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Home My WebLink About029-151-002` � 29-151-02 | � � ^"�~^..-, _ � lIj/ ur / . | /�lec'for lot�+��elo r/ " 'c� - �� —i' �� ,a eounl* 4 ✓d uiti OROVILLE, CALIFORNIA — GENERAL CLAIM CLAIMANT: Otis J. Crawford - ADDRESS: P.O. Box 136 - CITY & STATE: Storrie, CA 95980 _ IMPORTANT: February .8, 1991 SEE INSTRUCTIONS DATE OF CLAIM: ON REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT Owner has decided not to do work. ermi - , AP#29-151-02, Receipt #83215, dated 1/23/91. Total Permit Fees Faid --------------------------------- Retain Electrical Permit Filing Fee ------------- $10.00 Retain Pre -inspection kee ----------------------- Total Permit Fees Retained----------------------------- 25.00 TOTAL REFUND DUE--------------------------------- -----$20.00 TOTAL $20 00 rme r delivered• and tha his Claim is true and correct as stated. I, the undersigned, declare under penalty of perjury that the services or articles claimed have bee;ature Dated this �Q r# de of ,`� .i 19 et p ", /'� CaliL �(• �Z ......................i'... ...... Y ....................f... .�L.. .QhG!''Y. :.....• /..].. ......... ..................... ......... Si of Claimant 1. the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or de- livered and that there is a Budget Appropriation ❑ or Specific Board Approval ❑ (Check one) for a 8th February 91 Oroville Datedthis .................................... day of ............................. 19 ....... at .............................. . Calif. ..... .........../...... ......................._............... .. epartment Head or Authorized Deputy C de 440-002.. C de PAYABLE FROM ,,,,,,,, 4210500 C St. Permits ........................................................................................................................................................... FUND - DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSS AMT. 10 Co 0 oov t.)-- W,, ,00 te i,,- 13-61 LK 00 0 w L� (D Z-- 0 I U) (U Customer Address 'c ONGFELLOW UMB R 71ity Truss Design a-nd F160'r Systems 89 Uren Ave. Chico, - Ca 95928 916-893-0112 FkX 116-893-0140 COUNTY OF BUTTE - DEPARrMENT OF PUBLIC WORKS I'' w 7 County Center Drive - Oroville, qalifornia 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. Z r ASSESSOR PARZEL NUMBER 29-151-02 ZONING ARMH BUILDING PERMIT OWNER O.J. Crawford (message TELEPHONE 882-4362 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS P.O. Box 136, Storrie, CA 95980 CONTRACTOR'SNAME 777HONE Owner CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER None UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENCER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER None E NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 1237 Broadway, Richvale, 93974 Permit fee $ PLUMBING PERMIT FilingFee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. BDIVISION NAME SU 777�� L MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SFEI DuplexR Mobileh;men Other PIPI71"LiC SPECI FY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home Is 10.00ea TYPE OF WORK New n AdditionE] RemodelE] Utilities [I InstallationEl Other [NK Describe work: electric for future lot development Permit Fee $ Contractor ELECTRICAL PERMIT FilingFee 10.00 main service 600V OR LESS 100 AMP OR LESS 10.00 10.00 Main service EA. ADO'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): F� 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 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. 1044) 0 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 CONST. ( DWELLING OCCUP.&) OR ADDNS. ACC. BLDGS. 21/20sq It N E W CO NSTR. MULT'*OUTL E: T _NO..RE SID. BRA14CH CIR C U, TS) 2.50 ea, (POWER APPARATUS.&) SINGLE OUTLET CIR Ex. Occup( OUTLETS OR FIXTURES - 20@50C SAL@ 300 FIXED APPLNS. OR Ex. Occup. OUTLETS (RE SID .) EA.) 2.00 Temporary service 10.00 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 pre—inspection 15.00 Permit Fee $ 45.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): F_� The permit is for $100.00 (valuation) or less. E] 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. rR I shall not employ any person in any manner so as to become subject LJCN to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 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. 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 C u ty on nting of this permit 01 ,�sequenc f e gra ,Z-. Dat g A2 Signature Owrtr P� ContractorE] Agent �fp 1--.111 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 $ Energy Inspection Fee occ CONST TYPE TOTAL FEE $ 45.00 HAZ I CUA I PARK I SCHL I FLD I PAR PO HD I ISSUE This permit is riereby issued under is of the Butte County Code and/or work indicated above for which tees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date Receipt No. 83215—$45.00 WHITE-O.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD-APPL I CANT COUNTY OF BUTTE DEPARTMEN7,-,-OF,PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET Permit No. OWNER A. P. N 0. P-7 - / 5/ - Proposed Building Use e-54CE,--7-� Building. Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1 . All items have been submitted . .. ................................. 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans 4. Complete engineered plans and calcs, with wet signature on plans 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ............... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13. School District fees paid .............. 14. Sanitation approval from Health Department 15 . City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use:—(B) Parking: . ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction a�pproval required prior to occupancy) 20. Pre -inspection for required ... Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classificati 0 n) ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner 0, Mail to owner 0) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 26. 27. When you issue the permit, process as follows: Mai I to owner. —Mail to contractor. Telephone and hold for4;�-�kuat —office. —Del.iver w/inspector. -9- 9; .2 Other _Je4��4_ Ive "e e Applicant Date Copy of Haz-Mat form sent —Health Dept. —Fire Dept. ---Air Pollution D Copyofplanssent ____HealthDept. —FireDept. —Other ate, The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by—phone---mal I —counter by—date Contracto,r, designer, owner, was advised of above required data by—phone —mal I —counter by— date Plans checked by Date Plans approved by Date Sets of plans on hold in —File cabinet _AP folder Copy—DPW COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA .95965 Phone: 916--538-7541 OTMER-BUILDER VERIFICATION Attention Property Owner: An "ow.ner-builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to' avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. GI personally plan to provide the major labor and materials for construction I of the proposed property improvement (yes or no) 4�_. I_. I (have/have not) signed an application for a building permit for the proposed work. 3. 1 have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. 1 plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. 1 will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name . Address Phone Type of Work Signed: Property Owner. Social Secu7rty umber. D ate NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are'per- mitted to issue the permit. COUNTY OF BUTTE -11 I I &OFFICIAL RECEIPT 83215 Received from The Sum of ;2r-;�/&7' For /4-k nc Received: 2 7— / 57/— 0 Received By CASH n Title CHECK N 2 (�4a By DAVCO BUSINESS FORMS - (916) 743-8511 Z Z-3 .19 ?/ OWNER CONTRhCTOR. Psc TION -FOR - RE INS ONE PERIAIT ,,STORY - T. yps OF OCCUPpNCY fRE_IN Y, ZONING D As -FOLLOVS - FIELD IN-FORMTION T .114SPF CTOR 0 �aRps SpNITATION FPC-ILITI ,S GAS TE14N PINT JJAS �JCTRIC 0 cijplBD c PERSON. CONrpcT .. ED C3 REATED-COOLBD OVER COMENTS - 271� P,CTION RECOMENDED * 11OLO -FOR I ISSUE 7 CV I& OTHER po$4-1 q1t co, [4� t4 DATE %6n 0 P.RE-INSPECTION OWNER: 0 DATE ' 42 -3 -7 /1 -------- CONTRACTOR: Ow ZONING PRE -INSPECTION FOR: PERMIT HISTORY: NONE AS FOLLOWS: TYPE OF OCCUPANCY FIELD INFORMATION DATE TO INSPECTOR BUILDING USAGE: L/A P_ A A) 4,0 TENNANT: [:j OCCUPIED F__j - HAS ELECTRIC E:] HAS SANITATION FACILITIES HAS GAS HEATED -COOLED. PERSON CONTACT *D OTHER COMMENTS: w4lur-s i �,p m 0712�6L221'19__, ) V4 ACTION RECOMMENDED: ISSUE E11HOLD FOR ZA/ AO 7b rt- Rm 6'e- M�ff - 5�! COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ARC," M__ 2 IZOW� ASSESSOR PARC_� - ------ - ===BUILDING.-PERMI-T -M T. ....... SQ. F OCC. BUILDING VALUATION sMAI , G ADORF-55 Tg 0 CONTR kCTOR'S NAME Ile? CONTRACTOR'S MAIL G ADDRESS Fireplace CONSTRUCTION LENDER JUNKNOWN Total Valuation $ Filing Fee LENDER*S MAILING ADDRESS Permit Fee ARCHITECT OR ENGIN ER LICENSE NO. Plan Checking Fee Energy Plan Checking Fee ARCHITECT OR ENGIN ER'S MAILING ADDRESS Penalty BUILD NG ADDRESS Permit fee PLUMBING PERMIT Each Trap Solar or heat pu er LOT NO. SUBDIVISION NAME CEL MAP Water piping Each qas water heater or vent Gas piping system 1 - 5 outlets USE OF STRUCTURE mobilehomeE] '-.Other_�_ Building sewer I I JW I SFEI Duplex sllrl F1 Mobile Home S G TYPE OF WORK New f_1 Addition Remodel[] utilities[] instaliationD Other �9 Permit Fee e- - "/— 6 k � � �'?` � 4 X /, r— Contractor Dlescribe'work: ELECTRICAL PERMIT b F:.. . 1110, OR LESS main service 1 00 AMP OR LESS Main service F -A. ADD -L 100 AMP CONTRACTORS LICENSE LAW NEW CONST. DWELLING OCCUPM OR AOONS. ACC. BLDGS- I declare under penalty of perjury (check one): NEW CONSTFL ULT'.OUTLET rS) F� I am licensed 'Under provisions of Chapt. 9, Div. 3 of the Business (POWER APPARATUS & SINGLE OUTLET CIR. and Professions Code and my license is in full force and effect. I Ex. OCCUP( OUTLETS OR FIXTURES License No. Classification _FF I _XE A P --PL N S. 0 R 10-) EA E!.2c6u . O�LTLF`rs 'REs'o 1, as the owner, or my employees with wages as their sole compen- �eWporarRy sation, will do the work,and the structure is not intended or offered service - for sale. (Sec. 7044) Home Faci ies Mobile Home Facilities M 0 b i I, as the owner, am exclusively contracting with licensed contract- cle M i S ir' n, ors. (Sec. 7044) I am exempt under Sec.—, Business and Professions Code ' Fee Permit Fee P e rmi for this reason c to, Contractor MN WORKMEN'S COMPENSATION INSURANCE IC L MECHA A PERMIT M CH I Fdeclare under penalty of perjury (check one): The permit is for $100.00 (valuation) or less. Heating C] I have placed on file with the County of Butte Building Department Certificate a Certificate of Workmen's Compensation Insurance or a C li g of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject -Cooling Hood to the W. C. laws of California. Ventilation Notice to Applicant: If after making this statement, should you become subject Permit Fee to the W. C. provisions of the Labor Code, you must forthwith comply with such Contractor provisions or this permit shall'be deemed revoked. I Mobile Home Installation Fee I certify that I have read this application and state that the above informat on I Energy Insp ction Fee --rrect I anree to comply to all County Ordinances and State Laws relating 10.00 10.00 Filing Fee 1 10.00 0.00 0 00 2.50 20Sq It 2.50 ea SEL4122 1 is C' to building construction, and hereby authorize representatives of the CountyOt ST TYPE to -mentioned property for inspection purposes. TOTAL FEE S -30. �Butte to enter upon the above F�`T I also agree to save, indemnify and keep harmless the County of Butte against HAZ CUA PARK SCHL FLO PAR 'PO HO ISSUE all liabilities, judgments. costs. and expenses which may in any way accrue against said County in consequence of the granting of this permit. icable provi- I Th's permit is nereby issued under ine aPPi Date sions oT the But t e County Code and/or resolutions to do X work indicated above for which fees have been paid. Signature of Applicant O.nerCl Contractor C] Agent DIRECTOR OF PUBLIC WORKS An OSHA permit is required for excavations over S'0- deep and . demolition or construct ion of structures over 3 stories in Hai - 1� Ce B'_ Date COUNTY OF BUTTE - DEPARTMENT.OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET Permit No. OWNER A.P..No. Proposed Building Use Building Inspector YZ2;� — Date At time of permit application, I was advised.the following data must be submitted prior to permit processing and/or issuance: 1 . All items have been submitted. 2. Plot plans in duplicate/triplicate, signed by preparer of plans. 3. Complete plans in duplicate/triplicate, signed by preparer -of plans. 4. Complete engineered plans and calcs, with wet signature on plans. 5. Hazardous Material Form. 6. Energy Design Compliance and supporting douumentation. 7. Statement of Intent for Non -Heated and AC Buildings. 8. Engineered truss details and layout in duplicate (required prior to plan check). 9. Mobilehome installation data including manufacturer's installation instructions. 10. Fees of $ 11. Chico Urban Area fees paid. 12. Park fees paid. 13. School District fees paid. 14. Sanitation approval from Health Department. 15. City of Chico plumbing permit. 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use:—(B) Parking: 18. Improvements may be required. Contact Land. Development Section of DPW. 19. Driveway permit (construction approval required prior to occupancy). L.ef�:� 20. Pre -inspection for _,r -4Z -e -L required. 21. Contractor's license information (No., Name Style, Classification). 22. Certificate of Workmans Compensation Insurance. 23. Owner- Builder Verification (Given to owner 0, Mail to owner 0). 24. Recorded copy of Agricultural Acknowledgment Statement. 25. Letter of signature authorization. 9A 27 When you issue,the permit, process as follows: - J. Mai I to owner. _MAil to contractor. Telephone and hold fonvmkun at office. —Del - iver w/inspector. Other Applican GENERAL INFORMATION Date BUILDING DEPARTMENT OFFICES HEALTH DEPARTMENT OFFICES Chico . . . . 196 Memorial Way Chico . . . . 196 Memorial Way Phone: 891-2751 Phone: 891-2727 Hours: 8:00 a.m. - 12:00 a.m. Hours: 8:00 a.m. - 9:00 a.m. Oroville 7 County Center Drive Oroville 7 County Center Drive Phone: 538-7541 Phone: 538-7281 Hours: 8:00 a.m. - 5:00 p.m. Hotirs: 8:00 a.m. -- 10:00 a.m. Parad i se . . . 747 Elliott Road Parad i se . 747 Elliott Road Phone: 872-6307 Phone: 872-6308 Hours: 8:00 a.m. - 12:00 a.m. Hours: 8:00 a.m. - 9:00 a.m. PLANNING DEPARTMENT -.7 County Center Drive, Oroville - Phone: 538-7601 - Hours: 10:00 a.m. - 3:00 p.m. Original — Applicant 3/17/88 BUTTR COUNTY DEPARI'MENT OF PIJBLT(, WORKS 7 County Cent-er Drive, Oroville, CA 95965 PHONE: 538-7541 M08ILEHOME INSTALLATION INFORMATTON Obtain Assessor's Parcel. Number (A.P. .Check the zone of the property where you plan to place a mobilehome: Some zones have restrictions on the size and age of mobilehomes to .be placed on the property. - Most zones will only allow one dwelling per p . arcel. Some exceptions to this restriction could be: 0) Use Permit from the Butte County Planning Department to allow more 1-'hafl one dwell-ing per parcel (contact Planning Department at 538-7601 for fee and app.l.ication procedure). (2) 60/640 Affidavit -- A mobilehome or dwelling of 640 sq. ft. or less [or the occupancy of one or two adults over the age of 60. (3) AgriCUltUral Worker Affidavit Mobilehome or dwelling [or the .,o.c.ctipancy of agricultural workers in A5, AIO, A20, A40, A160 agrJ.cUItUra1 xones only. (4) Parcel Split - Contact the Land Development Section of: Public Works .'(.'538-7266) concerning parcel splits to facilit e*anoLher dwelling. Health Department: Contact for wel.1 and sewage disposal. Buil.ding Permit Application Procedures I'wo permi.ts are required from the Building Department for placing a mobile - home on private prop.erty. THF, FIRST PERMT,r is called the mobilehome util.ity permit. This permit is for the electric service, water lines, sewer piping, and gas piping (if ruqUixiDd). (See mob-ilehome util.ity handout from Butte County.) .[Lems required befor.e we will be able to issue permit- - Fees of approximatel-y $00.00 - Pl.ot plans ii -n triplicate. - SanitaLion clearance from the Health Department for septic and water, (or) T'ID, NBPUD (or) other utility districts as applicable. - Recorded agricultural statement of acknowledgement (required for every new residence in -the county). 'Ilk . - Driveway permit (required any time you put in a driveway off of a county -maintained road). Contact Public Works at 538-7339 (or) contact city Public Works Department if access is to a city street. - Parcels located within the Thermalito Drainage Area must pay a drainage assessment fee to the Land Development Section of Public Works. Allow eipproximately one week from the time of application for the issuance of this permit-, (assuming you have taken care of all the items you are respon- sible for.) THE' SECOND PERMIT is called the mobilehome installation permit. This permit is required to set and block the mobilehome, and connect to the utilities. This permit will not be issued until all of the mobilehome utilities have been installed and then inspected and approved by a Butte County Building Inspector. Items required prior to permit issuance: - Application fee of $70.00. - School. district fees must be paid to 'the appropriate school. district office. Complete our Mobilehome Installation Data Sheet with informat.-Lon from manufacturer's installation instructions. Install utilities (electric, gas, water, and sewer). Inspection and approval. required by Butte County field inspector prior Lo covering. NO'l.'E: The building inspector -'will not tag the electric or gas service and the serving utility cannot provide electricity or gas until the mobilehome installation has been inspected and approved. - City of Biggs and City of Gridley (plot plan approval from the appro- priate city office.) DO NOT INSTALL THE, MOBILEHOME ON I ' 'HE PROPERTY, BLOCK -IT UP, OR CONNECT TO UTILITTES UNTIL THE MOBILEHOME INSTALLATION PERMIT 14AS BEEN ISSUED. OTHER PERMITS REQUIRED Building permits will be required for the construction of mobilehome accessory structures (i.e., decks, awnings, cabanas, or stairs adjacent to your mobilehome or for the re -installation of any of these structures) and for other structures (i.e., garages, ramadas, carports, etc.). Except -Lon: One set of approved stairs must be installed at the time of the mobilehome installation inspection.. Additional stairs and decks less than 35 sq. ft. in size will be inspected at the same time. Any stairs/decks constructed after the mohilehome installation inspection will require a separate building permit. - 2 - Items required to apply for building permits for these structures: - Plot plans in duplicate. - Structural plans in duplicate (signed 'by preparer-of plans). � Application fees, (to be determined by the square footage of the struc- ure) , = SORitation clearance from the Health Department. WYM FOf the ft—iflotallati(ofl of docks or awningst in lieu of structural Plang, 9019MB gpocing and anchoring detail& ffluet be Submitted and attompanired by on@ of th@ following! I (1) Th@ ft5fld6fd Plan Approval # OR) by the Stat@ of Califorma rvie the @Wftj.-Hg, (2) Tf Pfgvi@U§!Y ih9tdll@d in a ffi@bil@hom@ pArkv% A topy of th,& S-tatt, Wildinp, Kfffilt f@f th-@ dir-i-ginal tomtrue-Lion. A I@t-t@f ffaffi Lh@ ffi@bil@hofn-@ park manapr �gt4tihg tht wvmjM wAs, V11th dPf3fdvq1 r3fld ifi§P@t-ft@n@ by th@ Stat@,, tb ffi@bi1thm@@ of tM, i q VOW WfHifig. qL-dv@§ wlt-fiffj Mbil@homn r@quirLB p@,fffiit.% fy,6m, §C-d�e at' POMP,; (§16)445-01355 pacific Gas and Electric Company 2 'Z24- ".k' 2: S ez Se.,v;:e Piann;n,; Suoel-i-so, -135 532' THANK YOU FOR YOUR INQUIRY�.REGARDING ELECTRIC SERVICE. In or -dr..... -i- +01- LA�:, t'�C) procesF. this7, reqUeSt and provide -f-c1l.owing items ;-z4.re e cl (t I. r cl in t.o th(i. complet.icin of thi,�� or I I i- E- m Date ELY - r ------------- -7 - - - DN'iF.CEL HAP --------------- ---------- nc'!TE F-LrIN ---------- 0�11CINTT�' SKETCH ---------- AF1- --------------------------- --------------------- F I 1,"-- 1 LAST e �n.: r n t zi c J d i ---------- C! P STATE Z' I P d S THE ------- ----------- C ! TT S T A T :- 7P 4. 01,10 *f i r s � IL n rT i c -:- p 0 U T .6. Hofne Phone FIC). P -1 -1 C). klort:: I orle ! --- - - - - - - - - - - - - - - - - - - B. Prelnen"l- empioyc�,-- q. ' C.� 1. - - ----- - - - --- - - - - - - - - - - - - - - - - - - - - - - - you hi:kd ce- F'. G. n �/uu.- name, in i ---he I a. S-; t tt-�o E) YEs r4o dci:- e s 4-n - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - S T F,.-:' 7 - - - - - - - - - - - - - - - - - C 1 Tj' S 7.� 7 P 1 . C 1. 'E� t�' E, o C C-1 r e rlu t e d R* C.- i d C-- n i 'a I El commer r-- i al E.0 ' - ) �- a, D . 19 1 C U. L', E) 1 n d U S S- c2 i L h t E) Tem.,pora�-y - - - - - - - - - - - A.-PLICANT RFQtTE1-T FOR �ERVICE EZST ENTIAL Dwelling�:' House 0 Mobile Home Other Proposed usage: 0 Full Time C3 Intermittent or seasonal Project size: Main/switch: Service type Sq. f t. —AmP5 CD Overhead D Underground Proposed starting date of this project: Proposed completion date of this project: Electric Gas Lights Refrigerator Range Water heater Domestic pu'mp/well Beat Heat pump Clothes dryer Air/conditioner Dishwasher Freezer Other Size I understand that service will be provided based on the information I have supplied herein and that the above loads will be con-nected within six months after service.has been established. I further understand that this is an application for permanent service to my new home and does not include any provisions for temporary construction power. If electric service is not now readily available, portable generators are to be supplied by me or my contractor for construction power. SIGNED Applicant Date APPLICANT PLEASE NOTE: When engineering has been completed, based on the information p . rovided by the applicant or his representative, any revisions and/or changes to the project Which necessitate re-engin.eering, may be at customer's expen,5e. REQUEST FQf� SERNICt OTHER AGRICULTURAL MOTOR SIZE: H. P. VOLTAGE: V OF WIRES: COMMODITY SERVED: F-1 STREET LIGHTING 13 1 PHASE 0 3 PHASE 0 240 V 0 480 V 0 3 WIRE 1:3 4 WIRE 1. SIZE (lumens) VOLTAGE 120 vol-ts 2. SIZE (lumens) VOLTAGE 120 volts 3. SIZE (lumens) VOLTAGE 120 volts COMMERCIAL/INDUSTRIAL COMPLETE ATTACHED SERCARE SHEET Fj TEMPORARY SERVICE PEAK CONNECTED LOAD MAIN/SWITCH SIZE VOLTAGE SINGLE OR THREE PHASE DURATION OF TEMP. SV. S I GNED APPLICANT AMPS VOLTS DATE �.NCiFL� GAS AND ELECTRIC COMPANY I e (Aoaross) Attention: Service Planning Superviscx (City) PRELIMINARY SERVICE PLANNING SHEET For Commercial & Industrial Projects/Developments This sheet is intended for Commercial and Industrial Preliminary job planning and estimation purposes only. Its use is not intended for PG&E to provide detailed job estimates or engineering. Contact the local PG&E office regarding detailed job planning requirements. Although not required, this sheet may be submitted with final plans to provide a summar of connected loads. Project: Location: (Street) (City) Name of Person and Firm Completing Form: City: State: Zip: Te I.: NOTE: Plea se furnish with this sheet three copies -of a p!eliminary plot plan and single-iin� electrical layout or dia- gram. The plot plan should show preferred gas and electric service and meter locations which conform to the basic utility service standards (reference PG&E Electric and Gas Service Requirernents Book). Loca- tions not conforming to the basic utility service standards will require PG&E approval. Date Preliminary Utility Engineering Design Required: Estimated Date for Utility to Set Service Meler(s): Approximate Net Building.Square Footage: Number of Stories: Hours of Business Operation: Per Day: Per Week: ELECTRIC SERVICE INFORMATION: Main Switch Size: AMPS Type of Service Desired: (Phase) No. of Meters at Service Location: Type of Tenant (Description of Tenant/Buildin-, ELECTRIC LOAD INFORMATION: 0. 100% rated or 0 80 0/b rated (check one) (Voltage) (Wire) Largest Motor: (3q HP (lq Lighting ......... KW 1 DAir Cond ......... ea. @ Receptacles ..... KW 30Air Cond ......... ea. @ Water Heating .... KW 10 Heat Pumps ..... _ea. @ Air Healers .... * . KW 30Heat Pumps ..... ea. Cc%) Cooking . ........ KVV Aux. Strip Hits . .... ea. @ X -Ray (input) .... KW 10Misc. Klo;ors ..... e a. Gc) Welders (input) ... KVA 30Misc. Motors ..... ea. @ GAS LOAD INFORMATION: (Use INPUT ratings in BtulHr) Space Hig. Equip .......... Water Hig. Equip . ......... Jot. Wir. Hirs.) _ Ranoes ................... Other Cooking ............ Boilers (indicate use) ....... Air Conditioning ........... Dryers .................... Incinerators ............... Pool Heater ............... Other TOTALS No. of Units FL amps. @ FL amps. (D HP HP KW HP HP FL = Full Load V E Total Connected Volts VA Volts VA HP HP KW HP HP Pressure is normally provided at 0.25 psig (7" water column). Other than normal service pressure requires PG&E review and approval and may be requested by letter stating needs and reasons why. 7" W.C. pressure is not adequate. . No. of meters at service location - Estimated Gas Demand: Total Btu/24 hr Period Maximum Btu/hr NOTE: Additional comments may be provided on the reverse side of this sheet.