The URL can be used to link to this page

Home My WebLink About072-600-024I A. P., e ` ;! John Sammet !M s. .I"-Forbestown Rd., 0fov lle 4 Permit 1177-70B (new summer kitchen to^ be used w/mobile home) i 11 � FAYE`Or"SAMMET W/SlLumpkin Rd.,4,mi. NE of. Forbestown Rd., Orovill"'e.t.-11 Perm' ##6-76P E (ut it . ,II� s LEC �:. g as� ' SUPPORT STRUCT REQ,. U { - I COMPACTION TEST REQ`_ 4 9f CONTR s ErniesNiH' Tr spoir;P+�a , y Permit'`#23=76NIIi }} i I A. P., e ` ;! John Sammet !M s. .I"-Forbestown Rd., 0fov lle 4 Permit 1177-70B (new summer kitchen to^ be used w/mobile home) i 11 � FAYE`Or"SAMMET W/SlLumpkin Rd.,4,mi. NE of. Forbestown Rd., Orovill"'e.t.-11 Perm' ##6-76P E (ut it . ,II� s LEC �:. g as� ' SUPPORT STRUCT REQ,. U { - I COMPACTION TEST REQ`_ 4 9f CONTR s ErniesNiH' Tr spoir;P+�a , y Permit'`#23=76NIIi }} 4 i r • I A. P., e ` ;! John Sammet !M s. .I"-Forbestown Rd., 0fov lle 4 Permit 1177-70B (new summer kitchen to^ be used w/mobile home) i 11 � FAYE`Or"SAMMET W/SlLumpkin Rd.,4,mi. NE of. Forbestown Rd., Orovill"'e.t.-11 Perm' ##6-76P E (ut it . ,II� s LEC �:. g as� ' SUPPORT STRUCT REQ,. U { - I COMPACTION TEST REQ`_ 4 9f CONTR s ErniesNiH' Tr spoir;P+�a , y Permit'`#23=76NIIi }} OVA M util.,MH PERMIT NO. '( P t s E M MH UTIL. 'PERMIT NO. _ f 6-76P,E PERMIT EXPIRES ,;OWNER Faye O. Sammet "CONTR. owner LOCATION A.P. 72-26-64 W/S Lunpkiri Rd 4 -'mi,. NE of Foftstown Rd., J ; Or:oville (f :a i f •K. �ee ios /FINALED/K r ole &E ti . Serv. d- �: -7 - %� iG&E " ' Serv. �- 2 %7GG&E-4_ �61 ¢-27/u/ K 91) m H l (Date) (Signatu e)' c, 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 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Piping -2 Piers Roofing Sewer — Z — 76 Garage Fdn. Vents Fixtures Footings Garacie Vents Water Htr. Stemwall Prov. for physically Heaters Slab handicapped Appliances Carport Conformance of ex. Gas Piping & Test Footings structure Temp. Gas Slab Final - Sanitation Patio FIREPLACE Final Footings Footing . ELECTRICAL Masonry Walls Throat Rough 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 OR CORRECTIONS 76 KGs zaev /REMARKS 'p�,6 a� Ao Z. 7- d �c�e •G /Gv sal p �L G'� d � �,Z) �� o ' , �. Uigrutt�' _ �s�S •�'irs�j/f �i L� v`' U.S � cQq//�,/!i=c3 . . �'�/O•Zy� ?'�'l� + �ii9 e/` f t�cv��lr �6ei.f �, , C4,- } .; ' z 3 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 germit number 2-✓7� for the followingJocation:_� 5%cfe �.«nvX;y OwnerT Owner's Address Mobilehome Mfg. Model 13 ) YearZ Insignia No. -13 6A C 5- Serial No. 2- S Z-- C It is hereby certified for occupancy at the above described location and may be occupied. Director of Public Works Date E THIS CERTIFICATE IS VOID WHEN MOBILEHOME J9RELOCATED 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 s-'� 7G� for the following location:G:.> r -r E Owner Owner's Address / Mobilehome Mfg. _t��"�•./�� Model —Year!G Insignia No. 1 3::� /� 5 Serial No. 2- > 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 MOBILEHOME INSTALLATION INSPECTION CHECK LIST -A I.' Is the mobilehome located with required separation from lot lines and buildings and generally conform to plot plan? Yes �o 2. Does the mobilehome have required clearances above ground? (Sec.5085) Yes 4"' No 3. Are footings and supports properly sized, spaced, and braced as per approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yeses No 4. Is the mobilehome level? (Sec. 5088). Yes 1"'No 5. I,f more thana single unit, are crossover connections properly installed? (Sec. 5088) Yes a,"No 6. Water A. Is fle�ble connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes No B.' Test - Does water piping withstand working .pressure or 50 lbs, air test? Yes J"" No C. Backflow --If coach is not State of California approved, does station have baekflow device and pressure -relief valve? Yes No e) �� 7. Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yesl No— B.. oB. Does it have minimum 4" per foot slope and is it properly supported? Yes No C..' Are any leaks detected in drainage system after running 3 -gallons of water through each fixture including washing machine standpipe? Yes No V D. If coach is not State of California approved, does station have required trap and vent? Yes No P N Q 8. Gas Piping and Gas Vents A. Connector - Is mobilehome connected to the gas supply with,,an approved 3/4" minimum mobilehome connector not more than 6 ft. long? Note-" All piping is to be at least as large as the mobilehome gas line inlet without reductions other than the mobilehome connector. Yes k --No B. Test OK as per following procedure? Yes 'moo 1. Open all appliance connector valves. 2.. Shut off appliance burner and pilot valves.. 3. Air test with manometer to 10"-14" water column, or test with slope gauge (minimum 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without drop. 4. Connect gas meter to mobilehome with connector', turn on gas, test connections with soapy water. C., Are all appliance vents properly installed? Yeses No 9. Electrical 3- 7 4.' Q A. Is service large enough to provide adequate amperage -to mobilehome (must equal rating'of mobilehome with a minimum of 1`00 amp) and other facilities on lot, i.e., water pumps, garage, cabana, etc.? Yes No B. Is there proper clearances around panels? Yes o C. Is power supply cord or feeder assembly properly fused? Yesl_,�No_ D.- Is continuity test satisfactory as per the following procedure? Yes L,- No_ 1. De -energize electrical wiring system of the mobilehome at the pedestal. 2. Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected, 3. Switch all breakers and switches in the mobilehome to the "on" position. 4. Connect one lead of a test.instrument to the mobilehome grounding conductor and apply the other lead to each rn.obileiiome supply conductor, including neutral. 5. All non-current., carrying metal parts of the mobilehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. 6. Upon completion of the above procedure, the power supply cord or feeder.assembly conductors. shall be connected to the site service equipment. A further continuity test shall then be made between the grounding electrode and the chassis of the mobilehorie. Upon satisfactory completion of the electrical tests, the lot or site service equipment may be approved for energizing. 10. Is job card signed by Health Department for water and sanitation? 11. If everything okay, sign off card and tag services. MOBILEHOME DATA Manufacturer and/or Namestyle Length IV& Width r Vehicle Serial No. ,q State Identification No. `? Additional:Informati.on or Comments:- -76 omments: -7G -/I-�Je tom/ t- h COUNTY OF BUTTE — QE -P PTMENT OF PUBLIC WORKS 7 County Center Drive — Orovilleo, California 95965 Telephone: 534-4541 _A APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above -me 'oned property for inspection purposes. X el � /z 3% Sig lure/of Permittee 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 BLIC WORKS By Date l— %-i b BtOing permit expires Date C _ i— 7 BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address `gam Tele hone No. �0��/ Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ Building Address — PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 r0Q Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping ,w Each gas water heater or vent 1.50 A. P. No. Zon' nning Gas piping system 1 - 5 outlets _U60 #00 Each additional outlet .30 ��11 Fie S i on Fire Dept. Fire Zone Use Permit Building sewer ---e& &•Q EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W Im r nts p Lawn sprinkler system 2.00 • BI tans Recd Parc Approval•• , Plans• pproval Permit Fee $ NEW ❑ ADDITION ❑ UTILITIES OTHER ❑ ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 Main service 6,0000'AOR LESS MP ORLESS 5.00:s—'00 Main service EA. ADD'L 100 AMP 2.50 ♦ Q Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service OVER 600V 1100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW CONST. DWELLING OccUP. S OR ADDNS. ACC. BLOGS. 2¢Sgft NEW CONSTR. MULTI.OUTLET NON-RESID. BRANCH CIRCUITS) 2.50ea • NEW CONSTR. POWER APPARATUS & NON.RESID. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Ex. Occup(OUTLETS OR FIXTURES)50 @25a SAL @1 Ex. Occu FIXED APPLNS. OR P•(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ Si7 Zj WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. 1:1 I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. ®I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner' so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby ,c TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above -me 'oned property for inspection purposes. X el � /z 3% Sig lure/of Permittee 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 BLIC WORKS By Date l— %-i b BtOing permit expires Date C _ i— 7 .z" e-�d . 10114 0. ,S y Oft U�40Z4Y This sat of plans MUST be kept on the lob at all tii-nas and it is unlawful to mako any changis or alt-3rations on same wHhout Written perrnisson from the Department of Public Wcwks, County of Butte. Septic system and location Bto to be as per County Health Dept. Re- Quirements. NOTE:—All- Matr,rirls & Workmanship Shall Be t. Accor•dr:n,-e with Rnconn;-led Gobd Practices of a qw-litis n, re�cr--hF-� for she Specified use in .r Uniform` BuUinn, Pllirnt inq & Machanical Codes and the National Electrical Code. The Bim. Setback shall be 5 . fr m the side property -line and 50 f . m the centerline of the road, pe itti g a maximum of a 2 ft. eave ovlrha q t .3w 1 o� F o ` 1 r +�rsarU, t�l.ti Lt A►y 1 �x c 14 �, '`i• ;G rTT� 4 i All utility Kn—n-;eCt' t— Y cons shall be C -tib r�JK located within 4 ft. outside the rear -s>`l3 otnird section of the mobile ho the left (road) side of them , ; IF home. J. BUTTE COUNTY 150'$- BUILDING DEPARTMENT APPROVED 1 4AI go. , a 1�e Location WE WILL aur SELL OR CONS/GH YOUR MOS/LE 110A DEALING IN 12 WIDES — EXPANDOS 24 WIDES — NEW & GOOD CLEAN USED HOMES `a 2 Miles South of Oroville on (Lincoln Blvd.) (old Palermo Rd.) Phone 916--534-7774 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - dro*ville,'California 95965 Telephone: 534-4541 APPLICATION AND PERMIT ...r�..��....�v�., v1 t- vUuniy vI ouuc iv CIRri uNun MU aboveCinature ioned property for inspection purposes. r % X Date of Perm/itee or Agent / Receipt No. �aR (_b- 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 cam, Date G Btriidir, permit expires Date _ BUILDING Owner A SQ. FT. OCC. BUILDING VALUATION Mailing Address .Telephone O No. Fireplace Contractor S /jif, /� f 74 Total Valuation Mai ling Address _ Permit Fee Plan Checking Fee&/or Penalty Tel eph ne No. C 26 Permit Fee Building Address�j(/ v"` ��^J � PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. _ r� Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 s Sapjtation Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Declaration Parcel Map 60' R/W Improvements Lawn sprinkler system 2.00 Bldg. ns Recd Parcel A�proval Plans/ proval Permit Fee NEW [:]ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 // // 4 ,�- '. 4n, Main service incl. 1 meter �r r Additional meters, each 1.00 - Single Family ❑ Duplex ❑ Mobil Home Others ❑ Sub -panel (12 or less) (more than 12) Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures b (d2 Receps„ switches & fix outlets 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:Water 7��^_�T��"�� Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. d1sp. or D.W. 1.00 Air conditioner or heat pump pump - Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No.Q?21 7 bQ Classification Misc. wiring ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee is 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. F5Y1 have placed on file with the County of Butte a certificate of �yW Workmen's Compensation Insurance. ❑I certify that in the performance of the work for which this permit .is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws, of California. MECHANICAL, No.1 @ FEEPERMIT FILING FEE J$3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances ,and State Laws relating to building construction, and hereby TOTAL PERMIT FEE $ Q' ...r�..��....�v�., v1 t- vUuniy vI ouuc iv CIRri uNun MU aboveCinature ioned property for inspection purposes. r % X Date of Perm/itee or Agent / Receipt No. �aR (_b- 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 cam, Date G Btriidir, permit expires Date _ i �h BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center'Drive, Oroville,.CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name: �%4 / C of /�)i/1 I M C , 2. Installer's name: Enj Iinr3'1 I N T A>J�a 3. Is the site currently under permit? Yes_- No _l (If yes, furnish permit number 6 e /10 ) OR 4 ' 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 `->el (If no, clarify 5. What is the mobilehome electrical rating? -At ------------------ 6. t----------------- 6. What is the mobilehome site service rating? --------------------- 7. What is the mobilehome site circuit breaker rating? ------------- 8. Is there any other electric load to be served by the mobilehome Amps Amps Amps Ono siteservice? --------------------------------------------------- Yes / / No (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? ---------------------- -(in.) 10. What is the type of gas seryice?----------------------------- Natural./ / LPG 75F/ 11. What is the gas pipe length from meter or tank to the mobilehome? �� (ft.) 12 :What is the mobilehome gas demand? ------------------------------ (BTU) (This information not required if pipe length less'than 6 ft. on natural gas or less than 50 ft, on LPG.) Ono MOBILEH,OME,SUPPORT DATA' Mobilehome Mfr.. Ci"Y-h ;f Setup Model No. c Year Width(ft.) Length (ft:) -Expando .Size ft.x ft. (Draw support details below) . On all mobilehomes'manufactured after October 7, 1973, furnish manufacturer's installation manual and Structural setup sheets..(if. not .on .file with the County of Butte). S' le . ..... _ Footings-- (check . one) �O l:. Wood :either . . pressure treated or Center Center Support �: fdn. •grade.:: Support Footing Sizes Locations (in.) 2.:Concrete pad. ,x In.(in'.) in. x � ,' V 711 3 . --Other, - specify Supports (check one) Concrete block 2. Concrete piers ........... 3. Steel piers • 771 . 4. Other, specify ,j ..4 ................... --� Typical Support . ... ... 0 Footing Size • 36 x in. in. .(in.) (in.) . • In. In.All )^.. e (in.) (in.)`k *If center piers are other than'drawn above, draw in locations, spacing, and dimensions. Icild �:/u 4ahtval 6 Max. Pier ff In. Spacing .: Overhang In.) BUTTE COUNTY" BUILDING DEPARTMENT APPROVED PERMIT NUMBER.— B 1177=70 Y�' —1 )p '991-70- " E . . PERMIT EXPIRES -a 3 - • / ' OWNER John Sammet yCONTR: owner ;LOCATION (A.P. 37-17-118 .<' w/s Lampkin Rd. app.4 mi, no. of c ' Forbestown Rd. ; `Oroville t • �V wt � r ...� ,`r • k. COUNTY OF BUTTE Department of, Public Works BUILDING INSPECTION RECORD Zoning . Setback Forms Foundation Piers & Girders Fireplace Rgh. Plumbing Bond Beam Lath & Plaster Rein. Steel Gas Piping & Test Found. Vents Framing Plmg. Topout Rough Elec. Wtr. Htr. Furnace Kitchen Vent Firewall Garage Vents Sanitation & Water ELECTRIC GAS BUILDING Temporary Temporary Cert. of Occup. Final Final Final DATE REMARKS OR CORRECTIONS V� i 1 ` COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - OrovilC, California 95965 Phone: 533-1230, Ext. 259 APPLICATION AND BUILDING PERMIT Permittee Owner Mailing Address - _ ✓ —+ ' r Contractor ' A. P. No. Fire Zone Zoning g _ Sanitation i .' + Planning Mailing Address . Plans Fees W.C. BLDG. Address - '-" �� ' -a-- / R W Encroachment �' r NEW Q ADDITION REPAIRS OTHER l Others - F 0 U N D A T 10 N MATERIAL EXTERIOR ORS d Single Multi USE OF STRUCTURE Family [] Duplex 0 Dwelling Others '� - Width at Top Width at Bottom Depth in GroundOff. I�A GOO XPi Oaei SQ. FT. OCC. BUILDING VALUATION R.W. PLATE SSI E SPAN Girders C oists- 1 Joist nd 1�oriir t0�• L,(iP't GO. Fireplace lr JoistsD,) k:eilin , Total Valuation Exterio4ii s C^ Jv t \ a Permit Fee Interior St:hAi, Plan Checking Fee &/or Penalty Roof Rafterslr15 -• w " Total Permit Fee Bearing Walls UUM 1 RAG 1 UK4 LIGEl'IJC LAW A. LICENSED CONTRACTORS COMPLETE THE FOLLOWING: I am licensed under the provisions of Chapter, 9, Div. 3, of the State of California Business & Professions Code under the name styleof..............................................................................................................................................................................................:................................................. License No, ,,,,,,,,,,,,,,,,,,,,,,,,,,, Classification,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,;,,,,,,,,,,, and certify that the aforesaid license is in -full force and effect. B. OWNER -BUILDER & OTHERS COMPLETE THE FOLLOWING: I am exempt from the Contractors License Laws of the State of California under Sec. 7031.5 because (check one): 0 I am the owner of the above property and I will contract to have all of the above work performed by licensed contractors, (Sec. 7044). Q I am the owner of the above property and do not intend to offer it for sale for one year from the date of completion of the improvements. (Sec. 7044). QBasis,. if any, for other statutory exemption.................................... ........................................................................ WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section 3700 of the California Labor Code which requires every employer to be insured against liabil- ity for Workmen's Compensation. I have placed on file with the County of Butte a certificate of compliance or proof of exemption pursuant to Section 3800. 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 County of Butte to enter upon the above-mentioned property for inspection purposes. X ......................... :....... ............................................. Date ................................ SIGNATURE OF PERMITTEE OR AGENT Receipt No ............................ L..:.. This BUILDING PERMIT is hereby issued under the appli- cable provisions of County resolutions and/or ordinances. DIRECTOR OF PUBLIC WORKS By............ :................................................................... Date Permit Expires Date ............................... , a COUNTY OF BUTTE , • DEPARTMENT OF PUBLIC WORKS 7 County Center Drive-tOrovifle, California 95965 Phones 533-1230, Ext. 259 A P P L I C A T I ON AND PLUMBING P E R M I T Permittee Owner _ 4 7 / + A.P. No. Mailing Address Contractor Mailing Address BLDG. Address / / .r ✓/ - ..,. �� %s, ,�•—�.--a� �� '�-_ DESCRIPTION" OF- WORK No. @ Fee $2.00 NEW F,—J" ADDITION F-1 REPAIRS 0 PERMIT FILING FEE Each fixture or trap or set of fixtures on one ap---- 1.50 OTHERS: �, _f-� .-* -+ �� / �_ �- L. Repair or alteration drainage.A. or vent piping 1.50 Installation or repair wafer piping ` 4 1.50 Remarks: _ , / Each gas water heater or _ USE OF STRUCTURE gas heater vent 1.50 Gas piping system 1 - 5 outlets 1.50 __. Single Multi RESIDENTIAL Family 0 Duplex Dwelling Gas piping 6 or more - Each .30 House Sewer 5.00 Lawn Sprinkler system 2.00 OTHERS: Remarks: TOTAL FEE $- CONTRACTORS LICENSE LAW A. LICENSED CONTRACTORS COMPLETE THE FOLLOWING: 1 am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name styleof................................................................................................................................................................................................................................................ P License No. Classification ............................................... and certify that the aforesaid license is in full force and effect. B. OWNER -BUILDER & OTHERS COMPLETE THE FOLLOWING: I am exempt from the Contractors License Laws of the State of California under Sec. 7031.5 because (check one): Q I am the owner of the above property and I will contract to have all of the above work performed by licensed contractors, (Sec. 7044). Q I am the owner of the above property and do not intend to offer it for sale for one year from the date of completion of the improvements. (Sec. 7044). Basis, if any, for other statutory exemption.................................................................................................................................................................: ........................................................................................................... WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section 3700 of the California Labor Code which requires every employer to be insured against liabil- ity for Workmen's Compensation. I have placed on file with the County of Butte a certificate of compliance or proof of exemption pursuant to Section 3800. I certify that I have read this application and state that the above information is correct. I agree to comply with 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. + ...................................................................................Date .......... ...................... SIGNATURE OF PERMITTEE OR AGENT ReceiptNo.,,,,,,,,,,{,;,,,;,,..,, .......................................... This PLUMBING PERMIT is hereby issued under the appli- cable provisions of County resolutions and/or ordinances. DIRECTOR OF PUBLIC WORKS By ............... Date ........................................................... .......:...................... 7d-4 a t �o