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HomeMy WebLinkAbout021-250-01921-25-19 & 20 ;74 se -7d. NWarr D. Rich ts ,i) 132, Rl�� in, 1321 Ri ins Ave., Gridley P p i ill c erm t -80P, ermit #1 E(uti.�.,MH) ELEC. GAS J SUPPORT STRUCTURE RE COMPACTION TEST REQ 1-25 19 Permit -MMHI Iss 21-25-20 Contr: Cal-Pac Roofing-,, Rancho Coi7d6va Permit#2610-83B(reroof/SF) ro 134 e d A Lo �PERMIT:-,NO. PERMIT EXPIRES. Warren D. Richins 'OWNER owner PONTR. - - (A.P. 21-25-19 & 20 1321 Richins Ave., 'Gridley T Temp. Power Pole Called PG&E Temp. Elec. Serv.— C42 ailed PG&E Te p. Gas Serv. Cp Called PG&E JOB FINALED 7-e6� A < If (D I ra_�— (Signature) / 017 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING back M NnBldg. otin s Ste. wall Slab Piers G r arage Footing Stemwa I I Slab Footi Slab Patio Footi Bond Mesh Fiffish Int rior Lath RLor Closer MOBILEHO M -E UTILI' Water Piping <J— Water Piping I DATE BUILDING INSPECTIOWRECORD A BUILDING (Cont'd) Newall PApets Rest om Finish Windo Siding Roof Shea Ning Rooting Fdn. Vents Garage Vents Insulation Prov. for physical[ andicapped Conformance of ex. structure y Final REP CE Footing Throat Final IFIRE SPRINKLERSN Test Final MECHANICAL Heatl,(Q ntilati I Ina I ------------------ Elec. Ser, Sewer PN ------ 7 ------- Support C4� Drainage PLUMBING V3rdoI I Piping P 'p t oor Floor loo, 2n Flooi oor or Water Pi Sewer Fixtures Heaters Appliances Gas Piping & Test Temp. Gas Sanitation Final Motors Water Htr. Subpane S Grd. FaV_t Prot. ServlcQ( Te p. Pole derground Lermanent ina Elec. PedestaL_so6 _A Gas Piping ilga 4 01— Elec. Continuity Gas Piping / REMARKS OR CORRECTIONS X4A (NOTE: An entry must be made on this form each time you visit the job site.) MOBILEHOME'INSTALLATION INSPECTION CHECK LIST l.' Is the mobilehome located with required separation from lot lin(js and buildings and generally conform to plot plan? Yes C��Do 2. Does the mobilehome have required clearances -above ground? (Sec.5085) Ye& --'No 3. Are footings and supports properly sized, . spaced, and braced as per approved plans? (Note possible variation at.spring shackles.) (Sec.,5082 & 5083) Yes a�-�o 4. Is the mobilehome le,�el? (Sec. 5088) Yes 11�-7�o 5. If more than a single unit, are crossover connections properly installed? (Sec. 50.88) Yes L__90' 6. Water A. Is f�l�eible.connector of adequate -size and properly installed (1/2" 11) min.)? (Sec. .5566) Yes— No— B. Test Does water piping withstand working pressure or 50 lbs. air test? Yes-- �No' �.�ackflow - If coach is not State of--Californi& approved, does.station have backflow device and pressure -relief valve? Yes No 7. Wastes and,Drains A., Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes '(_�O_ B. Does it have minimum �4" per foot slope and is it properly supported? Yes— No— C. Are any leaks detected in drainage system after running ons of water through each fixture including washing machine standpipe? Yes No I __D, ­If coach is'not State.of Californiaapproved, does station have required trap and vent? Yes No 8. Gas.Piping and Gas Vents A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum mobilehome connector not more than 6 it. long? Note: All'piping is to be at least as large as the mobilehome gas line inlet without reductions'otherthan the mobilehome connector. Yes 4,---N-o B. !Test OK as per following procedure? Yes t'__ �o 4r.-- open all appliance connector v�Llves. Shut off appliance burner and pilot valves. 3. Air test with manometer to 10"rl4" water c.olumn� or test with slope gauge (minimum W 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without drop. Connect -gas meter to'mobilehonte.with.connector, turn On gas, test connect ions with soapy water. C. Are all appliance vents properly installed? Yes 1'//No. 9. Electrical A. Is service large enough to provide adequate amperage -to mobilehome (must equal rating of mobilehome with a minimum of 100 amp) and other facilities on lot, i.e., water pumps, garage, cabana, etc.? Y e s %_�O B. Is there proper clearances around panels? Yes 11�0 C Is power supply cord or feeder assembly properly fused? YesL_.--N-o_ D. Is continuity test satisfactory as per the following procedure? Y e s 1_,,_O_� De -energize electrical wiring system of the mobilehome at the pedestal. Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected. 3/. Switch all breakers and switches in the mobilehome to the "on" position. 4 Connect one lead of a test instrument to the mobilehome grounding conductor 'and apply the other lead to each mobilehome supply conductor, including neutral. t/ All non-current, carrying metal parts of the mobilehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. j,,�Upon completion of the above procedure, the power supply cord or feeder assembly conductors shall be connected to the site service equipment. A further continuity test shall then be made betweeii the grounding electrode and the chassis of the mobilehome. Upon satisfactory completion of theelectrical tests, the lot or site service,eqqipment may.be approved for energizing. 10. Is job card -signed by Health Department for water and sanitation? ll.'If everything okay, sign off -card and tag services. MOB ILEHOME 'DATA Manufacturer and/or Namestyle Length 0 Width 'er Vehicle Serial No. State Identification No. q>014 Additional Information or Comments: I COUNTY OF BUTTE �Ik DEPARTMENT OF PUiJLIC ViORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the re Its juiremen . of the California Administrative Code, Title 25, Chapter �un er permit number for the following location: Owner a1iiii 6L Jil je- Owner's Address —14622 Mobilehome Mfg. Mode I J Year Insignia No. Z Serial No. ( ', / It is hereby certified for occupancy at the above described location and may be occupied. I Directorpf Public Works Date),'- By THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED White - Owner, Yellow - Installer, Pink - O.P.W. 6OUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 695 Oleander Avenue, Chico — Phone 343-4211, Ext. 70 7 County Center Drive, Oroville Phone 534-4541 Skyway and Elliott Road, Paradise Phone 877-3435 CORRECTION NOTICE BUILDING OR PROPERTY ADDRESS 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. n;,r-1 .COUNTY OF�`BUTTE - DEPARTMENT OF PUBLIC WO KS 7 County Center Drive — Oroville, California 95965 Tel ephone:,k-34-4540 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X 1�� a-. Date 0 - Signature of Permitee or 49ent Receipt No. 75-622 White-D.P.W. – Yellow-AS$e5sor – Pink -inspector – Goldenrod-Appli cant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated al;�which fees have been paid. ,D1REe+QR.ZF PURLIC WORKS !f1fl, —WARPIM WNS 2'. BUIL61NG " Owner SQ. F T. OCC. BUILDING VALUr%-TfO—N Mailing Address 43 -9 4Ji 7 j7S­9 / T I ephone No. Contractor Mai I ing Address Fireplace F Total Valuation Telephone No. Permit Fee Building Address 44 k -Tr PlanChecking Fee&/orPenalty Permit Fee $ $ PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 1-3 <)1-3 Each TraD 1.50 (5zo,e_0 J/_52f::�j Repair drainage or vent piping 1.50 A. P. No. c;20 142!F.ing & P K.ning Water piping 1.50 /0, C�O Each gas water heater or vent 1.50 Me/. Sagg n FireDept.1 FireZone Use Permit Gas piping system 1 - 5 outlets 1.50 EOA Parking Parce! Plans I Declaration Parcel 60' R/W I Improvements Each additional outlet .30 Building sewer 5.00 '00 Bldg. PI&—s__R..'d P Ica-n--s-A p p r. Lawn sprinkler system 2.00 NEW ADDITION UTILITIESW OTHER Permit Fee $ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 AC:)rID 600V OR LESSFS 910 Main service 100 AMP OR L _ S 5.00 S;Z— Single Family Duplex Mobi I Home �r OthersE] Main service EA. ADD -L 100 AMP 2.50 OVER 600V Main service 100 AMP OR LESS 25.00 Main service EA. ADD -L 100 AMP 1.00 NEW CONST DWELLING Oc OR ADDNS. * ( ACC. BLDGS. cup- 'I) �20 sq ft 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: NEW CONSTR_ -OUTLET ..N.RES'.. (MULTI BRANCH CIRCUITS) 12.50ea NEW.CONSTR. (POWER APPARATUS a NON RESID. SINGLE OUTLET CIR. 50 @ 250 Ex. OCCUD(OUTLETS OR FIXT(IRES) BAL@10� (FIXED APPLNS OR Ex. Occup. OUTLETS (RESI*D.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 Erl 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 Wo rkmen's Compensation Insurance. 2�1certify that in the performance of the work for which this . it is issued I shall not employ any person in any manner perm so as to become subject to the Workmen's Compensation Laws of Cal i forni a. 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 Land Development Fee $ TOTAL PERMIT FEE 1$ 731 authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X 1�� a-. Date 0 - Signature of Permitee or 49ent Receipt No. 75-622 White-D.P.W. – Yellow-AS$e5sor – Pink -inspector – Goldenrod-Appli cant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated al;�which fees have been paid. ,D1REe+QR.ZF PURLIC WORKS !f1fl, —WARPIM WNS 2'. COUNTY OF BUTTE' —� 'DEPARTMENT OF PUBLIC WORKS _7 Cou%ty Center Drive — Or6vi - Ile, California 95965 Tel ephone;�, 534-4641 APPLICATION AND PERMIT 1,11,1)-i Z' A authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date -q Signature of Permitee or'Agent Receipt No. 3 (!57 Ice> White-D.P.W. — Yellow -Assessor — Pink -Inspector — Golden rod-Appl i cant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated abo hich fees have been paid. 7-7DWEC-10,B OF PUBLIC WORKS 0�rr/A/ �%7 Po FRNZMFW?�/�Zw, 9 07mazo W.—AMFEW �; Building permit expires Date BUILDING /11 .... LZ Owner A,,�:_ CyV SO. F T. occ. BUILDING V A FU A T I 'ON Mailing Address L'. IV Telephone No. y4—,S-0Q3 Contractor Mai I ing Address Fireplace Total Valuation Telephone No. Permit Fee Building Address A L"c-_ Plan Checking Fee Vor Penalty Permit Fee $ PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 4 cl Repair drainage or vent piping 1.50 A. P. No. 9 1 a -Z5-- lei A o -7 -JO 1)9 l'oning & Planning Water piping 1.50 Each gas water heater or vent 1.50 F fes v4e. -1 &&,ta�l FireDept. FireZone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Parcel Pians Declaration I Parcel Map 1 60' R/W I Improvements Each additional outlet .30 Building sewer 5.00 Bldg. PI'an.R..'d Parcel 4r161_._I I PIoLn`s-_A_p`provol Lawn sprinkler system 2.00 NEW ADDITION UTILITIES OTHER Permit Fee $ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 600V OR LE SS Main service 100 AMP OR LESS 5.00 ly Single Fami Duplex Mobil Home Others El Main service EA. ADD -L 100 AMP 2.50 OVER main service 100 AM6P000VR LESS 25.00 Main service EA. ADD -L 100 AMP 1.00 NE ONST DWELLING Occup- �20sq ft ORWADDNS.' ( ACC. BLDGS. 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: NEW CONSTR. MULTI.OUTLET NON.RESID. (BRANCH CIRCUITS)l 12.50ea NEW.CONSTR. (POWER APPARATUS.&J NON RESID. SINGLE OUTLET CIR 50 @ 25q Ex. OCCUI)(OUTLETS OR FIXT 'R ES) BAL@1 FIXED APPLNS. OR % Ex. Occup.( OUTLETS (RESID.) EAY 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 20 am exempt from the contractors License Laws of the State of C alifornia. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions ot 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. certify that in the performance of the work for which this plermit is issued I shall not employ any person I n any manner so as to become subject to the Workmen's Compensation Laws of Cal i forni a. MECHANICAL N0.1 @ FEE PERMIT FILING FEE J$3.00 Heating Cooling Ventilation Hood 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 I-anrl r)i-v lonnent Fee $ Y0, C) TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date -q Signature of Permitee or'Agent Receipt No. 3 (!57 Ice> White-D.P.W. — Yellow -Assessor — Pink -Inspector — Golden rod-Appl i cant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated abo hich fees have been paid. 7-7DWEC-10,B OF PUBLIC WORKS 0�rr/A/ �%7 Po FRNZMFW?�/�Zw, 9 07mazo W.—AMFEW �; Building permit expires Date BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE�,534-4541­ MOBILEHOME INSTALLATION SHEET 1-2 1. owner's name: 2. Installer's name: 3. Is the site currently under permit? Ye!?, No (If yes., furnish permit number OR Is the site an existing site? Yes No furnish two (2) plo t plans.) 4. Willthe mobilehome be located at least 5 ft. away from septic tank and leach fields and c lear of all setbacks and easements? Yes No (If no, clarify 5. What is the mobilehome electrical rating? ----------------------- Amps C?_0_0 .6.. What is the.mobilehome-site service rating? --------------------- Amps WAmp s 7.. What is the mobilehome site circuit breaker'rating? ---------- -- 8. Is there any other electric load to be served.by the mobilehome site' service? -------------------------------------------- Yes No 777 (If yes,, identify the load and size:'. (Load) -(Amps)' 9., what is the mobilehome site gas pipe size? ----------------- On..) ''type Natural 15�7 LPG 10. What is the of gas service? ----------------------------- 11. What is the gas pipe length from me ter or tank to the mobilehome?. t I 12. What is the.mobilehome gas demand? ------------------------------- JBT U) (This informiation not' required if pipe length less than 6 ft. on natural gas' or less than 50 ft. on LPG..) MOBILEHOME SUPPORT DATA If ather than single wide, Mobilehome Mf r. furnish Setup Model No. Y e4 r La Width (ft.) Box Length (ft.) Tagalong or Expando Size ft. x ft. (SHOW SUPPORT DETAILS BELOW) On all mobilehomes manufactured aft ­ er October 7, 1973j furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of Butte). All center supports measured from front of mobilehome unless otherwise specified. Footings (check one) Single 1 Wood either LInk - - pressure treated or foundation grade. (ft )(in;) (in.) (in.) 2. Other (specify) Center su port Center sup, 01:t 'rt Supports (check one) locatio footing izes (in. l.; Concrete' block. 2. OtheF spe cify) (ft.-Xin. (in�) (in.) <--Tagalong or Expando,' show support details. (in.) (in.) X 30 Typical Support (in.) 1(in.) Footing Size \X (ft.)(in.) (in. (in.) 4,— Max. Pier Spacing (ft.)(in.) x Max. Overhang ft.)I(in.) (in.)l (i�.) t(ft.)(in i3UTTF= COUNTI BUILDING DEPARTMEN, APPROVED *If ce ' nter piers are o ther than drawn above, draw in. -locations, spacing, and dimensions. t -A 4 A: 4 j _4 Ak + - . :. 4 NOTE -LAN AA�tetiv FtE. L��C-c6 -6 I 'Of. ding', pfid th; Na f i6 4 1 �'E r k� tom Jhe 106 13-ra �-­rl­l . ;. -, -i- +. 1­ r�a�c I _q an.y,.Oaqcjej- Dufi\�r�tt�nt - .1 'Ri- N'bli-�A(V,orkvi Cdu�. r I I t 'I. i A T T 4- 4 J 1 4 j 4 4 4 y t 4 iutilit� C6. i.ctiqn5 i beiWithi I OnE h�jf` n 44t. 6fiAei mobil6h6ri)� 'dt're'd b h-4 d I.y. e. in orwitO ih fhe Ir ear, �ha If 6f �he lroa�sjde jZ1 1 �ft) bf th4 mpyi�ehome4 i e' 'eiqyiee�ffo-r.-j�h OUNTY h b A c _E the''m-o oe om e -RUILDING -PE-P 0,4 ,V A 'i I f -t. if �om'tHe 1 P; b T n�s.+an4 ;o h ,�.Of 4ce Mine �hpN �d cje� of 'STtuc ,ure$ �r"6i�me v .4 A _L -W-b-b 4_4- - _�d 36oa ra tices� end j. e -d -f T ri �Wmbirv4i& _�ica 4 pde.. ,IV IC L J'. J 4- jp Jq16-s4a6d. n�j 1b. 'witb- -4- p-.p6me- J- t I 15P. 1­49nj the ent 01 f pft Ulf j e.. j,. t A,V_A I COUNTY OF BUTTE - DEPARTMEJ OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT P E R7M I T N'10. ASSESSOR PARCEL NUMBER C> ZONING BUILDING PERM177 OWNER &xg 19710-3 TELEPHONE SQ.FT. OCC. BUILDING vAi_UATION 7-7 OWNER'S4AAILING ADP_RESS CONTRACTOR'S NAME (24�L — 194 c ;"1— 6) TELEPHONE 2.5as- 1 CONTRACTOR'S MAILING ADDRESS 62 /1 Z 57 7 If o4 0^9 642K Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ s-SOO ARCHITECT OR ENGINEER SE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER's MAILING ADDRESS Permit fee $ -76-, C<D BUILDING ADDRESS PLUMBING PERMIT Fi ling Fee 10.00 Each Trap 2.00 Solar Water Heater 20-00 Water piping 5.00 LOT NO. UBDIVISION NAME is PARCEL MAP Ea h qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF�t Duple,n MobilehomeF-1 Other SPECIFY Building sewer 5.00 Mobile Home I S I G JW -J 10.00 e TYPE OF WORK New El Add ition [:] Remode I [I Uti I ities [:1 lnstallatio,R Other)!� Describe work: AV,.,f,000;X= Permit Fee $ Contractor ELECTRICAL PERMIT FilingFee 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. 21/20sq ft CONTRACTORS LICENSE LAW I de la nder penalty of perjury (check one): Col am licensed under provisions of Chapt. 9, Div. 3 of the Bus I ness and Professions Code and my license is in full force and effect. License No. 3 Classification 1, 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) El 1, 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 CONSTP-11 MULTI-OUTLE T NON . RESID, N BRANCH CIRCUITS) 2.50 ea NEW.CONSTFL PO ER APPARATUS.&') NON RESID. (SINWGLE OUTLET CIR Ex. Occup(OUTLETS OR FIXTURES 1.20 @ 500 AL@ 300 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT Fi I ing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): F1 he 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 Certiti cate of Consent to Self-In1ure. F-] 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 shal I be deemed revoked. Heating Cooling Hood 3.00 1 Venti lation Permit Fee $ Contractor I certify that I have read this application and state that the above informati— on 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. 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 againsteegncounty in consequence of the granting of this permit. X Date -P'77 -;z Signature of ApplicaOt Owner 0 Contractor El Age 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, IPARCELI PD I This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIREQ_J�OROF ePLIC By. PERMIT EXPIRES Date— the applicable provi- resolutions to do fees have been paid. WORKS Date P �g 0 -3 IF Receipt No. 6ir, WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD-APPLI CANT