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COUNTY OF BUTTE — DE ARTMENT 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.
P
Date
Signature of Permitee or Agent
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
BY Date
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone Na.
Permit Fee
$
$
Building Address
PLUMBING
No.
@ FEE
PERMIT FILING FEE $2.00
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.Gas
Zoning 8 Planning
piping system 1 - 5 outlets'
1.50
Each additional outlet .30
Fees
W. C.
Sanitation
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
Declaration
Parcel Ma P
60' R/W
Im rovements
P
Lawn sprinkler system 2.00
Bldg. Plans Recd I
Parcel Approval
Plans Approval
Permit Fee
$
$
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ❑
ELECTRICAL
No.1
@ FEE
PERMIT FILING FEE $3.00
Main service incl. 1 meter
Additional meters, each
1.00
Sub -panel (12 or less) (morethanl2)
Single Family ❑ Duplex ❑ Mobil Home ❑ Others ❑
Range, Cook -top or Oven 1.00
Water Heater or Space Heater
1.00
Light fixtures e1—( io
Receps., switches &fix outl2-5
ets n
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
License No. Classification
Misc. wiring
❑ 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
above-mentioned property for inspection purposes.
P
Date
Signature of Permitee or Agent
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
BY Date
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WO
S ,
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.
X iaZte, Date 60 -16 9-3
/' Signature of Permiteee/or Agent\
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By Date
Building permit expires Date /�-Z
BUILDING
Owner C �-� ✓�
SQ. FT. OCC. BUILDING VALUATION
Mailing Address V :� GC19
///
I'o t/ I C�`e
Telephone No.
Fireplace
Contractor wn
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee
$
$
Building Address /,9 �jj
r� "' �a
PLUMBING
No.
@
FEE
PERMIT FILING FEE $2.00
P
Each Trap 1.50
Repair drainage or vent piping
1.50
Water piping 1.50
, SD
Each gas water heater or vent 1.50
A. P. No. �% I`Zling & Planning
Gas piping system 1 - 5 outlets
1.50
-a O
Each additional outlet .30
Fe & -<l
e.-
a Fire Dept.
Fire Zo Use ermit
ing sewer 5.00
GG
EQA
Parking I Parcel
Plans Declaration
Parcel Ma P
60' R/W
Improvements
P
Lawn sprinkler system 2.00
Bldg. Plans Recd
I Parcel Approval
Plans Approval
Permit Fee
$
NEW ❑ ADDITION ❑ UTILITIES Q OTHER ❑
ELECTRICAL
No.
@
FEE
PERMIT FILING FEE $3.00
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 25
bal_�I10
Receps., switches & fix outletsba I Q 10
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
Hood, Ex. Fan or F.A. Furn. Motor
1.00
Evap. cooler, gar. di sp. or D.W. 1.00
Air conditioner or heat pump
Water pump
Mobil Home Facilities 5.00
Temp. Power Pole 5.00
License No. Classification
Misc. wiring
am exempt from the Contractors License Laws of the State of California.
01 am
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.
21�1certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL
No.
@
FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
1 certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
TOTAL PERMIT FEE
$
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X iaZte, Date 60 -16 9-3
/' Signature of Permiteee/or Agent\
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By Date
Building permit expires Date /�-Z
All
All utility connections shall be
located within 4 ft. outside the rear
third section of the mobile home
on the left (road) side of the mobile
home.
Septic system andd_
i�-srab=eert� to be as per
Butte County Health Dept. Re-
quirements..
�l
VIL
t
BUTTE COUNTY'
BUILDING DEPARTMENT
APPROVED.
� 7< / e 1,,4e -L—
`ftis set of plans and specifications 'MUST be
$kept on the job at all times and it is unlawful to
make any changes or alterations on same without
written permisson from the Department of Public
Works, County of Butte: