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Home My WebLink About079-310-017r W � ` T - _ - �% 07g -310-017 8 RON EAVES % "Uf ' 40 Crane Ave . , Oroville �� ::oritr:Foothills Constr.`,- Palermo Permit ##56-76B(reroof/SF) - eter A. Hart 40 Crane Ave., Oroville Perc>at #3235-76B(new private garage) ; Permit. #334"9=76p;E (plbg &elect. for 3235-76) pri. garage L-4; _A4_!j4?/ /9� PERS IW94 2869 _CONNELY., LAURA - 40 CRANE AVE . , OROVILLE CONT:fALLADIN ROOFING REROOF/SF �, B07-1137 079-310-017 MISCELLANEOUS Siding/Stucco VINYL SIDING 150 L AND, INSTALL 40 CRANE AVE,! TRACY &LAURA CONLVY BUTTE COUNTY w AREA DEPARTMENT OF DEVELOPMENT SERVICES 2 INSPECTION CARD MUST BE ON JOB SITE 24 Hour Inspection Line: (530) 538-7636 (Oroville) (530) 891-2834 (Chico) Office: (530) 538-7541 Fax: (530) 538-2140 Website: www.buttecounty.net/dds Permit No: B07-1137 Issued: 5/24/2007 Address: 40 CRANE AVE Area: OROVILLE Owner: TRACY & LAURA CONLAPN: 079-310-017 Applicant: P F REILLY AND COMPMap Page: 61Z�A—' Permit Type: Siding/Stucco Description: VINYL SIDING 150 LF AND INSTALL 1 WI Flood Zone: None SRA Area: Yes SETBACKS Front Setback: Side Setback: Rear Setback: Other Setback: Minimum Setback From Centerline of Street: ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING Inspection Type IVR INSP DATE Setbacks 132 Foundations / Footings 111 Pier/Column Footings 122 Grade Beams 114 Eufer Ground 216 Forms/Steel/Holdowns 122 Do Not Pour Concrete Until Above are Signed Pre -Slab 124 Gas Test House 404 Gas Test Yard 404 Masonry Grout 120 Masonry Bond Beam 119 Underfloor Framing 149 Underfloor Ducts 319 Shear Transfer 136 Under Floor Plumbing 412 Under Slab Plumbing 411 Gas Piping 403 Do Not Install Floor Sheathing or Slab Until Above Signed Holdowns/Straps 122 Shearwall/B.W.P.-Interior 135 Shearwall/B.W.P.-Exterior 135 Roof Nail/Drag Trusses 129 Do Not Install Siding/Stucco or Roofing Until Above Signed Rough Framing 128 Rough Plumbing 406 Rough Mechanical 316 Rough Electrical 208 Gas Piping 403 Shower Pan/Tub Test 408 Fire Sprinkler Test 702 Fire Sprinkler Final 702 Building Final 802 Electrical Final 803 , Mechanical Final 809 Plumbing Final 813 Pool Final 802 Mobile Home Final 802 Fin4ls Ins ection Type I IVR I INSP I DATE Do Not Insulate Until Above Signed Wall Insulation 117 Ceiling Insulation 118 Do Not Cover Until Above Signed T -Bar Ceiling / RC 145 Stucco Lath 142 Stucco Scratch 143 Stucco Brown 144 Swimming Pools Setbacks 132 Pool Plumbing Test 504 ' Gas Test 404 Pre-Gunute , 506 Pool Elec/Bonding/Light Nitch 502 Pool Fencing/Alarms/Barriers 503 Pre -Plaster 507 Manufactured Homes Setbacks 132 Blocking/Underpining 612 Tiedown/Foundation System 611 Site Utilities/Trench Insp. 137 Gas Test Yard 404 Manometer Test 605 Continuity Test 602 Skirting/Steps/Landings 610 Coach Info Manufactures Name: Date of Manufacture: Model Name/Number: Serial Numbers: Length x Width: Insignia: Public Works Fina 538-7681 Fire Department/CDF 538-6837 ext 169 Env. Health Final 538-7281 Sewer District Final **PROJECT FINAL 801 -r-rulect anal is a ♦,eruncace ui vccupancy for tnesiaennal vmy) PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE. IF WORK HAS COMMENCED, YOU MAY PAY FOR A 1 YEAR RENEWAL 30 DAYS PRIOR TO EXPIRATION Inspector Copy J BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING"PERMIT • r 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds ' P F REILLY AND COMPANY INC 3028 ESPLANDE SUITE F CHICO, CA 95973 (530)898-0833 DBMSC Stucco/Siding-StoneBric DBMSC Window/Sldng GIs Dr -Rept P F REILLY AND COMPANY 3028 ESPLANDE SUITE F CHICO, CA 95973 (530)898-0833 FEE INFORMATION $110.00 $110.00 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. /,Class / Expires P F REILLY AND COMPANY INI 711037 / B / 8/31/2007 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000) ofD' ion 3 of the Business and Professions Code, and my license is in full force and effect. X 5/24/2007 Contractors Signature Date _ , , , _-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 performance of the work for which this permit is issued. 1 1HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; Carrier: State Fund Policy Number 713-0015191 Exp. Date:1/1/2008 .(This section need not be completed if the permit is for one hundred dollars ($100) or Tess ) ❑ ISSUED, 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 Workers' Compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of t e Labor Code, I shall forthwith comply with those provisions. X 5/24/2007 Signature Date - WARNING: FAILURE TO SE RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,+ AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY , I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lenders Address City State Zip, Permit No: B07-1137 Issued Date: 5/24/2007 By GLB Expiration Date: 5/23/2008 Occupancy: Zoning: AR 0 - Square Footage: Building Garage Remdl/Addn Other Porch/Patio Total Total Charged: $220.00 Fees Paid: $220.00 Balance Due: $0.00 Receipt No: 133213 OWNER/ BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such peril to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: 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 (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). ' ❑I, AS OWNER OF THE PROPERTY,•ANI EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). ❑ I AM EXEMPT under Section B. & P.C. for this reason: X 5/24/2007 Owners Signature Date Ihereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the props o r a a rho ' to act on the property owner's behalf. ` 5/24/2007 Name of Per ee [SIGN] Print Date Owner Contractor OR; DAgent for Owner gAgent for Contractor FILE COPY e PROJECT INFORMATION-'. _ Site Address: 40 CRANE AVE Owner: APN: 079-310-017 TRACY & LAURA CONLEY Permit type: MISCELLANEOUS 40 CRANE AVENUE Subtype: Siding/Stucco . OROVILLE, CA 95966 Description: VINYL SIDING 150 LF AND INSTAI (530) 533-3423 Cnntrnrtnr - - A,,,,I:��,.r• - - P F REILLY AND COMPANY INC 3028 ESPLANDE SUITE F CHICO, CA 95973 (530)898-0833 DBMSC Stucco/Siding-StoneBric DBMSC Window/Sldng GIs Dr -Rept P F REILLY AND COMPANY 3028 ESPLANDE SUITE F CHICO, CA 95973 (530)898-0833 FEE INFORMATION $110.00 $110.00 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. /,Class / Expires P F REILLY AND COMPANY INI 711037 / B / 8/31/2007 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000) ofD' ion 3 of the Business and Professions Code, and my license is in full force and effect. X 5/24/2007 Contractors Signature Date _ , , , _-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 performance of the work for which this permit is issued. 1 1HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; Carrier: State Fund Policy Number 713-0015191 Exp. Date:1/1/2008 .(This section need not be completed if the permit is for one hundred dollars ($100) or Tess ) ❑ ISSUED, 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 Workers' Compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of t e Labor Code, I shall forthwith comply with those provisions. X 5/24/2007 Signature Date - WARNING: FAILURE TO SE RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,+ AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY , I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lenders Address City State Zip, Permit No: B07-1137 Issued Date: 5/24/2007 By GLB Expiration Date: 5/23/2008 Occupancy: Zoning: AR 0 - Square Footage: Building Garage Remdl/Addn Other Porch/Patio Total Total Charged: $220.00 Fees Paid: $220.00 Balance Due: $0.00 Receipt No: 133213 OWNER/ BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such peril to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: 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 (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). ' ❑I, AS OWNER OF THE PROPERTY,•ANI EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). ❑ I AM EXEMPT under Section B. & P.C. for this reason: X 5/24/2007 Owners Signature Date Ihereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the props o r a a rho ' to act on the property owner's behalf. ` 5/24/2007 Name of Per ee [SIGN] Print Date Owner Contractor OR; DAgent for Owner gAgent for Contractor FILE COPY e BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT 7I1YIE OF APPLICATION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER INFORMATION Last Name D) I kEi5t Name I I rq --t La ung Mailing Address / r� City O ro1.1l Zip 957(��yD Zip Phone L� Elate E-mail CONTRACTOR ARCHITECT/ENGINEER Name City r+ / Address Zip 957(��yD City CJ Stat Zigsx-� Phone _ Fax E-mail E-mail Lic. # —I , , �-1 Class (� APPLICANT INFORMATION ARCHITECT/ENGINEER Name City r+ / '-Addiess Zip 957(��yD City e6 State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name Address 3 ®Z fj 1 r1 and e Ste, F City r+ / State C� Zip 957(��yD Phonee6-q f , b$ 53e6 e6 E-mail APPLICANT SIGNATURE PERMIT NO. BIN # PROJECT LOCATION AP# r Q 1 Pro Address City WORKER'S COMPENSATION Policy Number 02 00 Oo�SI<; Carrier ` Q 'P r n If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: .�VAn Flood Zone t C\ SRA I Yes No 1 Q to Type Const. i i Sq FT- Living Garage Open Cov ` ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): i For office use only: Zoning Flood Zone SRA I Yes No Occ. Type Const. i i 3028 Esplanade, Suite F, Chico, CA 95973 • CA Lic #711037 AGREEMENT Chico: (530) 898-0833 Fax (530) 898-1599 18221 Hanford: (559) 585-1800 Santa Rosa: (707) 568-0333 NAME 1'2ACY f !_HUp A COn lei PHONE 530-5.33-3uZ (HM WK MB MR MRS) ADDRESS _Hp CKAN� AVE PHONE p/� (HM WK Me MR MRS) CITY UOUILL�y STATE CA ZIP PHONE GI�O�O� S(lg�o1 (HM WK Me MR MRS) EST. START DATE �7 EST. COMPLETION DATE Email ALL CHECKS MUST BE MADE OUT TO P.F. REILLYI CAUTION: DO NOT SIGN THIS PROPOSAL UNTIL YOU HAVE READ THE CONTENTS OF THE REVERSE SIDE. ACCEPTANCE: ALL PRICES, SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY AND HEREBY ACCEPTED. Authorization is given to P.F. Reilly, its employees and assignees for all rights and access to accomplish the work commissioned. P.F. Reilly is not responsible for existing structural defects, code violations, or conditions existing beyond their control. CUSTOMER'S SIGNATURE DATES ✓T - 192 DATE —V REGISTRATION# SUBMITTED BY C�(�C� � /�� DATE rJIU12-(50-7 ACCEPTED FOR P.F. REILLY DATE Contractors are required by law to be licensed and regulated by the Contractor's State License Board, which has jurisdiction to investigate complaints against contractors if a complaint regarding a patent act of omission is filed within four years of the date of the alleged violation. A complaint regarding a patent act or omission pertaining to structural defects must be filed within 10 years of the date of the alleged violation. Any questions concerning a contractor may be referred to the registrar, Contractors State License Board, Post Office Box 26000, Sacramento, California 95826. You, the buyer, may cancel this transaction at any time prior to midnight of the third business day after the date of this L C 2 DES-r6LE P NG WIN W- t7 -N LI!=E-nmF l,✓p 2 `Y ? ig N0 iE ADD F FG loc S Color- wh I z - Part 6 rte— Le 4D �. AN l AT Itta GF-fPA-71q Doc2, TfJF_p21C INC_Lut7ra5 /�(I LICer� eS F� tr x2S cend , -D1 r C PLE I U- UL ! 1 De b r 1S Cf etc t -f t o o (3 The total amount specified thereunder is due upon completion of the project. Any payment not made within 15 days of completion shall be deemed to be in default and a late fee of 10% plus finance charges figured at 1.5% monthly which is an annual rate of 18% will be charged on the unpaid balance each month. The project is deemed completed upon verbal or written notice of an authorized representative of P.F. Reilly. SUB TOTAL b $ 30G 2 SALESTAx b $ MIV D e This proposal may be withdrawn if not accepted within 7 days of the date shown above. All agreements, or under -CASH standing must,be set forth in writing in this proposal. This proposal is not valid or binding on either party until signed b and approved y the customer and an authorized representative of P.F. Reilly. This contract repretents the entire agreement between the parties. P.F. Reilly shall not be. bound by any promises, representations or agreements not expressly incorporated herein. The company gives no warranties, express or implied, other than those warranties previously provided in connection with its services. TOTAL $ 3 O�Z DOWN PAYMENT b $ BALANCE DUE C* $ 3 U Z ALL CHECKS MUST BE MADE OUT TO P.F. REILLYI CAUTION: DO NOT SIGN THIS PROPOSAL UNTIL YOU HAVE READ THE CONTENTS OF THE REVERSE SIDE. ACCEPTANCE: ALL PRICES, SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY AND HEREBY ACCEPTED. Authorization is given to P.F. Reilly, its employees and assignees for all rights and access to accomplish the work commissioned. P.F. Reilly is not responsible for existing structural defects, code violations, or conditions existing beyond their control. CUSTOMER'S SIGNATURE DATES ✓T - 192 DATE —V REGISTRATION# SUBMITTED BY C�(�C� � /�� DATE rJIU12-(50-7 ACCEPTED FOR P.F. REILLY DATE Contractors are required by law to be licensed and regulated by the Contractor's State License Board, which has jurisdiction to investigate complaints against contractors if a complaint regarding a patent act of omission is filed within four years of the date of the alleged violation. A complaint regarding a patent act or omission pertaining to structural defects must be filed within 10 years of the date of the alleged violation. Any questions concerning a contractor may be referred to the registrar, Contractors State License Board, Post Office Box 26000, Sacramento, California 95826. You, the buyer, may cancel this transaction at any time prior to midnight of the third business day after the date of this I 3028 Esplanade, Suite F, Chico, CA 95973 • CA Lic #711037 Chico: (530) 898-0833 Fax (530) 898-1599 Hanford: (559j" $M- O Santa Rosa: (707) 568-0333 NAME TRACY -- LRUR4:1 Con ley ADDRESS L-10 CfZANE AVE- CITY VECITY OROVILLG STATE`'1") ZIP EST. START DATE rJ �� TEST. COMPLETION DATE 6 7 AGREEMENT 1.8189 PHONE 530-533- 3 H 23 (MM WK MB MR MRS) PHONE (HM WK Me MR MRS) PHONE (HM WK MB MR MRS) Email fDATESAREAPPROXIINATEniw vi • • • • NSTAt►t_ Mo OG �m Vi YL 5 /N& cv/TH 7fzaA-NTY • • (� IMt� (AJ -t6 -r V D R E S AS Anl0tJS` C0102 - 5+C0KNvK- - COtONLOA WvAi te, L-ige 1'5'r S FP It f Fill 1614 O 10d W�l l STR-L-L S F D S Ct l4Lt_ PorcVx Cei ht7 S and 1,F N b 0 VGR_ HR woRk r -m PfvTio D oOk t...i t I I (6F --r rF- lv S M-6 -a ' e :I/q F-OArYl l U CZi L W14 LLS Q C r tY. Tike c� c_,_ 'mae o c S P t O o+hgc e TH 1: C2r- s will her Lc owe debris ereaf-e -ham - The total amount specified thereunder is due upon completion of the project. Any payment not made within 15 days of completion shall be deemed to be in default and a late fee of 10% plus finance charges figured at 1.5% monthly which is an annual rate of 18% will be charged on the unpaid balance each month. The project is deemed completed upon verbal or written notice of an authorized representative of P.F. Reilly. SUBTOTAL $ 12 9 SALESTAx $lnC(uD O This proposal may be withdrawn if not accepted within 7 days of the date shown above. All agreements, or under- standing must be set forth in writing in this proposal. This proposal is not valid or binding on either party until signed .CASH and approved by the customer and an authorized representative of P.F. Reilly. This contract represents the entire agreement between the parties. P.F. Reilly shall not be bound by any promises, representations or agreements not expressly incorporated herein. The company gives no warranties, express or implied, other than those warranties previously provided in connection with its services. TOTAL {� $IZ1 'q DOWN PAYMENT b $ 0 BALANCE DUE �a $ IZ ARck ALL CHECKS MUST BE MADE OUT TO P.F. REILLY CAUTION: DO NOT SIGN THIS PROPOSAL UNTIL YOU HAVE READ THE CONTENTS OF THE REVERSE SIDE. ACCEPTANCE: ALL PRICES, SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY AND HEREBY ACCEPTED. Authorization is given to P.F. Reilly, its employees and assignees for all rights and access to accomplish the work commissioned. P.F. Reilly is not responsible for existing structural defects, c ations, or conditions existing beyond their control. CUSTOMER'S SIGNA DATE � f ss -- DATE O REGISTRATION k SUBMITTED BY C (V� DATE 5l i { /2007 ACCEPTED FOR P.F. REILLY DATE Contractors are required by law to be licensed and regulated by the Contractor's State License Board, which has jurisdiction to investigate complaints against contractors if a complaint regarding a patent act of omission is filed within four years of the date of the alleged violation. A complaint regarding a patent act or omission pertaining to structural defects must be filed within 10 years of the date of the alleged violation, Any questions concerning a contractor may be referred to the registrar, Contractors State License Board, Post Office Box 26000, Sacramento, California 95826. You, the buyer, may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction. See the accompanying Notice of Cancellation form for an explanation of this right. COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS t: BUILDING INSPECTION; RECORD BUyLDIIP I BUILDING (Cont'd) I PLUMBING Setback ( Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out 17 Slab Roof Sheathing Water PI . Piers Roofing Sewer Garage P Fdn. Vents Fixtures Footings Garage Vents Water Htr. Stemwall Insulation Heaters Slab Carport Footings Prov. for physically handica ed Conformance of ex. structure Appliances Gas Piping & Test Temp. Gas ; Slab Final •— ' Sanitation Patio F REPLACE Final Footin s Footina xLecAlOAL Masonry Walls Throat Rough Relnf. Steel Final Fixtures Motors _. i Stucco Final Subpanels ` ' Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground 4. Interior Lath Ventilation Permanent Door Closer Final Final DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you.visit the job site.) 'COUNTY OF BUTTE - DEPARIMENT OF PUBLIC WORKS 7 County Center Drive — Urovilie, California 95965 _ Telephone: 534-454176, ` APPLICATION AND PERMIT Receipt No. 9 -J i0 B Date cy- �te White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant wilding permit expires D 7 7 BUILDING / Owner 2r%er� -r— SQ. FT. OCC. BUILDING VALUATION OO Mai I ing Address C> y A Ne A v _, `061' GZ- e— Telephone No. " y6 %00 Fireplace Contractor Total Valuation -1) S Z • O Mailing Address L.,1Wi— Permit Fee 0 0 Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ , 00 OC Building Address t)/ U C v A/� % 1/ ,Z PLUMBING No. @ FEE PERMIT FILING FEE $3.00 L L 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 - -,?6 — Q) — ,_ Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F es SV#ion Fire Dept. FireZone Use Permit Building sewer 5.00 EQA Parking Parcel Declaration ra ce�Ma p 60' R/W Im r p ovem nts Lawn sprinkler system 2.00 ,Plans Bldg fans Recd Parcel Approval Plan ppro�ol Permit Fee $ $ NEWJH ADDITIONELECTRICAL ❑ UTILITIES ❑ OTHER ❑ No. @ FEE PERMIT FILING FEE $3.00 00V OR L Main service 10000 AMP ORSLESS 5.00' Main service EA. ADD•L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home ❑ Others Et Main service VER 600V 10 0 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 -NEW p CONST. DWELLING 0CUP. & OR ACDNS. ( ACC. BLDGS. ) 2¢sgft - NEW CONST.R. MULTI -OUTLET NON•RESID. ( BRANCH CIRCUITS) 2.50ea ' NEWCONSI'R /POWER APPARATUS & NON -RESID. %SINGLE OUTLET CIR. 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: Ex. Occup(OUTLETS OR FIXTURES)`4L� BALC�1 Ex. Occu (/ FIXED APPLNS. OR p• l OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 FT 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 p ermit is issued I shall not employ any person in any manner so a's 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 authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date / Signature of Permitee or Anent TOTAL PERMIT FEE Is CC 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 T PUBLIC WORKS lJ Receipt No. 9 -J i0 B Date cy- �te White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant wilding permit expires D 7 7 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Uroville, California 95965 • �� - • Telephone: X34-4541 / APPLICATION AND PERMIT - 'BUILDING Owner_ �- SQ. FT. OCC. BUILDING VALUATION Mailing Address l-- o C(z,— �/� Tel ho e No . Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee&/or Penalty • Telephone No. Permit Fee Building Address �. ��IZ� PLUMBING No. @ FEE PERMIT FILING FEE $3.00 QT] l/k Vv I I e, Each Trap 1.50 Repair drainage or vent piping 1,50 Water piping 1,50 a _ Each gas water heater or vent 1.50 A. P. No.Cry —..� Zoning & Planning Gas piping system 1 - 5 outlets 1.50 _ Each additional outlet .30 Fees oma' W.C. Sanisa.iieri 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 fte'd Parcel Approval Plans Approval Permit Fee $ NEW ADDITION UTILITIES 0 OTHER ®, ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 dD (J ALA V OR LES Main service_ i°oo AMP ORSLESS '5.00 Main service EA. ADD'L 100 AMP 2.50 Single Family Q Duplex Mobil Home E] Others ® OVER Main service 1100 AMP oR LESS 25.00 Main service EA. ADD•L 100 AMP 1.00 &I 1161C �+ v NEW CONST. DWELLING OC U & OR AODNS. ( ACC. BLDGS. ) 22 sq ft NEW CONSTR.I MULTI -OU NON-RESID. (BRANCH CIRCUITS) 2.50ea NEW CONSTR. POWER APPARATUS & NON•RESID. (SINGLE OUTLET CIR. 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: r , Ex. Occup(OUTLETS OR FIXTURES)50 @250 100 Ex. Occu FIXED APPLNS. OR P•(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 +' License No. Classification Misc. Wiring 6.25 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 EJ Workmen's Compensation Insurance. I certify that in the performance of the work for.which this ermit 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.1 @ I FEEPERMIT ' 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 s •�r••��•••�•�-�� . •, �, . �U, — cIIMI uNUII Lilt: This permit is hereby issued under the applicable provisions of above-mentioned property for inspection purposes. the Butte County Code and/or resolutions to do work indicated �✓j�,, [� G above for which fees have been paid. X DIR OR OF PUBLIC WORKS Signature of Permitee or Agent BY Date. 4117 Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant ,fig -permit expires Da' e i� ��` �.. .y. � � '�'Y � �. '��. �" � �. � ._ ,.` .K t. F .f t � � ♦ � _ `. 5! � E i ... �. � ._ ,.` .K t. COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVIS ON 7 County Center Drive - Oroville, California 95.965 - Telephone (916) 538- PERMIT D. APPLICATION AND PERMIT �� Z ASSESSOR PARCEL NUMBER 036-770-017 ZONING AR BUILDING PERMIT OWNER LAURA COMM, X TELEPHONE SQ. FT- OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 40 CRANE AVE OPOVILl°P CONTRACTOR'S NAME `LLADIN RMIFING t�, TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 20.00 Permit Fee $ 27.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS 40 AME PERMrr FEE S 47*00 -- -- PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Water piping 15.00 Each gas water heater or vent 15.00 USE OF STRUCTURE SFUDuplex ❑ Mobilehome ❑ Other SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G I W @20.00 TYPE OF WORK New O Addition ElRemodel ❑ Utilities ElInstallation 1:1Other).. Describe Work: 18 COMP PERMIT FEE J$ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( BOOV OR LESS ) 200A OR LESS 23.00 Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( & ACC. BLDS. ) SO, 3.50 FT. CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) CRI am a licensed under provisions of Chapter 9, Division 3 of the Business and m Professions Code and license is in full force and feci J� I License No. 3 Classification ❑ I, as the owner, or my empl gees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec 7044) O I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) O I am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET -NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) @ 1.0000 BAL. FIXED APPS. OR EX. Occup. ( OWUTLETS (RESID.) EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. J> I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certify that I have read this application and state that the above information is correct. 1 agree to comply to all Butte County Ordinances and California 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 cons. ear a of the gr nting of this permit. X r �`t Date � t)--/ 7— S!/ Signature of Applicant - 6 Owner X Contractor C) Agent �� An OSH permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST, TYPE TOTAL FEE $ 47.00 HAZ. I D. FEES I IMP I FLOOD I CDF PARCEL I PD HD ISSUF� v/ This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions indicated above for which fees have been y ..= By �p1r�:� � / I PERMIT EXPIRES ON ,/'. %` (Date) provisions to do work paid. Date �Ir;-r, ' - Receipt No. 170413 WHITE-D.D.S.-B.O. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DTVI 7 County Center Drive - Oroville, (raliforria 95965 - Telephone (916) 53 - 1 ._ 2gR IT o• APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 036-770-017 ZONING AR BUILDING PERMIT OWNER LAURA CONNELY TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 40 CRANE AVE' OROVILLE 1,080-00 CONTRACTOR'S NAME ALLADIN ROOFING' 771_7ELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS PERMIT FEE S 47.00 40 CRANE AVE PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Water piping 15.00 Each gas water heater or vent 15.00 USE OF STRUCTURE SFXQI Duplex ❑ Mobilehome O Other SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W ` 20'00 TYPE OF WORK T/ New ❑ Addition E) Remodel ❑ Utilities ❑ Installation ElOtheX� Describe Work: 18 COMP PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee • 20.00 OR LESS Main Service ( 'OV) OR 200A LESS 23.00 Main Service ( 200A TO IOOOA ) 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( & ACC. BLDS. ) 3.5C SO, FT. CONTRACTORS LICENSE LAW( dare under penalty of perjury (check one) I\I am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and m license is in full forynd1fegt. License No. Zr Classification �� ❑ I, as the owner, or my empl yees with wages as their sole compensation, 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 contractors. (Sec 7044) ❑ 1 am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI.OUTLET .NON-RESID. ( BRANCH CIRCUITS ) @7.50 POWER APPARATUS ) & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 a 1.00 BAL.50 FIXED APPLNS. OR EX. Occup. ( OUTLETS IRESID.1 EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Dept. of Development Services, Building Division 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 Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certify that I have read this application and state that the above information is correct. 1 agree to comply to all Butte County Ordinances and California 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. 1 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 Co my in o, Se a of the gr ming of this permit. X Date ��^/%-9� Signur of Applicant - 0 Owner X Contractor ❑ Agents An OSVA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ HAZ• 1 D. FEES IMP I FLOOD FDF PARCEL I PD HD ISSU 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 Date PERMIT EXPIRES ON ! e) ReceiptNo. 170413 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT I s ;PERMIT NO. 56-76B. P E . l , M j' MH UTIL. 3'PERMIT NO. PERMIT EXPIRES. OWNER Ron Eaves CONTR. Foot -hills Construction, Palermo r� 67- 05 - ,;;L`OCATION (A.P. 36 ) 140 Crane Ave., Oroville ;r Temp. Pow r Pole Called G&E Temp. ec. Serv. Ca ed PG&E Tem . Gas Serv. Called PG&E O B �j INALED (Dat / (Sig ture) e COUNTY OF BUTTE-. = DEPARTMENT OF PUBLIC. WORKS-: BUILDING INSPECTION'RECORD BUILDING BUILDING (Cont'd) PLUMBING.' • Setback Firewall Soi I _Piping Forms f' Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows , 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Piping Piers Roofing - 'C 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 ? ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels 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. Z6' 74 1 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive,! OroviIIe, California 95965 Telephone: 634-4541 56 APPLICATION AND PERMIT 76; authorize representatives of the county of Butte to enter upon the above-mentioned/property for inspection purposes. v, X— Date/ Signature of�PLer itee or Agent Receipt No. J o,0%SDS 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 bee aid. DIRECTOR 0 UBLIC WORKS Rv Date kilding permit expires Date/ -7-77 - 77 BUILDING Owner SQ. FT. OCC. BUILDING VALUATION J! - Mailing Address ; Telephone No. Fireplace J Contractor Total Valuation Mailing Address ;7 Permit Fee Plan Checking Fee &/or Penalty Telephone o. Permit Fee Building Address PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 / y bs / A. P. No. (p 1p Zoning &Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 / FE s -S� 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 Parcel Approval Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 l Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (morethan 12) Single Family Duplex ❑ Mobil Home ❑ Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures- ego (d2 a 10 Receps.,, switches & fix outlets 25 CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code rider the name style of.T - 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.a i 3 �'S�Classification /� 93 C 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. 01- have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. F-1 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. @ I FEE PERMIT FILING FEE J$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. v, X— Date/ Signature of�PLer itee or Agent Receipt No. J o,0%SDS 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 bee aid. DIRECTOR 0 UBLIC WORKS Rv Date kilding permit expires Date/ -7-77 - 77