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072-590-013
®-7a-5a®-o13 ARVID RIGGSmi W of boat ' ' g/S Stringtown Rd * aPP 4 o rainp;"Orovil'le'� Permit #2826-81P,E(u' ELEC r; GAS COMPACTION TES _ SUPPORT v.STRUCTU RE Per it#3211-84P,E(util, MR) LEC lir!! r GAS SUPPORT STRT6W E RE COMPACTION TEST YZE' F ! ontr:�P.,acific Modular Concepts Permit-# 212-84MHI { YIs`,ued /D /S—ci� Perm 567-84B new open.& cov de—s/MH' Per ;k3156785B(lst renewal/3567-84) ` 1 1 t • a i � c� tri ori L PERMIT NO. 32.11-84P E(MH) replaces 2826-81 PERMIT EXPIRES OWNER A.G RIGGS r CONTR.. owner ASSESSOR PARCEL 72-26-33 LOCATION #9339 Striingtown Rd,, mi W Boat. Ramp r +a , f. Y ' I� Y , k i' �f Temp. Power Pole 1 Called PG&E Temp. Elec. Service F� Called PG&E Temp. Gas Service 4 F' Called PG&E JOB FINALED (Date) Signature J OK O = Not OK - = Not Applicable MOBILEHOMES * = Not Ready MISCELLANEOUS Date MOBIL OME UTILITIES (Plans) OK except a's Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except H's oni equirements—Setbacks—Easements 1. Zoning Requirements—Setbacks—.Easements oils• pecial MH Support—Ske 2. Footings; Size—Depth—Spacing—Connectors Jo.e--.r; L-eeatien— Test— F -C/O—Concrete 3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails ater; 1=eeeti =Dgj34asement Needed (Sketch) 4. Wood Awn.; Posts—Beams—Rftrs.—Con nec.—Shthg.—Rig.—Bracing / Electricit earances—Grnd.—/ / Am —Concr tg 5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures 6. ocati est—Wrap:/ /"L"ft./ /"Nat. or L"ft. PG 6. Carports; Windows—Doors Utility Clearance 7. Elea i Card -BI @ and -BI Date 1Card-BI Date Card -BI Date Card -BIS t Card -BI Date Card -BI Date Card -BI Date Date MOBIL ME INSTALLATION (Plans) OK except N's o g Requirement etbacks—Easements IDate POOLS (Plans) OK except N's 1. Setbacks—Easements oot' gs; Size—S cing—Marriage Line 2. Soils; Compaction—Structure Stability 3 MH esemand—valve—Connector 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining 4. ricity; MH Test—Crossovers—Breakers—Clearances 4, Elec.; Receptacles and Lighting; Distances—GFI rain; MH Test—Fall—Flex Connector { 5. Elec.; Pool Lighting; 15 volts—GFI 6. t�H Test—Regulator—Connector 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed 7 t d Sewer Connected—C/O to Grade—HD Approval 7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater and Electricity Tagged 8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg. Boxes—Enclosures—Panel boards—Ins. to Main in Conduit its; Insp.—Sketch 1 art. of Occupancy g. Health Department Approval _C 10. Plumb; Cir. Test—Water Supply Test t Card Date and -BI Date (Card -BI Date Card -BI Date . Card B-1 Date Card -BI Date Card -BI Date Card -BI Date f t f f 1 = OK P = Not OK = Not Applicable = Not Ready RESIDENTIAL (Single and Duplex) Date UNDERFLOOR Plans OK exce t#'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 -B lockouts -Wrapped -S lab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. 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. 12. Electric; Underground 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 Date Card -BI Date FINAL (Plans) OK except q'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. 59. Smoke Detector Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection Bedroom Exiting 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. 19. Test Tub & Shower, 2nd Floor -Tub Access Gas Pipe; Size & Anchors 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 62. Stairs & Rails 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. 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 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 [3 Yes 25. 2 Appliance Circuits in Kitchen &Conductor Size Guard Rails & Deck Construction -Post Caps 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral ❑Yes [I No 75. Following instld.: Drive F] Yes []No; Walks ❑ Yes [-]No; Planters El Yes❑No 28. Service -Riser Conductors & Ground -Main Disconnect 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. 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B -I Date Card -BI Date 81. 82. Ventilation throughout House Glass Protection Card B -I Date Card -BI Date Date MECHANICAL (Permit) OK except N's 31. A.C. Ducts; Insulation & Support 83. 84. Corrections from Previous Inspections Gas Test -Meters Tagged; Gas -Electric 85. Water & Sewer Connected -C/O to Grade -HD Approval 32. Vent Fan; Exhaust above Insulation 86, Energy Compliance Certificate -Other Certificates 33. Condensate Drain & Overflow; Size & Grade 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Dale Card -BI Date Comments at Final: Date FRAMING Plans OK except q's 36. Sills; Proper Material & Anchors 37. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound 38. Bearing Walls over Girders & Floor Nailing 39. Draft Stop in Walls (rat proof) 40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. Header & Beam -Size & Bearing 42. Hangers -Post Caps -Anchors -Connectors 43. 44. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-_Rfn_g._ _ Fireplace Ties or Type A Flue -Fireplace Throat 45. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 46. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing (NOTE: An entry must be made each time you visit jobsite) 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 < ^r Owner's Address Mobilehome Mfg. '' f Model % ' Year `- Insignia No. 7"1" 7 � Serial No. 1 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 White - Owner, Yellow - Installer, Pink - D.P.W. COUNTY OF BUTTE DEPARTMENT OF PUBLIC, WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 5T CORRECTION ®TICE G BUILDINGI&4*ROPERTY ADDRESS 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. If you have any question pertaining to this matter, or need additional explanation, -please contact this office immediately. �r[14tF0 XMjl'(& PO R C H' AN r) oR n8t ys - PEjQn4 I T s I & n Inspector_ _ � � -23-Sr 1�) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT N 7 County Center Drive - Oroville, Calif_Qrnia 15965 - Telephone 916/534-4541 APPLICATION AND PERMIT ASSESSO ARCEL NUMBER _ — � — ZONING BUILDING PERMIT OWNER i k TELEPHONE S0. FT. DCC. BUILDING VAL IO WjaI,E R.iS M 7R SS NTRACTOR'S NAME G TELEPHONE ONTR CT R'S MAILI AD RESS r _ ,q- Fireplace CONSTRUCTION LENDERUNKNOWN Total Valuation $ Filing Fee $ ' 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. iP+an-etreek-imng-Ee211 4.. -( ``` $ ✓ Penalty $ ARCHITECT OR ENGINEER' MAILING ADDRESS Permit fee $ eut� _L5 ADDRESS PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 T � I i f Cc1 C>� � a(f , t9T pjping 5.00 LOT NO. DIVISION NAME p,nrce,z PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USEOUCTURE SF ❑ Duplex ❑ Mobi lehome Other SPECIFY Building sewer 5.00 Mobile Home 10.00 e TYPE OF WORK / New ❑ Addition [:1Remodel ❑ Utilities ❑ Installation {W"Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 600V OR LESS Main service 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. ( DWELLING OCCUP.&` OR ADDNS. L ACC. BLDGS. t I 2/20sgft CONTRACTORS LICENSE LAW I declare der penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Profess ons Code and my license is in full fore and effect. -� f License No. 3 ClassificationL, f+/ ❑ 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 NO N.RESID BRANCH CIRC ITS 2,50 ea NEW CONSTR. ( POWER APPARATUS &) NON-RESID. SINGLE OUTLET CIR. Ex. Occup(o FIXTURES &ALeao BAL@30 FIXED A PL Ex. OCCUp. OUTLETS P(RESID )REAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): Te 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. MECHANICAL PERMIT Filing Fee 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 Countyot enter upon the above-mentioned property for inspection purposes. ree to save, indemnify and keep harmless the County of Butte against ities, judg nts, costs, and expenses which may in any way accrue )agaisaid Cou ty i c%, equenc f the granting of thispermit.This Date of Applicant — 0w Contractor ®gent permit is required for excavation's over 5'0" deep and demolition or construct- ctures over 3 stories in height. Mobile Home Installation Fee $ c- TOTAL PERMIT FEE $ Q. ��- OCCUP. GROUP TYPE OF CONST. PARCEL PD HD S OE permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIREC OR OF BLIC BY PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Rl � A eceipt No. U WHITE-D.P.W., YELLOW-ASS&SSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT .,.,. .. COUNTY OF BUTTE - DEPARTMENT QF„,PWBLIC .WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE,LIFORtilA 95965 - TELEPHONE: 916/534-4541 / PERMIT APPLICATION DATA SHEET Permit No. t_ I OWNER A. P. No. 72 - z� Proposed Building Use Permit Fee Based Upon: Complete Contract Price DPW Valuation Other (Explain) Building Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED -APPROVED 1. All items have been submitted. . . . . . . . . . . . 2. Plot plans in duplicate./triplicate. . . . . . . . . . 3. Complete plans in duplicate./triplicate.. . . . . , , 4. Complete engineered plans and calcs. . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. State Energy Forms No. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ , . , , , , , , 9. Letter of signature authorization. . . . . . . . . . . 10. Sanitation approval from Health Dept. 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. 13. Contractor's License Information (no., name style, classif.) Y 14. Owner -Builder Verification (Given to owner[], Mail to owner ❑.) 15. Improvements may be required. . . . . , , , , , , 16. Mobilehome Installation Data. . . . . . . .. 17. Pre -Inspection for •Pre-Inspec. request to Required, Building Inspector (Dote) 18. Other TTe'lephone-4-2:2- --issue the p rmit, process as follows: Mail to owner. Mail to contractor. ickupat Deliver w/inspector. Other Applicant Copy of plans sent Health Dept., Fire Dept., During the plan checking process, the fol 'owing -data -mu. (For required items not checked above at ti 1. Index permit for above Items No. 2. Additional items required: i Date )fher Date be submitted prior to permit issuance. kof application, circle item.) (Contractor, Designer, Owner) was advised of above required data by Telephone Mail Other 1 By Date Plans checked by Date Plans approved by FF Date Other: v Copy—DPW I _ f, : - BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oraville, CA. PHONE: 534-4541 ' MOBILEHOME INSTALLATION SHEET � I. Oytner' a name 2. Installer's name: 13 x� $. 'Is the site currently 6633 1SKYWAY 8774661 (If yes, furnish permit number ) r� 21't -ls :the esite�an .existing site? Yes / No yee, furaish `two (2) plot plans.) , 4. Will the mobilehome be located at least 5 ft. away fr septic tank and leach fields and 3 clear of all setbacks and easements? Yes kgwG (If no, clarify 0 ) tSi ) v - 5. What is the mobilehome electrical rating? ------------- -- ----- a ?`!'' 6. What is.the mobilehome site service rating. -- �r �,g- Amps O 7.. What is the mobilehome site circuit breaker rating? ------------- 'Amps 8. Is there any other electric load,�t'o bers.erved by the mobilehome siteservice? --------------------------------------------- ------ -Yes No (If yes, identify the load and size: (Load) t (Amps) ,9. What is the mobilehome site gas pipe size? ---- --------------- 3� (in.) Ab. _What is 'the%e?- +type of gas ,servic-- - ------ Aatural `LPG 41. ..What .is the ..gas .pipe length from meter or tank to the mobilehome? ;' ''" (ft.) a 12. What is the mobilehome gas demand? ------------------------------ X'BTU) (This information not required if pipe -length less than,6 ft. on natural gas or less than 50 ft. on LPG.) - - '"' j BUTTE COUNTY BUILDING DEPAU1" M APPK0\Vu If other than single widelI bilehome Mfr. furnish ,Setup Model No. Slo01-.208 Year e r_h (ft.) Box Length�_(ft.) Tagalong or Expando Size„_ft. x ft. (SHOW SUPPORT DETAILS BELOW) ,.; all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation nan,jal and structural setup sheets (if not on file with the County of Butte). '+_14 center supports measured from front of f:r.- ilehome unless otherwise specified. (check one) • Single t -v,r', A �c:�: r) e r�- 1 1 .:�c'C�. �-: :c 1. Wood either , :pressure treated orj d= foundation grade. /-�x 3 � (in.) (i •) 2. Other: ( specify) ;'P'Letr suppo t Center upport V SupSup (check one), '1 ;- - ations* footin sizes oncrete block. E] -2. Other. (specify) .ft.)(in.) 4.) (in.) ft.)(in.) (ft.) in.) (in.) t.)j (in.) I -(in.)j (in�) ,j z:enter'piers are other than drawn above, " in -locations, spacing, and dimensions. tagalong or 8xpandc,' show support details. - Typical Support (in.) (in.) Footing Size �� -- Max. Pier Spacing JA (ft-Xin.) (ft.)(in.) -- Max. Overhang JCOUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS r 7 County Center Drive - Oroville, California 95365.- Telephone 916/534-4541 APPLICATION AND }PERMIT PERMIT NO� ASSESSOR PARCEL NUMBER_ .1 ZONING - BUILDING PERMIT OWNER `C` " TELEPHONE .rz j��/� SO. FT. OCC. BUILDING VALUA OWNER'S MAILING ADDRESS ' IV -S "p, CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER _ ry ®/v irZ UNKNOWN Total Valuation $ FilinSS g Fee $ '40'00'• LENDER'S MAILING ADDRE Permit Fee $ ARCHITECT OR ENGINEER - LICENSE NO. Plan Checking Fee $ 0C) Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS ^ , PLUMBING PERMIT Filing Fee 10.00 ' Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Each qaS water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome© Other SPECIFY Building sewer 5.00 Mobile Home S 10.00e�d� TYPE OF WORK New❑ Additio ❑ Remodel[] Utilities Installatioq❑ Other❑ Describe work:! �r,/�1�� <'% a `cam% KpI Permit Fee $0 Contractor 6AS CAL 6A ev 'M/V %1kif-51T ELECTRICAL PERMIT Filing Fee 10.00 Main service 1100v OR LESS 10.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ( ACC. BLDGS. 2t/20sq ft 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 Professions Code and my license 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) Rf 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 NON•R ESID BRANCH CIRCUITS) 2.50 ea NEW CONSTR POWER APPARATUS .&) NON -RES D. (SINGLE OUTLET CIR, Ex. Occup(oUTLETS OR FIXTURES 9A ®30 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 $ ^7 ;Q5) 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 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. 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 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 id County.in consequence of the granting of this permit. Date `o s f Appli aOwnerX Contractor ❑ Agent ❑ /OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 storiesinheight. Mobile Home Installation Fee $ TOTAL PERMIT FEE k'$ OCcUP, GROUP I TYPE OF CONST. PARCE PD H ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which D I R7FTOR YQ5PLIC 4 By. t PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date � FK— Receipt No. A 3,—/ _AS� WHITE-D.P.W., 7ELLOW-ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT i R� J s ``Too Building Depmrtment From: E.vf ro men.t.cA, :aeaitli Subject o Sanit �a.,on Clearance � � S'� ��U rL�� -32 imer 1 c Plan Approved for: Savage Disposal � Water Sup;�l.y . Hold FJ_na1 for w Water Supply Final Clearance C..E.® for: Water Supply cleavxace ."or bedroom house/mobilehome or other NOTE � � a _ 7 COUNTY OF BUTTE - DEPARTMENT OF1P—UBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 7, TELEPHONE: 916/534-4541 PERMIT APPLICATI.ON*DATA SHEET l Permit No. OWNER � 166S A. P. No. %,--Z —,-z Proposed Building Use /W//-/ L76^1T/(ES Permit Fee Based Upon: Complete Contract Price DPW Valuation Other (Explain) Building Inspector �J/' ; Date At time of perr�.it application, I was advised the following data must be submitted prior to permit processing and/or i swannce: DATE RECEIVED APPROVED All it s have been submitted. . . . . . . . . . 2. Plot plans in duplicate/triplicate. . . . . . . . . . . 3. Complete plans in duplicate./triplicate. . . . . . . . . _ 4. Complete engineered plans and calcs. 00 5. Plans with Energy Design Compliance Statement. . . . . . 6. State Energy Forms No. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . 9. Letter of signature authorization. . . . . . . . . . . 10. Sanitation approval from Health Dept. 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation:ln'surance. . . . . 13/ Contractor's License Information (no., name style, classif.) 4. Owner -Builder Verification (Given to owner , Mail to owner 15. Improvements may be required. . . . . . . . . . . . 16. 'Mobilehome Installation Data. . . . . . . . . •. . 17. Pre -Inspection for RequiredPre-Inspec. request to. Building Inspector (Date) 18. Other When ou issue the permit, process as follows: Mail to owner. _ Telephone � �4147 and hold for pickup at --office. Other ;:5�SE � V S F/ AVG— L D7L1-W_ S Applicant Copy of plans sent Health Dept., Fire Dept., Other _Mail to contractor �Deli•ver w/Inspect Date Date— During, the ate During-the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: } (Contractor, Designer, Owner) was advised of above required data by Telephone —Mai I`' Other By Date Plans checked by Date Plans approved by i Date Other: Copy—DPW COUNTY OF BUTTE - DeWartment of Public Works 7 County Center Drive, Oroville, CA, 95965 Phone: 916-534-4541 OWNER -BUILDER VERIF ICAT ION ` Attention Property Owner:- An wnerrAn "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your build- ing permit. No building permit will -be issued until this verification is received. 1. I personally plan to provide the major labor and uiAtqrials for construction of the proposed property improvement (yes or no) , r 2. I (have/have not)signed anryapplication for a building y permit for the proposed work. 3. I have contracted with the,following person (firm) to provide the proposed construction: Name Address. City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the fallowing person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors.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 PhoneType of Work .,V¢f _ �&n _ n _ .9 Signed: Property Owner Social Security numbers , ►- ® ?• Date ro/s If r .r -- NOTE:. This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. r!n? COMPAREDWITH Return to DPGbRIGINAE D000 ICULTURAL STATEMENT OF ACKNOWLEDGEMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8.1 of the Butte County Code requires this acknowledgement be recorded prior to issuance•of a building permit. QCT 43 PPS The property described herein is adjacent to land or included rLU,"tIa.; E kR> - hl Jf�i)ra within an area zoned for -agriculturgl" purposes, and residents of this ���'��`; property may be subject to inconveniences or discomfort arising from �� F the use of agricultural chemicals, including, but not limited to herbicides, pesticides,. and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, -plowing,-.spraying, pruning, and harvesting which occasionally generate. dust, smoke, noise, and odor. .Butte.County.has established agricultural zones yhich 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. _ 33 All that real property situate in the County of Butte, State of California, described as follows: Parcel I. A portion of the East half, of the East half of the South: East .corner of section two, Township 19. North, Range 5 East, M. D. B. and M. and Imre particulalrly described as -follow, cam-tencing on the South East corner of said section two, 02ce North 00* 01' 02", East 1935.91 along East line of section 2,ftence leavinj said east line North 64* 6' 46" West, 220.00' to the true point of beginning for the parcel herein described: THENCE from said true point of beginning, South 24* 56' 04" West, 215.96',then South 06* 09' 02" West,100. 33' to the beginning of a 195.95' radius curve to the right, thence along the arch of said C rve, thru the central angle of 35* 41' 38" an arc length of 122.07' to the beginning of a 100' radius curve to the left, thence along the arch of said curve, thru a central angle of 50* 56' 12' an arc length of 88.901, then& along the arc of al31.86' radius curve to the right, whose tangent at this point bears south 80* 54' 28" West, thru a central angle of 24* 50' 45" an arc length of 57.151,'thence South 56* 03' 44" West, 110.50' to the beginning of a 102.50 radius"angle of 88* 27' 46" an arc length of 158.26' to a point of the wrest line of the East hal£ of the South East Quarter of said section 2, thence North 00* 18147" West, 450.81' Date: /0 -S- 9K PROPERTY OWNERS: (over) State of ) On this the day of, 19 , before SS. tee, the undersigned Notary Public, personally appeared County of ) STATE OF CALIFORNI SS. COUNTY OF On before me, the undersigned, a Notary Public In and or said County and State, per- sonally appeared L P S i0 personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to the within IL IL Instrument (or proved to be such by the oath of a credible witness who v is personally known to me), as a subscribing Witness thereto, who LU being by me duly sworn, deposes and says. �y That SS A e- resides in S� - / �A/� Z _,�A�ADi and that n e was present and saw o C A', 44_f �` ✓9u �•_/�J , personally known to Z � 4, 9to be the same persons described in W i. J and whose name 4 i4 R Z subscribed to the within and annexed ~Instruments as Part ! es thereto, execute and deliver the same, and S A e' acknowledged to v a -. executed the same; and that said z v said affiant that subscribed hi'•/ name thereto as a Witness. affiant Signature OFFICIAL SEAL KATHY DANCE NOTARY PUBLIC - CALIFORNIA PRINCIPAL OFFICE IN BUTTE COUNTY Mr COMMISSION EXPIRES OCTOBER 5, 1983 cno +InTj�ely cFAI nR STAMP Oy y .h p i n _ , along said West line, thence leaving said West Line North 51* 40' 19" East, 318.14', thence South 64* 06' 46" East, 236.65' to,the point of the beginning; A.P. # 72-26-33 . . n _ , along said West line, thence leaving said West Line North 51* 40' 19" East, 318.14', thence South 64* 06' 46" East, 236.65' to,the point of the beginning; A.P. # 72-26-33 . . PERMIT NO. (MH) PERMIT EXPIRES- • OWNER ARVID RIGGS CONTR. Omer ASSESSOR PARCEL 72-26-33 LOCATION SIS Stringtown Rd, app 4 Mi'W Boat ramp, Oroville Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E Temp. Gas Service IIID Called PG&E JOB FINALED (Date) Signature V =.OK O = Not OK . - = Not Applicable = Not Ready MOBILEHOMES MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except N's Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 2. Footings; Size -Depth -Spacing -Connectors 4r5ewer; Location -Test -Fall -C/O -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts- Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete '` 5. Alum. Awn.; Columns -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. Card -B to ` 1� Card -BI .Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except k's 1. Zoning Requirements -Setbacks -Easements Card -BI Date _ Date - • • Card -BI Date POOLS (Plans) OK except ti'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-GFl" 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/O to Grade -HD Approval 8. Gas and Electricity Tagged 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 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 -B1 Date Card -BI Date Card B -I Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date R I = OK = Not OK = Not Applicable RESIDEN;IALASingle and Duplex) - = Not Ready Date UNDERFLOOR Plans OK exce t#'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-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 9. Gas Pipe; Size -Anchors 55. Shear Walls; Nailing -Bolts 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 p's Card -BI Date Card -BI Date Date _ PLUMBING (Permit) OK except q's 14. Water Ht.; Vent -Access -Combustion Air 15. Water Pipe; Test & Anchors -Nail Protection 56. Ext. Steps -Door & Sidelight Protection -Landings 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 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. Stairs & Rails _ 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. 67. Elec. Outlets & Receptacles at Kit. Counter Garage Fire Door; Swing -Landing -Closer Date ELECTRICAL Permit OK except p'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-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 E] 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. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or At, Insulated Neutral []Yes ❑No 75, Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters Dyes ❑No 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77. 78. A.C. Unit; Disconnect-Cirnces-Brkr. & Cond. Size -115V Outlet Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 30. Clothes Closet Light -Shower Light 79. Water Well; Disconnect, Electrical, Plumbing - 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B -I Date Card -BI Date 81. Ventilation throughout House Card B -I Date Card -BI Date 82. Glass Protection Date MECHANICAL (Perrr,it) OK except p's 83. _ Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 31. A.C. Ducts; Insulation & Support 85. Water & Sewer Connected -C/O to Grade -HD Approval _. 32. Vent Fan; Exhaust above Insulation 86. Energy Compliance Certificate -Other Certificates _ _33. Condensate Drain & Overflow; Size & Grade 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic Card -BI Date Card -BI Date Card -BI _ Date _ i Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Comments at Final: Date FRAMING(Plans) 36. OK except #'s Proper Material & Anchors 37. _Sills; _ Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound _ 38. 39. Bearing Walls over Girders & Floor Nailing Draft Stop in Walls (rat proof) 40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub _ 41. 42. 43. 43. 44. 45. Header & Beam -Size & Bearing Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties -Purl in -Roof erac.-Truss-Shthng.-Rfng. Fireplace Ties or Type A Flue -Fireplace Throat Attic Access; Size & Rom_ex Protection -Draft Stop -Ins. Baffles _ 46. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions _ 47. Garage Fire Protection Framing (NOTE: An entry must be made each time youvisit jobsite) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION A- •PERMIT PERMIT NO. AA ASSESSOR P RCE UMBER —�� 3 3 ZONI G 7, BUILDING PERMIT °W �I //D ?J/ `I�-'/ SQ. FT. OCC. BUILDING VALUATION ^53,�12-4l 0W0 MAI LING_ ADDRESS'll/� /,� O�V ! V' / • �5✓ y/�% CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Q Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINE LICENSE NO. Plan Checking Fee R $ OU Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ B �tG ADDg rJ .VW �f PLUMBING PERMIT Filing Fee 10.00 — �OA P MP Each Trap 2.00 Repair drainage or vent piping 5.00 / / OROVILLG Water piping 7U _0a LOT NO. SUBDIVISION NAME PARCEL MAP Each gas water heater or vent 5.00 Gas piping system 1 - 5 outlets -00 USE OF STRUCTURE SF ❑ Duplex❑ MobilehomeR__16ther SPECIFY Building sewer lo. 0 Z) Lawn sprinkler system 5.00 TYPE OF WORK,, New ❑ Addition [JRemodel ❑ Utilities L(� Installation❑ Other ❑ Describe work: Permit Fee Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP 0V OR ORSLESS 5.00 C;__00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. /DWELLING OCCUP.y) OR ADDNS. % ACC. BLDGS. 2�sgft 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 Professions Code and my license is in full force and effect. License No. Classification 1, .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. .OU LET NON.RESID BRANCH CIRC ITS 2.50 ea NEW CONSTR ( POWER APPARATUS 01 NON.RESID. SINGLE OUTLET CIR. Ex. Occup OUTLETS OR FIXTURES_ 50025 IXED APPLNS, OR EX. Occup.(OUTLE TS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 -00 MIs Wirin 7.50 A 0 0 Permit Fee $ 3rL5d Contractor 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. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee S 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 of 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 expens#s which may in any way accrue against said County in consequence of the r ting of this permit. X - (1P '_��_ �� Date Signature of Applicant — Owner V C ntractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over storiesin height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP I TYPE OF CONST, PARC; IYJ HD Issu This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRE R OF PUBLIC BY P IT EXPIRES Date the applicable-provi- resolutions to do fees have been paid. WORKS Date 7-7-2-21 Receipt No. 55-7J J WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT OWNER 4 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE; CALIFORNIA 95965 - TELEPHONE: 916/53413541 PERMIT APPLICATION DATA SHEET Permit No. z, 11 D � S A. P. No. �Z_2�' Proposed Building Use �'%� u77L Permit Fee Based Upon: Complete Contract Price DPW Valuation Other (Explain) Building Inspector Date Z�_S1 At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted. . . . . . . . . . . . 2. Plot plans in duplicate/triplicate. . . . . . . . . . . 3. Complete plans in duplicate./triplicate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. State Energy Forms No. �. 7 Statement of Intent for Non -Heated and AC Buildings. ' 8. Fees of $ . . . . . . . . • 9: Letter of signature authorization. • Sanitation approval from Health Dept. 11 V. Planning approval for (A) Use: (B) Parking: - arking:12. 12 . Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) �►� 14. Owner -Builder Verification (Given to owner, Mail to owner ❑•) 15. Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . .. •Pre-Inspec. �17. request to Pre -Inspection for Required. Building Inspector (pole) 18. Other When you issue the permit, process as follows: ✓ Mail to owner. Mail to contractor. ` Telephone and hold for pickup at office. Deliver w/inspector. Other Applicant_ �� - E. Date 7' L 7IP Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at time of ap Iication, circle item.) 1. Index permit for above Items No. , 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone MailOther By Date`; Plans checked by Date Plans approved by Date 2 Other: Copy -DPW L -C SO UOT2-1-PPIT aOJ 30ulea-90TO anK o oiimir .)L[ i,,L;qo7 luo0apecl roj ovouvxaa-r� :.Toj -'I'l-0 n*uvj,-aaTa- I SIdd-as lonlim *201 TRUTJ PTOR c dns a��4.wa r.,tjFod�31.p ;-159�axas :aoj P4Aojddv aeTj T 001 19 tau -1 ql,T-qAFj- Tv4u-amuoj',iAUj J'Uam-txedo(j; Su -PL TTTlq OtT, 05 Z14 o �0 N E:—Alli Accordant aterrals & Wor!c of a �ewith Roc,, inarship Shall rf:7� r . �rrY ' Uniforrgi�u g �re`P�P�, for ,t©c' • cticos and the �. ding. le.. ,�, 0 lfja z al Hectrical � -,a -C Codon an e d •.. r.- � � goo ��a .. • A' •v � �' V A' r ;rrt�htn i b GA ��Ct<LrK a9 +` 'V • torl�ect'lOnS ��t "'" . ��r ey .: • ti � ,�• �� ►Itty; •. o'uileh root oh. of t o Vit%�r © ,� ,��4- -A kind or directiYMt noside:ail V .5.x/2.'/97.07'jo5Q ��y9 L.ROA DW A/SO.67' 4720' t21, 4wired for .ado' w(Y1er11VJ A setback of 5 ft. fromfhoproperty lines andasetbeck �of 50ft. from the road centerline shall be clear ofstructures or equipment excoptfor a 2 ft. eave overhang. ;PARO�Ac.409 .4C. ctficatt�ns MUST 6evm_is s C#` Di i'r is G�Irywf"�! toCt �rmr' �vit%out chrnrli=.r •��ns ,n - ar}ment of punY. ? Q permission frotehc[)cp V 2 ICJ v V'dor .County of BtO li f BUILDING DEPARTM v 7 COR VE �A TA ' _� �E . •.�. � � APPROVE A - . b 44'24'S3' ,e_ /00.00 a N . L= /S..SO` L • /�.c?O1 L: 13.27' r\.eti 117 40 q ccorda Mater►q • W t v �� t •�� 5 of p nce or„ ' E;��• •• � : �,.•��tVni.for�uBuildpr@tcr'l,���,°��•..�� �►dnS�jlb 5� Ing, ' ,� �► p +ail National Etrcl����°s c,��„��4��c`'^n��a nd pd� rgCh�nlC� 1 Ito !n �33.c9' �.( p' Cod fhe g^� esand t. c. ::'� . _a._ V!. cam• - • . �-- :.�.✓�/ � � .; � .. 2 a �0 0 3.94 a' n IVY. �^r q3 �P .2 ' 4gc o Iq A N99°30aq'E /97.07' r'.-S1�oG' _AC'O,gs e 5 aj r w rte, 1 59,43 , /SO. C, 7' rUt....jam j � ^►, 0. Nr { / 70.00' . UN 2 1 t> A % i r; LAI A setback of 5 ft.:from the, i O property lines and p;sefback of 50ft. from the road `� centerline shall be dear of O structures or equipment except for a 2 ft. eave overnana. PA 'CEL i0A.eC,4 .3 � .4 32,2 AC. �p W ^ _ - `� "This set, of plans .and, ,pecifications MUST be .:: kept n +6 jn� -at cell 'sir s c+nd. it is unlawful to L�-, on same wltk�out rvvWrltte permission from the Department of Publla or C0: r�ty' of Butte. N DA 7A A - d - 44 D - A : 00,_-74.,21 •E', 1,0.00 R 1.3:.'' • ' t ' R /00.00' p :.'r, L: /S. SD' L • /9.8�7i 4-1.3.27, n n; 11 PERMIT NO. B }7 PERMIT EXPIRES A. C. RIGGS OWNER CONTR. owner f 72-26-33 ASSESSOR PARCEL S/S Stringtown Rd, 4 mi W Boat Ramp LOCATION Oroville • c a f, 'f -i Temp. Power Pole `i '.1 Called PG&E " Temp. Elec. Service Called PG&E Temp. Gas Service Called PG&E JOB FINALED (Date) 2 �� , Signature k J = OK ' 0 = Not OK — =Not Applicable MOBILEHOMES = Not Ready I MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except #'s Date DEC , COVERS, CARPORTS, ETC. (Plans) OK except #'s 1. Zoning Requirements—Setbacks—Easements Zog Requirements—Setbacks—.Easements 2. Soils; Special MH Support—Sketch 2, oot'ngs;:Si'ze—Depth—Spacing—Connectors 3. Sewer; Location—Test—Fall-C/0—Concrete 3 s; Girders and/or Joists—Decking—Bracing—Stairs—Rails 4. Water; Location—Test—Easement Needed (Sketch) 4 W Awn.; Posts—Beams—Rftrs.—Con nec.—Shthg.—Rfg.—Bracing 5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete 5/Alum. Awn.; Columns—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. Card -BI Date Card -BI Date Card -BI Date z ard- I Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements—Setbacks—Easements Card -BI Date Dat Card -BI Date POOLS (Plans) OK except #'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 S. Drain; MH Test—Fall—Flex Connector 4. Elec.; Receptacles and Lighting; Distances—GFI 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 B. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg. Boxes— Enc losures— Pane lboards— 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 r43( S -LA 6,,tC.CAad,0(G- 0_ = OK = Not OK = Not Applicable = Not Ready RESIDENTIAL (Single and Duplex) Date UNDERFLOOR Plans OK except #'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. 4. Ftg., Garage; Soils -Steel- / /" Ftg. Depth Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 50. 51. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 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. Glazing Area -Glass Protection -Skylights -Plastic 8. 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. 12. Electric; Underground 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 Card -BI Date 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 #'a 57. Smoke Detector 14. 15. Water Ht.; Vent -Access -Combustion Air Water Pipe; Test & Anchors -Nail Protection 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 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. Stairs & Rails 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 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 22. 23. Size Boxes & No. of Conductors -Stapled Romex Installed Close to Edge of Studs & C.J. 70. Plb., Elec. & Mech. Equip. Listed for Location 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 73. 74. Guard Rails & Deck Construction -Post Caps 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 At 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or A[, Insulated Neutral ❑Yes ❑No 75, Following instld.: Drive ❑Yes E] No; Walks El Yes ❑ No; Planters ❑Yes El No 28. Service -Riser Conductors & Ground -Main Disconnect 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. 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B -I Date Card -BI Date 81. 82. Ventilation throughout House Glass Protection Card B -I Date Date Card -BI Date MECHANICAL (Permit) OK except q's 31. A.C. Ducts; Insulation & Support 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 85. Water & Sewer Connected -C/O to Grade -HD Approval 32. 33. Vent Fan; Exhaust above Insulation Condensate Drain & Overflow; 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 -BI Date Card -BI Date 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 FRAMING Plans OK except q's Comments at Final: 36. Sills; Proper Material & Anchors 37. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound 38. Bearing Walls over Girders & Floor Nailing 39. 40. Draft Stop in Walls (rat proof) Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. Header & Beam -Size & Bearing 42. 43. 44. Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng_.-_.frig_._ _ Fireplace Ties or Type A Flue -Fireplace Throat 45. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 46. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing (NOTE:Anentrymust be made each time youvisit jobsite) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovil le, :,aIY(,,rnia 95965 - Telephone 916/534-4541 APPLICATION AND` PERMIT PERMIT NO. 3 5� %7_ n/1 ASSESSOR PA=a -3R Zo"y BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNE 'S MAILING ADDRESSCLk r -:2700 CONTRACTOR' NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER e LICENSE NO. Plan Checking Fee $^r Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $,©� BUILDING ADDRES h ��7• PLUMBING PERMIT Filing Fee 10.00 I / D11t w Each Trap 2.00 Solar Water Heater 20.00 Tv Water piping 5.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF ❑ Duplex Mobilehome Other SPECIFY Building sewer 5.00 Mobile Home I S I G JW 10.00 e TYPE OF WORK New ❑ Addition 5� Remodel ❑ Utilities ❑ In taIIation ❑ Other ❑ Describe work: b Pe -n Al e0 ✓ �C,e _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service jp0 AMP ORV OR LESS10.00 Main service EA. ADD'L too AMP 2.50 NEW CONST. ( DWELLING OCCUP.& OR ADDNS. ( ACC. BLDGS. t 2/20sgft 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 Professions Code and -my license 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 MULTI -OUTLET 2,50 ea NON -REBID BRANCH CIRCUITS) NEW CONSTR POWER APPtRATUS & NON.RESID. (SINGLE OUTLET.CIR. zo®soa Ex. Occup(ouTLETs OR FIXTURES 9AL®ao FIXED APPLNS. OR Ex. 2.00 OCCUp. OUTLETS (RESID.) EA.1 Temporary service 10.00, Mobile Home Facilities 15;00 Misc. Wiring 15.00 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 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. 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 Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against and expenses which may in any way accrue all liabilities, judgmentj�s�ilce against said County in c of the granting of this permit. X (� Date /�'— Signature of Applicant — ner ❑ 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 TYPE OF CONST. PARCEL PO HD 95 This permit is hereby issued under sions of the Butte County Cod and/or work indicated above for whi h DIRECTOR OF PUB BY P IT EXPIRES Date the applicable provi- resolut,ions'to do fees have been paid. IC WORKS Date /%� // Receipt No. f .�2 8 WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF'PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, C.ALI,F,OR,NIA 95965 - TELEPHONE: 916/534-4541 OWNER Proposed Building Use Permit Fee Based Upon Building Inspector PERMIT APPLICATION DATA SHEET ff t Permit No. I A. P. No. z -2-� Complete Cdnjract Price Other (Explain) DPW Valuation Date At time of permit application, I'4s advised the following data must be submitted prior to permit processing and:/or issuance: DATE RECEIVED. APPROVED 1. All items' have been submitted. . . . . . . . . . . . 2- Plot plans in duplicate./triplicate. . . . . . . . . . 3. Complete plans in duplicate. /triplicate. . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. State Energy Forms No. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ , titter of signature authorizati,o . . . . . . . . . . . Sanitation approval from Health Dept. 1. Planning approval for (A) Use: - (B) Parking: 12. Certificate of Workmen's Compensation Insurance. 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner, Mail to owner ❑.) 15. Improvements may be required. .. . . . , , , , , 16. Mobi lehome Installation Data. . . . . . . . •Pre-Inspec. request to 17. Pre -Inspection for Required. Building Inspector (Date) 18. Recorded copy of Agricultural Acknowledgment Statement. A� 19. Other i When you issue the permit, process as follows: / Mail to owner. Mail, to contractor., Telephone and hold for pickup at office. Deliver w. /inspector. Other- i .. Applicant Date %/—Fi "—�j Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance. (For required items not checked above t' a of application, circle .item.) 1. Index permit for above Items No. 2. Additional items required: J (Contractor, Designer, Owner) was advised of above required data by Telephone t' Mail Other By Date Plans checked by Date Plans approved by Date Other: Copy—DPW To: Building Department Prom: Environmental. health Sub to Sanitation Clearance KSt�dw, 2- - 2- hnrn�r '� on flan approved for: Sewage Disposal Nater Supply Bold Final for: Water Supply Fina. Clearance O.K. for: Water Supply Clearance for hedroom house/mobilshome or other r n� `f NOTE '"** (4) 04, OAAd Call JYI'm (,1 0d(X Ib(h_n we—yam/ ��_ . I , I I " . • EI_, _NTMI - -:I j i N . . ......... IA! 4-f I k jn ale . .......... aq- ;-,1 06 Hi U -AL vj - T -J T IA! 4-f I k jn ale IA! 4-f I k COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 .,. APPLICATION AND?ERMIT PERMIT NO. ASSESSOR PARCEL UMBER ZONING BUILDING PERMIT - OWNER ' C, el TELEPHONE ,SQ, FT. OCC. BUILDING VALUATION OWNER'S MAILING ADD E - 1-33q G� C O!'N T/RAC TOR'S NAME W TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Flling Fee $ 10.00 LENDER'S ADDRESS Permit Fee $ I`✓J . (� ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee ,$ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 G(� Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 00 5�5_.O USE OF STRUCTURE (�ni0n�Y�,''�/ Duplex❑ Mobilehome� Other !9sPecl�'r Gas piping system 1 - 5 outlets Building sewer 0SF❑ Mobile Home S G W 10.Oea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Instal lation ❑ Other ❑ Describe work: _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service SS 100 AMP OOR R LESS 10.00 Main service EA. ADO'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check One): F-1NON-RESID I am licensed under provisions Of Chapt. 9, Div. 3 of the BusinessI and Professions Code and my license is in full force and effect. License No. Classification 1, 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 OR ADDNS. CONST. ACC. BLDGS. DWELLING OCCUP.& , �2 OSq ft NEW CONSTR ULT' -OUTLET BRANCH CIRCU, TS 2.50 ea POWER APPARATUS &) %SINGLE OUTLET CIR. EX. OCcup(OUTLETS OR FIXTURES 200500 erAL®90 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. bYirin 15.00 9 Permit Fee $ 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. Ca 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. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling g 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 Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, sts, and expenses which may in any way accrue against said County in cons uence of the granting of this permit. %� - � Date/ -',O" 3 f — �'.� Signature of Applicant — Herr 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 $ Energy Inspection Fee $ TOTAL PERMIT FEE $ �S occuP. CONST.TTPE I FLOOD PARCEL PD ND 99UE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for ich DIRPdTO F UB By EXPIRES Date e the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. �� FTE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD-APPLICANTPERMIT