is service large enough to -provide -adequate amperage -to mobilehome (must equal rating,of mobilehome with a minimum of ,10 an�p) and other facilities on lot, i.e., water puop�,'" garage, cabana,' etc.?. Yes o B. Is there proper clearances around panels? Yes C. Is power supply cord or feeder assembly properly fused? Yesc_, o D. Is continuity test satisfactory as per the following procedure? Yes_LZI�o De -energize electrical wiring system of the mobilehome at the pedestal. Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected. I -Switch all breakers and switches in the mobilehome to the "on" position. // Connect one lead of a test instrument to the mobilehome grounding conductor and apply the other lead to each mobilehome supply conductor, including neutral. 1. 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.. 61.1/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 the electrical tests, the lot or site service equipment may be approved for energizing. '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 %60, 7�- Length Width Vehicle Serial No. State Identification No. DIAL PD -_2-3-21? % :f 16 Additional Information or Comments: r COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS y 7 County Center Drive - Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT all LIIVI IIU [UPICJCIIIGtI VCJ UI IIIC k UUIIIjr UI DUMC LU CrIICI UPUII Ir1C above-mentioned property for inspection purposes. is Dat5-1-71 74atur of P %ift aAggent 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. DIREC76-RO-V6JBLIC WORKS BV Date /Z' Z -C^ -71P wilding permit expires Date zz, - 79 BUILDING OwnerSO. 2r FT. OCC. BUILDING VALUATION Mailing 07UQ JA o %J 950,5/ &_ Telephone No. Contractor Mailing Address Fireplace Total Valuation Telephone No. Permit Fee i Building Address �cet PI an Checking Fee Vor Penalty Permit Fee nplD Y501 e el 1E, tt PLUMBING No. @ FEE PERMIT FILING FEE $3.00 "S.Cx!> Each Trap 1.50 b6f- 6,4'4 2,A Repair drainage or vent piping 1.50 e' A. P. No. °-(0(, -2-4 ,3 7 1 Pt-J-71PIonning Water piping 1.50 /U, ®G Each gas water heater or vent 1.50 "Nes San Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 /O,ac) EOA Parking Plans Parcel Declaration Parcel Map 60' RI Improvements Each additional outlet .30 sewer 5.00 •v, 0C.0Bldg'14ans '\Building Recd Parcel Approval Plan pprov.al Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ® OTHER ❑ Permit Fee $ 33,00R 3 O ELECTRICAL No. @ FEE ov PERMIT FILING FEE $3.000V OR Main service 100 AMP ORSLESS 5.00 pe) Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service EA. ADD'L 100 AMP 2.50 2_:50 Main service OVER 25,00 V AMPP OR LESS Main service// EA. ADD'L 100 AMP 1.00 NEW OR AODNST %ACC•SLOGS.LING CCUP. 71\ 22sgft l/ CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business 81 Professions Code under the name style of: NEW CONSTR MULTI.OUTLET NON.CONST ( BRANCH CIRCUITS) 2.50ea NEW CONSTR. (POWER APPARATUS a NON•RESID. SINGLE OUTLET CIR. Ex. OCCU()(OUTL.ETS OR FIXTIIRES g � ,� FIXED APLNS. Ex. Occup. ( OUT ETS P(RESID )REA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 21`a`m­­exernpt from the Contractors License Laws of the State of California. Permit Fee $ ,9 $ 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. 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 I Land Development Fee $ TOTAL PERMIT FEE $ all LIIVI IIU [UPICJCIIIGtI VCJ UI IIIC k UUIIIjr UI DUMC LU CrIICI UPUII Ir1C above-mentioned property for inspection purposes. is Dat5-1-71 74atur of P %ift aAggent 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. DIREC76-RO-V6JBLIC WORKS BV Date /Z' Z -C^ -71P wilding permit expires Date zz, - 79 . 4 ..:i. I r, COUNTY &F BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT out, rurI" reNreZSentauves�or-tne uounty or tsutte to enter upon the above -mention -6d tinned property for i:rispection purposes. X Zt6�� Date Signature offfPeeC itee or Agent Receipt No./I-- 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. DIRECT BLIC WORKS ByDate !v- yf� 7� ilding permit expires Date _ z"—,F- 7% BUILDING Owner t. ` SO. FT. OCC. BUILDING VALUATIO Mailing Address Telephone No. Contractor Mailing Address17' Fireplace Total Valuation Telephone NV Permit Fee Building Address Plan Checking Fee&/or Penalty Permit Fee PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 ©]� k- 0 Repair drainage or vent piping 1.50 A. P. No. Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 ire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 Bldg. Plans roval PI s Approval Lawn sprinkler system 2.00 ___Eacel NEW ❑ ADDITION F -UTILITIES ❑ OTHER ❑ permit Fee $ $ ELECTRICAL No.1 @ I FEE PERMIT FILING FEE $3.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 Single Family ❑ Duplex ❑ Mobil Home B�-- OthLys ❑ Main service EA. AOD'L 100 AMP 2.50 Main service OVER 100100 AMPsoov OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW OR ADDNST // 1 ACCLBLOGSDWELING CCUP. 51� 22sgft CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code un er the name style 0 o TLET NEW RESID,CONS�BRANCH CIRCU \ NON-RESID l BRANCH CIRCUITS/ 12.50ea NEW CONSTR. ( POWER APPARATUS & NON-RESID. SINGLE OUTLET CIR. 2154 Ex. OCCUD(OUTLETS OR FIXTIIRES g L 1 FIXED APPLNS. OR EX. Occup.(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 / License No. c2i � � 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 whic equires every employer to be insured against liability for Wo en's Compensation. i I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 1 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.1 @ FEE PERMIT FILING FEE J$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 $ 0004 TOTAL PERMIT FEE $30 04 out, rurI" reNreZSentauves�or-tne uounty or tsutte to enter upon the above -mention -6d tinned property for i:rispection purposes. X Zt6�� Date Signature offfPeeC itee or Agent Receipt No./I-- 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. DIRECT BLIC WORKS ByDate !v- yf� 7� ilding permit expires Date _ z"—,F- 7% NOTE:—AII Materials & Workmanship Shall Be in Accordance with Recognized Good Practices and " of a quality prescribed for the Specified use in the Uniforp Building, Plumbing & Machanical Codes and the Nitiona7 *leci~ric—al- ;tiidLe:— - ..:....,.. /16P. 99 ` This sof p lans and specifications ML e kept on t e job at all times and it is unla, make any r-hanges or alterations on same written pe"isson from the Department of Warks, Ca -ntY of Butte. Yn; All utility connections sha I be located within 4 ft. outside th rear »-� —;---�---� third section of the mobile ome to. ,sem on the left (road) side of the obile ,ui ! home. a� m o 0 s .O m 0� O •u- E } iJ C.' 0 4- J-0. jO. e�j 6 M/! The W*g Setback shall be 5 ft. from t e side prol.erty line and 50 ft. from t e cen'terlin of the road, permitting a merlin ff. eave overhang but entir ly out of all easements. -77,141-1 BUT74 COUNTY BUILDING DEPARTMENT ,4'J"I' l i —R Z' ,.¢:f APPROVE® 1. Owner's name: 2. Installer's na BUTTE COUNTY DEPARTMENT OF.PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 P � e MOBTLEHOME INSTALLATION SHEET 3. Is the site currently under permit? Yes I/ 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 mobilehome be located at least 5 ft.awayfrom septic tank and leach fields and clear of all setbacks and easements? Yes l%/ No (If no, clarify, ) ( ) 5.' What is the mobilehome electrical rating? ----=------------------ /00 Amps 6. What is the mobilehome site service rating? --------------------- �'Amps 7. What is the mobilehome site circuit breaker rating? ------------- %d 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 ofgasservice?---------------------------- Natural / / LPG 11. What is the gas pipe length from meter or tank to he mobilehome? (ft.) 12. :What is the mobilehome gas demand? ------------- ---------------- (BTU) (This information not required if pipe leng h lesss than 6 ft. on n to al has or less than 50 ft. on,LPG.) C��'/ MOBILEHOME SUPPORT DATA 4�v sm a dKA If other than single wide, Mobilehome Mfr. APA)Z-44c furnish Setup Model No. - Year Width -(ft.) Box Length ,.6 (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 -supports measured from front of mobilehome unless otherwise specified. Center support locations* (ft.) (in.) R��] (ft.)(in.) (ft.)(in.) (ft.)I (in.) (in.) (in.) Center support footing sizes (in.) (in.) (in.) (in.) (in.) Fa W44 - (in.) (in.) (in')I (in.) Single *If center piers are other than drawn above, draw in -locations, spacing, and'dimensions. Footings (check one) 1. Wood either pressure treated or foundation grade. D 2. Other (specify) Su orts (check one) 1: Concrete block. 2. Other (specify) 4 -Tagalong or Expando, show support details. x�J -- Typical Support .) (in.) Footing Size (ft.)(in.) I a D I (ft.)(in.) -- Max. Pier Spacing -- Max. Overhang BUTTE COUNTY BUILDING DEPARTMEN' APPROVED Dec. 13, 1978 BUILDING DEPARTMENT OROVILLE, CA. To Whom It May Concern: I hereby authorize my son, Gregory K. Rogers, to obtain for me a building permit on my lot located in Kelly Ridge Estates. Sincerely, Mary A. Rogers 2707 Donovan Ave. Santa Clara, Ca. 95051 P 1050-79B PERMIT NO. PERMIT EXPIRES ✓/ 0/y 6 ti OWNER Mary Rogers Holmes Mobile Home SERv., Oroville CONTR. LOCATION (A.P. 34-66-26 12 Hanging Tree Ct., lot 43, KR#2A, Oroville Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E JOB FINALED ! v7 (Date) 4kQIA-&�, (Signature) L. r i. COUNTY OF BUTTE —• DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback 7 27--7 Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish A 2nd Floor Footings Windows I V 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents 14 Fixtures Footin s Stemwall y Garage Vents A Insulation / Water Htr. Heaters Slab Carport Footings Prov. for phsically Chandicaped x. Conformance of e structure Appliances Gas Piping est Temp. Gas [Sanitation Slab Final --.i Patio FIREPLACE Final Footings Footing ELECTRICA Masonry Walls Throat z Rou h Relnf. Steel Final Fixtures Bond Beam I FIR PR NKI ERS Motors nal Mesh , / 1 ME4HANICAL I Gird. Fault Prof. \ Scratch Heatino Service Brown Cooling Temp. ole Finish Ducts x Und Oround Interior Lath Ventilation Pe anent Door Closer Final Findi MOBILEHOME UTILITIES ------------------ Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping MOBIL�EHOME� INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE .— D'ARTMENT OF PUBLIC WORKS ;. 7 County Center Drive - Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT /050 �9 ' BUILDING ZZ Owner SQ. FT. OCC. 1, BUILDING VALUATION lSd U Mailing Address Telephone No. Contractor Mailing Address (, Fireplace Total Valuation Tel &ne No. Permit Fee 2 Building Address Plan Checking Fee &/or Penalty Permit Fee Z4 PLUMBING No.@ FEE I a PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 A. P. No. Doing & Planning Water piping 1.50 Each gas water heater or vent 1.50 Flees WA -;J Qajj Fire Dept. Fire Zone Use Permit Gas piping system 1 -5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improveme is Each additional outlet .30 Building sewer 5.00 Bldg. ns ec'd Parcel royal s Approval Lawn sprinkler system 2.00 NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ Permit Fee $ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 Single Family ❑ Duplex❑ Mobil Homexr Others ❑ Main service EA. ADD'L too AMP 2.50 t ' Main serviceVER 600 v 0 AMP OR LESS 25.00 Main service EA. ADD•L 100 AMP 1,00 NEW CONST. DWELLING OCCUP. Y OR A.D.S. ACC, BLDGS. 20sq 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 CON MULTI.OUTL T NON.RESID BRANCH CIRCUITS 2.50ea NEW CONSTR. (POWER APPARATUS .&, NON•RESID, SINGLE OUTLET CIR, 250 Ex. Occup{OUTLETS OR FIXTIIRES 6 L Ex. QCCU FIXED APPLNS. OR p•(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Z License No.�,L%� 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 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 1 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 Land Development Fee $ TOTAL PERMIT FEE is2-% authorce representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X YM4Date 71 ignature of Permitee or Agent � Receipt No. ! eco 1.6p 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. DIREOf0% OF PUBLIC WORKS BY Date��6 uilding permit expires Date �����