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072-150-036
N ~ - 600 ft. off e/s Oroville-Bangor Hwy.1/2 mi. so. of Miners Ranch Rd.,OroPermit 1517-74 P.E (util. for MH)4util, MH.GAS I PCSUPPORT STRUCTURE R15Issued072-150-036 02-332CLARK, June INALE5211 Oro Bangor Hwy, 0 2- ` ` Y , � � �. r .� .� , r � �; • .. .I�.! .r - 'w.: _.'r" ��'•i��'""p"tyn"AYi!Fs"F�`."'v��,'�_,ti.-r-r•rv. y w..."7;w"r-ili`+r•-�r�w'v jly � r rs,.,x. �.m:�'v.-..yvc)' i'a Y^4!�`; •.�;r+�1n*Y'e T�.n+.T,.✓... ar. �`'� '�/�`� 072-150-036 02-2326 CLARK; June 52 N Oro Bangor Hwy, Oroville Change Woodstove Flue/SF (Rev. 12/96) COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 APPLICATION AND PERMIT PERMIT NOM 02-2326 ASSESSOR PAR`JC "VmB�R,^ A36 ; ZONING BUILDING PERMIT OWNER CLARK LARK TELEPHONE 589-5692 SO, FT, OCC. BUILDING VALUATION OWNERS 11111107E15RO BANGOR EW, OROVILLE 95966 CONTRACTOR'S UW 4 TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace A 1500.-00 LENDER'S MAILING ADDRESS Total Valuation $ 1500.00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 35.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDS 211 ORO BANGOR HW, OROVILLE Energy Plan Checking Fee $ $ PERMIT FEE $ 55.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE v SF EI Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Unities ❑ Installation ❑ Other P Describe Work: CHANGE FLUE ON WOODSTOVE T Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE S i ELECTRICAL PERMIT Fling Fee 20.00 EOOV OR LESS Main Service 200AORLESS 23.00 1 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.{ License Class Lic. No. OWNER- BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt'from the Contractors License Law for the following reason: I 1, as owner of the property, or my employees with wages as their sole cc pensation, 1P.Mobile will do the work, and the structure is not intended or offered for sal ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. i ❑ 1 am exempt under Sec. Business and Professions Code for this reason 1 WORKERS' COMPENSATION DECLARATION i 1 hereby affirm under penalty of perjury one of the following declarations:l ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ( ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 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 workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. / X e _�� C't"14, zDate "'� "^ A[A Signature of Applicant - 0 Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. SO OR ADONS. ( & ACC. BLDS. 3.50FT; NEW CONS MULTI-OLfTLET NON RESID. @7.50 S APPARATU 61INGLE OUTLEr CIR. zo Q ,.00 Ex. Occup. OUTLET OR FVTURES BAL. @ .50 PREBIDLNS. . OER Ex. Occu . OUTLETSFUCED A'(,=-.)0E, A 5.00 Temporary Service 23.00 Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ . 55.00 HAZ. p. FEES IMP I FLOOD I CDF PARCEL I PID I HD ISSU This permit is hereby issued under of the Butte County Code and/or indicated ab ve for which fees have By \ PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date( . ate .....�..-. yam....... ReceiptNo. WHITE-D.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT %COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMEN— SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 05965, • Telephone (530) 538-7541 PERMIT NO. ;Rev. 12/96) APPLICATION AND PERMIT 02-2326 ASSESSOR P V / G M1 O-036 ZONING BUILDING PERMIT OWNER JUNE CLARK TELEPHONE 589-5692 SO. FT. OCC. BUILDING VALUATION OWNERS 111nnTE16,0 BANGOR HWY , OROVILL95966 CONTRACTORbFT,R TELEPHONE g ��II �1�� ��++,, yi CONTRACTORS MAILING ADDRESS 1 CONSTRUCTION LENDER LENDER'S MAIUNG ADDRESS Fireplace A 1500.00 Total Valuation $ 1500.00 - ARCHITECT OR ENGINEER LICENSE NO. ARCHITECT OR ENGINEERS MAILING ADDRESS Filing Fee $ Permit Fee $ Plan Checking Fee $ 20.00 35.00 BUILDING ADDRESS n 5211 ORO BANGOR HWY. OROVILLE Energy Plan Checking Fee $ $ PERMIT FEE $ 55.00 LOT NO. SUBDNIS IONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF �] Duplex ❑ Mobilehome ❑ Other SPECIFY__ Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other R3 Describe Work: CHANGE FLUE ON WOODSTOVE Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I s I G I W 920.00 PERMIT FEE S . ELECTRICAL PERMIT Filing Fee 20.00 LESS Main Service zo.A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license. is in full force and effect.PSING License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: VAI, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ I am exempt under Sec. Business and Professions Code for this reason Main Service zooA To I000A 46.00 NEW CONST. DWELLING OOS. OR ADDNS. a ACC. BLDS. SO 3.50 FT. N" tI.R�ID. MULTI.OUTLET @7,50 d OITRE'r CIR. OWELER APPARATUS Ex. Occup. OUTLET OR FDCTURES BAIL p I:w FILED APPLNS. OR Ex. Occu . ouTLETs RESID. EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 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 workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall rthwith comply with �se provisions. X 9 __' Date 2 S' n ure of Ap ' is t - Owner O Contractor ❑Agent A SHA permit is required for excavations over 60" deep and demolition orconstruction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE S Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 55.00 HAZ. I D. FEES IMP I FLOOD CDF PARCEL I PD I HD ISSU This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated ab ve for which fees have been paid. • 6� By DateJb (( PERMIT EXPIR O /, -%t o� Date Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT r� O`VNER-BUILDER VERIFICATIOl� A;tencion Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your si�oipse. Please complete and return this information at your earliest opportunity to avoid W in processing and issuing your building permit. No building permit will be ism ed urns .d& verification is received. I personally plan to provide the major labor and materials for construction of the proposed property improvement: YES g NO C 2 I HAVE M HAVE NOT E3 signed an application for a building permit for the proposed w=L 3. I have contracted with the fbllowing person (firm) to provide the proposed eonsttuetian: NAME: ADDRESS: CITY: PHONE: COiNMUCTOR'S LICENSE NO. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: NA<titE: � ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTYOWNEi/ DATE: iVOTE: This Owner -Builder Ver&ation is required by Section 19831 and 19832 4V&d California Health and Safety Code. This verification must be canplsW and returned to our office before we are permitted to issue the permit OVER PERMIT- NO. 3080-83P,E(MH) PERMIT EXPIRES— OWNER XPIRES OWNER DAVID, CLARK CONTR. owner ASSESSOR PARCEL 72-15-09 LOCATION 600' off E/S Oro Bangor Hwy 2 mi S of Miners Ranch Rd, Oroville /-- OFFIC COPY Address i --------------- GAS Meter By ` ELECTRIC t Meter By { Dater/d— Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E Temp. Gas Service Cal led PG&E w JOB FINALED (Date Signature COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS - 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway aqd Elliott Road, Paradise — Phone: 872-2961, Ext. 57 P. CORRECTION NOTICE L it 3, asa OWNER PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. you have any question pertaining to this matter, or need additional exp la ion, please contact this office immediately. In 1 c3LIU Inspector " ` ���/��/ 'JDate// j ,r_�� � � � ��� COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 'i County Center Drive, Oroville — Phone: 53414541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be c rcted. Please notify this office when correction of work is completed. If y 6 have any question pertaining to this matter, or need additional explanation, lease .contact this office immediately. C / / r iC 2r� D`� U 0 10, Inspector e O'OK = dAot'OK Not Applicable MOBILEHOMES = Not Ready MISCELLANEOUS- Date ISCELLANEOUS- Date MOBILE OME UTILITIE K except #'s '' Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except q's oning Requirements -S tbacks-Easements 1. Zoning Requirements -Setbacks -Easements oils; Special MH�S�pport-Sketch 2. Footings; Size -Depth -Spacing -Connectors ewer; Locatior-••F,-st-Fall-C/0-Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails ater; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing_ ectricity; Locate -Clearances-Grnd.-/ / Amp -Concrete 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas- Location -T t -W :/ /"L"ft./ /"Nat. or/ "L"ft./ "LPG 6. Carports; Windows -Doors tility Clearance „, 7. Elea Card -B Dat24U_�Card-BI Date Card -BI Date Card -BI Date C BI ate/*-/- Card -BI Date Card -BI _ Date Card -BI Date Date MOBILEHOME INS ALLATION (Plans) OK except N's Date _ POOLS (Plans) OK except N's oning Requirements -Setbacks -Easements 1. Setbacks -Easements otin s_ Size -Spacing -Marriage Line t 2. Soils; Compaction -Structure Stability S' Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining ctricity; M st-Crossover learances I _ 4. Elec.; Receptacles and Lighting; Distances-GFI ; MH Test -Fall -Flex Connector t 5. Elec.; Pool Lighting; 15 volts-GFI ater; MH Test -Regulator -Connector j 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed er and Sewer Connected -C/0 to Grade -HD Approval I 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater and Electricity Tagged 8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes -Enclosures- Pane Iboards- Ins. to Main in Conduit x' Insp.-Sketch t. of Occupancy 9. Health Department Approval - 10. Plumb; Cir. Test -Water Supply Test 1 v ate -o Card -BI Date 1 Card -BI Date Card -BI Date C d B -I DateCard-BI Date i Card -BI Date Card -BI Date , `7 3 , N J = QK r 0 = Not OK - = Not Applicable RESIDENTIAL (Single and = Not Ready Duplex) f ' Date UNDERFLOOR (Plans) OK exce t#'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Fig., 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. Fig., 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-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. 55. Glazing Area -Glass Protection -Skylights -Plastic Shear Walls; Nailing -Bolts - 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 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 Card -BI Date Card -BI Date Date Card -61 Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI 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. Smoke Detector 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meth. Protection 15. Water Pipe; Test & Anchors -Nail Protection 59. 60. Bedroom Exiting G.F.I. & Bath Fixtures & Tub Access _ 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 17. Shower Pan; Test, First Floor -Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels Gas Pipe; Size & Anchors 62. 63. Stairs & Rails Fireplace or Stove; Clearances -Hearth _ __19_. 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 Perrrit OK except q's 67. Garage Fire Door; Swing -Landing -Closer 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-Mech. Protection _ 21. Elec. Receptacles Spacing -Lights & Switches at Doors 70. Plb., Elec. & Mech. Equip. Listed for Location _ 22. Size Boxes & No. of Conductors -Stapled 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 23. Romex Installed Close to Edge of Studs & C.J. _ - 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. Insulation -Foam -Looked in Attic ❑Yes 73. 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. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 27. 28. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or AI, Insulated Neutral JYes ❑No Service -Riser Conductors & Ground -Main Disconnect 75. Following instld.: Drive ❑ Yes No; Walks ❑ Yes ❑ No; Planters []Yes ❑No 76. Stucco; Brown -Finish --- 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77, 78. A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. - ---- Card B -I Card B-1 30. _ Clothes Closet Light -Shower Light _ ------ - Date -__ -_ Card -BI - Date -_ Date Card -BI Date 79. Water Well; Disconneqt, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground 81. 82. 83. 84. 85. Ventilation throughout House Glass Protection _ Corrections from Previous Inspections Gas Test -Meters Tagged; Gas -Electric Water & Sewer Connected -C/O to Grade -HD Approval Date __- _ _____34. MECHANICAL 31. 32. 33. (Permit) OK except it's A.C-. Ducts: Insulation & Support Vent Fan; above Insulation Condensate Drain _& Overilow; Size & Grade Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 86. Energy Compliance Certificate -Other Certificates 35. Attic Access & Platform if Furnace in Attic Card -BI Card -BI Date --- - - -- - -- - -- Date__- _Card-BI� Date Date Card -BI Date FRAMING(Plans) OK except N's Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Comments at Final: _ 36. -37. Sills; Proper Material & Anchors 38. 39. _ Walls; _Studs -Nailing, Sp_acing_& Bracing -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 & B_earing Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthnq.-Rfnq. Fireplace Ties or Type A Flue -Fireplace Throat Attic Access Size & Romex Protection -Draft Stop -Ins. Baffles Bdrm. Windows or Exiting Doors -Sill H_gI. & Dimensions Garage Fire Protection Framing (NOTE: An entry must be made each time youvisit jobsite) t 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 requirements of the California Administrative Code, Title 25, Chapter 5, under permit number for the following location: Owner Owner's Address Mobilehome Mfg. Model Year Insignia No. Serial No. h- is hereby certified for occupancy at the above described location and may b -t iupied. Director of Public Works I Vate THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED White - Owner, Yellow - Installer, Pink - D.P.W. / COUNTY OF BUTTE-D,EPAt�.TMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 S© - APPLICATION AND PERMIT M ASSESSOR PARCEL NUMBER ZON G .- _ C� BUILDING PERMIT OWNER TELEPHONE 0 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 690 - CONTRAC TO�R�')SyN%AME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ t-4f3:6(r_ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee I $ /5 Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee ` $ I BUILDING ADDRESS PLUMBING PERMIT Filing Fee 10.00 1Each !)I / ., SO ' O Trap 2.00 Solar Water Heater 20.00 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[] MobilehomEVI Other SPECIFY Building sewer 5.00 Mobile Home S 10.00e B� TYPE OF WORK New❑ Addition Remodel❑ Utilities Installation[— Other❑ Describe work: / 0 14� Permit Fee $ !07 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service &OOV 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. 1 2/20sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check One): ❑ I am licensed under provisions of Chpt. 9, Div. 3 of the Business and Professions Code and my licensee is in full force and effect. License No. 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-RESID BRANCH CIRCUITS) NEW CONSTR POWER APPARATUS &' NON-RESID.SINGLE OUTLET CIR. ( Ex. Occ Up(OUTLETS OR FIXTURES gw ®30 FIXED APPLNS, OR 11 EX. Occup. OUTLETS (RESID,) EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 00 Misc. Wiring 15.00 Permit Fee $ r-5-0 Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 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 $ Contractor 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the 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 Iia ' ' 'es, judgments, costs, and expenses which may in any way accrue n t sai Count 'n con a of t granting of this permit.. Date D �3 Signature of Applicant — Owner � Contractor ❑ Agent ❑ 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. GROUP I TYPE OF CONST, I ARCEL PD M' ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DI OR O UBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS [Receipt No. RITE-D.P.W., YELLOW-ASSeSSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT J fiu • °4Wrc� t F •'6�-•ux� �!' � � � �+' � � t � Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT j "v�h �?rG08i9S F1eQuE ,T � r "¢ FOR RESIDENTIAL DEVELOPMENT:r Q *� +�i Q'j�` �a , 1- c i,� L''�✓ Section 26-8.1 of the Butte County Code requires this acknowledgement be recorded prior to issuance of a building permit. ELEANOR M.8ECKE,` CLERK - RECORUER 'FrM ` The property described herein is adjacent to land or included within an area zoned for agricultural purposes,' and residents of this property may be subject to inconveniences or discomfort arising from the use of agricultural chemicals, including,,but not limited to herbicides, pesticides; f,.. and fertilizers; and from the pursuit of agricultural operations including, but not limited�:h to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate 'dust;'' smoke, noise, and odor. Butte County has established agricultural zones which have as a priority use for productive agricultural purposes, and residents.within said zones and on adjacent property should be prepared to accept such inconvenience or disconform from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: _ All that real property situate in the County of Butte, State of California, described as follows:'. A parcel of land lying in the East half of Section 31, Township 19 North, - Range 5 East, M.D.B.& M., Butte County, California, said parcel being the West portion of Lot 4 of the Daniels Subdivision as said Lot 4 is designated -on that certain map entitled, "Official Map of the Daniel Subdivision", filed as of record on December 6, 1920 in Map Book "B" at page 1, in the office of the Recorder of Butte County, California, said parcel being more particularly described -as follows: BEGINNING at the Northwest corner of said Lot 4 of the Daniels Subdivision from which point the Northeast corner.of the above mentioned Section 31, bears North* 330 51' East 2206,58 feet; thence North 860 46' East along the Northerly boundary of said Lot 4, a distance of 849.98 feet to a point in the produced center line. of an 18 foot wide easement. for road -purposes; thence South 260 49' East along said centerline and production thereof, 313.31 feet; thence along the centerline of a 6 foot wide easement for pipeline and head ditches the following courses and distances; South 100 50' East 257.90 feet; South 140 34" East 331.95 feet; thence leaving the centerline of said 6 foot wide easement South 140 34' East a distance of 384.32 feet to a point on the Southerly boundary of said Lot 4, of the Daniels Subdivision; thence along the Southerly and Westerly boundaries of said Lot 4, the following courses and distances; South 670 22' West 720'.19 feet to a point in' the 'centerline of the Oroville-Bangor Bonded County Highway; thence North 20° 13' West along said centerline and the Northwesterly production thereof, a distance of 364.20 feet to a point in the Northerly boundary of said Highway; thence North 69° 07' West along said Northerly boundary of said highway, a distance of 25 feet to a point; thence, leaving said boundary North 200 07'West 1176•.49 feet to the Point of Beginning. EXCEPTING THEREFROM the rights acquired by the County of Butte in and to a portion thereof under deed dated April 23, 1937 and recorded May 10, 1937 in Book "86" of Official Records, at page 317, records of Butte County, California. c4-n%IrvrNnc Date: Sept.8,1983 State of California SS. County of Butte f P TY OWNERS: c� On this the 8th day of Sept. 19 83 before me, the undersigned Notary Public., personally appeared David L. Clark and June D. Clark Personally known to me. /X/ Proved to me on the basis of satisfactory evidence. to be the person(s) whose hame(s) are subscribed to the within instrument and acknowledged that they executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. EVA L. BOATWRIGHT NOTARY PUBLIC -CALIFORNIA Dune County My Commission Expires Oci. 26,1964 JL� Notary Public Present A. P. No. 7-?' /S -'o 9 COUNTY OF BUTTE -,DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATIOU AND PERMIT PERMIT NO. M ASSESSO PARC L NUMBE &-- 0 � ZONING BUILDING PERMIT OW ER TELEPHONE SQ. FT. OCC. BUILDING VALUATI N OWNER'S MAILING ADDRES �Zf / '040 A cJ O CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CO TRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee I Permit Fee $ 10.00 $ ARCHIT T OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING AD RESS ;tp 6 8� PLUMBING PERMIT Filin Fee 10.00 9 t Each Trap 2.00 O _ Solar Water Heater 20.00 (aZ Water piping 5.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Each qas water heater or vent 55,00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE Building sewer 5.00 Mobile Home S G W 10.00e SF ❑ Duplex❑ Mobilehome_ Other SPECIFY TYPE OF WORK Permit Fee $ New ❑ Addition ❑ Remodel ❑ Utilities ❑ InstallationL+ Other ❑ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Describe work: — /> �2 �- 2zil �`7'1'� 3� d $--� Main service 100 OR OR L 100 AMP OR LESS 10.00 ' Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADONS. ( ACC. BLDGS. 2/20sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): F1I am licensed under provisions of Chapt. 9, Div. 3 of the Business license is in full force and effect. and Professions Code and m Y n License No. Classification NEW CONSTR MULTI -CUTLET 2,50 ea NON.RESID BRANCH CIRCUITS) NEW CONSTR. / POWER APPARATUS &) NON-RESID. %SINGLE OUTLET CIR. 20e50c OR FIXTURES BAL�30 Ex. Occup(o XED A FIXED APP LNS. OR Ex. OCCUp. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 ® 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 Mobile Home Facilities 15.00 for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- Misc. Wiring 15.00 ors. (Sec. 7044) Permit Fee $ ❑ I am exempt under Sec. , Business and Professions Code Contractor for this reason MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE Heating I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. Cooling ❑ 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. Hood 3.00 Ventilation ® 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 Permit Fee $ Contractor provisions or this permit shall be deemed revoked. 1 certify that I have read this application and state that the above information Mobile Home Installation Fee $ �(9� 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. TOTAL PERMIT FEE $ I also agree to save, indemnify and keep harmless the County of Butte against all li • ities, judgments, costs, and expenses which may in any way accrue cccuP. GROUP I TYPE OF CONST. PARCEL PD HD s E In t s id C2'oun"i c nse nce oft granting of this permit. This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do X Date�— O —S3 Signature of Applicant — Owner X Contractor ❑ Agent ❑ work indicated above for which fees have been paid. An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. DIRE OR OF PUBLIC BY p I 11 EXPIRES WORKS Date/!> -1y3 -p3 Receipt No. 096 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT MOB ILEHOME SUPPORT DATA . _ r(:fLj,5j(6/M)furnish If other than single wide, ,•Mobilehome Mfr.,E UA Setup Model No. Year 701 _ Width s� (ft.) Box Length -s-&-- 0t.)-- Tagalongtor •Expando'Size�ft. x ft. (SHOW SUPPORT DETAILS BELOW) +a,` - •'cam .i Vit' _._ __ 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. Footings (check one) -A o x (ft.)(in:) (in.) (in.) Center support Center support locations* r4 footing sizes (in.) (ft.)(in.) Na (in.) (in.) Q W (ft.)(in.) (in.) (in.) W • Single 1*. Wood either pressure treated or foundation grade. El 2. Other: (specify) Supports (check one) 1, Concrete block. - ®� E] •2 : Other. (specify) 4 ---Tagalong or Expando,' show support details. X -- Typical Support (in.) (in.) Footing Size -- Max. Pier Spacing (ft.)(in.) _� x '- Max. Overhang (in.) .) (inL.)J '�,rf s. t r (ft.)(in.,)1 ��g�''8,3•: t t , rBUTT� •COUNTY' BUILDING DEPARTMENT -APPROVED *If center piers are other than drawn above, draw in --locations, spacing,. and dimensions. BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name: f)4 U I Al 2. Installer's name: S74m E 3. Is the site currently under permit? Yes / / No t ( 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. away from septic tank and leach fields and clear of all setbacks.and easements? Yes / / No ( If no, clarify ) S. :What is the mobilehome electrical rating? ----------------------- 4!570 Amps 6. What is the mobilehome site service rating? --------------------- 2 d Amps 7.. What is the mobilehome site circuit breaker rating? ------------- Amps 8. Is there any other electric load to be served by the mobilehome siteservice? -------------------------------------------- -----.- Yes No (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? ---------------------- y (in.) 10. What is the type of gas service? ----------------------------- Natural /% LPG 777 11. What is the gas pipe length from meter or tank to the mobilehome? �7� (ft.) 12. What is the mobilehome gas demand? ------------------------------ A &A_ i (BTU) (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) BUTTE COUNTY DEPARTMENT OF HEALTH CRNIA A-0 DIVISION OF ENVIRONMENTAL HEALTHSEWAGE DISPOSAL PERMIT 695 OLEANDER AVENUE 7 COUNE CHICO, CALIFORNIA 95926 747 ELLIOTT ROAD. OROVILLE, 5 PARADISE, CALIFORNIA 95969Phone: 891-2727 Phone: 1 872-2961, Ext. 58 Date Issued '2 " 7'8 J EXPIRES ONE YEAR FROM DATE OF ISSUANCE Permit Issued to :Z i0 _ To construct a sewage disposal system for: 'd _Lecj1ZcCrd&Located at- at- 5Z 11 00-0— 6yw CA SEPTIC CTANK SYSTEM REQUIREMENTS Septic Tank (Inside Measurements) Leaching Field Length: . . . . .cj ft. Total Length:. .�%.Q4. . . ft. Width: 3.` . . . . ft. Trench width:inches . Liquid depth: . . . . ft. ;11inimum No. of liners . Liquid capacity: .750 . . gals. Rock under tile .b. . . inches l- App %eaL(kticld a.aea Aaltet , o 1a4j �-.c40&&K a>1d as deep as jcss,jjf, s Specia Gond'tions: +N'. "3J �' ��d. � �P a, caiicuc�. .► a le.asi �� ;vt kaad �6;,rP tach{�ld� 'b"Z`dL�c3C. *ul4dRaiEtlihtifSD �1 awe� yield. 3 'moi ail (ed Z x.�a.t,a$ 'welts C( 31.'L 41 l.ja u + ey,�.P w Re.at�,ib ( s Irt kk1t���djua ra il�s s • uaf y Su�ail scph� a} tca.st"� tvleaci.T„mss iee� c�.c any wei( cry ►� Additionalleac�i4ng �f1 d• wl; fequ,rllceN ift, experience shows it to be necessary. No part of the system may be located within 50 feet of the center line of any .County Road. NOTE: Satisfactory inspection by the Health Department is required before backfilling or putting the system into use. Occupancy of a new .building is not permitted until the system is approved. Permit Fee S Penalty Fee .9 _ Total Fee g�� Building Sewer Fee 8 Issued By: Receipt No. S31 -278R lo: r " t" a. PLnn. �' i i7 O or: ��t:---7e k-:1 Oa B?' .c� c uL �D~ 1 pl C final -. or: . r';_ager su-a-ol Final c l ra_nce 0. K. for: ,rater supp! J Cyeararce ,for p2 bedroom mob-i I home Other —a 1 ?flan Date AGRICULTURAL AFFIDAVIT EMPLOYER/EMPLOYEE Please read the following carefully before signing: Section 24-21.2 Agriculture Employer/Employee (Applicab-le only in .zones A -5,.A-10, A-20, A-40 and A-160) 'An individual who verified, by personal affidavit and by affidavit. • of his employer, that he is, or will be, employed at least -thirty- two (32) hours per week for at least sixteen (16) weeks per year, or'that his primary source of annual.income is, or is anticipated to be, derived from, any of the following described occupations:. (a) The preparation, care and treatment of farm land, pipelines or ditches, including leveling for agricultural purposes., plowing, discing and fertilizing the soil; .(b) The sowing and planting of any agricultural or horticultural commodity; (c) The care of any agricultural or horticultural.commodity. As used -in this subdivision, "care" includes,.but is not limited to, cultivation, irrigation, weed control, thinning, heating, pruning, or tieing, fumigating, spraying and dusting; (d) The harvesting of any agricultural or horticultural commodity including, but.not limited to, picking, cutting,thrashing, mowing, knocking off, field chopping, bunching, baling, balling, field packing, and placing in field containers or in the ve- hicle in which the commodity will be hauled on the farm or to the place of first processing; (e) The.assembly and.storage of any agricultural or horticultural commodity including, but not limited to, loading, roadsiding, banking, stacking, binning and piling; (f) The raising,Ifeeding and management of livestock, fur -bearing animals, fish, frogs and other aquatic animals, and bees in- cluding, but not limited to, -herding,' housing, hatching, milking,-,. shearing, handling. eggs and extracting honey; (g) The operation, conservation, improvement )or maintenance of such farm and its tools and equipment. AGRICULTURAL AFFIDAVIT EMPLOYEE Employee-TLMAMAr► >77, Z /ems h Fe/d Phone cq.�7/ Employee's Address (Present) ivC ,V C Name of Owner �L�1 r �f �, ��(.t, �'J P 1 ¢� P, - Owner's Owner's Addressr2c;�// (,Pip Rawga k '14,(Aj u • (0,Aqy/l% (jig, c Owner's Assessor's Parcel No. /-5 C) Building/Environmental Health Permit Description and Number Date Issued/a-7--V/4 .12- PZ`: f-3 Planning Department Approval: Date 20 ShPT S3 Zone .G� S' Dwelling on AP# By I, , 10,;-?a-M0_,zC, , do declare, subject to the penal of perjury, that I am `the employee of A C7),Oa r, % address (present) Q h a /.3 A ale& s. IV,., r• v Z on APS /5-- O9 l and that I will be employed under Section 24-21.2 A �C,, cl F, 6-'. for at least -T-a-to g thirty-two (32:) hours per week for at least sixteen (16) weeks per year on Signe Dated AGRICULTURAL AFFIDAVIT EMPLOYER Employer I�Ay 1 d A CA ,4 A k Phone Employer's Address (Present) If © k '0 /3A Name -of Owner SA 4,1 Owner's Address . 7,4 w, .E- Owner's Assessor's Parcel No. Building/Environmental Health Permit Description and Number /4 4 -t E'J, ir. Sr Date Issued/,,9- S/ /:Z - %- F 3� B �®w o4 �" � CT y � �TS.vU0/ J_.Jr, Planning Department Approval: Date 20 S��f S'� Zone ,4-5 Dwelling on AP# I, 104 v a� C'A/A r �t , do declare, subject to the penalty of perjury, that I am the employer of©/iy,afl /4 ^/y address (present ),�-_,,'? 5`O 6A Vf i -/w e, eo�ov,titin AP# and that I will be employer under Section .24-21.2 A dl,G for at least a to g thirty-two (32) hours per week for at least sixteen (16) weeks per year on. AP# %f -/S - O Sign Dated fit i PERMIT NO. � r P I' E M , MH UTIL. 1517-74 P E PERMIT NO. PERMIT EXPIRES/ DOWNER David L. _ Clark ,CONTR. owner LOCATION (A.P. -72-15-9 ) 600 ft, off.e/s.Oro-Bangor .Hwy. 1/2 mi. so. of Miners Ranch Rd., Oroville A ri i ` P zTemp.Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E JOB f FINALED (Date) (Signature) f.. COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 7 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. StemwalI Slab Prov. for physically handicapped Heaters I Appliances Carport Footings Conformance of ex. structure I Gas Piping & Test Temp. Gas Slab Final . Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final DATE REMARKS OR CORRECTIONS 0 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORK % 7 County Center Drive — Orovi lie, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the C;ounty of Butte to enter upon the ;aZ- entioned proper or inspection purposes. Date -�/ Signature of Permitee or Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date _1q 731 �Lling permit expires Date.....................-lY.`,7 BUILDING Owner Aa SQ. FT. OCC. BUILDING VALUATION Mailing Address / T .phone too ` Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty telephone No. Permit Fee $ $ Building AddressD t PLUMBING No. @ FEE PERMIT FILING FEE $2.00 �S:2/1 _ Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 t Each gas water heater or vent 1.50 A. P. No. _.., S ;' zo ' P fr Gas piping system 1 - 5 outlets 1.50 , Each additional outlet .30 F eA< W. Sa t' ire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Parcel s Declaration parcel Ma P 60' R/W Im rovemen s P Lawn sprinkler system 2.00 B ahs Recd Porcel pproval Plans Approval Permit Fee $ $ NEW ADDITION ❑ UTILITIES OTHER ❑ ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 Q Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Single Family ❑ Duplex ❑ Mobil Home Others ❑ Range, Cook -top or Oven 1.00 7 tLc — ��� SPS Water Heater or Space Heater 100 2U P_2T Light fixtures bal d10 Receps., switches & fix outlets im CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. di sp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 w �, Temp. Power Pole 5.00 License No. Classification Misc. wiring rV I am exempt from the Contractors License Laws of the State of California. Permit Fee $ L4L Ix 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. MI certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT FEE $ authorize representatives of the C;ounty of Butte to enter upon the ;aZ- entioned proper or inspection purposes. Date -�/ Signature of Permitee or Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date _1q 731 �Lling permit expires Date.....................-lY.`,7 a A MI fc Z.-Workman'ship Shall Be in KAccord-,-!ce, w::fh Recognized Good Practices and brii-Form Building Code, Uniforni Plumbing Code, and %e. t�`,�tional Electrical Code. 'bf a vnli-' for the Specified use in the Ig. kep. oil the 10, TIII.Is set obllan�, / and si�&O ip Bons MUST be , all time (kimand it is unlawful to make any changes or alterations on same without writlk-n permission from the Department of Pub- lic Works, County of,tte- is, "A' —Sic .O 01 .0 �K 00Z 190 /0 6 q/- 6 I. 0 10 0 Ell IQO 0er 6 ')? b % 0 rhe - A7 /be I - S/Qle!� $ef6a the cent 10/-0 ck 6�// Oott/o?a-\-i� er/x% 0 etjll� f e SO fl6-oo A C-,