HomeMy WebLinkAbout069-170-043y
l
io
i
rn.
tac D n
89 Montrose Dr., lot 43, KR4P4A, Oro.
Permit3 3-78P,E(util. MH)
ELEC .o'i i gapp
GAS
SUPPOR TRUCTURE REQ.- I.
COMPACTION TEST REQ.
® n r: E?r1eV6wrie`MH Ser, Paradis
ermit #936-,78MHI
s_s ied
contr: Coleman Const., Oroville
Permit #2142-78B(new opendeck & coveml
deck/MH);4� SAW -App
6`7-/7--43
Contr: Wilson MH Ser, Oroville
Permit # 64-7 B(a & beauty room)
wi�
MH / �l
69-17-43
NEW OWNER
DON DRESSLER I�1C�. l �%�a ✓
t
U
Contr: Wilsons MH
Permit#3158-83B(new covered deck &
awnings)
3
i
.ft. I -
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS L 7 COUNTY CENTER DRIVE
OROVILLE, CALIF. - 534-4541
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 for the following location: -L
Owner
Owner's Address
Mobilehome Mfg. " ' Model Year
Insignia No.Sgcal No.
It is hereby certified for occupancy at the above described location and
may be occupied.
Director, of Public Works-'
Date By "
THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED
303=78P.-iv—
PERMIT NO.
PERMIT EXPIRES
OWNER Jack D. Donaldson
CONTR. owner
LOCATION (A.P. 34-76-43
89 Montrose Dr., lot 43, KRYKA, Oroville
Temp. Power Pole
Called PG&E
Temp. Elec. Serv. 3 ��
Called PG&E
Temp. Gas Serv.
Called PG&E
/Fol
B NALED !/jJ 3�„ e D/
lam%
(Date)
lfkXX-Jff 10, it 'J�� 1 '4 ""Z
(Signature)
L�
u
v
Temp. Power Pole
Called PG&E
Temp. Elec. Serv. 3 ��
Called PG&E
Temp. Gas Serv.
Called PG&E
/Fol
B NALED !/jJ 3�„ e D/
lam%
(Date)
lfkXX-Jff 10, it 'J�� 1 '4 ""Z
(Signature)
L�
u
i
I , .
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
(NOTE: An entry must be made on this form each time you visit the job site.)
BUILDING INSPECTION RECORD
BUILDING
A BUILDING (Cont'd)
PLUMBING
SNF
rewall
S I Piping
F
Pa ets
1 t Floor
ldg.
Rest om Finish
2n Floor
ins
Windo s
3rd oor
Stem all
Siding
To out
Slab
Roof Shehhlng
Water Pi i
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footin s
Stemwa I I
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Carport
Po
Footings V
Prov. for physica
hand ica ed
Conformance of ex.
structur V
Appliances
Gas Piping &Test
Temp. Gas
Slab A
Final
Sanitation
Patio
RE ACE
Final
Footings
Footing
EXECTRICAXL
Masonry Walls
Throat
Rough
Reinf. Steel
Final
Fixtures
Bond Beam
FIRE SPRINKLE
Motors
Framing
Test
Water Htr.
Stucco
Final
Subpane/
MECHANICAL.
Grd. F It Prot.
Heat
Servi e
4sh
Co Ing
T mp. Pole
D cts
nder round
In
entilation
Permanent
oor Closer
Final
Final
MOBILEHOME UTILITIES ------------------ Elec. Service Qd/a,—
Elec. Pedestal�_ %^%�
Water PipingIZ 3
Sewer
Gas Piping ub
_MOBILE M INSTALLATI N
- - - - - - - - - - - - - - Support - ( -
Elec. Continuity
Water Piping
Drainage %
Gas Piping
D fE
REMARKS OR CORRECTIONS
(NOTE: An entry must be made on this form each time you visit the job site.)
;; �el 6
------------
s AW/V
9. Electrical
A. Is service large enough to provid adequate amperage -to mobilehome (must equal' rating of
mobilehome with a minimum of)eM amp) and other facilities on lot, i.e., water pumps,
garage, cabana, etc.? Yes No
B. Is.there proper clearances around panels? Yes v No_
C. power supply cord•or feeder assembly properly fused? Yes_ No_
D. Is continuity -test satisfactory as per the following procedure? Yes _Y No
�11.. De -energize electrical wiring system of the mobilehome at the pedestal.
.2r 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.
jConnect one lead of a test instrument,to the mobilehome grounding conductor and
apply the other lead to each mobilehome supply conductor, including neutral.
_ 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.
I Upon completion of the above procedure, the power supply cord or feeder assembly
conductors shall be connected t6-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 d ectrical tests, the lot, or site
,service equipment may be approved for energizing.
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 t
Length (d Width
Vehicle Serial No.
State Identification No. CAL- C� �i fog � '' CaL Ol 412_,_�
Additional Information or Comments:
3-13.
P�..,®�l a2 �/o �� P te- �� r M 4 �
it a c4 W I
MOBILEHOME INSTALLATION INSPECTION CHECK LIST
1. Is the mobilehome located with equired separation from lot lines and buildings and generally
conform to plot plan? Yes No
2. Does the mobilehome have required clearances above ground? (Sec.5085) Yes No
3. Are footings and supports properly sized, spaced, an -braced as per proved plans? (Note
possible variation at spring shackles.) (Sec. 50 & 5083) Yes+ No
4. Is the mobilehome level? (Sec. 5088) Yes_ No
5. If morean a single unit, are crossover connections properly installed? (Sec. 5088)
Yes o
6. Water
A. Is flex' a 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 o_
C 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 No
B. Does it have minimum" per foot slope and is it properly supporte ? Yes_ No
7
C. Are any leaks detected in drainage system after running 3- ons of water through each
fixture including washing machine standpipe? Yes No
xDr oac is not State of California approved, does station have required trap and vent?
Gam` Yes_ Not
i 1
8. Gas Piping and NGas Vents
A. Connector - s mobilehome connectZep
supply w' an approved 3/4" minimum
mobilehome co ector not more thaNote• All piping is to be at least as
large as the mo or
gas line re ctions.other than the mobilehome
connector. Yes No
B. Test OK as per follows procedur1. Open all appliance c nector 2. Shut off appliance burner nds.
3. Air test with manometer 10 4" water column, or test with slope gauge (minimum
6oz.-maximum /oz.) brated in enth pound increments. Test for 10 min. without
drop.
4. Connect gas mbilehome with conn tor, turn on gas, test connections with
soapy water.
C. Are all applioce vents properly installed? Yes_ No
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — UroviIle, California 95965
1
• �-
Telephone: 534-4541
APPLICATION AND PERMIT
u
BUILDING
Owner Jack D. Donaldson
SQ. FT. OCC. BUILDING VALUATION
Mailing Address 3 Glen Drive
Fairfax, California 94930
Telephone No.
Fireplace
Contractor (Owner)
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee&/or Penalty
Telephone No.
Permit Fee $
Building Address 89 Montrose Drive
PLUMBING No.1 @ FEE
PERMIT FILING FEE 1$3.00,
Oroville, CA. 95965
Each Trap 1 1.50
Repair drainage or vent piping 1.50
Water piping 1.50 def
o ;�rii ice ��d C9n1
Lot 43 Unit 4A — Kelly Ridge
Each gas water heater or vent 1.50
A. P. No. 34 - 76 - 43
k3%-
n
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
F
INSVIK-on
Fire Dept.
FireZone
Use Permit
Building sewer 5.00 1. &C
EQA
I Parking
Plan
Parcel parcel a
Declaration p
60' R/W
Improvements
provements
Lawn sprinkler system 2.00
Bldg. P1161s Rec'd
Par Approval
Plans Approval
Permit Fee$ ,Z%�
$LA
NEW ADDITION
❑ ❑ UTILITIES OTHER ❑
ELECTRICAL No. @ FEE
PERMIT FILING FEE
Main service 600V OR LESS
100 AMP OR LESS 5.00
Main service EA. ADD'L 100 AMP 2.50
Single Family ❑ Duplex ❑ Mobil Home Others ❑
Main serviceOVER 0 AMP OR LESS 25.00
Main service EA. ADD'L 100 AMP 1.00
r7y.,A,1
6� S("�• FT. MIM
SQ. r M (`I SIV' M
NEW CONST. DWELLING OC cup, &
OR ADDNS. ACC. BLDGS. ) 2�Sq ft
NEW CONSTR. MULTI.OUTLET
NO.RESICIRCUITS1 2.50ea
FOR MOBILES
NEW-CONSDTR APPARATUS
NON-RESIDOUTLET CUR.&)
, (POWERC
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
Ex. OCCUp(OUTLETS OR FIXTURES)BAL @1 @290
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
2<6: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.
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
.-eZe,
vim- C9_0
TOTAL PERMIT EE
$7
QUU IUIILC ICtlICJCIILGUVCS UI L IU �.UUHLy oI ou tte to enter upon me
above-mentioned property for inspection purposes.
•� Date
Signature of Permitee or Agent
!ceipt No. ) G G /
C) it
ite-D.P.W. — Yerlow-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 tlJt- 1PUBLIC WORKS
By _ Date Z- Io `' 7,F
Building permit expires Date
N®T F- - All- Mrl+ei ials & Workmanship Shat) - Be in
�ccar if ~"e wr't�, P,�t)ces and
of a ceryl:+„ �6a ifie4 use in Elio
Uniform Ruil din & lvlachanical Codes and
the National Elpct-ic(i Code.
LOT -43
UNIT 4A
DONALIDSOt�.�
-F- UQUA
I'his set of plans and specifications M'tr K O
<ept on the ;ob at a;' lir-n-s and it is un nw{si tc
M make any ;'-i'i ges or FJ',eralirrts on satnt, withoul
The R*., Setback shal3 be 5 ft. from the '
C1.f li;:e and 50 ft. from the written permisson from the Depactment of Public
sicc f:: op y 1 I .
of -,he roa;., permitting a maxr-
Works, County of Butte.
2 ft. eave overhang but entirely
out of all easements.
A`ON S ac)s^
R v = Al connections
--�_ 04e 19,00„ la'a7je 'lir ft shall be
9so. O0, third sect,•'cn • outside the rear
= 7 1'. 5 ho mon �e left (road) side of the m home
o, mobile
ScT-13 ACK
rJr I 0
Gr �: CTS O ✓1111
0.
OQ
a
a
co IE
20o AMP. 2 '
P-D=S.TAL.
200 p.MP.
sQ=AK_R
SMS y'3-s�q
A, nT y3
I
2o,
w
V1 71 ,57'
!iAle
.17
f L
417- /,•/
4,04
D _ 040 19, 00„
.R = a 5o. oo,
1_ = 64.0¢,
6'
M
S=T- BACK
SC AL = I"= 20
P4-4 ITS 2,0 3•—'78
BUTTE COUNTY
3UILDING DEPARTMENT
—S_�-3AcOPR OVED
I.00' NO ACC.SS STQ�p
t4IOV;%L= A,00=0 II -30-i-/ O '-D
5-8-77 *0--D-
2
-• COUI'6TY.0�, BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Orovi Ile, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned property or inspection purposes.
X Date -
Signature of Permitee or Agent
Receipt No. %
White-D.P.W. - Ye�sessor - 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 U LIC WORKS
By a e�-3—'7�_
3
B (ding permit expires Date ` 3 lc
,
BUILDING
Owner J 4eie QoA)A4DSDAJ
SQ. FT. OCC. BUILDIN.GJ:VALUATION
t
ePf' ` .
Mailing Address
50ir .
Telephone No.
' -
Fireplace • • �,•{y
Contractor F T W N E
Total Valuation 1°(�
Mailing Address 3-b35 iffleCLE LAJ
Permit Fee
Plan Checkin g Fee &/or Penalty I'
A/?A0 (S �
Tne No.
ele h
Permit Fee $ !
Building AddressPLUMBING
'r
No.1 @ %FE
- ;•
+
PERMIT FILING FEE J$3.00 1
3 -
Each Trap 1 50 (
c/C
Repair drainage or vent piping 1.50 '• "�
t,
Water piping . 1.50 ,,,
Each gas water heater or vent 1.50 �.
A. P. No. .�44 3
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
' 1
Each additional outlet .30
s
S•aR1lEtift71P
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
PPlans Declaration
I Parcel Map
60' R/W
I Improvements
Lawn sprinkler system 2.00
Bldg. Plks_lReed
Parcel A val
Plans If
Permit Fee $
$
NEWOADDITION ❑ UTILITIES ❑ OTHER
ELECTRICAL No.1 @ FEE
PERMIT FILING FEE J$3.00
d
oy
Main service 600V OR LESS
100 AMP OR LESS 5.00
Main service EA. ADD•L 100 AMP 2.50
Single Family ❑ Duplex ❑ Mobil Home Er Others ❑
ER 600V
Main service 10 0 AMP OR LESS, 25.00
Main service EA. ADD•L 100 AMP 1.00
`
NEW CONST. DWELING
OR ADDNS. ( ACCLBLDGS.OCCUP, &) 2¢sgft
NEW CONSTR. MULTI.OUTLET
NON.RESID, ( BRANCH CIRCUITS) 12.50ea
NEWCONSTR. POWER APPARATUS &,,
NON •RESID. (SINGLE OUTLET CIR,
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style 7
le oy —
•'
r
-
Ex. Occup(OUTLETS OR FIXTURES) rBOA@25�
FIXED TS APPLNS. OR
Ex. Occup.(OUT LETS (REST D,) EA) 2•00
Temporary service 10.00
Mobile Home Facilities 15.00
G
License No. 2�5 %` S Classification C'"d �
Misc. Wiring 6.25
t
❑ 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.
F -1I 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 ee $
$
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
411HQ
TOTAL PERMIT FEE
$
authorize representatives of the County of Butte to enter upon the
above-mentioned property or inspection purposes.
X Date -
Signature of Permitee or Agent
Receipt No. %
White-D.P.W. - Ye�sessor - 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 U LIC WORKS
By a e�-3—'7�_
3
B (ding permit expires Date ` 3 lc
,
<< MOBILEHONE SUPPORT DATA
If other than single wide,
Mobilehome Mfr,,t& 0 furnish Setup Model No. Year 197
r•
Width 2-1 (ft.) Box Length 'S (ft:) Tagalong or Expando Size ft. x ft.,t
(SHOW SUPPORT DETAILS BELOW) 1
On all mobilehomes manufactured after October 7, 1973; furnish manufacturer's installation j.
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.
Footings (check one)
Single
® 1. Wood either
(ft.)(in:)
Center support
locations*
r� •
(ft.)(in.)
(ft.)(in.)
(ft.) I (in.)
(in.) (in.)
Center support
footing sizes
(in.)
4A
*If Canter piers are other than drawn above,
draw in. -locations, spacing, and dimensions.
pressure treated or.
foundation grade. i
2. Other (specify)
Supports (check one)
[2'1.; Concrete block.
2. Other (specify)
4-
Tagalong or Expando,
show support details.
Typical Support
in.) (in.) Footing Size
-- Max. Pier Spacing
(ft.)(in.)
-- Max. Overhang
(ft.)(in.)
BUTTE COUNTY
BUILDING DEPARTMENT!
. APPROVED
7
�y
CS
,J
F
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS
7 County Center Drive, Oroville, CA.
PHONE: 534-4541
MOBILEHOME INSTALLATION SHEET
1. Owner's_ name : .an
2. Installer's name:
3. Is the site currently.under permit? Yes IKNo
(If yes, furnish permit number ) OR
Is the site an existing site? Yes / / No
(If yes, furnish two (2) plot plans.) a
4. Will the mobilehome be located at least 5 ft. away from septic tankand leach fields and
clear of all setbacks and easements? Yes /.f/ No
(This information not required if pipe length less than 6 ft. on natural gas
or less than .50 ft. on LPG.) 1
( If no, clarify
)
5.
What
is the mobilehome electrical rating? -----------------------
Amps.
6.
What
is the mobilehome site service rating? --------------------`
Amps
7.
What
is the mobilehome site circuit breaker rating? -------------
�
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 of gas service? ----------------------------- Natural
/ / LPG
11.
What
is the gas pipe length from meter or tank to the mobilehome?
(ft.)
12. -.What
is the mobilehome gas demand? ------------------------------
(BTO)
(This information not required if pipe length less than 6 ft. on natural gas
or less than .50 ft. on LPG.) 1
COUNTY OF BUTTE
Department of Public Works
7 County Center Drive.
Oroville ----- 534-4541
ELECTRICAL INFORMATION FOR DE -RATING MOBILEHOMES
Owner �� C° <� i D nJ L D s g dt)
Location Sq. Ato A)7_/?,e s
Mobilehome Installation Permit No. f3
FILL IN INFORMATION FOR ITEMS 1 THRU 10
Watts
1. Width 2 df x Box Length 5"� x 3
2. 2 Kitchen Appliance Circuits ................. _ 3,000
3. 1 Laundry Circuit 1,500
4. Ovens ......................... K w ... .�.. = cS^ 5
5. Cook Stove Top xGv ..5 : y...... ..:..:.
6. Hot Water Heater . 4�! . !c/.e:. , .. , , ..... ......
7. .Dishwasher &Disposal ... ........... 7
8. Clothes Dryer ... _
9. Other (specify, i.e., motors; exhaust fans,
etc.)
Sub -total - Watts ..... Z % /6
First 10,000 watts @ 100% .................................. = 10,000
Remaining / Zl D watts @ 40% ....................... = g
10. Air Conditioner X UYI1 watts @100%.. = ) i
,yak Largest Demand = � 21
g; 0 (Central Heat System watts @ 65%.. = )
TOTAL DEMAND WATTS REQUIRED ............. Z 3,3 / 6%
"Demand Watts Required" - 230 ..... ............ _ —.10/,71- AMPS
De -rate Mobilehome to ........ �� Y AMPS
BUTTE �'Y. .
BUILDING DEPARTMENT
A . PROVED
PERMIT N0. 6864-78B
PERMIT EXPIRES U/M 0�
OWNER JACK DONALDSON
CONTR. Wilson MH Service
LOCATION (A.P. - 34-76-43 )
Y f l a wee o s �-
t
F
Temp. Power Pole
Called PG&E
Temp/Elec. Serv.
•alled PG&E
Te p. Gas Serv.
Called PG&E
JOB
FINALED
(Daly)
�
(Signature)
Footin
Throat
Reinf. Steel Final %� Fixtures
Bond Beam FIRE,SPRINKLERS Motors
Framing I -A 4! 7 5r'61__� Test Water Htr.
ELECTRICAL
stucco
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS'
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont'd)
PLUMBING
Setback
Firewall
Sol l Piping
Forms
Parapets
1st Floor
Main Bldg.
Restroom Finish Y
2nd Floor
Footings
Windows
3rd Floor
Stemwall
Siding
To out
Slab
Roof Sheathing
Water Piping
Piers
Roofing 4_2 09 G.��
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Stemwall
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Car ort
p
Footings
Prov. for ph sically
handica ed
Conformance of ex.
structure
Appliances
Gas Piping & Test
Temp. Gas
Slab
Final
Sanitation
Patio
FIREPLACE
Final
Footin
Throat
Reinf. Steel Final %� Fixtures
Bond Beam FIRE,SPRINKLERS Motors
Framing I -A 4! 7 5r'61__� Test Water Htr.
ELECTRICAL
stucco
Final
Subpanels
Mesh
MECHANICAL
Gird. Fault Prot. _
Scratch
Heat Ing
Service
Brown y
Cooling
Temp. Pole
Finish
Ducts
Underground
Interior Lath
Ventilation
Permanent
Door Closer
Final f
Final
MOBILEHOME LifilLITIES ------------------ Elec. Service
Elec. Pedestal
Water Piping
Sewer
Gas Piping
OBILEHOME INSTALLATION .............. Support
Elec. Continuity
Water Piping
Drainage
Gas Piping
G
DATE �� �a 7� REMARKS OR CORRECTIONS
(NOTE: An entry must be made on this form each time you visit the job site.)
COUNTY OF BUTTE — DEPAF;TMENT OF PUBLIC WORKS
7 County Center Drive — Oroville, California 95965
T'ef ephone". 534-4541
APPLICATION AND PERMIT
BUILDING -
_ /
Owner /� (J O /ALI%
SQ. FT. OCC. BUILDING VALUATION
5E4 0, 0 0
Mailing Address'vJ J
0
Telephone No.
Contractor (�lJ��,� _� �Q��
7 P� 2?, , /
Mailing Address ���.c—Y
Fireplace
Total Valuation
Telephoneo.
Permit Fee
`
Building Address
Plan Checking Fee&/or Penalty
-
Permit Fee UO
C
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
/�
T Gff%
Repair drainage or vent piping 1.50
y �>C_
A. P. No. �t
Zoning 8 Planning
Water piping 1.50
Each gas water heater or vent 1.50
Fe!eS
eerAq JO&
I Fire Dept.
FireZone
Use Permit
Gas piping system 1 -5 outlets 1.50
EQA
Parking Parcel
Plans Declaration
Parcel M p
60' R/W Improv ents
Each additional outlet .30
Building sewer 5.00
Bldg. Pla ec'd
Parcel proval
Plans Approval
Lawn sprinkler system 2.00
NEW ADDITION ❑ UTILITIES ❑ OTHER ❑
Permit Fee $
$
?f-xxq
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service 600V OR LESS
100 AMP LESS 5.00
Single Family ❑ Duplex Mobil Home Others
❑ � ❑
-L
Main service EA. ADD'L too AMP 2.50
Main service OVER 600V 25.00
100 AMP OR LESS
Main service EA. ADO'L 100 AMP 1.00
NEW
OR ADDNST ( ACCLBLDGS.LING CCUP. Y) 2¢Sgft
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 �(R
'
NEW CONSTRESID. MULTI -OUTLET
NON-RESID BRANCH CIRCUITS) 2.50ea
NEW CONSTR. (POWER APPARATUS .&,
NON-RESID. `SINGLE OUTLET CIR, 1
0250
Ex. Occuo(OUTLETS OR FIXTIIRES BA@L 01
BAL1
Ex. Occup.(OUTLETS FIXED . OR
OUTLETTSS (RESRESID•) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. 72-1 (o%1 tf Classification C--
Misc. Wiring 6.25
❑ I am exempt from the Contractors License Laws of the State of Cal ifomia.
Permit Fee $
$
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
C d h' h 1 t b' d
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heating
o e w Ic requires every emp oyer o e Insure aga(nst Hablllty
for Workmen's Compensation.
rZi+-ftaVe 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.
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 gelating to building construction, and hereby
F
hI' representatives of the County of Butte to enter upon the
ve-men Toned property for inspection purposes. j
Date
Signature of Permitee or Agent
Receipt No. y�0
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
Cooling
Ventilation
Hood 1 1 2.00
Permit Fee $ $
Land Development Fee $
TOTAL PERMIT FEE $ -Lr 00
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 ELIC WORKS p
By Date
B ding permit expires Date
I
PERMIT N0. 2242-78B
PERMIT EXPIRES
OWNER Jack Donaldson
CONTR. Coleman Const., Oroville
LOCATION (A.P. 34-76-43
89 Montrose Dr., Oroville lot 43,KR#4A
1
Temp. Power Pole
Called PG&E
Temp. Elec. Serv.
Called PG&E
Temp. Gas Serv.
Called PG&E
O B
FINALED s
(Da )
(Signature)
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING
BUI ING (Cont d)
PLUMBING
Setback 41-
Firewall
Soil Piping
Forms
Parapets
1st Floor
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
Stemwall
Siding
To out
Slab
Roof Sheathina
Water Piping
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footincis
Stemwa I I
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Carport
Footings
Prov. for ph slcally
handica ed
Conformance of ex.
structure
Appliances
Gas Pi In & T t
Temp. Gas
Slab
Final
Sanitation
Patio
FIREPLACE
Final IF
Footings - 7 -7
Footing
)ELECTRICAL.
Masonry Walls
Throat
Rough
Relnf. Steel
Final
Fixtures
Bond Beam
FIRE SPRINKLIdRS
Motors
Framing -7--
Test
Water Htr. '
Stucco
Final
Subpanels
Mesh
ECHANICAL
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
B E E TION - - - - - - - - - - - - - - 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 — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive .- Oroville, California 95965
t�
Telephone: 534-4541
APPLICATION AND PERMIT v
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X7Date
Signature of Permitee or Agent
Receipt No. T�
White-D.P.W. - Yellow -Assessor - Pin -Inspector - Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Bute County Code and/or resolutions to do work indicated
abov which fees have been paid.
C70HOF PUBLIC WORKS
Building permit expires Date
BUILDING
Owner
SQ. FT. OCC. I BUILDING VALUATION
Mailing dress
Telephone No.
Contractor
Mailing Address
Fireplace
Total Valuation
n [Telephone
(�
-7of
� �
Permit Fee
Building Address Z) /LL,.t
P I an Checki ng Fee &/or Penalty
Permit Fee
PLUMBING
No.1
@ FEE
PERMIT FILING FEE
$3.00
Each Trap 1.50
Repair drainage or vent piping 1.50
A. P. No.C��j
Zoning 8 Planning
Water piping
1.50
Each gas water heater or vent 1.50
F _ Sd
Fire Dept.
Fire Zone
Use Permit
Gas piping system 1 -5 outlets 1.50
Parking
EQA Plans
ParcelEach
I Declaration
I Parcel Map
0' R/W
I Improveme is
additional outlet .30
Building sewer 5.00
/� � �
Bldg. Pla�c'd
Parcel Approval
Plans Approval
Lawn sprinkler system 2.00
NEW ADDITION ❑ UTILITIES ❑ OTHER ❑
1
Permit Fee $
i$
ELECTRICAL
No.
@ FEE
PERMIT FILING FEE
$3.00
Main service 600V OR LESS
100 AMP LESS 5.00
Single Family Duplex Mobil Home Others
g v ❑ p ❑ ❑
-L
Main service E4. ADD'L 100 AMP 2.50
Main service OVER 800V25
100 AMP OR LESS
00
Main service/ EA. AOD'L 100 AMP 1.00
OR ADDNS.CONST. ACCN EW GS.LING Ccup- h) 20sgft
C
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:�J
NEW CONSTR / RANCH CIRCUITS)
NON -REBID 1 BRANCH CIRCUITS/
2.50ea
NEWCONSTR /POWER APPARATUS 8
NON .RESID. (SINGLE OUTLET CIR.
Ex. Occup{OUTLETS OR FIXTIIRES 1 5 L250�
EX. Occup ( FIXED OR
OUTLETTSS (RESRESI.D.) EA) 2•00
Temporary service 10.00
Mobile Home Facilities 15.00
p�
License Nol!U!'g / 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.
Imo• 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 $
$
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
Land Development Fee
$
TOTAL PERMIT FEE
$
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X7Date
Signature of Permitee or Agent
Receipt No. T�
White-D.P.W. - Yellow -Assessor - Pin -Inspector - Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Bute County Code and/or resolutions to do work indicated
abov which fees have been paid.
C70HOF PUBLIC WORKS
Building permit expires Date
t'
V
PERMIT NO. ''3158-83B
i PERMIT EXPIRES -2,
I
OWNER 1)ON DRFSST.F.R
CONTR. Wilsons MH
ASSESSOR PARCEL 69-17-43
LOCATION 80 Montrose Dr, Oroville
- u
J
i
(
F'
a
t
4
i
I
r
i
t "
d
1 Temp. Power Pole
i
Called PG&E
Temp. Elec. Service
Called PG&E _
Temp. Gas Service
Cal led PG& E
JOB FINALED (Date)
Signature
J = OK
0 = Not OK
— = Not Applicable MOBILEHOMES
* = Not Ready
MISCELLANEOUS
Date
MOBILEHOME UTILITIES (Plans) OK except N's
Date
DEC , COVERS, CARPORTS, ETC. (P s) OK except N's
1. Zoning Requirements—Setbacks—Easements
1 Zo g Requirements—Setbacks—Easements
2. Soils; Special MH Support—Sketch
_
o_ngs; Size—Depth—Spacing—Connectors
3. Sewer; Location—Test—Fall-C/0—Concrete
_
ec s; -Girders and/or Joists—Decking—Bracing—Stairs—Rails
4. Water; Location—Test—Easement Needed (Sketch)
"o n.; Posts—Beams—Rfirs.—Connec.—Shthg.—Rig.—Bracing
5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete
6. Gas; Location—Test—Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG
7. Utility Clearance
Ium. Awn.; Columns—Connections—Splice—Decal—Enclosures
6. Carports: Windows—Doors
7. Elec.
r
Card -BI
Date Card -BI Date
C&dBI,Date)
� %�Card-BI Date
Card -BI
Date
Date Card -BI Date
MOBILEHOME INSTALLATION (Plans) OK except H's
1. Zoning Requirements—Setbacks—Easements
Card -BI
Date
V___
Date Card -BI Date
POOLS (Plans) OK except H'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
6. Elec.; Enclosures; Conduit Entries—Terminals—Listed
7. Water and Sewer Connected—C/0 to Grade—HD Approval
7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater
8. Gas and Electricity Tagged
8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg.
Boxes—Enclosures—Panel boards—Ins. to Main in Conduit
9. Exits; Insp.—Sketch
10. Cert. of Occupancy
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 -I
Date Card -BI Date
Card -BI
Date Card -BI Date
V = OK ..
0 = Not OK
- = Not Applicable RESIDENTIAL. (Single and Duplex)
= Not Ready
Date
UNDERFLOOR Plans OK except N'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- / /" Fig. 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- Bloc kouts-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.
Plenums & Ducts; Clearance -Material -Support -Ins,
13.
Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
Card -BI
Date Card -BI Date
Card -BI
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
15. Water Pipe; Test & Anchors -Nail Protection
57.
Smoke Detector
58.
Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. 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
Pipe; Size & Anchors
61.
Elec. Trim & Subpanel; Breaker Sizes -Labels
62.
Stairs & Rails
_Gas
63.
Fireplace or Stove; Clearances -Hearth
64.
Elec. Outlets at Wood Panel; Int. & Ext.
Card -BI
Date Card -BI Date
65.
Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI
Date Card -BI Date
66.
Elec. Outlets & Receptacles at Kit. Counter
Date
ELECTRICAL Permit OK except N's
67.
Garage Fire Door; Swing -Landing -Closer
68.
A.C. Duct in Garage -Damper
---
--
20.
21.
Fixture & Transformer Clearance -Ins. Protection
Elec. Receptacles Spacing -Lights &Switches at Doors
69.
Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
70.
Plb., Elec. &Mech. Equip. Listed for Location
22.
23.
Size Boxes & No. of Conductors -Stapled
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 ❑Yes73.
Guard Rails & Deck Construction -Post Caps
_
25.
2 Appliance Circuits in Kitchen & Conductor Size
74.
Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance
Looked under Floor ❑ Yes
-
26.
27.
28.
Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al
Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or A1,
r-! r
Insulated Neutral ._Yes 1No
Service -Riser Conductors & Ground -Main Disconnect
75,
Following instld.: Drive Yes No; Walks
9 ❑ ❑ ❑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-1- _ Date -_ Y _ Card -BI -- Date
Card B -I Date 'Card -BI Date
79.
Water Well; Disconnect, Electrical, Plumbing
80.
81.
Exterior Elec. Trim; G.F.I. Receptacle -Underground
Ventilation throughout House
82.
83.
Glass Protection _
Corrections from Previous Inspections
Date
MECHANICAL (Permit) OK except p's
84.
Gas Test -Meters Tagged; Gas -Electric
-
31.
A.C. Ducts; Insulation & Support _
85.
Water & Sewer Connected -C/O to Grade -HD Approval
_
32.
33.
Vent -Fair; Exhaust above Insulation
_Condensate Drain _& Overilow; Size & Grade
86,
Energy Compliance Certificate -Other Certificates
34.
Furnace -Vent, Access -Comb. Air -Return Air Vent -115V outlet
35.
Attic Access & Platform if Furnace in Attic
Card -Bl
Card -BI
--
---------
Date _ Card -131 _ Date
Date CaBI Date
rd-
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Date
FRAMING(Plans) OK except q's
Comments at Final:
36.
37.
38.
39.
40.
Sills; Proper Material & Anchors
WaIts: Studs -Nailing, Spacing & Bracing -Plates -Sound
Bearing Walls over Girders & Floor Nailing
Draft Stop in Walls (rat proof) _
_Fire Stops; Furred Ceilings -Stairs -Chases -Tub
_
41.
42.
43.
44.
45.
46.
47.
Header & Beam -Size & Bearing
Hangers -Post Caps -Anchors -Connector;
- - -
Cing. Joist-Rftr. Ties-Purlin--Roof Brac.-Truss-Shthnq.- - -- -- --Rfn- --------
q.
Fireplace Ties or Type A Flue -Fireplace Throat
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
Bdrm.-Windows or Exiling Doors -Sill _HgL_& Dimensions__ -
Garage Fire Protection Framing-,- - -_
- -
(NOTE: An entry must be made each time youvisit jobsile)
7,J ,
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATIQN AND PERMIT
PERMIT NO.
7/5�� Y
ASSESSOR PARCEL NUMBER
ZONING'
BUILDING PERMIT
OWNER
S /_Z 2
TELEPHONE
S0. FT. OCC, BUILDING VALUATION
�Q
OWNER'S MAILING ADDRESS
CONTRACTOR'S NAME�`�.nn T�EEyyLEPPHONE
—gC�
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 10,00
LENDER'S MAILING ADDRESS
Permit Fee
$ 51&0
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ &0
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUIL] NG ADDRESS
Mavrgvses
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Solar Water Heater
20.00
®' Z%/
Water piping
5.00
LOT NO. SUBDIVISION NAME
PARCEL MAP
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
5.00
USE OF STRUCTURE
SF ❑ Duplex ❑ Mobi lehome �2[ Other
SPECIFY
Building sewer
5.00
Mobile Home S G W
10.00 e
TYPE OF WORK
New Addition Remodel❑ Utilities[ Installation Other
Describework:_�r�d� 64t 11V C,
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service OOOV OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. DWELLING OCCUP.&`
OR ADDNS. ( ACC. BLDGS. /
2/20sgIt
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one): s
[�] I am licensed under provisionof Chapt. 9, Div. 3 of the Business
and Professions o e an my license is in full force nd effect.
License No.,12s— 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
NEW CONSTR ULTI.OUTLET 2.50 ea
NON.R ESID BRANCH CIRC ITS.
&'
NEW .CONSTR (POWER APPARATUS .&')
NONRESID. SINGLE OUTLET CIR
Ex. Occup(o OR FIXTURES BAL®30
BAL@30
FIXED A
Ex. Occup. OUTLETS P(RESID )LNS REA.)
2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring15.00
Permit Fee $
Contractor
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
oyConsent 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.
MECHANICAL PERMIT
FiIingFee 10.00
Heating
Cooling
Hood
3.00
Ventilation
permit Fee
$
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 County ofr
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 abilities, judgments, costs, and expenses which may in a way accrue/",/>•
gains s County in consequen f the granting of this perm' .
Date /
Signature of Appy nt — Owner Contractor ❑ Age
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE $
occuP. GR%uP
TYPEoF co 5T.
PARc,L
r/
PD
HD
1
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRE OR OF P
By.
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
LIC WORKS
/
Dae
Receipt No. LV20 r'S K
WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT