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Home My WebLink About078-180-042' 0 Ig0- o� 9.3 6 M PERMIT#95-1148 j I BACA, Mauricio St., Oroville 5249 Parkdale Cont; John Wheeler Const. New Roof Structure/SF OVA • . Oy2. F RESIDENTIAL �} 036-176-014 PERMIT#95-1148 BACA, Mauricio 5249 Parkdale St., Orovilie Cont; John Wheeler Const. i" New Roof Structure/SF JOB FINALED (Date) _ Signature J=OK f O = Not OK =Not Applicable =Not Ready MOBILE HOMES # Date MOBILE HOME UTILITIES (Plans) OK except ft's 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch ' 3. Sewer; Location -Test -Fall -C/O Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap: / /" L"ft. / /-Nat. or/ /"L"ft./ /"LPG 7. Well Clearance & Disconnect 8. Utility Clearance t Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except ff's 1. Zoning Requirements -Setbacks Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 10. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 - MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Bea ms- Rftrs.-Connectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except N's 1. Setbacks -Easements - 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. _ Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK O = Not OK = Not Applicable Not Ready RESIDENTIAL (Single = Date UNDERFLOOR (Plans) OK except h's i 1. Zonina-Setbacks- Easements- Flood -Slone I 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth I '3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth I 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Sla teel-Wrapped le!Sie Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16. Insulation Date / Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit),OK except h's 16. Water Htr.. Vent -Access -Combustion Air -Baffle 17. Water Pipe; Test & Anchor -Nail Protection 18. D.W.V.; Test -Fittings & Anchor -Nail Protection 19. Shower Pan; Test, First Floor -Tub Access _ 20. Test Tub & Shower. Second Floor -Tub Access - --- 21. Gas Pipe: Size & Anchors Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except h's 22. Fixture & Transformer Clearance -Ins. -Protection - - - - ------------------ 23. - --------- 23. Elec. Receptacles Spacing -Lights & Switches at Doors ------------------------ - ------------------------------------------- 24. Size Boxes & No. of Conductors -Stapled --- ---- - --------------------------- 25. Romex Installed Close to Edge of Studs & C.J. ----------- --------------------------------------------------------------- 26. Equip. Ground made up w/Meth. Fastners_Bond Gas & Water - -------------- 27. 2 Appliance Circuts in Kitchen & Conductor Size!GFI - 28. Subfeed Wire Size i r ga. Cu or AI-A.C. Wire Size ! ! ga. Cu or At ------------ ------------------------------------------- ---- 29. Range Circ. / r ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No - ---- ----------------------------------------- - -- - -------------------------- 30. - - ------------------------------------ 30. Service -Riser Conductors & Ground -Main Disconnect --------------------------------------------------------------------------------- - 31. Equip. -Clearances- Panels-Motors-Mech. Equip. -------------------------------------------------- - ----- 32. Clothes Closet Light -Shower Light -Spa Light -------------- 33. Smoke Detector ---------------------------------------------------------------------------------- ----------------------------------------------------------------------------------- Date Card B-1 Date Card B-1 - ------------ ------------------------------------------------------------------ Date Card B-1 Date Card B-1 Date MECHANICAL (Permit)OK except h's 34. A.C. Ducts Insulation & Support ----------------- --- ---- ------------------------------------------------------ - -- - 35. Vent Fan,;. Exhaust above insulation densate Drain & Overflow: Size & Grade - 7 Furnance-Vent: Access -Comb. Air -Return Air Vent -115 outlet -- - ----`� ------------------------------------------------------ 38. Attic Access & Platform if Furnance in Attic ----------------------------------------------------------------------------------- --------------------------------------------------------------------------------- Date Card B-1 Date Card B-1 ---------------------- --- --- ------ ----- ----- -- --- -------------- ------------- Date - --- - -------- Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except h's 39. Sils. Proper Material & Anchors ---------------------------------------------------- ------------------ --------- 40. Walls Studs -Nailing. Spacing & Bracing -Plates -Sound ------------- 41. Bearing Walls over Girders & Floor Nailing -- --- -- - - - --------------- ------------------------- ------------------- -------------- 42. Draft Stop rn Walls (rat proof) ------------- ---------------------------------------------------- 43. Fire -Stops: Furred Ceilings -Stairs -Chases -Tub -------------------------------------------------- 44. Headers & Beam -Size & Bearing & Duplex) Date MING (Continued) Hangers -Post Caps -Anchors -Connectors Ing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Ring. _- 47. fireplace Ties or Type A Flue -Fireplace Throat clearance 8. Attic Access: Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garaae Fire Protection Framina 51. Property Line Firewall & Openings 52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection --- - plywood on Roof Overhang -Attic Vents -Rafter Outriggers -- ---siding-Nailing Veneer 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access ------------------- --- 57. Glazing Area -Glass Protection -Skylights -Plastic _ 58. Shear Walls; Nailing -Bolts 59. Insulation -Walls -Ceilings 60. Infiltration -Walls -Windows ----------------- ---------------------------- Date Card B-1 Date Card B-1 --------------------------- Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except h's 61. Ext. Steps -Door & Sidelight Protection -Landings -62. Smoke Detector ------------- 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meth. Protection 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures•&& T�cess-Spa ------------- 66. Elec. Trim & Subpanel; Breaker Sizes & Labels ------------ 67. Stairs & Rails 68. Fireplace or Stove: Clearances -Hearth 69. Elec. Outlets at Wood Panel Int. & Ext. 70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 71. Elec. Outlets & Receptacles at Kit. Counter 72. Garage Fire Door; Swing -Landing -Closer ---------------------------------- ---- - - 73. A.C. Duct n Ga age 74. Wtr. Htr. Vents- Clearance-Com� Atr-Connector-P.R.V. In Garage; Above Floor -Meth' Protection 75. Plb. Ele_c. & Mech. Equip. Listed for Location 76. Elec. Receptacles in Garage: (G.F.I.)-Romex Protection 7-,. Insulation -Foam -Looked in Attic ❑ Yes 78. Guard Rails & Deck Construction -Post Caps ----------------------------------------- 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth -----------Clearance --------Clearance Looked under Floor ❑ Yes --- - - ---------------------------- 80. Following instld.; Drive ❑ Yes ❑ No: Walks ❑ Yes ❑ No: Planters ❑ Yes ❑ No ----------------------- - ------ - --- - -- 81. -----------------------------------81. Stu_c_co: Brown -Finish - - 82. A, _ nit; Disconnect. Electrical, Plumbing Vents Above Root; Plbg.-Appliance-Fireplace.-Clearance to Openings 84. Water Well; Disconnect, Electrical, Plumbing -------------- ----------------------------- --- 85. Exterior Elec. Trim: G.F.I. Receptacle -Underground -- ----------------------------- 86. Ventilation Throughout House--- - - - 87. Glass Protection -------------------------------- 88. -----88. Corrections from Previous Inspections ---------------------------------- 89. ----•---- -----------------89. Gas Test -Meters Tagged; Gas -Electric - - - --------------------- ------------------------ 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates Date_ _ �S __Card_B 1 f Date Card B-1 -- Date Card B -1 --Date---- -Card B-1 Date Card B-1 Date Card B-1 Comments at Final: 7�.c1S�cs 6f� COUNTY OF BUTTE- DEPARTMENT OF A�21_6PMEN— SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541!K PERMIT NO. APPLICATION AND PERMIT 0_// vs ASSESSOR PARCEL NUMBER 036-176-014 ZONING R1 BUILDING PERMIT OWNER MAURICIO BACA TELEPHONE SO, FT, OCC. BUILDING VALUATION CONTR_ 9,500 00 OWNER'S MAILING ADDRESS 16 DICK PHELPS RD WATSONVILLE, 95076 CONTRACTOR'S NAME JOHN WHEELER CONSTRUCTION TE530PH 4 E 5449 , CONTRACTOR'S MAILING ADOn BOX 5262 OROVILLE,- 99566 Fireplace CONSTRUCTION LENDER UNLwOWN Total Valuation Is Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ 117.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 76.05 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILAINGADDRESS 5249 PERMITFEE $ 213.05 PARKDALE ST PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 LAT NO. SUB01141SION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 USEOFSTRUCTURE SF EK Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Ublities ❑ Installation ❑ Other 0K Describe Work: NEW ROOF STRUCTURE Mobile Home I S I GI W 1 @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filinq Fee 20:00 Main Service a OV OR LESS ( 200A OR LESS / 23.00 Main Service ( 200A TO ,000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class OA ioeez &_ Lic. No. � OWNER -BUILDER DEGLARATION� 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 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 offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUR OR ACDNS. ( a ACC. BLAS. ) SO. 3.SQ FT. NEW CONST.MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 ( 8 POWER APPARATUS ) SINGLE OUTLET CIR. Ex. Occup. (OUTLET OR FIXTURES ) zo p ,.00 sAl S0 EX. Occup. ( OUTLETS (RESID.OEA ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE _ Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' mpensation i surancrrier and policy number are: Carrier e Policy Number _ (rhe above sections nee not b& completed if the permit is for wbrIZ'of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall Yh ith Comply -th those provisions. Date' r_ g ure of Ap icant - ❑ Owner ❑ Contractor ❑ Agent kofAn OSHA permit is required for excavations over 5'0" deep and demolition or construction structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 9 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Mobile Home Installation Fee $ Energy Inspection Fee $ CO 3 cV 7. ,T1 PE �D. TOTAL FEE $ 213.05 HA2. FEES ^ I IMP _ I FLOOD CDF PARCEL I PO HD 5SU This permit is hereby issued under the applicable of the Butte County ode and/or Resolutions indica a v r w ich fees have been B_ PERMITEXPIRESON (Data provisions to do work paid. ate 3 Receipt No. O WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE OWNER NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. f � N Date ''% Inspector REV 10/92 COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any questions perta' ing to this matter, o need additional explanation, please contact this office immediately. 417 i Datel6� Inspector; REV 10/ . ; '"7r�frF''"*�^'rm-t�F,•M�i�'�-�: ,^u-i,��.►F%i�``.�.r �-: �`'�.4 =' < t - ./ a i COUNTYOF BUTTE - DEPARTMENTOF D EL PMENTSERVICES -BUILDING DIVISION// 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER 1�3�P o. Proposed Building Use 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 BY 1. All items have een submitted . ........................................ 2. Plot plans, 3/4 sets, signed by preparer of plans . .......................... 3. Complete plans, 3%4 sets, signed by preparer of plans. ...................... 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material. Form . ............................................ 6. Energy Design Compliance and supporting documentation . .................. 7 Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). ...: Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $ .......................................... 11. Impact fees as shown on attached schedule. ............................. . 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval Health Department . ........... . 15. City of Chico plumbing permit. CY........................................ 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: . ........ 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). .. -Freanspection n:q. .ues__ 20. Pre -inspection for required. .. to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Build &Verification (Given to owner , Mail to owner . .......... . 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on building use . ......................................... 28. Mobilehome utility clearance . .......................................... 29. Documentation of legal access . ..................... :.................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan check list . ..................................................... 33. 34. When you issue the permit process as follows: Mail to owner. Mail to contractor. _� Telephone and hold for pickup at office. Deliver with inspector. Other Parcel Creation77 q Acreage Applicant %� Date �' J� /� Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to 1. Index permit for above items No. 2. Additional items required: issuance: (Circle new item not checked above). Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by (Z Date3- Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works COUNTY OF BUTTE- DEPARTMENT OF E4NEL)OPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville; California 95965 - Telephone (916) 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER _ l ZONINGKI BUILDING PERMIT OWNER NE SO. FT. OCC. BUILDING VALUATION OWN75 MAI ADDRE S / Coq% Vjt CSV! CO CTO R'S NAM �EPM�ONE� CO R NG ADDRE Fireplace CONSTRUCTION LENDER UN14NOWN Total Valuation $ Fling Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDtNGADORESS ^ `G PERMITFEE $ �, �p O PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 LOT NO. SUSONISION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 USEOFSTRUCTURE SF 9, Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Oth 9k Describe Work:PERMITFEE - Mobile Home I S I GI W 1 920.00 _ Contractor ELECTRICAL PERMIT Flina Fee 20.00 Main Servicea00v OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A To I000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION% 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUR. OR ( a ) S0. 3.5¢ Fr CNSS. LTI-ACCUTLEBLOS. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup. (OUTLET OR FIXTURES) .00 BA20 L @ I•50 50 Ex. Occup. I FIXEEors PLNS.OR ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X Date Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee Is occ CONST. TYPE I TOTAL FEE $ a v HAZ. 1 0. FEES I IMP I FLOOD I COF PARCEL PO HD ISSUE This permit is hereby issued under the of the Butte County Code and/or indicated above for which fees have By PERMITEXPIRESON applicable provisions Resolutions to do work been paid. Date (Date) Receipt No. 2 WHITE•D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT