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Home My WebLink About079-130-027LYLE SAINT / M70-.- Circle, OroviI e Contr: North State Aluminum, Inc. Permit #3799-83B r475ANC 02-2847 E, DAN INALEDORA CIRCLE,:OROVILL b -Z1,: ARTIC AIRE LOSET HEATER i BUXTON, Don 1183-70B r 1 1081-70E._. �+ 079-130--QD-7 45 Andora Circle, Oroville OONTR: O.W.Clink' gbeard, 2195 Ithica St."Oj (fire damage) 7 0 FAMAS, Raymond S 2918B 39 2321P Lot 24, Cop CONTR:New T (new, single family) Oroville H_: Vents -2 OP - II 3069E h0(° pec C. Copley Acres,. Croville: Trend Corp., 2605 Foothill Blvd:, l A i 036-620-027 02-2847 PIERCE, DAN 45 ANDORA CIRCLE, ORoVILLE CONT: ARTIC AIRE C/O CLOSET HEATER r COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541D� (Rev. 12/96) APPLICATION AND PERMIT ASSESSORPARC >NU,�.IBER• / - ��-7 �,!lFF�'.•//ww b 11 ZONING BUILDINGPERMIT OWNER' P1 c ✓-c e 4DCk V1 TELEPHONE -57 3 SQ. FT. OCC. BUILDING VALUATION / OW S IUNG^AVR.?1o/ & CI c /e oro✓I'► c.Cid- 95500 �i4/- CONTRTOCTOR'S NAME t �� TELFPHOIE (,J() CONTRACTORS MAILING ADORES l V e , !) 4-. �� . 1 CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filen Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS ' ,r1 rr-C`f �r� L J t Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑C Utilities ❑ Installation ❑ Other ❑ Describe Work:CL OLA -I'- Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 800VOR UE Main Service zo.A OR LESS 23.00 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 '� �'?.D '� . Lic. No. Z��Q 1 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: I ❑ 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 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. E3' 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 carrie and policy number are: Carrier L_t.�.�n�{►--�fY�n..- ^C111&N^ Policy Number ': ,A1,,,- 84 1 -- (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;_ s `1+�.� Date t� �� Q- C 17�-_ ? Signature of Applicant - ❑ Owner ❑ Contractor gent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service 200A TO tOooA 46.00 NEW CONST. DWELLING UP. SO OR ADDNS. a ACC. BLOS. 3.5¢Fr: NON-R61�T. BRANCHCIRCUITS MULTI -OUTLET @7,50 POWER APPARATus 8 SINGLE OUTLET CIR. 200 ,.00 Ex. Occup. OUTLET ORFORURES BALD .s0 Ex. Occup. oUTLEEDTSA RES,SID °EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating (, E- 4� �! t 115.04, Cooling Hood 6.50 Ventilation PERMIT FEE S (D Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $'5 HAZ. D. FEES IMP FLOOD CDF PARCELPD HD ISSUE 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. B jJ(JJJ /J /f �% Date Y PERMIT EXPIRE ON rl0'/0 'y� ate Receipt No. G 15 00 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541® —,Z o (Rev. 12/96) APPLICATION AND PERMIT ASSESSORP UJ.IBER- �.J� r 0,^°)1 riw `l/FF�q�� ZONING BUILDING PERMIT OWN I. i e tic e a n IEPHONE -573 SO. FT. OCC. BUILDING VALUATION . OWILI D 55 or?" Cl ✓cjic Oro✓f 1,c 95 Flo CONT CTO N71ME �� Tey G CONfF�@CTjiR'S MAILING A4MM _/Wt� 1 ✓Q� 50 ru— 1 -co CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS �-^ /I , r vv IYI Energy Plan Checking Fee $ $ PERMIT FEE S LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.0023.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat um water heater Water piping 15.00 Each gas water heater or vent 15.00. TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installationny❑ Other ❑ Describe Work: _ CJD hCa t �-i— L Gas piping system 1 - 5 outlets 15.00 Buildingsewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT' Filing Fee 20.00 '"oOR LESS Main Service p A OR LESS 23.00 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 >�L�� [, O Lic. No. ?d� 1 3 OWNER -BUILDER DECLARATION I 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 Main Service 200A 1000A TGNG 46.00 NEW CONST. DWELLIEL OCCUP. CU OR ADDNS. ( a ACC. BMS. SO 3.5¢FT, =R.,. MULTI.OUTLET @7,50 POWER APPARATUS a SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES 20 @ 100 SAL 9 .50 Pn Ex. Occup. ounErs RES,6.UNISGF,)_ 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ I 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 pIerformance of the work for which this permit is issued. 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 cardej and policy number are: Carrier L -t,. M&,---,rnQ0= `Y11 ; _ Policy Number _ (The above sections need nbf 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. 1 X D__atee� I i d- �b�� Signature of Applicant - ❑ Owner ❑ Contractor fYAgent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating 15 A Cooling Hood 6.50 Ventilation PERMIT FEE S Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ HAZ. 1 0. FEES [-"OD I CDF PARCEL PD HD SSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated ove for whit ees have been paid. By M��Date �v PERMIT EXPIRE ON fzTE-D.D.S.-E.D. Date rReceiptNo. CANARY -A SESSOR PINK -INSPECTOR GOLDENROD -APPLICANT PERMIT NO. 3799-83B PERMIT EXPIRES OWNER LYLE SAINT CONTR. North State Alum. ASSESSOR PARCEL 36-62-27 LOCATION 45 Andora Circle, Oroville Temp. Power Pole Called PG&E Temp. Elec. Servi 3 Called PG&E ( Temp. Gas Service r Called PG&E JOB FINALED (Date) -.. 2- / :?0/1 Signature — Zk� J =SOK ' 0 = Not OK — = Not Applicable MOBILEHOMES MI CELLA►NEOUS - = Not Ready Date MOBILEHOME UTILITIES (Plans) OK except It's Date DE2P-1COWERS, CARPORTS, ETC. (Plans) OK except N's 1. Zoning Requirements—Setbacks—Easements 1.Z�ng Requirements—Setbacks—Easements 2. Soils; Special MH Support—Sketch _ 2,. Footings; Size—Depth—Spacing—Connectors 3. Sewer; Location—Test—Fall-C/O—Concrete 3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails 4. Water; Location—Test—Easement Needed (Sketch) 4. Woo wn.; Posts—Beams—Rftrs.—Con nec.—Shthg.—Rfg.—Bracing_ 5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete _ 5 tum. Awn.; Columns—Connections—Splice—Decal—Enclosures 6. Gas; Location—Test—Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG ---- 6. Carports; Windows—Doors .. 7. Utility Clearance 7. Elec. Card -BI Date Card -BI Date Card -BI Date i Card -BI Date Card -BI Date Card -BI Date Card -BI _ Date Card -BI Date Date MOBILEHOME INSTALLATION (Plans) OK except N's 1, Zoning Requirements—Setbacks—Easements Date POOLS (Plans) OK except #'s 1. Setbacks—Easements 2. Footings; Size—Spacing—Marriage Line 2. Soils; Compaction—Structure Stability 3. Gas; MH Test—Demand—Valve—Connector 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining 4. Electricity; MH Test—Crossovers—Breakers—Clearances _ 4. Elec.; Receptacles and Lighting; Distances—GFI 5. Drain; MH Test—Fall—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI 6. Water; MH Test—Regulator—Connector 7. Water and Sewer Connected—C/O to Grade—HD Approval 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed 7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg. Boxes—Enclosures—Panel boards—Ins. to Main in Conduit 9. Exits; Insp.—Sketch 10, Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test—Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date T = OK = Not OK = Not Applicable RESIDENTIAL (Single and Duplex) = Not Ready Date UNDERFLOOR Plans OK exce t#'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /'' Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer / 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access } 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 9. Gas Pipe; Size -Anchors 55. Shear Walls; Nailing -Bolts _ 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date FINAL (Plans) OK except #'s 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date Date Card -BI Date PLUMBING (Permit) OK except #'s 57. Smoke Detector _ 14. Water Ht.: Vent -Access -Combustion Air 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access _ 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. Stairs & Rails - Card -BI - - Date Card -BI Date 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except #'s 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper -- 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 70, Plb., Elec. & Mech. Equip. Listed for Location 22. Size Boxes & No. of Conductors -Stapled 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 23. Romex Installed Close to Edge of Studs & C.J. 72. Insulation -Foam -Looked in Attic ❑Yes _ 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 73. Guard Rails & Deck Construction -Post Caps 25, 2 Appliance Circuits in Kitchen & Conductor Size 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At _ 27. 28. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or At, Insulated Neutral DYes ED No Service -Riser Conductors & Ground -Main Disconnect 75, Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters Dyes ❑No 76, Stucco; Brown -Finish _- 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77, A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet _ 30. Clothes Closet Light -Shower Light - 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. Water Well; Disconnect, Electrical, Plumbing Card B -I Card B-1 _ ____-__--____._ Date Card -BI _- Date Date Card -BI Date 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground 81. Ventilation throughout House 82. Glass Protection Date MECHANICAL (Permit) OK except #'s 83. _ Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric -- 31. A.C-.-Ducts: Insulation & Support 85. Water & Sewer Connected -C/O to Grade -HD Approval _ 32. 33. Vent Fan; Exhaust above Insulation Condensate Drain _& Overilow; Size & Grade 86. Energy Compliance Certificate -Other Certificates 34. Furnace-Ve_nt;_Access-Comb._Air-Return Air Vent -115V outlet - 35. Attic Access & Platform if Furnace in Attic - -- Card -BI .Ca d -EI -_ -- _ _ _-- ------_------ _ Date _ _ Card -B]_ Date Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FRAMING(Plans) OK except #'s 36. Sills; Proper Material & Anchors Comments at Final: -37..-Wal 38. 39. Is; Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls over Girders & Floor Nailing Draft Stop in Walls (rat proof) _ 40. _ Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. 42. 43. 44. 45 46. 47. Header & Beam -Size & Bearing Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Sh_hng.-Rfnp. Fireplace Ties or Type A Flue -Fireplace Throat Attic Access: Size & Rom_ex Protection -Draft Stop -Ins. Baffles Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions _ Garage Fire Protection Framing (NOTE:Anentrymust be made each time youvisit jobsite) COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS, 196 Memorial Way, Chico — Phone: 891-2751' 7 County Center Drive, Oroville — Phone: 5344541 Skyway and Elliott Road, Paradise— Phone: 872-2961, Ext. 57 CORRECTION NOTICE s/ a7— 32x9 OWNER PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. -inspectorl��w f Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATIOWANt PERMIT PERMIT NO. r`J ASSESSOR PARCEL NUMBER o36-62-0-027-0 ZONI A_ 9 BUILDING PERMIT OWNER Mr. Lyle Saint TELEPHONE 228 S0. FT. OCC, BUILDING VALUATION 140 8 0.00 OWNER'S MAILING ADDRESS 5 Andora Circle Oroville 72 432.00 CONTRACTOR'S NAME North State Aluminum Inc. TELEPHONE 6 CONTRACTOR'S MAILING ADDRESS 3029A The Esplanade, Chico CA 95926 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation 1$1,272.00 Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ 25.00 ARCHITECT OR ENGINEER Gordon H. Klipple LICENSE NO. 654 Plan Checking Fee $ 15.00 Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS 1525 U Street S ramento CA Permit fee $ 0.00 BUILDING ADDRESS same as above PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SFU Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home S G W I 10-00e TYPE OF WORK New.0 Addition El Remodel❑ Utilities❑ Installation [I Other❑ Describe work: Install an 8 r- x 17.5 r awning and a 6' x 121 awni Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST.(DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. 2/20sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check One): Q 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. 424499 Classification B-1 ❑ t, 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 CONSTR ULTI.OUTLET 2,50 ea NON•R ESID BRANCH CIRC ITS)— NEW CONSTR / POWER APPARATUS &') NON RES,D. SINGLE OUTLET CIR. ( 20®50s Ex. Occup( OR FIXTURES SAL@30t FIXED APPLNS. OR EX. OCCup. OUTLETS (RESID,) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring _j_15.00 Permit Fee $ Contractor 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. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ 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 saio County i co eq ce of the granting of this permit. Date 10/3183 Signature of Applicant — Owner Contractor ❑ Agent K) An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP I TYPE OF CONST. PARCEL PD HD K.SSUP This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRE C OF PUBLIC BY PEF4fdT EXPIRES Date. the applicable provi- resolutions to do fees have been paid. WORKS Date#—/,re3 Receipt No.y/ WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT a 4 � f- . . i s KI £86C 9 not SxbOM onand AO 'ld3a