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HomeMy WebLinkAbout079-260-019JIM HURST 31411 Lowej Wyandotte Rd, Oroville Permit## 3793-74B(stucco) -6-3=-' �l`118-90 KRAMER.,, Donald 7131 Lower -Wyandotte Rd, c oville I (repairs/sf) f i I f l I ( 1 I ! f I I I _ _Gay_ c cnj — �0 "�s.v+nyW,�y, i, .^.^a°ytcw"�� `-`,�+-�" �-. •-tea';�A�""`-'9^`f'c"-.�t�,Yi'i..L��+J h ' f q a . i.. .• � t' �, j � / � i'r ' + - 1 ', �1r , ,�.� �"'�.zF t `=�_s Yip° f T. i�r!{'�✓ �' �`g'rss�-+ VOTIFA I COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKSs PERMIT NO. 7 County Center Drive - Oroville, California 95965 !,Telephone: 916/538-7541 � 90 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT O E Donald Kramer TIRVEPHONE 589-0 11 SQ. FT. OCC. BUILDING VALUATION cont ria 5730 OWNER'S MAILING ADDRESS 7 Wa teRd Oro 566 CONTRACTOR'S NA E Unknown TELEPHONE i CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $5730 Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $56.50 ARCHITECT OR ENGINEER LICENSE NO. i Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 7131 Lower W a dotte Rd Oroville Permit fee $66.50 PLUMBING PERMIT Filing Fee 10.00 t t Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARC MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF[X Duplex❑ Mobilehome❑ Other f SPECIFY �, Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 10.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other Describe work: Repair d L'Ist y Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 j Main service soov OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury p y p l y (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 Of the dusines$ and Professions Code and my license is in full force d effect. License No. Classification R ❑ 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)', Q I, as the owner, am exclusively contracting with license icontract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason fi NEW CONST. DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. 2/20sgft NEW CONSTR MULTI -OUTLET NON-RESID BRANCH CIRCUITS 2.50 ea POWER APPARATUS 6 SINGLE OUTLET CIR. ) Ex. OCcup(OUTLETS OR FIXTURES 20@50Q SAL@30 FIXED PLNS IKE Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $25 00 Contractor )- WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.0^, (valuation )..or less.. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmel's Compensation Insurance or a Certificate of Consent to Setf-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 said County in consequence of the granting of this permit. / X /h>' � �.x .:" / : , � ., ; ::" ; Date / ' Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 1.50 HAz I CUA PARK I SCHL I FLD I PAR JPDJMD I IS U This permit is hereby issued under sions of the Butte COUnty Code and/or work indicated above for which fees DIR CTd 1OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS DateQ //.- tZ—�/.i L,on,Col iptNo. 64045 -D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT s COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. 9�- ASSESSOR PARCEL NUMBER I _ ZONING I BUILDING PERMIT O WAOR3 Donald Kramer TECffPHONE 589-0211 SO. FT. OCC. BUILDING VALUATION cont ri e 5730 OWNER'S MAILING ADDRESS t r CONTRACTOR'S NA TTnknown TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ 5730 Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 56.50 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 7111 Lower Wyandotte Rd. Oroville Permit fee $ 66.50 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF U Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G W 10.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other [ Describe work: epJ_- 1Per a6hP_d- I—J_81 _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 1000V OR 0 AMP ORLESS10.00 Main service EA. ADD'L 100 AMP 2.50 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) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.& -OR AODNS. ( ACC. BLDGS. , 2/z¢sgft NEW CONSTR. ULTI-OUTLET NON-RESID BRANCH CIRC ITS 2,50 ea POWER APPARATUS ( al OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES BAL030 FIXED PR Ex. Occup. OUT —LETS (RESID,IEA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. �Virin 9 15.00 Permit Fee $ WORKMEN'S 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 FiIingFee 10.00 Heating Cooling g '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 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 co sequence of the granting of this permit. X _ K� 1 ddCC�(�, �n-Ph - Date �f - / 3- �D Signature of Applicant — Owner K Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- uctures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ HAZ I CUA I PARK I SCHL I FLD I PAR PD I HD Is u This permit is nereby issued under sions of the Butte County Code and/or work indicated above for which fees DIR CT OF PUBLIC BY PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS r Date 1- 3 LRece,.ptrNo. . W., YELLOW-ASSESO 1 K -INSPECTOR, GOLDENROD -APPLICANT STANDARD STRUCTURAL PEST CONTROL INSPECTION REPORT (WOOD -DESTROYING PESTS OR ORGANISMS) This is an inspection report only -- not a Notice of Completion ADDRESS OF BLDG NO. SIRLE. I' 11ROI1ERI'Y INS11ECILD Road----.--- -Oroville.95966... DATE 01-- INSIIECTION C-0. CODIL _Ap[iI 10, L99 Affix slihereon Hoard copy only 4101615# 515 Garden Highway A LICENSED PEST CONTROL Yuba City, CA 95991- 6354 OPERATOR IS AN EXPERT IN CLARK 916 674-2900 800 624-8450 - Fax 916 674-5190 HIS FIELD. ANY QUESTIONS rion PEST CONTROLovir i RELATIVELTO THIS REPORT HIM CO. III : '11ORI, S*lAl`vIl1 1 SHOULD BE REFERRED 1-0 HIM LICLNSE , No. PR 2 6 NO. (11 1: ANY)_U_4z7153_____. NO...2853441P.__j Inspection Ordered by (Name and Address) .. Donald Kramcr7131 Lower Wyandoitc Rd., Oroville 95966 .. ....... . Report Sent to (Name and Address) Same as above Owner's Name and Address Same -as above Name and Address of a Party in Interest Original Report Elxl Supplemental Report Limited Report Reinspection Report No. of Pages: F-4-1 BELOW SEE DIAGRAM BELOW YES Code SEE DIAGRAM BELOW-] YES Code BELOW YES Code SEE DIAGRAM SEE DIAGRAM B S Subterranean Termites 0 - Beetles - Other Wood Pests Z - Dampwood Termites X EM Excessive Moisture Condition xx I I- I I K Dry Wood Termites XX FG Faulty Grade Levels SL Shower Leaks xx IA Inaccessible Areas Rot EC Earth -wood Contacts CD Cellulose Debris xx Fl Further Inspection Recom. x F Fungus or Dry _1. SUBSTRUCTURE AREA (Soil conditions, accessibility, etc.) Partly inaccessible Damp See below 2. Wd§ stall shower water tested? Floor coverings indicate leaks? Tub/ycs See below 3.. FOUNDATIONS pe, Relation to Grade, etc.) Concrcte,_p jcL&_post See below 4. PORCHES ... STEPS ... PATIOS Concrete & wood 5. VENTILATION (Amount, Relation to Grade, etc.) ears, adequate—above a c 6. ABUTMENTS ... Stucco walls, columns, arches, etc. None .--7....ATTIC SPACES (Accessibility, insulation, etc.) Accessible* Nut insulated 8. GARAGES (Type, accessibility, etc.) None 9..WFodb _D_EC_K_SNone 10.OTHER- --.....Sccbclo\v DIAGRAM AND EXPLANATION OF FINDINGS (This report is limited to structure or structures shown on diagram) ' General Description One story, wood frame, wood exterior, metal & composition roof, I'urnishcd, carpeted, occupied Inspection Tag Poste(:_(location) subarea Other Inspection Tags—_ — ------- 11 F FI 10 F FI 4 EM Fl 15 EM FI 3 S1 1 A FI I 7FGEM EM 9 2 F EM 6 -- CONTINUED ON SECOND PAGE Inspected by: M. Winkel —License No. 6294 —Signature YOU ARE ENTITLED TO OBTAIN COPIES OF ALL REPORTS AND COMPLETION NOTICES 014 THIS PROPERTY FILED V41TH THE BOARD DURING THE PRE- CEEDING nVO YEARS UPON PAYMENT OF A 52.00 SEARCH FEE TO STRUCTURAL PEST CONTROL BOARD, 1430 HOWE AVE. SACRAMENTO. CA 95825 PAGE: 2 OF STANDARD INSPLCTION REPORT ON THE PROPERTY LOCATI'D AT: Address of... Property Inspected: 7131 LoNvcr Wyandotte Road Orovillc 95966 BLDG NO. STREET CTTY 2853441P 4-10-90 04-7153 STA MP NO. DATE OF INSPECTION CO. REPORT NO. (IFANY) IMPORTANT NOTICE CONCERNING FURTHER INSPECTION ITEMS: Except as noted below, we did not inspect detached decks or structures, roof, columns, abutments, plumbing, appliances, wall coverings, painted surfaces, plaster cracks, tile, grout, the interior of hallow walls, or behind veneer. No insulation was removed to inspect any wood member. We did not inspect the area under or the condition of any floor covering, the interior of furnished rooms, footings, spaces between a floor and ceiling or soffit below. We do not have the license or expertise to inspect for building code violations or the quality of work completed by others. An infestation of termites or wood destroying beetles, fungi, dryrot, or conditions deemed likely to lead .to any of the above, could exist in the uninspected areas. If parties in interest require an inspection of any of these areas, we will employ appropriate craft and file a supplemental report. There will be an additional charge. We will reinspect work completed by others up to four months after our original inspection. Open wall and floor inspection is required to provide certification. A charge no greater than our original inspection fee will be made for each supplemental inspection. SUBSTRUCTURE AREA FINDING #1 : The crawl space has less than 12 inches clearance between the bottom of the joists and the unimproved ground area. See "IA, FI" on diagram. RECOMMENDATION: Because complete excavation could weaken the footings, we recommend removing enough soil to permit inspection. List adverse findings, recommendations and additional any costs in a supplemental report. FINDING #2 : There is a faulty grade in the subarea. See "FG" on diagram. RECOMMENDATION: Redistribute soil to conform with requirements of the California Structural Pest Control Act. FINDING #3 : Subterranean (ground dwelling) termites are tubing out of the soil, and have damaged at least 110 feet of damaged wood members See "S" on diagram. RECOMMENDATION: Replace or resupport 110 feet of damaged wood members. Scrape down accessible termite tubes. Chemically treat with Dursban TC In conventional construction this may include, but is not limited to: rodding or trenching the soil around the foundation walls, piers and plumbing pipes in the subarea; rodding or trenching the soil around the exterior foundation; drilling attached slabs (or blacktop) such as patios, porches, sidewalks or driveways that abut the structure; drilling brick or stone veneer extending below grade level; treating voids in foundation walls or piers. Soil treatment to be applied by our State licensed applicators per California Department of Food and Agriculture regulations and current label instructions. STALL SHOWERS FINDING #4: The sheetrock adjacent to the bathtub is moisture damaged. See "EM, FI" on diagram RECOMMENDATION: Remove and replace approximately 6 sq. ft. of sheetrock. Inspect the exposed wood members. List any additional findings, recommendations, and costs in a supplemental report. Tape and texture. No painting included. FINDING #5 : The floor covering is buckled adjacent to the bathtub See "EM, FI" on diagram. RECOMMENDATION: Remove commode and underlayment to permit further inspection of exposed wood members by our State licensed inspector. List adverse findings, recommendations, CLARK PEST CONTROL, License Number: PR0226 r 1'AGE: 3 OF STANDARD INSPECTION RE?1'012'1- ON THE, PROPUAIT'Y LOCATED AT: Address of Property Inspected: . 7131 Lower Wyandotte Road Oroville 95966 BLDG NO. STREET CITY 2853441P 4-10-90 04-7153 STAMP NO. DATE OF INSPECTION CO. REPORT NO. (IFANY) and any additional costs in a supplemental report. If no further damage is found, install new floor covering and reset commode on a new wax seal. FOUNDATION FINDING #6: The existing concrete foundation is cracked and pulled away from the structure. See "EM" on diagram RECOMMENDATION: Owner to employ a licensed conractor to inspect and make necessary repairs. FINDING #7: A faulty grade exists at the side of the structure allowing moisture to enter the subarea. The subarea is inaccessible in this area due to lack of clearance. See "FG, EM, FI" on diagram RECOMMENDATION: When recommendation #1. is completed, further inspection will he made. Any adverse findings, recommendations, and any additional costs will be listed in a supplemental report. OTHER FINDING #8: Wood decay fungi was noted a t the flooring adjacent to the front and rear doors. See "F, FI" on diagram RECOMMENDATION: Remove and replace the damaged flooring. Inspect the exposed wood members. List any findings, recommendations, and any additional costs in a supplemental report. FINDING #9: Voids were noted in the wood siding. See "EM" on diagram RECOMMENDATION: Seal the voids as necessary. FINDING #10: Wood decay fungi is infecting and damaging wood members at the caves. See "F" on diagram RECOMMENDATION: Replace approximately 30 lineal feet of I x 10. Inspect adiaccnt Wood members. List adverse findings, recommendations and any additional costs In a supplemental report. Treat adjacent wood members with zinc napthenate. Wood treatment to he applied by our State licensed applicators as per California Department of Food and Agriculture regulations and current label instructions. Painting not included. FINDING # I I.: Decay fungi is infecting wood members at the eaves of the structure and structural damage is evident. See "T, FI" on diagram. _ _ RECOMMENDATION: Cut off damaged ends of twelve rafter tails and splice on new ends. Inspect adjacent wood members. List adverse findings, recommendations and any additional costs in a supplemental report. Treat adjacent wood members with zinc napthenate. Wood treatment to he applied by our State licensed applicators as per California Department of Food and Agriculture regulations and current label instructions. Painting not included. PESTICIDE NOTICE: CLARK PEST CONTROL, License Number: PR0226 I'AGE: 4 OF STANDARD INSPECTION RE"VORT ON THE PROPLRTY LOCATED AT: Address of Property " hispected: 7131 LoNNcr Wyandolic Road Oroville 95966 BLDG NO. STREET CITY 2853441P 4-10-90 04-7153 STAMP NO. DATE OF INSPECTION CO. REPORT NO. (IFANY) In a proper termite control application a non-toxic odor will lie produced as a result of solvent evaporation. The odor will dissipate in approximately 60 days. The odor contains no technical pesticide and is not hazardous. The following pesticides may be used: Chloropicrin, Copper naphthenates, Copper Quinolate, Demon, Dragnet -F7; Dursban, Ficam, Methyl Bromide, Permethrin, Silica Aerogel, Spear, Tribute, Vikanc, Zinc naphthenates. Pesticides are toxic chemicals. Structural Pest Control Operators are licensed and regulated by the Structural Pest Control Board, and apply pesticides which are registered and approved for use by the California Department of Food and Agriculture and the United States Environmental Protection Agency. Registration is granted when the State finds that based on existing scientific evidence there are no appreciable risks if proper use conditions are followed or that the risks are outweighed by the benefits. The degree of risk depends upon the degree of exposure, so exposure should be minimized. If within 24 hours following application you experience symptoms similar to common seasonal illness comparable to the 11u, contact your physician or poison control center and your pest control operator immediately. Your health and safety are our major concern. If you experience; the symptoms as outlined above, leave the structure immediately and contact our office. Clark Pest Control: 1-800-421-7829 Poison Control Center: 1-800-342-9293 Structural Pest Control Board: 91.6-924-2291 'Butte County Health Department 916-538-7581. Butte County Ag Comissioner 916-538-7381. CLARK PEST CONTROL, License Number: PR0226 A * PERMIT NO. 3793-74B a� �t :1 P � E M QMH UTIL. A PERMIT NO. PERMIT EXPIRES / —/�/ ZS - ,'OWNER Mr. Jim Hurst 0 ICON TR. LOCATION (A.P. 36-31-18 ) r! 3171 Lower Wyandotte Rd, oroville } .p T+ 6 • 1 �i a« r' I Temp. Power Pole Called PG&E. Temp. Elea Serv. Called PG&E T mp. Gas Serv. Called PG&E } JOB FINALED t (D te) t igna r A COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor - Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. Stemwall Slab Prov. for physically handicapped Heaters Appliances Carport Footings Conformance of ex. structure Gas Piping & Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing ELECT Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Sub anels Mesh MECHANICAL _ Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final DATE REMARKS OR CORRECTIONS COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WOR 7 County Center Driye — Oroville, California 95965 i. Tel dphone: 534-4541 APPLICATION AND PERMIT Of Of BUILDI G Owner U -�� SQ. FT. OCC. ILDING VALUATION ©0 Mailing Address fl �� S7� Telephone No. Fireplace Contractor Total Valuation Mai I i ng Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ $ Building Address PLUMBING No.1 @ 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. Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F on Fire Dept., FireZone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W Improvements P Lawn sprinkler system 2.00 Bldg. Plans Rec'd Parcel Approval Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER 0 ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 .S/AE 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 1410 Receps., switches & fix outlets EM 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 X XI 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. 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. Date `/ w/ v Sig; ature f Permitee or Agent Receipt No. Whitf-D.P.W. — Y`ellow-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 UBLIC WORKS By � Date 5''`%-- ,/e - ding permit expires Date................F-1d...... ?IJ