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HomeMy WebLinkAbout073-240-013J zjr -/.3 A. P. NON: H. RUSSELL j r . S 12 Siesta Circle, Lot 459 Merry Mt. Village #1, Clip er Mills Permit -1277-72 (new sin le fami yj lwl%/�GI . ) A.P. .__ LOT BLOCK gDAT VERNON H. RUSSELL, Jr . 79-zf-/1 12 Siesta Circle, Lot 45, Merry TYPE PERMIT NO. PLAN NO. PERMIT T Mtn. Village, Cli er Mills Permit 2903-73B .nd/ / //(.�Y6 (renewal B.P. 1 77-72) AP - VERNON H. RUSSELL, JR. 7Z? 1 V -1S 12 Siesta Cir., bot 45, Merry Mt: Village, Clipper Millq Permit# 2945-74B no/f�� (2nd renewal of 1277-72) O!/����i73-24'Ief -13 Permit #596-7813(3rd. & 4th. ren- ewal/l277-72) SF "W/ III /073-24-13 Contr: Frank -N. Worden Const, MAry sville Permit#6581-79B(6th & 7th renewal/ - 1277 -72) F z�rgas�e.•- mwo,�. �u C.•.Z t/; 'JQ�!/7Kd}i 73-24-13 Sandy Galvin 12 Siesta Cir., lot 45,, Mei+ry Mt., Clilper Mills -" contr: Frank N. Worden Const., Marys. Permit #722111,77al B(add deck & s orage shed/SF) 1l/�/Q 73-24-13 B06-2512 073-240-013 MISCELLANEOUS • Re -Roof - REROOF 20 SQ 11384 SIESTA CIR BARNHART, CHARLES W & LINDA D Sandy Galvin 12 Siesta Cir., lot 45, Merry Mtn. Village, Clipper Mills contr: Frank N. Worden Const., Marys. Permit #668-80B( �.dd co edecks/ SF PERMIT DESIGNATION: B—BUILDING E—ELECTRICAL U—USE PERMIT HM—HOUSE MOVING DEPARTMENT OF P—PLUMBING TV— RAD 10•TV ANTENNA V—VARIANCE EP—ENCROACHMENT BUILDING AND SAFETY T—TRAILER S/W—SIDEWALK NOTICE S—SIGN PERMIT D — DEMOLITION 600.1 I _ 31V0 'VI8 3100 'VIS 31VO 'VIS 31tl0 'VI9 31V0 VIS NOIIVNDIS30 =M36Wf1N 11WM3d 87Vd0?IddV SIlOffAlV77HJ9IM lVNid SM313W 530NV1'1ddV 8 S3Mf11Xld NvHfl110M 31VO VIS 3100 flIS 31V0 '0I9 31VO 'DIS 31VO VIS 8M39Wf1N 11WM3d 97VAOUddV 7V3I?I.L3,gTV 1VNId S1N3A 8 S30NVIlddV 3NIl M3M3S ONldld M31VM 1531 3Mf1SS3Md SVS NI-Hfl110M 31tl0 OIS 31VO VIS 31V0 'SIS 31V0 VIS 3100 'fl18 I tm3HWf1N llWM3d S7VA02lddV ONISItl117d 87VAOUddV OkiavQS (MOON NOI.L33dSNI MN EC 31tl0 'SIS 31VO 'SIS 31tl0 'DIS 31V0 'VIS 3J V0 '0t3 31V0 'flIS 31V0 'flIS 31V0 '+JIS 31Va 'DIS 31V0 ' 'fl19 31v0 'SIS 3100• y r' m mD f� r M0 nA �m m �z I �p D� m 1p �p I m >m -1� z tt�-� Dm 1� D tnz in m°z r o a C -q0 ZOD Y3� �mZ 2 Z-. Cm m3 87VAOUddV OkiavQS (MOON NOI.L33dSNI MN EC BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 11384 SIESTA CIR Owner: Permit NO: B06-2512 APN: 073-240-013 BARNHART, CHARLES W & L Issued Date: 10/24/2006 By AAM Permit type: MISCELLANEOUS P O BOX 177 Subtype: Re -Roof CLIPPER MILLS, CA 95930 Expiration Date: 10/24/2007 Description: REROOF 20 SQ Occupancy: Zoning: R1 Contractor Applicant: Square Footage: BARNHART, CHARLES W & . Building Garage Remdl/Addn P O BOX 177 CLIPPER MILLS, CA 95930 Other Porch/Patio Total FEE INFORMATION Re -Roofing $110.00 Total Charged: $110.00 Fees Paid: $110.00 Balance Due: $0.00 Receipt No: B635 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed 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 pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects X 10/24/2006 the applicant to a civil penalty of not more than five hundred dollars ($500); Please check one of the following: Contractors Signature Date I, 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 WORKERS' COMPENSATION DECLARATION OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, by ❑ 1, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED as required CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: Section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. The Contractor's License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the_ projects with a contractor(s) licensed pursuant to the Contractor's License Law.). Carrier: Policy Number: Exp. Date: (This section need not be completed if the permit is or onsundtF red dollars ($100) or less. ❑ I AM EXEMPT under Section B. 8 P.C. for this reason: 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 Workers' Compensation laws of California, and agree that if I should become subject to the workers'X 10/24/2006 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owner's Signature Date pZi_CQ__ XL� 10/24/2006 I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, including death, and property damage caused arising out of, in any way connected with HUNDRED THOUSAND DOLLARS $100,000, IN ADDITION TO THE COST OF COMPENSATION, ( ) the issuance of this permit. I hereby acknowledge thatt is issuance of this pea rmit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the prope:, or am authorized to act on the property owner's behalf. 4 10/24/2006 CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Permittee [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) XOwner Contractor OR:. E]Agent for Owner ❑Agent for Contractor FILE COPY R - Lender's Address City State Zip B- e County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. ° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal ° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations unders state law, contact the Department of Benerit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform thier work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons prefessing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not requir3ed to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. I PERSONALLY PTO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY tv/ IMPROVEMENT. & OR NO) OHAV VE NOT) SIGNED AN APPLICATION FOR A BUILDING 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 THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: NAME ADDRESS CITY PHONE CONTRACTORS LICENSE NO 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 Description: REROOF 20 SQ Reference Number: B06-2512 Applicant Name: BARNHART, CVARLES W & LINDA D XSignature of Property Owner: Date: BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.nettdds "PLEASE PRINT CLEARLY" APPLICANT INFORMATION OWNER INFORMATION Last Nam Y, n irst Name Mailing Address 77 Cit'C/ 2_ r �`� j/t, i State �ii 1. ZiPTSIS Phone Fax Fax E-mail State License Number APPLICANT INFORMATION CONTRACTOR ame A ress Ci City Zip�� G I State Zip Phone Zip Fax E-mail Fax Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER me Ci Addr s Zip�� G I City Fax State Zip Phone Date Approved: Fax E mail State License Number APPLICANT INFORMATION Ny ne �� V v� v Add ss v L Ci Stat e'1 l� Zip�� G I Phones a 3 VAL Fax E-mail APPLICANT SIGNATURE X I- Foroffice use only: Zoning Property Address (� /� � 1 � 4 `i ✓ Flood Zone SRA I Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. BIN # PROJECT LOCATION Property Address (� /� � 1 � 4 `i ✓ City � f YV`t<<� Cross Streetyy�� WORKER'S COMPENSATION olicy Number Cam If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: Sq'FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: Amount: Bldg SRA Receipt #: Sheriff SMIP Other Date: 1W. (A) Total 7229-79B Q. y HERMIT NO. PERMIT EXPIRES ' Sandy Galvin OWNER CONTR. Frank.N. Worden Const., Marysville V LOCATION (A.P. 73-24-13 12 Siesta Cir., lot 45, Merry Mtn.Village#l, Clipper Mills k 4 .. Temp. Power Pole Called PG&E { Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E JOB /FINALED / C� (Date) (Signaturtl COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD INKLERS Mesh ME61iANICAL I Grd. Fault Prot. Scratch BUILDING BUILDING (Cont'd) j PLUMBING Setback --2 -/O - % �_ Firewall Soil Piping Forms Interior Lath Parapets 1st Floor Main Bldg. Final Restroom Finish 2nd Floor Foot in s !o� `/D - Windows 3rd Floor Stemwal l - /U - Siding To out Slab Drainage Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Stemwal I Garage Vents Insulation Water Htr. Heaters Slab Carport Im Footings Prov. for phsically handica ed Conformance of ex. st ture Appliances Gas Piping &Test Temp. Gas Slab nal Sanitation Patio FIREPLACE Final Footings ,/cq Footing ELECTRICAL Masonry Walls _ Throat : Rounh si INKLERS Mesh ME61iANICAL I Grd. Fault Prot. Scratch Heating N Service Brown Cooling Temp, Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES ------------------ Elec- Service Elec. Pedestal Water Piping Sewer Gas Piping MOBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE y— DEPARTMENT OF PUBLIC WORKS 7,Coun . ��enter Drive +— Oravi I Le, Cal i forni a 95965 • Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above- ntioned property for inspection purposes. r� Date Signature of Permitee or Agent Receipt No. :32,767 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 PUBLIC WORKS BY Date 7 y (ding permit expires Date / Z — 1_( �-o BUILDING Owner S0/FJ LV V1 AJ SQ. FT. OCC. BUILDING V LUATIO O o C - O. �v Mai I i ng Address Telephone No. Contractor Fe A -AJ 4 C72 L)E C04J9 / Mailing Address //LIZ ILL ,gyp, Fireplace Total Valuation Q. O a 6495*1_YfZPermit phoe � Fee /5,00 Building Address -Plan Checking Fee /or Penalty 100 Permit Fee $ .00 PLUMBING No. @ FEE 4u pp,c2 "/4L5 PERMIT FILING FEE $3.00 Each Trap 1.50 _ LOT # 45 M /LLA-4rE Repair drainage or vent piping 1.50 i A. P. No. 73--24- —/ 3 Zoning &/Planning Water piping 1.50 Each gas water heater or vent 1.50 F W.C. S i Ire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Parcel Plans Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 Bldg. P ns Rec'd I Parcel 6pprova Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION UTILITIES ❑ OTHER ❑ Permit Fee $ $ DEG�L 57-DeA4 C SoLS J ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 Main service 100 AMP ORSLESS5.00 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD'L too AMP 2.50 Main service OVER soov 25.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 1.00 NEW CONST. ( OR ADDNS. ACCLBLDGSLING CCUP, S) 22sgft 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: / �/ T i16X � e d Ag N G F7A✓S/ TLET NEW RESID. BRANCH CIRCU RESID. BRANCH CIRCUITS% 2.50ea ..NON NEW CONSTR. POWER APPARATUS 6 NON-RESID. SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTIIRES) B L , FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA) 2.00 /=,�, Temporary service 10.00 Mobile Home Facilities 15.00 99 License No. -;3-; Classification Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. 14 I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. lecertify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby Land Development Fee $ TOTAL PERMIT FEE $ 2`� authorize representatives of the County of Butte to enter upon the above- ntioned property for inspection purposes. r� Date Signature of Permitee or Agent Receipt No. :32,767 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 PUBLIC WORKS BY Date 7 y (ding permit expires Date / Z — 1_( �-o PERMIT NO. 668-80B Af��� -r PERMIT EXPIRES %OWNER Sandy Galvin CONTR. Frank N. Worden Const.,XNX Marys. 73-24-13 LOCATION (A.P. ) . 12 Siesta Cir., lot 45, Merry Mtn.Village, Clipper Mills �1 q 7r C t t 3 4 Temp. Power Pole 1� Called PG&E 0 Temp. Elea. Serv. Called PG&E Temp. Gas Serv. Called PG&E JOB _ p FINALEDQ 4 4e)) i COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback -- / 2 — Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Sidina To out Slab Roof Sheathing ✓ Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Stemwa I I Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for physically handica ed Conformance of ex. structure Appliances Gas Piping & T st Temp. Gas Slab Final -" 2 Sanitation Patio FIREPLACE Final Footings J Footing EL CTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam F14E SPRINKLERS Motors Stucco Final Subpanels Mesh MECRANICAL Grd. Fault Prot. Scratch Heating Service Brown i Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES ------------------- Elec. Service Elec. Pedestal Water Piping • Sewer Gas Piping 31LE� HOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 16 7 County Cent-er Drive - Croville, California 95965 Telephone: 53.4-4541 APPLICATION AND PERMIT pf,� AF"' authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. !*,: ? /i- Date Z_ $ignatur�f�r� � Agent Receipt No. 34 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 O.F PUBLIC WORKS By ` Date a-! ilding permit expires Date yet F"8/ BUILDING Owner S /TV /PY 4:/_/A l SQ. rT. OCC.y BUILDING VAL ATI N /7] .di7 Mailing Address Telephone No. Contractor rj ,4A J /2- A OP—D .5 Mailing Address Fireplace Total Valuation 7✓y P e i t e / . O O Building Address (Z '51Cs� ClP_�e &/or Penalty Permit Ian Fee Permit Fee /p, p0 7, . Q;�' 7,9 IV� PLUMBING No.1 @ I FEE /% f� (• G PERMIT FILING FEE $3.00 Each Trap 1.50 j A/. Repair drainage or vent piping 1.50 2 p Water piping 1.50 A. P. No. J ��� ��` / Zoning & Planning Each gas water heater or vent 1.50 F s Q-wiit� Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 Parking Parcel EQA Plans Declaration Parcel Map 60' R/W Improvements Each additional outlet B Flding sewer .30 5.00 Bldg. PI s Recd Parcel Approval L,4 Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION UTILITIES ❑ OTHER ❑ 1 permit Fee $ rs �jf �� ���% Q ELECTRICAL No. @ FEE {, Single Family 00'Duplex ❑ Mobil Home ❑ Others ❑ PERMIT FILING FEE 600V OR LESS Main service 100 AMP OR LESS Main service EA. ADD'L 100 AMP $3.00 5.00 2.50 Main service OVER 100 AMPP O OR LESS 25,00 Main servlce EA. ADD'L 100 AMP 1.00 NEW CONST OR ADDNS. ACCLBLDGSLINC CCUP. 4') 2¢Sgft CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style O y NEW CONSTR BRANCH CIRCUITS) NON.CRESID.ONST � BRANCH CIRCUITS) 2.50ea NEW CONSTR (POWER APPARATUS.8, NON.RESID. (SINGLE OUTLET CIR, Ex. OCCUD(OUTLETS OR FIXTIIRES, g L104 Ex. Occu FIXED APPLES. OR P• OUTLETS (RES-. O) EA) 2•00 , Temporary service 10.00 Mobile Home Facilities 15.00 License No.311 -74-S Classification 25 Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability Heating for Workmen's Compensation. Cooling ❑Ihave 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 Ventilation Hood 2.00 California. Permit Fee $ $ 1 certify that I have read this application and state that the above Land Development Fee $ information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT FEE $ Zg I& authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. !*,: ? /i- Date Z_ $ignatur�f�r� � Agent Receipt No. 34 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 O.F PUBLIC WORKS By ` Date a-! ilding permit expires Date yet F"8/ PERMIT NUMBER — B J277-72B9P,E 7Z P E PERMIT EXPIRES "c2j 7:3 OWNER Vernon, H. Russell Jr. y f CONTR: owner _ f LOCATION (A.P._71}_1� ) 12 Siesta 'Circle, Lot 45, MerryMt. }r Village #l,`Clipper Mills * I rL v 4 • ti ' �. e COUNTY OF BUTTE. ' Department of Publip. Works s` BUILDING INS'P'ECTIOKI RECORD Zoning Setback �7 •"cam 2 4'., Forms Qde 7 — `Z— Foundation Piers & Girders Fireplace Rgh. Plumbing Bond ,Beam 5� ZZ-7� Lath & Plaster Rein. Steel Gas Piping &Test Found. Vents Framing 7—" Plmg. Topout. 7` Rough Elec. Wtr. Htr. Furnace Kitchen Vent Firewall %,/ Garage Vents - '` Sanitation & Water ELECTRICT GAS BUILDING $ Te orar emporary Cerj..4 Oc p ina Final DATE REMARKS OR' CORRECTIONS r % �3 . � - ��,,,`�� C�.j'�•�`,�-'J�i�� /o a </ _-?,- ? •S�u� � ed or t a7 ore 7-0 '1-11 . I COUNTY OF BUTTE DEPARTMENT OF PUBLIC _ 7 County Center Drive — OsoviIIe, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT WORKS authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. C�2GG1C��l/� Date _ �y` Signature of PPeermitee or Age t Receipt No. v O0 Z 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 UBLIC WORKS BY Date Bu ing permit expires Date BUILDING Owner 9e,(10iJ SO. FT. OCC. BUILDING VALUATION , Mailing Address Telephone No. Contractor ,040VAl- 100fD6A1 IST 1C 60 Mailing Address INZ( V /-1/LL ab. Fireplace Total Valuatio Permit Fee Z . 00 Building Address /Z .5 ES7%}- Plan Checking Fee&/or Penalty Permit Fee S. D0 D< PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 / Al.J pr 4s AAl /IJ_�� Repair drainage or vent piping 1.50 �,Z, !_ /3 A. P. No. 'fit' Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 Re/esJ SartttatfvrT' Fire Dept. Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EOA Parking Plans I Parcel Declaration Parcel Map 60' R/W I Improvements Each additional outlet .30 Building sewer 5.00 BI s ec Parcel Approval I Plans Approval Lawn sprinkler system 2.00 ❑ ADDITION ❑ UTILITIES ❑ OTHER � permit Fee $ $ //NEW !p �/��i�-� O� i� Z7%�JZ ELECTRICAL No. @ FEE Lir CeA)"tJ 5�I�o 78� PERMIT FILING FEE $3.00 00V OR LE Main service 100 AMP ORSLESS 5.00 Single Family 0/ Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD'L 100 AMP 2.50 �n F-6-12- / ��N OVER 600V Main service 100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW CONST. ( DWELING OR ADDNS. ACC`BLDGS.CCUP. 'i) 20sgft CONTRACTORS LICENSE LAW I am licensed under the provisiops of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name Style .CONS / BRANCH CIRCUITS)TLET 2.50ea NEW RESID, BRANCH CIRCUITS)— NEWNON NEW CONSTR {POWER APPARATUS 6 NON .RESID. SINGLE OUTLET CIR. Ex. Occup{OUTLETS OR FIXTIiRES) g L ,� FIXED APP LNS. OR Ex. Occup. OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. 3-33 - 1�' 7-3; Classification Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. 0 1 have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby Land Development Fee $ TOTAL PERMIT FEE $ Qd authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. C�2GG1C��l/� Date _ �y` Signature of PPeermitee or Age t Receipt No. v O0 Z 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 UBLIC WORKS BY Date Bu ing permit expires Date COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive —, Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the bove-mentioned property for inspection purposes. Date /( Signature of Permitee or Agent Receipt No. (0(0,c? 0 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. DIREC OF P B IC WORKS By 41 kC7ate 8s�ikUag permit expires Date b BUILDING Owner O �I �<f SQ. FT. OCC. BUILDING VALUATION Mailing Address �0 4 Melone N Fireplace Contrac or Total Valuation Mailing Address Permit Fee Plan Checking F &/or Penalty Telephone No. Permit Fee $ $ Building Address P Lb PAR ING No.1 @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 S Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. _ --1 Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F s -Ser�i4,4,a_ Fire Dept. re Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma p 60' R/W Improvements p Lawn sprinkler system 2.00 ane ec d 1 Parcel Approval Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ • FEE PERMIT FILING FEE $3.00 ra _ ')__, Main service ;0000 AMP V OR LESOR LESS 5.00 Main service EA. AOD•L too AMP 2.50 OVER 600V Main service 100 AMP OR LESS 25.00 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD'L too AMP 1.00 NEW CONST DWELING OR ADONS. ( ACCLBL GS,CCUP. &) 2¢sq ft NEW CONSTR. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS) 2.50ea • NEW CONSTR. POWER APPARATUS &) NON.RESID. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name le of: style Ex. Occup(OUTLETS OR FIXTURES) BALL@)09 Ex. Occup.( 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 $ $ WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑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 TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the bove-mentioned property for inspection purposes. Date /( Signature of Permitee or Agent Receipt No. (0(0,c? 0 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. DIREC OF P B IC WORKS By 41 kC7ate 8s�ikUag permit expires Date b COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — ,Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the county of Butte to enter upon the above-mentioned property for inspection purposes. e` _07,�Z 16Signature of Permitee or Agent Receipt No. Zz 6 96 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. DIR TOR OF PUBLIC WORKS z� BY Date Building permit expires Date .....................a�...75. BUILDING Owner Vernon H. Russell, Jr. SQ. FT. OCC. BUILDING VALUATION Mailing Address 22 Gibson Rd. R E N E W A L Woodland, CA. 95695 Telephone No. Fireplace Contractor Owner Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone Na. Permit Fee Zg (1/2 fee) $ 26.50 $ 26 5( Building Address 12 Siesta Circle, Lot 45, Merry PLUMBING No. @ FEE PERMIT FILING FEE $2.00 Mtn- Village., Clipper Mills 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. 37-74-13 Zoning 8 Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Sa4rte4w FireDept. FireZone Use Permit Building sewer 5.00 EQA Parki Plans Parcel Declaration Parcel Ma P 60' R/W Improvements P Lawn sprinkler system 2.00 134-4D1- Parcel Approval Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ® ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 2nd Renewal of Permit 1277-72 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 Water Heater or Space Heater 1.00 Light fixtures 20 E1@2 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: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 Lic nse No. Classification Misc. wiring I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT FEE $ 2 5( authorize representatives of the county of Butte to enter upon the above-mentioned property for inspection purposes. e` _07,�Z 16Signature of Permitee or Agent Receipt No. Zz 6 96 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. DIR TOR OF PUBLIC WORKS z� BY Date Building permit expires Date .....................a�...75. COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — _Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT Owner Vernon H. Russell, Jr. Mailing Address 22 Gibson Rd. Telephone No. Woodland, CA. 95695 Contractor owner Mailing Address Telephone No. Building Address 12 Siesta Circle, Lot 45, Merry Mtn. Village, Clipper Mills A. P. No. 37-74-13 Zoning & Planning Sa"iietienr Fire Dept. FireZone Use Permit EQA Parking Parcel Parcel Ma 60' R/W Improvements Plans Declaration P P Bldg. Plons—d Parcel Approval Plans Approval NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER 1st RENEWAL of Permit 1277-72 Single Family Duplex ❑ Mobil Home ❑ Others ❑ 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: Lice e No. Classification 1 am exempt from the Contractors License Laws of the State of California. WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have ced on file with the County of Butte a certificate of W en's Compensation Insurance. x 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. 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. to Signat�,!4erAgent y Receipt No.y I�2� White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant _ BUILDING SQ. FT. 1 OCC. I BUILDING VALUATION RIENEWAL Fireplace Total Valuation Permit Fee Plan Checking Fee &/or Penalty Permit Fee ee PLUMBING PERMIT FILING FEE Each Trap Repair drainage or vent piping Water piping Each gas water heater or vent Gas piping system 1 - 5 outlets Each additional outlet Building sewer Lawn sprinkler system Permit Fee ELECTRICAL PERMIT FILING FEE Main service incl. 1 meter Additional meters, each Sub -panel (12 or less) (more than 12) Range, Cook -top or Oven Water Heater or Space Heater Light fixtures Receps., switches & fix outlets Hood, Ex. Fan or F.A. Furn. Motor Evap. cooler, gar. di sp. or D.W. Air conditioner or heat pump Water pump Mobil Home Facilities Temp. Power Pole Misc. wirinq Permit Fee MECHANICAL PERMIT FILING FEE Heatinq Cooling Ventilation Hood Permit Fee • Jl FEE $2.00 1.50 1.50 1.50 1.50 1.50 .30 5.00 2.00 $3.00 2.00 FEE TOTAL PERMIT FEE $ G .JU 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. DIREC OR OF PUBLIC WORKS By Date Building permit expires Date ...� { July 30; 1973 j I• Vernon H. Russell; Jr. RE: #Renewal Application 22 Gibson Road # Woodland, California 95695 Dear Mr. Russell: -With,reference to the above subject and your telephone conversation with this office today, we are enclosing, herewith, a permit application to be completed and signed where indicated. Please return all copies of the application together with your check in the amount_of $26.50 payable to Butte County Treasurer. ,As soon as the permit applic-ation and fees are received by this office, we shall process for�the necessary permit. Should'you have any.questions, please contact us. Yours very truly, Clay Castleberry Director of Public Works J.F. Glander JFG:dd Assistant Director Enclosure 411111- , - , I 'I.; : . ", j, � " I t -, 170 f, 0.1 f FILE NO. BUTTE COUNTY (For Action - 1, 2, 3) Public Works Dep. (For Inform. V) Director Dop. Dir. Sec. Rd. Moint. Shop Bldgs. & Ping. Planning Permits Mapping Sub. C:,::Z. Co. Bldgs. D, -s. & Con. Cnnst,. Rd. Des. Br. Des. Wot3r Res. COUNTY OF BUTTE — DEPAR-TMENT OF PUBLIC WOR 7 County Center".Dl,ive, %Oroville, California 95965 412X"-) ` r Telephone: 533-1230, Ext. 259 APPLICATION AND PERMIT ® i am exempt from the Contractors License Laws of the State of California. WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code ,which requires every employer to be insured against liability for Workmen's Compensation. F-1 I .have placed on file with the County of Butte a certificate of VpIermit orkmen's Compensation Insurance. certify that in the performance of the work for which this is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. I certiify 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. ry 4 r4�pate7d— Signature of Permitee or Agent Receipt No. d White-D.P.W. – Pink -Inspector – Goldenrod -Assessor – Yellow -Applicant Permit Fee $ Z/J1 MECHANICAL No. @ I FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Permit Fee $ $ Intr ation Fee,for Strpn rogMotion $0.07/$1000 Evaluation $ % state men TOTAL PERMIT FEE 6, VY 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 .2 L Building Permit Expires Date BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address f O Fireplace Contractor Total Valuation Z 9i Mailing Address Permit Fee Plan Checking Fee &/or Penalty Permit Fee $ Building Address � PLUMBING No. @ FEE PERMIT FILING FEE $2.00 o" Each Trap 1.50 _ Repair drainage or vent piping 1.50 Water piping 1.50 S� Each gas water heater or vent 1.50 A. P. No. 3;2 Zoning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .50 Fire Zone Fire Dept. Sanitation Planning Building sewer 5.00 Plans ,/ Fees / W. C.� R/W I Encroachment Lawn sprinkler system 2.00 NEW ADDITION ❑ OTHER ❑ Permit Fee $ dG ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service incl. 1 meter L �' Additional meters, each 1.00 Sub -panel (12 or less) (more they -12) 17--—4-6 USE OF STRUCTURE Single Family Duplex ❑ Others ❑ Range, dryer or water ater 1.00 Oven, Cook -top or space-11—eater 1.00 Light fixtures ld In s'lu R s., swi s & fix 96t9ets " 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: Hoed, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Misc. wiring License No. Classification ® i am exempt from the Contractors License Laws of the State of California. WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code ,which requires every employer to be insured against liability for Workmen's Compensation. F-1 I .have placed on file with the County of Butte a certificate of VpIermit orkmen's Compensation Insurance. certify that in the performance of the work for which this is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. I certiify 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. ry 4 r4�pate7d— Signature of Permitee or Agent Receipt No. d White-D.P.W. – Pink -Inspector – Goldenrod -Assessor – Yellow -Applicant Permit Fee $ Z/J1 MECHANICAL No. @ I FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Permit Fee $ $ Intr ation Fee,for Strpn rogMotion $0.07/$1000 Evaluation $ % state men TOTAL PERMIT FEE 6, VY 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 .2 L Building Permit Expires Date .11il" T7 q, M? MRIR�v .1, j,� -J� 3-1 FR9,""', M fly, Ufffirl E In 14 v All 7, 1TY i b I ot, I'16 4q 147 Zip Ole, e IOb for with PON v4 w le :59 f4. 44 4- . 4a .. . ... .. e14 ee, AAI '=** /-,o 4** -- , -0 OW At all OF kit* tD, el MA /0 OW ' P" k 14, pi, P p Ap ATES, kfj 0, j 00 t A� 0. 0 N 0) L T N 12 tlih t A UU0 Aytd bf AtsMst' i 4�0 or 14 A: # 10, look -bog ws. P, HOTA 41: 1,� .. .......