HomeMy WebLinkAbout078-330-02192, 96-5B.iW,
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LINCOLN, 'Augti§t,&,Kdren
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330 -0�
02-1
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I
J=OK
O = Not OK
=Not Applicable
' = Not Ready MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'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
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE NOME INSTALLATION (Plans) OK except #'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'13=1
Date
Card B-1 Date-Card,13-1
t � f
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s-
1. Zoning Requirements -Setbacks -Easements t
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel I
3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood'Avwn.; Posts-Beams-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 j
Date Card B-1 X Date Card B-1
Date 'Card B-1 ! Date Card B-1
Date POOLS (Plans) OK except #'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 '1% Date Card B-1
r
J=OK
O = Not OK
= Not Applicable
' = Not Ready RESIDENTIAL (;
Date UNDERFLOOR (Plans) OK except #i's
1.
Zoning -Setbacks -Easements -Flood -Slope
2.
Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
3.
Ft \, Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. epth
4.
Ftg., orches & Decks; Soils -Steel-/ /Ftg. epth
5.
Stem IIs, Main; Steel-Blockouts-Wrapp d
6.
Stemwa , Garage; Steel- Bloc kouts-' apped
6a.
Hold Do s and Special Anchor
7.
Slab; Steel- rapped
8.
Piers-Fireplac Ftg.-Steel
9.
10.
D.W.V.; Fall -Fitt g-Tes Way C/O -Sewer Test
UF. Gas Pipe; Siz chors - yard gas piping: size -test
11.
Water Pipe; Tes An or -Regulator -Service Test
12.
Electric; Un rground
13.
Pienums Ducts; Clear)Qce-Material-Support-Ins.
14.
Girde -Sills-Anchor Bolts oists-Ve-tts-Cripples
15. Access & Ventilation
16.
Insulation
Date
Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date PLUMBING (Permil),OK except s's
16.SWat Htr.: Vent -Access -Combustion Air -Baffle
---------SSS-- --- -- ---------------------------
17. Water ipe: Test & Anchor -Nail Protection
--SSSS-SSSS-- -SSSS-- ------------------------------
18. D.W.V.; est -Fittings chor-Nail Protection
--SSSS-- -SSSS-- -- -- - -----------------
19. Shower P . First Floor -Tub Access
SSSS---SSSS----------------SSSS-- -SSSS--
20. Test & S wer. Second Floor -Tub Access
-SSSS---SSSS--
21. Gas Pipe: Size & chors
---- ---------- -------------SSSSSSSS-- --------------------------------------
Date Card B-1 Date Card B-1
------------------------ -------- -SSSS-SSSS-- SSSS -- -----------------
Date Card B-1 Date Card B-1
Date ELECTRICAL (Permit) OK except 4's
22.- Fixture & Transformer Clearance - Ins. `rotection
-----------------qSSSS-p -- 9 -9 --- -------------------------
23. Elec. Receptacles S acin Li hts Switches at Doors
--------------- -------------
24. Size Boxes & No. of Conductor Stapled
--------------------------------------------- ----------- ------- ---------------
25. R ex installed Close to Ed e of Studs & C.J.
--------SSSS-- - --SSSS-- ----------- -------------------------------------
26. Equ . Ground made up !Meth. h. -Bond Water --------------SSSS-- PP --SSSS---SSSS-- --------------------SSS-Gas-&-----SSS--SSSS--
27. 2 A I nce Circuls i lchen &Conductor SizeiGFl
-------------- -SSSS--- ce Ci --------tche --Conn- forSize-- -
22. Subfeed re Siz ya. Cu or AI-A.C. Wire Sizer ga.
Cu or At
-SSSS-- --- -------------- -----------SSSS-- ------------------------------
e
--SSSS-- --- -----SSSS-- ---
29. Range Circ ga. Cu or AI -Oven Circ. / I ga. Cu or Al.
Insulate Neutra ❑ Yes ❑ No
---------------------------------- ------ ------------- O -No -------------------
30. Servi -_Riser Condu rs & Ground -Main Disconnect
---------------- ---------- -----------------------------
-------------- Eq . Clearances Pane Motors-Mech. Equip.
-----------------------------------SSSS-- ----------------SSSS---SSSS---SSSS--
32. Clothes Closet Light-Showe Light -Spa Light
-------------------------------------------- -SSSS- - SSSS- -----------
33. Smoke Detector
------------------------------- ------------------------------------------------
Date Card B-1 Date Card B-1
-------------------------------------------------- ---------------
----------------
Date Card B-1 Date Card B-1
Date MECHANICAL (Permit) Ok except k's
34. A.C. Ducts Insulation & Supp t�
SSSS- -- --- --- -- SSSS SSSS - SSSS-- - SSSS-----------------SSSS----------
35. Ve Fan: Exhaust above ' ulation
--------- --- SSSS ----------- ------------------------ -------------
36. Cond sate Drain erflow: Size & Grade
--------------------- --------- -------------------------- -------- ------
37. Furnanc Vent ccess-Comb. Air -Return Air Vent -115 outlet
--------------------- --- --- -------------------SSSS-----SSSSSSSS-SSSS--------
38. Attic Acc & Platform if Furnance in Attic
----- --------------------------------------------------------------------------
Date Card -B-1 Date Card -B-1 ------------------------------------------------------SSSS---------------------
Date Card B-1 Date Card B-1
Date FRAMING (Plans) OK except 4's
39. Sils. Proper Material & Anchors
------ ------------------------------------- ----------------------------
------------- 40. Walls Studs -Nailing. Spacing & Bracing -Plates -Sound
------------------------------------------------------
41 Bearing Walls over Girders & Floo' Nailing
----SSSSSSSS-- --SSSS------- ----------------------------------------------------
42. Draft Stop in Walls (rat proof)
-----------------------------------------------------------------
43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub
-----SSSS-- ------------------------------SSSS----SSSS--
44. Headers & Beam -Size & Bearing
'ingle & Duplex)
Date FRAMING (Continued)
45. Hanger - aps-Anchors-Connectors
_415 ng. Joist-Rflr. ties-Purlin-roof Bra c-Truss-Shthng.-Rfng.
-- 47 -,Fireplace Ties or Type A Flue -Fireplace Throat clearance
--- 48.�ttic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
50. Garage Fire Protection Framing
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
54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers
___ - _ _ 55. Siding -Nailing Veneer
_ 56. Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access
_ 57. Glazing Area -Glass Protection -Skylights- Plastic
58. Shear Walls; Nailing -Bolts
59. Insulation -Walls -Ceilings
60. Infiltration -Walls -Windows
Da �ard B-1Ila
Date Card B-1
� ---� ------
Date Card B-1 Date Card B-1
Date FINALL-(Plans) OK except N's
Ext. Steps -Door & Sidelight Protection -Landings
moke Detector
------------------ --
urnace: Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor -Ducts -Meth. Protection
------------------------------------
04_Be4rew-Ex i c i n g
-SSSS------------SSSS-o- -SSSS-- --
& ath Fixtures & Tub Access -Spa
----------------------------- Fanel; Breaker Sizes &Labelsb
------------- --------------&---Su-
----
nzls
------------
-------SSSS----SSSSSSSS-- -
,68 Fireola-r Stove: Clearances -Hearth
-SSSS-- SSSS- ^�------------SSSS--
50.-E4 ae--n a is t Wood Panel; Int. & Ext.
- ----- -- -- ----------------------------
7Q_A41-Frrr.-& Appliance; Grnd.-Air Gap -Cooking Clearance
- -- - ----------------------SSSS-- -
G - ^ is & Receptacles at Kit. Counter
---SSSS-- SSSS-- 1-- - - - ---
arage Fire Door Swing -Landing -Closer
--------------------------------------
Garage -Damper
--------------------------
t4-NVR-ftr,-Vents-Clearance-Comb. Air-Connector-P.R.V.
In Garage: Above Floor -Meth. Protection
Flet. & Mech. Equip. uip. Listed for Location
-----------------------
'
.7fr-Elee-Reeeptacles in Garage; (G.F.I.)-Romex Protection
-----------------------------SSSS-- ---
7, 1^ ,Ia1i^^-Foam-Looked in Attic ❑ Yes
-------------------------------------SSSS-- --
_1&,Qeerrd-Rails & Deck Construction -Post Caps
- ---------------------------------------
a_0_- an. Vents & Crawl Hole Door -Drainage & Wood -Earth
Clearance Looked under Floor ❑ Yes
--- -- ---------------------------------SSSS-- --
39-fvITOWtTSTinstld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No;
Planters ❑ Yes ❑ No
------------------- ----SSSS--
i1LSFeeco-Brown-Finish
ni :Disconnect. Electrical, Plumbing
--------SSSS--- --SSSS-----------SSSS-- --
a3 u�ove Roof: Plbg.-Appliance-Fireplace.-Clearance to
Openings
- - - - - - - -- -- --SSSS---SSSS-- SSSS--SSSS--
tet^'We-, Disconnect, Electrical, Plumbing
-----------------------------
A&-&oe+' e;ec. Trim; G.F.I. Receptacle -Underground
- ....--.._ --SSSS--
a6_44eA4rtdrion Throughout House
SSSS-- ---------------------- --SSSS--
aW- G4 ss-Pratection
.----- ----------------------------------SSSSSSSS-------
8a•-6errULrmns from Previous Inspections
------ --- ------------- ------------------SSSS--
W_-)-. s"Fest-Meters Tagged; Gas -Electric
-- -- -- -- - --- ---- SSSS-------------------SSSS--
99r& Sewer Connected -C/O to Grade -HD Approval
cL &mTT Compliance Certificate -Other Certificates
Date j Lar -d B-1 Date _ _ Card B-1
- -- ------ ----SSSS-- -
...--- - --- - SSSS - -
Date Card B-1 _ _ Date Card B-1
--------------------------
Date Card B-1 Date Card B-1
Comments at Final
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - OrovilL,e,-Callfgrnia 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
36-34-21
ZONING
A R
BUILDING;PERMIT
OWNER
&D KAREN LINCOLN
TELEPHONE
533-2487
SQ. FT. OCC. BUILDING V ATION
6,000
O WNER•SUGUSTLING DRESS
P.OMA I. BOX 582 PALERMO 95968
CONTRACTOR'S NAME
CURRENTS CONST
ITELEPHONE
34-8464
CONTRACTOR'S MAILING ADDRESS
147 SILVER BAR DRIVE 95966
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
6,000
LENDER'S MAILING ADDRESS
Filing Fee
$ 15.00
Permit Fee
$ 67.5.0
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ 33.75
Ener Plan Checking Fee
9Y 9
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
35 INGLEWOOD DRIVE OROVILLE
Permit fee
$ 116.25
PLUMBING PERMIT
FilingFee 15.00
Each Trap
5.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
7.00
Each qas water heater or vent
7.00
USE OF STRUCTURE
SFEI Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home I S I G I W
@ 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work: ADD ;RODE STRUCTURE _
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 600V OR LESS
200A OR LESS
18.50
Main service 200ATO1000A,
37.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
am licensed under provisions of Chapt. 9, Div. 3 of the Business
and SProfessions/ Code and my license is in full force and effect.
License .Jo. Classification 46
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
.NEW
NEW CONST. / DWELLING OCCUP.8d)
ACDNS. \ ACC. BLDGS. //
3.64 sq.ft. '
NEW CONSTR.ULTI.OUT LET
NON-RESID BRANCH CIRC ITS
@ 5.00
( POWER APPARATUS 1f 1
SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES
20 76
FIXED APLNS.
Ex. OCCUp. OUTLETS P(RESID )RE A.�
I 3.00
Temporary service
15.00
Mobile Home Facilities
15.00
Misc. Wiring15.00
Permit Fee
$
—
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -insure.
jZk I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
FiIingFee 15.00
Heating WO VENIS2
1 4.501 9.00
Cooling
g
Hood
6.50
Ventilation
permit Fee
$ 24.00
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against sai ounty i consequence of the granting of this permit.
X e Date y
Signature of Applicant — Owner❑ Contractor 9 Agent ❑
An OSHA permit is required For excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Receipt No—&O-30By
WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT
Mobile Home Installation Fee S
Energy Inspection Fee $
occ CONST TYPE TOTAL FEE $
HAz 1 DFEES IMP FLOOD CDF PARCEL I PD I HO I SUE
This permit is hereby issued under the applicable provi-
sions of the Butte County Code and/or resolutions to do
work indica d abov r which fees have been paid. ate
IR OF PUBLIC WORKS
✓ D
PERMIT EXPIRES Date
COUNTY OF BUTTE - DEPARTMENT -OF -,PUBLIC WORKS - BUILDING DIVISION
-7 COUNTY CENTER DRIVE = ORO_VIL CALIFORNIA 95965. -.TELEPHONE: 916/538-7541
PERMIT APP1,AXATION DATA SHEET
/ Permit No. _
OWNER h r_0[ A. P. No. 36 _3 L/
Proposed Building Use n Building Inspector Date
t
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED APPROVED
1. All items have been submitted. ..........
2. Plot plans in duplicate/triplicate, signed by preparer of plans........
3. Complete plans in duplicate/triplicate, signed by preparer. of plans . .
4. Complete engineered plans and calcs, with wet signature on plans ..
5. Hazardous Material Form ..........................................
6. Energy Design Compliance and supporting documentation .........
7. Statement of Intent for Non -Heated and AC Buildings ..............
8. Engineered truss details and layout in duplicate (required prior to plan check)
9. Mobilehome installation data including manufacturer's installation
instructions..................................................
10. Fees of $
11. Chico Urban Area fees paid .......................................
12. Park fees paid ....................................................
13. School District fees paid ..............
14. Sanitation approval from Health Department
15. City of Chico plumbing permit .....................................
16. Plot plan and business license approval from City of
(see City for other requirements)
17. Planning approval for (A) Use: (B) Parking: ......
18. Improvements may be required. Contact Land Development Section DPW
19. Driveway permit (construction approval required prior to occupancy)
20. Pre -Inspection for required Pre-Inspec. request to
Building Inspector (Dat(
21. Contractor's license information (No., Name Style, Classifications ...
22. Certificate of Workmans Compensation Insurance ..................
23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) .....
24. Recorded copy of Agricultural Acknowledgment Statement .........
or 25. Letter of signature authorization p
26. C'• V1tiQ.� 2tO /�A�o�i�ionn j D-�TQd
27.
When you issue the permit, process as follows: Mail to owner. Mail to contractor.
Telephone :L3 �/-SL16%and hold for pickup at �20 office. Deliver w/inspector.
Other
Applicant
Date LI 1- 52
Copy of Hdz-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 permit issuance: (Circle new item not checked above).
1. Index permit for above items No.
2. Additional items required:
Contractor, designer,
owner, was advised of above
required data by_phone-__nail-counter by
.date
Contractor, designer,
owner, was advised of above
required data by_phone_maII_counter
date`
Plans checked by
Date
Plans approved
by �
Date
Sets of plans on hold in
Copy -DPW
File cabinet AP folder
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville,.-California 95965 - Telephone: 916:'538-7541
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
ZONING
BUILDING PERMIT
OWNER -
�a 3 ih c lH
TELEPHONE
S 3 -Z Y9
SQ. FT. OCC.`, BUILDING VALUATION
OWNER'S MAILLNG ADDR S
^ oI,,e Ct l e rn o S" 6
CONTRACTOR'S NAME-
ef rnth•rlZ �0h r�
TELEPHONE
.3�/ 8`/6
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 15.00
LENDER'S MAILING ADDRESS
Permit Fee
$ 7
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ -7 7�
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$ //61"
PLUMBING PERMIT
Filing Fee 15.00
Each Trap
5.00
O� r2 v ^ G
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
7.00
Each qas water heater or vent
7.00
USE OF STRUCTURE
SF/�,{ � Duplex❑ Mobilehome❑ Other
v SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home S I G I W
@ 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Installation ❑ Other ig
Describe work: _
�I'!)C9-F _�I-r-4 r t%
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 2001 OR LESS
00A OR LESS
18.50
Main service 200A TO 1000AI
37.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ 1 am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. ( DWELLING oCCUP.&\
O //
R AODNS. ACC. BLDGS.
3.66 sq.ft.
NEW CONSTR. ULTI.OUTLET
NO N•R ESID BRANCH CIRCUITS
@ 5.00
POWER APPARATUS e
(SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES
20 764
RA
FIXED APPLNS.
EX. Occup. OUTLETS IRESID IREA.�
3.00
Temporary service
15.00
Mobile Home Facilities.
15.00
Misc. Wiring
15.00
Permit Fee
$
—
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 15.00
Heating
Cooling
g
Hood
6.50
Ventilation
Permit Fee
$ 2c/
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
X Date
Signature of Applicant — Owner❑ Contractor ❑ Agent ❑
An OSHA
ion of structuresover3 storiesoineheight ions over 5'0" deep and demolition or construct-
Mobile Home Installation Fee S
Energy Inspection Fee $ —i
occ
CONST TYPE
TOTAL FEE $ /Z/ Z D
I
HAz
1 0FEES
IMP
I FLOOD
I CDF
I PARCEL
I PD
I HO
I ISSUE
This permit is hereby issued under the
sions of the Butte County Code and/or
work indicated above for which fees
DIRECTOR OF PUBLIC
By
PERMIT EXPIRES Date
applicable provi-
resolutions to do
have been paid.
WORKS
Date
Receipt No.
WNITE-O.P.W.. YELLOW-ASSE340R• PINK -INSPECTOR. GOLOENROa-APPL CANT
1- Thls set of plans and speclflcatlons MUST be
-- kept on the job at all times and it is unlawful to
NOTE.:—AD Materials & Workmanship Shall 16 i�1 make any changes or alterations on same with-
tiS out written permission from the Department r+;
Accordance with Recognized Good Practices: � fo
of a .quality prescribed for the Specified use In fho r ��5��-,gyp PO' a��bl�c W�rk�, (61onty of 11"-,
Vniform Building, Plumbing & Mechanical Codes or ' p
S
the National Electrical Code.
VWAHWM per ft 3%wa
.1d
`�..� .
i y-
01 OA
A0
• '�' � � I a � K O0.
rip 6614J ' Ri
S i to
CO
�
0 i �� p_,_G� Sots S Y 4 -� ,.�
Sde �2
,
_- i -. .�( A `� •�---moi^ •l - _. 'i... ... --. -. et
4- a ��
eA
_ . BUTTE COUNTY
{ . - 'BUILDING DEPARTMENT
AP'PR011ED-
�9�9