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HomeMy WebLinkAbout069-130-0339 r enn tOP,9-347 510 Silverleaf Dr., lot 84, KR#1, Oro. Permit f062 ,MH, ELEC. ^/ ` GAS i120-r+.e - SUPP T STRUCTURE REQ. COMPACTION TEST REQ. i Mve? 34=&2z -M cont--r:Carneros Mobile Transport, Napa Permit #183r--77MHI Issued 19-13-33 Permit 1284-79B(new carport/MH) i Permit117103-79B(new d' deck) 9 •�3- ' . 69-I3-3' Contr; Sandy Schlesinger Const, Oro Permit #3506-82B(cabana7s0 ariu MH [cflia�i���M� Q0G iaJ 3506-82B c ` PERMIT NO. (see 7103-79) J� � PERMIT EXPIRES `( E, OWNER EDRIENNE TOMAY CONTR.Sandy Schlesinger, Oroville ASSESSOR PARCEL 69-13-33 LOCATION 510 Silverleaf Drive, Oroville _ Temp. Power Pole Called PG&E Temp. Elec. Servi Called PG&E Temp. Gas Service Cal led PG&E A JOB FINALED (Date) Signature = OK = Not OK = Not Applicable MOBILEHOMES = Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except N's Date DEC OVERS, CARPORTS, ETC. (Plans) OK except q's 1. Zoning Requirements—Setbacks—Easements Zo' gRequirements—Setbacks—Easements 2. Soils; Special MH Support—Sketch _ ootin s; Size—Depth—Spacing—Connectors 3. Sewer; Location—Test—Fall-C/0—ConcretepM,Girders and/or Joists— kin racing—Stairs— rls ^Wood 4. Water; Location—Test—Easement Needed (Sketch) Awn.; P t e r Gond ct�.—_Siir — fg.—Bracing 5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete _ 5. Alum. Awn.; olumns—Connections—Splice—Decal—Enclosures _ 6. Gas; Location—Test—Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows—Doors- 7. Utility Clearance _ 7. Elec. I Date d -BI aAe rZ D Card -BI Date Card - BI Date Card -BI Date Card -BI Date , bra -BI _ a Card -BI Date Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements—Setbacks—Easements Date POOLS (Plans) OK except N's 1. Setbacks—Easements 2. Footings; Size—Spacing—Marriage Line 2. Soils; Compaction—Structure Stability 3. Gas; MH Test—Demand—Valve—Connector 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining _ 4. Electricity; MH Test—Crossovers—Breakers—Clearances 4, Elec.; Receptacles and Lighting; Distances—GFI 5. Drain; MH Test—Fall—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI 6. Water; MH Test—Regulator—Connector 7. Water and Sewer Connected—C/O to Grade—HD Approval 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed 7, Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater 8. Gas and Electricity Tagged 9. Exits; Insp.—Sketch 10. Cert. of Occupancy 8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg. Boxes—Enc losures— Pane lboards—Ins. to Main in Conduit 9. Health Department Approval 10. Plumb; Cir. Test—Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B-1 Date Card -BI Date Card -BI Date Card -BI Date J OK ' 0 = Not OK - = Not Applicable RESIDENTIAL Single and Duplex) � Not Ready Date UNDERFLOOR Plans OK exceptq's Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Stemwalls; Garage; Steel-Blockou(s-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic - B. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10, Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground, 12. 13. Plenums & Ducts; Clearance -Material -Support -Ins. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Card -BI Date Card -BI Date Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FINAL (Plans) OK except N's 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date _ Date Card -BI Date PLUMBING (Permit) OK except q's 14. Water Ht.; Vent -Access -Combustion Air 57. 58. Smoke Detector Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meth. Protection 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.: Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting _ 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access _ 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19._ Gas Pipe; Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth Card -BI Card -BI Date Card -BI Date Date Card -BI Date 64. Elec. Outlets at Wood Panel; Int. & Ext. 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 66. 67. Elec. Outlets & Receptacles at Kit. Counter Garage Fire Door; Swing -Landing -Closer Date . ELECTRICAL Permit OK except k's 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor -Meth. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 22. Size Boxes & No. of Conductors -Stapled 70. Plb., Elec. & Mech. Equip. Listed for Location _ 23. Romex Installed Close to Edge of Studs & C.J. 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. Insulation -Foam -Looked in Attic E] Yes - 25. 2 Appliance Circuits in Kitchen &Conductor Size Guard Rails &Deck Construction -Post Caps - 26. Subfeed Wire Size i / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes -_ - 27. _Insulated 28. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or At, Neutral "-'Yes 0 N Service -Riser Conductors & Ground -Main Disconnect 75. Following tnstld.: Drive g ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑Yes ❑No 76. Stucco; Brown -Finish _-_ 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77, A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet _ 30. Clothes Closet Light -Shower Light - 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. - -- Card B -I Card B -I ------------- ---- ----•-- _ _Date_ _ _ Card BI _ Date Date Card -BI Date 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground 81. Ventilation throughout House 82. Glass Protection Date MECHANICAL (Permit) OK except M's 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric _ 31. 32. 33. A.C. Ducts; Insulation &Support _ Vent Fan; Exhaust above Insulation Condensate Drain _& Overflow; Size & Grade 85. Water & Sewer Connected -C/O to Grade -HD Approval 86, Energy Compliance Certificate -Other Certificates 34. 35. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet Attic Access & Platform if Furnace in Attic Card -BI Card -BI ----------- - - Date - - Card -8I_ Date Date Card -BI Date Card -BI Card -BI Date Card -BI Date Date Card -BI Date Card -BI Date Card -BI Date Date FRAMING(Plans) OK except q's Comments at Final: _ _ 36. _37. 38. 39. Sills; Proper Material & Anchors _Walls; Studs -Nailing, Spacing & B_racing-_Plates-Sound Bearing Walls over Girders & Floor Nailing--- Draft Stop in Walls (rat proof) _ _ 40. _Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. 42. 43. 44. 45. 46. 47. Header & Beam -Size & Bearing Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin -Roof Brac.-Truss-Shthnp.-Ring. Fireplace Ties or Type A Flue -Fireplace Throat Attic Access: Size & Romex Protection -Draft Stop -Ins. Baffles Bdrm._Windows or Exiting Doors -Sill Hgt. & Dimensions_- - Garage Fire Protection Framing (NOTE: Anentrymust be made each time youvisit jobsite) -. 1. 11 .,/ __ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, Califofnia 05955 - Telephone 916/534-4541 APPLICATJON AND PERMIT PERMIT NO. 4—d -.2) eiiiiiiw,) ASSESOR PARCEL NUMBER `1 ZONING BUILDING PERMIT OWNER rnany V TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNE 'S AI I G ADDRESS Co TRACTOR'S NA4E n4-01 ITELEPHONE O ' CONTRACT R'S MAILING A OR a Fireplace CONSTRUCTION L NDER KNOWN Total Valuation I $ 44 -IR D Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ t' Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ 1AD ID0 BUILDINGS OADDRES SS PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 •MAP Water piping 5.00 LOT NO.SUBDIVISION NAME PARCEL Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF ❑ Duplex ❑ Mobi lehome [pl<ther SPECIFY Building sewer 5.00 Mobile Home -Fs--FG W1 110.00 e � TYPE OF WORK Addition R �jmodel ❑ Utili ❑11 Install, 'on❑ Other ❑ New ❑ � Describe work: Jr�l apcl 0 Vv► abBVVN i _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee !20 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW OR ADDNST (AC C�SLDG U &� 21/2¢Sgft 2p CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professi s Cod and my license is in full force and effect. License No. A Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEWCONSTRL If MULTI -OUTLET 2,50 ea NON .RESID. BRANCH CIRC ITS NEW CONSTF;L !POWER APPARATUS If) NON-RESID. ILSINGLE OUTLET CIR. Ex. OCcup(OUTLETS OR FIXTURES eq ®g3 Q FIXED APPLNS, OR EX. Occup. OUTLETS (RESID,) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject • to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating Cooling Hood 3.00 Ventilation permit Fee iL 22 Contractor 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 authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date 9�— Signature f Applicant — Owner❑ Contractor Agent n An OSHA permit is required for ex ovations ove 0 ' deep and molition or construct- ion of structures over 3 stories in eight. Mobile Home Installation Fee $ Q 7 TOTAL PERMIT FEE $ t� occuP. GROUP �Li(J I TY_P�FSE�ONST TJX A`/ PARC D HD Issu This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIREC , OF PU IC WORKS 10� By Date PERMIT EXPIRES Date Receipt No. r�� fig` `. WHITE-D.P.W., YELLOW -ASSESSOR, PINK-INSPEC O GOLDENROD- PPLICANT •�. /1'I �1 18� t PERMIT NO. 862-77P.E PERMIT EXPIRES OWNER Edrinne E. Tomany CONTR. owner LOCATION (A.P. 34-62-33 510 Silverleaf Dr., lot 84, KR#1, Oroville Temp. Power Pole Called PG&E Temp. lea Serv. C led PG&E L!—�o1� " 22 Te p. Gas Serv. Called PG&E JOB 0-4 FINALED (Date) Al C , (Signature) Stucco COUNTY OF BUTTE-. DEPARTMENT OF PUBLIC -WORKS BUILDING INSPECTION RECORD - -j Subpanels BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor 1.001, Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Pi I Piers Roofing Sewer Garage Fdn. Vents Reures Footings Stemwa I I ge Vents Insula Water Htr. Heaters Slab Carport Footings Prov. for p scally handica e Conformance of a structure Appliances Gas Pi in &Test Temp. Gas Slab Final 100e, Sanitation Patio FIREPLAC Final Footings Masonr Walls Reinf. Steel *FootingoELECTRICAL al *Rough iztures Bond Beam FIRE SPRINKLERS o Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Inters th Ventilation Permanent r Closer Final Final MOBILEHOME UTILITIES Elec_ Service @2�}� - "I%� ? Elec. Pedestal _2M Water Piping : — Sewer — — �Cp� Gas Piping laa ^x E O E INSTALL TION - - - - - - - - - - - - - - Support Elec. Continuity — Water Piping — Drainage Gas Piping &J 6 DATE —� ` 77 REMARKS OR CORRECTIONS 5CW' -r6----OA4D NO 645 A-11) sup 7/' ? .0 d C i,z 0 Lot T— ,(� �T— � cr i� S 2 4'® Corn e�G �C r- �.¢ r� a c R L (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 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the re uirements of the Cal -i• rnia Administrative Code, Title 25, Chapter 5 un er permit number- for the following_location: %10 � Q L 7.41 Lr�, OwnerFt-A/i✓%VI"" Owner's Address S41W F. Mobilehome Mfg. 4A NCE�lzModel (6 0 / _GYear Insignia No.QAL. 0 1 li�. Serial No. It is hereby certified for occupancy at the above described location and may be occupied. / Direct of ublic Work f Date `�' `� r 7? Y � THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED M0BT!J'110ME` INSTALLA`I'IW4 INSPECTION CHECK LIST 1� Is the. mobilehomE loc�!tcd wi.l.h equired separation from lot lines and buildings and generally ,conform to plot plan? Yes4e No 2, Does the mobile -home have required clearances above ground? (Sec.5085) Yes k' No 3. Are foot.i.n,;s and supports properly sized, spaced, and braced as pe approved plans? (Note possible. variation at spring shackles.) (Sec. 082 & 5083) Yes 'o a 4. Is the mobilehome level.? (Sec. 5088) Yes— No— s. If more nan a single unit, are crossover connections properly installed? (Sec. 5088) Yes No S. [Dater A. Is flep-,i,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 � ¢ 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 -41--No B. Does it have minimum /," per foot slope and is it' properly supported? Yes C. Are any leaks detected in drainage system after running 3-.Ylons of water through each fixture including washing machine standpipe? Yes No . /III-f coach is not State of California approved, does station have required trap and vent?{{� - 11 Yes No 1 r 8. Gas Piping nd Gas Vents A. Connecto - Is mobilehome connected to the gas supply with an approved 3/4" minimum mobilehome onnector not more than 6 ft, to Note: All piping is to be at least as large as the obilehome gas line inlet wi out'redue_t-ions other than the mobilehome connector. Ye No B. Test OK as Xneding procedures Yes_ No 1. Open alconnect0 alves. ` �. i 2. Shut ofe b n and pilot valves'`� +� 3. Air tesom �er 10"-14" water column,,or test with slope gauge (minimum 6oz.-macalibr ed in tenth pound increments. Test for 10 min, without drop. 4. Connect: to mobilehome 'th connector, turn. on gas, test connections with soapy w C., Are all&pliance vents properly i.nstal'leNk Yes No its 9. Electrical A Is seivice Large enokigh to provide adequate amperage to mobilehome. (must equal rating 'of mobilehome (aith a. s;inii,:um of lao amp) and other faciliti_Eis on lot, i.e. , water pumps, ,,arage, cabana, etc..? Yes i, No li is then proper clearances around Parnels? Yes_e N C. Is power supply cord or feeder assembly properly fused? Yes_ No_ u' test satisfactory as per tiie following procedure? Yes_ No D. I., continuity Y ,r/ De -energize electrical wiring system of the mobilehome at the pedestal. D1ake sure that the power supply cord or feeder assembly conductors, including neutral conductor, have> been disconnected. 3..,-�Swi.tch all breakers and switches in the mobilehome to the "on" position.., 4,,--(,'onnect one load of a test instrumient to the mobilehome grounding conductor and ��iLy the Giii.i' .i.Gau %G eak.;ii n1Gul.�ciwuie Sli it CGtiuuCtor, 1llC1Lid lTlg Y1eUirdt. 5-�All nor. -current, carrying metal parts of the mobilehome (aluminum siding, gas Brie, water line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. 6,completion of the above procedure, the power supply cord or feeder assembly conductors shah!. be connected to the site service equipment. A further continuity te,<;t shall then be wade between the grounding electrode and the chassis of the vioi)ilehome. Upon satisfactory completion of the electrical tests, the lot or site service equipment may be approved for energizing. job card signed by Health Department for water and sanitation? q, "` eve_rything ol<ay, sign off card and to services. 'MOBTLLMM..L_ DATA G � Manufacturer and/car Namestyle 'Length Width Vehicle Serial No. State Identification No.CSL loS� ✓_ . r.diiitional Information or Comlp.ents: C44 03667 I COUNTY OF BUTTE` — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 ✓ Telephone: 534-4541 APPLICATION AND PERMIT t Gut,,IU[ IGC ICrIICJ CIILGLIVCJ UI the LrUUIILY UI mune to enter Upun Ine above-mentioned property for inspection purposes. Date �A) 6_� rte rmitee or t Receipt No. / 4 076 - 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 By - Date q-0_-77 Becring/permit expires Date q-1�'-7 F BUILDING Owneri;drienne E. Toman SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Fireplace Contractor Carneros Mobile Transport Total Valuation Mailing Address 1290 F1 Capitan Permit Fee Plan Checking Fee&/or Penalty Napa, Telephone No. 707 _ Permit Fee $ $ Building Address PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 51: Each Trap 1.50 Oroville " r Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. 34-62-33 Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F W.G1 -artTTBt on I Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma p 60' R/W Im r p ovem nts Lawn sprinkler system 2.00 Bldg. li� Rec'd � Parcel's prov'01 Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ U ILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 INSTALLATION Main service 600V OR LESS 100 AMP OR LESS 5.00 _-7 GOVER Main service EA. ADD'L 100 AMP 2.50 - Single Family ❑ Duplex ❑ Mobil Home EJ Others ❑ 600V Main service 100 AMP OR LESS 25.00 Main service// EA. ADD•L 100 AMP 1.00 NEW CONS. OR ADDNST % ACCLBL GDWELING OCCUP. &) 20sq ft 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: y Carneros :Mobile Transport Ex. Occup(OUTLETS OR FIXTURES) (2P51qt09 Ex. Occup.(FIXED APPLNS. OR OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. 259158 Classification C-61 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 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 Mobile Home Installation .00 TOTAL PERMIT FEE $ Gut,,IU[ IGC ICrIICJ CIILGLIVCJ UI the LrUUIILY UI mune to enter Upun Ine above-mentioned property for inspection purposes. Date �A) 6_� rte rmitee or t Receipt No. / 4 076 - 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 By - Date q-0_-77 Becring/permit expires Date q-1�'-7 F 7 PERMIT APPLICATION WORK SHEET jEdrienne E. Toman OWNER Y Lot. 84, Unit 1 Zoning Use Proposed Permit fee based upon: 1. 2. s4 3. Complete contract price. Partial contract price (explain). DPW Valuation (show): Permit No. A.P. No. 34-62-33 Approved Not approved At time of permit application, the applicant was advised the following data or information must be submitted prior to permit processing and/or issuance: _ 1. All items have been submitted. ------------------------------ 2. Plot plans in duplicate/triplicate. ------------------------- 3. Complete plans in duplicate/triplicate. ---=----------------- 4. Complete engineered plans and cales. ------------------------ 5. Fees of $ ------------------------ 6. Letter of signature authorization. -------------------------- 7. Sanitation approval. ---------------------------------------- 8. Planning approval for -- 9. Workmen's Compensation Insurance Certificate. --------------- 10. Contractors license information. ---------------------------- 11. Parcel declaration, recorded copy. -------------------------- 12. Access declaration. ----------------------------------------- 13. Aunt Minnie information. ------------------------------------ 14. Deed of access, recorded copy. ------------------------------ 15. Deed of parcel creation, recorded copy. --------------------- 16. Parcel map, recording data. --------------------------------- 17. Pre -inspection request for 18. Improvements - plans required & DPW approval. --------------- 19. Other thl, I,, By �. GA \ Date 4'// T177 Bldg. Inspector During plan checking process, the following data or information must be submitted prior to permit issuance: 1. Index permit for items above and in addition the following: 2. Applicant advised by Telephone Mail Other 3. Plans checked by a Date 4. Plans approved by Date When permit is issued, process as follows: 1. Mail to owner. 2. Mail to contractor. 3. Deliver with inspection. 4. Telephone and hold for pickup. �j 5. Other Date Received Before permit issuance, all of the.following items must be signed or marked NA: 1. Zoning use 2. Legal parcel 3. Envir. Health Plans Sent A. Sanitation B. Restaurant C. Other 4. Public Works Plans Sent A. Street Imp. B. Drainage C. Permits & Fees D. Other 5. Planning A. Use Permit B. Variance C. Other 6. Other Agencies Plans Sent A. Fire Dept. B. Other MOBILEHOME SUPPORT DATA Mobile Mfr. Lancer Homes Setup Model No. 660 Year 1977 NET Width 24 (ft.) Length .. 56 .(ft:) - Expando Size _ ft.x ft. (Draw support details below) . On all mobilehom?-s. manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets .(if.not .on file with the County of Butte). Sin le - .. Footings--(check.one AX/ 1. Wood :either . . pressure treated oz Center Center Support A -fdn.'grade.: Support Footing Sizes `d Locations (in.) 2-. -.Concrete pad. 3.. Other,., specify (in.) in. Supports (check one 1. Concrete block 2. Concrete piers 0 ,.1tin 3. Steel piers ' / /A. Other, specify . Typical Support -� 24 ". ' ' ' . Footing Size - k. ;f -t. ice=) x 30 in• in. .(in-) (in.) Max. Pier. 5 6:. Spacing (ft. in. in. in.) .. x 30 Overhang - •-� - j in, `If center piers are other than drawn above, draw in locations, spacing, and dimensions. BUTTE COUNTY BUILDING DEPAFITA''NIT APPROVE® r 't BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville,'CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name: Edrienne E. Tomany Lot 84, Unit 1 _. electrical rating? ----------------------- 200 2. Installer's name:_ Carneros Mobile Transport 3. Is the site currently under permit? Yes %T/ No —1 (If yes, furnish permit number i -7 ) OR Is the site an existing site? Yes / / No % K (If yes, furnish two (2) plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields -and clear of all setbacks and easements? Yes / x/ No / / ( If' no, clarify 5. What is the mobilehome electrical rating? ----------------------- 200 Amps 6. What is the mobilehome site service rating? --------------------- 200 Amps 7. What is the mobilehome s.ite.circuit breaker rating? ------------- 200 Amps 8. Is there any other electric load to be served by the mobilehome site service? -------------------------------------------- --" Yes / / No A / (If yes, identify the load and size: (Load). -0- (Amps) 9. What is the mobilehome site gas pipe size? ---------------------- -0- (in:) 10. What. is...the.type of gas service? ----------------------------- Natural,/ / LPG 11. What is the gas pipe length from meter or tank to the mobilehome? -0- (ft:) 12. What is the mobilehome gas demand? ------------------------------ -0 (BTU) (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) COUNTI:OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Uroville, California 95965 —77 7 7 Telephone: 534-4541 (JJ( / APPLICATION AND PERMIT C/ •.r1— r....r. – ,.1--r•ssessor – rinR-mspecror – uolaenroa-Appllcanr ' •+-.—.••' r ­.n•. -- ....... BUILDING OwnerZ40(A gi C.Q A C SQ. FT. OCC. BUILDING VALUATION Mailing AddressL��5/7 Tel 'phone No. ��� — Fireplace Contractor 42 1 1A 1P ACTotal Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ $ Building Address PLUMBING No. @ FEE PERMIT FILING FEE $3.00 `J�C°�_ ,..� /� 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. o. Zon' Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 FeeVJ W. el%� 42Yr Fire Dept. Fire Zone Use Permit Building sewer 5.00 0�� EQA Parking Plans I Parcel Declar n arcel Ma P 60' R/W Improvements P Lawn sprinkler system 2.00 Bldg. Plans Recd Parcel ApprovalI ns Approval Permit Fee $ $ C5 NEW ❑ ADDITION ❑ UTILITIES OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 '3,0-0 Main service 100 AMP ORSLESS 5.00 012 ' Main service EA. ADD•L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service OVER 600V 100 AMP OR LESS 25.00 Main service EA. ADD•L 100 AMP 1.00 iOO SQ, FT. MINIMUM NEW CONST. OR ADDNS. ( ACC`BLDGDWELING OCCUP. &) 2¢.sgft NEW CONSTR MULTI.OUTLET NON.RE D. ( BRANCH CIRCUITS) 2.50ea FOR MOBILES NON -RES NEWCONSDTA (POWER APPARATUS 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) 50 BA@2i FIXED APPLNS. OR Ex. Occup. (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 $ O 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 $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County OrdinancesOTAL and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. Date _� Signature of Permltee or Agent Receipt No. /C�a��V _ ... .. _. J o PERMI FEE $ 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 BLIC WORKS By Date a — 7 p / _-i-,? A__ rJ__- _�-.v a �__-_-�- M1 7_ - L e — 7 •.r1— r....r. – ,.1--r•ssessor – rinR-mspecror – uolaenroa-Appllcanr ' •+-.—.••' r ­.n•. -- ....... . PERMIT APPLICATION WORK SHEET Permit No. OWNER Zoning Use Proposed A. P. . Approved 2 r 3 Permit fee based upon: 1. Complete contract price. Not approved Partial contract price (explain). 3. DPW Valuation (show) :__A % /j� a [ / I �S At time of permit application, the applicant was advised the following data or information must be submitted71. .or to permit processing and/or issuance: Date Received All items have been submitted. ------------------------------ 2. Plot plans in duplicate/triplicate.------------------------- 3. Complete plans in duplicate/triplicate.--------------------- 4. Complete engineered plans and calcs. ------------------------ 5. Fees of $ ------------------------ 6. Letter of signature authorization. -------------------------- 7. Sanitation approval. ---------------------------------------- 8. Planning approval for 9. Workmen's Compensation Insurance Certificate. --------------- 10. Contractors license information. ---------------------------- 11. Parcel declaration, recorded copy. -------------------------- 12. Access declaration. --------------------------- _-__-- 13. Aunt Minnie information. ------------------------------------ 14. Deed of access, recorded copy. ------------------------------ 15. ------------------ ----__15. Deed of parcel creation, recorded copy. --------------------- 16. Parcel map, recording data. --------------------------------- 17. Pre -inspection request for 18. Improvements - plans required & DPW approval. --------------- cf19. Other By .. 16L (5r. Date Bldg. Inspector hiring plan checking process, the following data >r information must be submitted prior toP ermit Cssuance: Index above permit for items and in addition the following: Applicant advised by Telephone Mail Other I. Plans checked by it Dat -.2 Plans approved by C.41 Date -2.,/7-:Z 'hen permit is issued, .process as follows: 1. Mail to owner. 2. Mail to contractor. 3. Deliver with 'n p ctiop. r��,�}..., Telephone anti hold for pickup. 5. Other Before permit issuance, all of the following items must be signed or marked NA: 1. Zoning use 2. Legal parcel 3. Envir. Health Plans Sent A. Sanitation B.'Restaurant C. Other 4. Public Works Plans Sent A. Street Imp. B. Drainage C. Permits & Fees D. Other 5. Planning A. Use Permit B. Variance C. Other 6. Other Agencies Plans Sent A. Fire Dept. B. Other � �r0 NOTE:—All Materials & Workmanship Shall Be fn k�° o+,' Accordance with Recognized Good Practices and ` ��'�' �C�° pd`.�APA of a quality prescribed for the Specified use in the be O k'�••�R.A,�e(`I Uniform Building, Plumbing 8 Mechanical Codes and �Xo� a� �"0" v -the l4afiona1Electrical& Code, _ , _ °C, Q ho LTi s sef OT plant on*9 A ' s •MUST 6e CIO's° \��`esoaa°yep kph} can 1h- _^J, ^1t pill times and it is urlawfi l to aA e�� e (0e icy rr,r1n an-� rhery s or alferafinns on same without �N <oQeo% ��.e deo written permission from the Department of. Public '��:8e ear Works, County. of . 11 - AT_ET� Co�vy.� . �� 0% o�� �.� o J/ O 3 + � n• M o �0►, .P' a M �. cD N C O °%3 ' co s 3 m O O �:3Qcr MCD 3o' LOT 84 Unit 1 'E60 �,P,'� ,3y -Ga •33 /O o•Oo - H IEI 2.750, 00' -I per I� I wl ere obilehome. installation of theL I I . � I I ACCESS" 2/ �. 8 pECN �2Z•A �szBA cK- D' C _L7_ le ✓ E_. ��� COUNTY c - 2 (2 G so) z / BUILDING DEPARTMENT peptic system to be as per pu#e County Health D quirements, Com. opt. Ra: -z!1 T_ � r-7 T y� _ L O T. i D �/_S__%�I_zE�� - � ..............: •.; APPROVED i Support G fi S #N,0 �t Ctsap=c r: Test Rei i , I& PERMIT NO. 7103-79B PERMIT EXPIRES OWNER EDRIENNE TOMANY w 5 CONTR. owner LOCATION (A.P. 34-62-33 ) 510 Silverleaf Dr, lot 84,KR#1 , Oroville Temp. Power Pole r Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E JOB G FINALED O (Da aw ( ignature) _a COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback 8.— 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 Stemwal I Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for ph sicall handicapped Conformance of ex. structure Appliances Gas PI in &Test Temp. Gas Slab J Final "' Sanitation Patio 'FIREPLACE, Final Footings '3— Footing ELECTRICAL Bond F Su Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES ------------------ Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping MQBILEHOME INSTALLATION - - - - - - - - • - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE `� / O Z> REMARKS OR CORRECTIONS © G� -- (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, 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. Z&�X Date Signature of Permite or A ent .3 c (/ Receipt No. �q2i 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 By Date 7—d - 1f ding permit expires Date l/ -a6 ,'u BUILDING Owner C p 1RI N e -Fo A N SQ. FT OCC. BUILDING VALUAIfIONJ Z3 Mai Iing Addrtolzoess 512 S I L.UC LG -Ar- VIP— r V l L%CA­9 �9 I epho-e 1o 7� 13 �T Contractor b WI(?_ (Je I Mailing Address Fireplace Total Valuation Telephone No. Permit Fee 5 , o O Building Address 210 SI LA C - 1— D2— Plan Checking Fee &/or Penalty Permit Fee �j• -0 rj o0 PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Trap 1.50 �` jEach �LL-;E, Repair drainage or vent piping 1.50 3 ) A. P. No. �{D L� 3� -I- Zoning Planning Water piping 1.50 Each gas water heater or vent 1.50 F A<W. Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W I Improvements Each additional outlet .30 Building sewer 5.00 Lawn sprinkler system 2.00 Bldg. Plan Recd Parcel ApprovaI Plans Ap royal NEW ® ADDITION ❑ UTILITIES ❑ OTHER ❑ Permit Fee $ $ �CGJL ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 �--�/ Single Family 1:1Duplex ❑ Mobil Home 2 Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service OVER 600V 25.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 1,00 NEW OR ADDNST ( ACCLBLOGSLINGCCUP. !) 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 BRANCH CIRCUITS) NON •RESI T ( BRANCH CIRCUITS/ 2,50ea NEW C ON ST R ( POWER APPARATUS B NON-RESID. SINGLE OUTLET CIR, Ex. OCCUD OUTLETS OR FIXTIIRES ( ) BALN Ex. Occup. ( IIXID 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 $ $ 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 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 authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. Z&�X Date Signature of Permite or A ent .3 c (/ Receipt No. �q2i 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 By Date 7—d - 1f ding permit expires Date l/ -a6 ,'u PERMIT NO. 3284-79B e PERMIT EXPIRES OWNER E. E. Tomany .,,CONTR. owner 34-62-33 LOCATION (A.P. ) 510 Silverleaf Dr , lot 84, KR#l, OroviBe Temp. Power Pole Called PG&E -. Temp. Elec. Serv. Cal l eed"PG& E Temp./as Serv. Called PG&E Jot S RINALED v (Dat (Signature) COUNTY OF BUTTE — DEPARTMENT'OF PUBLIC WORKS BUILDING INSPECTIONAECO,RD . BUILDING BUILDING (Cont'd) PLUMBING Setback /- ;2 -Xe) 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 Stemwa I I Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for physically handica ed Conformance of ex structure Appliances Gas Piping & Test Temp. Gas Slab Final `' Sanitation Patio FIREPLACE,.,-- Final rootln s Footin 'ELECTRI Al - LMasonr Masonry Walls Throat Rough Relnf. Steel Final Fixtures Bond Beam FIFE SPRI LERS Motors Framing — D a Test Water Htr. Stucco Final Subpanels 11 Mesh ME HANICAL Grd. Fault,16rolk Scratch Heating Service Brown Cooling 01 Te p. ole Finish x Ducts 1.114dviground Interior Lath Ventilation P nnanent Door Closer Final Final MOBILEHOME UTIL TIES - - - - - - - - - - - - - - - - - - Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping M 1 EHOME INSTALLA`ION - - - - - - - - - - - - - - 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 — tlEPANTMENT OF PUBLIC WORKS 7 County Center Drive Oroville, 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 Signature of Permite r Agent Receipt No. 59a �J 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 OFRUBLIC WORKS By �`/,�� Date Building permit expires Date BUILDING Owner G5 /yl SQ. FT. OCC. BUILDING VALUATION Mailing Address 6—/C> �� r!, Telephone No. Contractor Mailing Address Fireplace Total Valuation Telephone No. Permit FeeC70 Building Address ' �� Plan Checking Fee&/or Penalty Permit Fee ,®10 PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 L L Repair drainage or vent piping 1.50 �1 A. P. No.? -- (e pZ, 1 Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 F40's' 4. `. -SeRiiatinn Fire Dept. Fire Zone Use Permit Gas piping system 1 -5 outlets 1.50 EQA Parking Plans Parcel'Each Declaration Parcel Map 60R/W Improve ents additional outlet .30 Building sewer 5.00 � Bldg. P Recd Parcel App oval Plans Approval Lawn sprinkler system 2.00 NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ Permit Fee $ $ ELECTRICAL No.1 @ I FEE PERMIT FILING FEE J$3.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 Single Family ❑ Duplex ❑ Mobil Home 14 Others ❑ Main service EA. ADD'L 100 AMP 2.50 OVER Main service OVER 25.00 AMPP OR LESS O Main service EA. ADD'L 100 AMP 1.00 NEW OR ADDNST % ACCLBLDGS.LING OCCUP, s) 20sgft 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 CONSTP_ /MULTI-OUTL T NON.RESID ` BRANCH CIRCUITS)l 2.50ea NEW CONSTR. (POWER APPARATUS8 NON.RESID. SINGLE OUTLET CIR. Ex. OCCUP(OUTLETS OR FIXTIIRES) B L01 FIXED ALISIS Ex. Occup.(OUTLETSP(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 $ $ 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. ❑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. 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 relatinq to buildinq construction, and hereby Land Development Fee $ TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Signature of Permite r Agent Receipt No. 59a �J 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 OFRUBLIC WORKS By �`/,�� Date Building permit expires Date