HomeMy WebLinkAbout030-181-01430-181-14
FESSIE FITCH 81-1 4
14th. St., Ogroville
4 w
erm. -LbO4-76P bldg. sew ihst)
MH
Z.
30- 1+14
T. V. LEWIS
1064 14th St, Oroville
Contr: G & T Ele/ar�jj
Permit#1077-87E(new ele serflod
'
0
3-3695
COMCA T COMM,
SEE ATTACHED, 6ROvIJLLE
Cont: WESTCOA�T
PLACE CATV POWER SUPPLY
KERR, M.W. 1226B
1367P
2 -75E ---17-5-4-E I -
1W. end of Dodge Ave., Oroville
(-cele change -Hu 01
1 �/service cha _ggitt Elec.,' Oro
Y!TdH, Essie 1250-,71B* 1155-71E--
0-181-1
1064 14th St.... Oroville
(*demolish residence)
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
SEE ATTACHED
ZONING
BUILDING PERMIT
OWNER
COMCAST COMMUNICATIONS
TELEPHONE
Sp, FT, OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS
4350 PELL DR SACRAMENTO
CONTRACTOR'S NAME
WESTCOAST COMMUNICATIONS 3 3-2473
TELEPHONE
CONTRACTORS MAILING ADDRESS
140 MEYERS ST CHICO CA 95828
CONSTRUCTION LENDER
LENDER'S MAIUNG ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDING ADDRESS
10 OROVILLE LOCATIONS SEE ATTACHED
Energy Plan Checking Fee
$
$
PERMIT FEE
$
IDT NO.
SUBDIVISION'S NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
Each as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: PLACE CATV POWF'R SiTPPT Y
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I G I W f
@20.00
PERMIT FEE
$
ELECTRICAL PERMIT
Fling Fee 20,00
800V OR L
Main Service 200A OR LESS
0 23.00 230. 00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class Lic. No.
OWNER -BUILDER DECLARATION
I herebyaffirm under penalty of perjury that I am exempt from the Contractors License
P tY P 1 rY p
Law for the following reason:
❑ I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation Insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Main Service 200A To 1000A
46.00NEW
CONST. DWEWNG OCCUP,
OR ADDNS. ( 3 ACC. BLos.
SO
3.5¢Fr:
NEW CONST. MULTI -OUTLET
NON -REBID. BRANCH CIRCUITS
@7.50
POWER APPARATUs
8 SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FORURESe2'
.50.
Ex. OCCU F -ED APP— OR
ouTLETs RESID. EA
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE
S 250.00
MECHANICAL PERMIT
Fling Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEt
S
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 1 certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensatio visions of section 3700 of the Labor Code, I shall
it comp it a provisions.
!
X Date `"
4of
Signa Applicant - ❑ Owner Contractor ❑ Agent
An OSHA 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 $ 250.00
IMP
FLOOD
CDF
PARCEL
PD
HDJ:::
This permit is hereby issued under
of the Butte County Code and/or
indicat d bove for which fees have
y
RMIT EXPIRES O
IF
the applicable provisions
Resolutions to do work
been paid.
Da70/0
DL.
Receipt No.
WHITE-D.D.S.-B.D. CA A -ASS S OR PIN"SPECTUTT GOLDENROD -APPLICANT
�;
;;
. .
P
1'
.
I
Permit #1077-87E
T.V. Lewis,
1064 'i4th,' St , Oroville
. r
• y
i
1
OFFICE py-
Address
GAS
Meter By
Date_
ELECTRIC
Meter By '/17
Date
1
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT NO v1.
ASSESSOR PIIIIIRCEL N'MMBER
ZONING
f
BUILDING PERMIT
OWNER�" /
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNER'S tMAILING -ADDDRESSf y.
[Fireplace
CONTRACTOR'S PNAM EE-` "" - '
xis 4t' l- "( �! lP ,, 4 t r
TELEPHONE
CONTRA-C-TOR'S MAILING ADDRESS
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
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
$
PLUMBING PERMIT
Filing Fee 10.00
/ 7� S
I /d <% / �l �f vi�/,i
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF ❑ Duplex[-] Mobilehome[ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G W
10.00ea
TYPE OF WORK
1 Installation❑ Other ❑
New [-IAddition ❑ Remodel ❑ Utilities[311
Describe work:�• -� K1 ». iS'E%a+.� r _
I
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
I
Main service 100 AMP LESS
10.00
Main service EA. ADD -L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the BusinessPOWER
and Professions Code and my license is in full force and effect.
License No. Classification
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑� 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.6 21/2
New CONSTR.� A � ¢sgft
MULTI -OUTLET
NON.R I -SID BRANCH CIRC ITS 2.50ea
APPARATUS 61
I SINGLE OUTLET CIR.
Ex. OCCUp(OUTLETS OR FIXTURES 20050Q
eALO 30
Ex. OCCUp. OUTLETS FIXED P(RESID )REA.1 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $ -2 1— --
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ Vshall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Cooling
Hood
3.00
Ventilation
Permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating,
to building construction, and hereby authorize representatives of'the 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 County in consequence of the granting of this permit.
X 0� ." ���
�, � Date<��a !�� �_
Vv Ar/'A I/` ` V / `
Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height. e— ^ — / i
Mobile Home Installation Fee
$
Energy Inspection Fee $
TOTAL PERMIT FEE $
OCCUP.
CONST.TYPEJ
FLOOD
PARCEL
P11
F7T7777
This permit is hereby issued under the applicable provi-
sions of the Butte County Code and/or resolutions to do
tr b
work indicated above for which fees have been aid.
_ p
DIRECTOR,OF PUBLIC WORKS
By` �' 'l Date f//7 / C 7
PERMIT EXPIRES Date K/2 Ike
Receipt No. /7,Or�`���
WNITE-D.P.W.. YELLOW-ASB[930R, PINK -INSPECTOR. GOLDENROD -APPLICANT
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534-4541
_"Yy vay" hd Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
nwniFo ! o.
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
Inspector---- P Date_ _QN�__ _
JK.
flu
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - OroviIIe, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT NO
Ai / 4
ASSESSOR PARCEL NUMBER
ZO ,LNG
BUILDING PERMIT
OWNE
TELEPHONE
SQ. FT. OCC, BUILDING VALUATION
OWNER'S MAILING ADDRESS {� �t /
CONTR TO�.,R'S NAM ,^ ,
T y
TELEPHONE
'
CON CTOR'S MAILING ---
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 10,00
LENDER'S MAILING ADDRESS
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
$
PLUMBING PERMIT
FilingFee 10.00
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF ❑ Duplex[] Mobilehome[4Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home Is
10.00 ea.
TYPE OF WORK
New ❑ Addition ❑ Remodel [:]Utilities �, Installation[]Other ❑
Describe work: ZZAyo— --5•P,r/✓/ c_ 4 _
t
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00'
Main service 100V OR LESS
100 AMP OR LESS
10.00 , ,61
Main Service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Busines$
and Professions Code and my license is in full force and effect.
License No. Classification
FJ 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
�or sale. (Sec. 7044)
LJ i, as the owner, am exclusively contracting with licensed contract-
1 ors. (Sec. 7044)
❑ 1 am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUP.N,
OR ACDNS. ACC. BLDGS. /zQsgft
TLET
NEW CONSTRESID, RANCH CIRCUITS)2.50 ea
NON -R ESLD BRANCH CIRC ITS
POWER APPARATUS &)
SINGLE OUTLET CIR.
Ex. Occu A0 0 LO30
p�OUTLETS OR FIXTURES .2z00930
Ex. Occup. OUTLETS P(RESID )FIXED ALNS.REA.1 2.00
Temporary service 10.00
Mobile Home Facilities 15.00 S
c.
Mi Wiring- 15.00
_tlr
Permit Fee IF $�� �--�
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
�f Consent to Self -Insure.
U shall not employ any person in any manner so as to become subject
'
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
s.
MECHANICAL PERMIT
FiIingFee 10.00
Heating
Cooling
g
Hood
3.00
Ventilation
Permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the 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 sat County i con quence of the granting of this permit.
X p I uen ��/� /1C�7
Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" ee d de tion or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
TOTAL PERMIT FEE $ ��
OCcUP.
CONST.TYPEJ
I
IFLOODIPARrELI
PD
I HD
I ISSUE
This permit is hereby issued under the applicable provi-
sions of the Butte County Code and/or resolutions to do
work indicated above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
BY � �/1-A_44��� /ate &Z
PERMIT EXPIRES Date V
Receipt No. O � Q0
WMITE-D.P.W., YELLOW -ASSESSOR, PINK-INSPEC TO GOLDENROD -APPLICANT
c PERMIT NO' 1601-76P
PERMIT EXPIRES 4/5/77
r' OWNER ESSIE FITCH
x .•s .. CONTR. owner
LOCATION (A.P. 30-181-14
1064 14th. S ., Oroville
15
1
lv _
1i
1�
j
ar
wt
`f
Temp. Power Pole
Called PG&E
Temp. Elec. Serv.
Called PG&E
Temp. Gas Serv.
Called PG&E
JOB
FINALED
(Date)
(Signature)
THERMALITO IRRIGATION DISTRICT
410 GRAND AVENUE
OROVILLE, CAMFORNIA 95965
TELEPHONE 533-0740
N° 090
CSA 26 SEWER SERVICE APPLICATION AND CONNECTION' PERMIT
Service Address:
Owner's Name: 5S tea" Ga�
Date: 11 -Z
Address: IOLA 10117W 15];T
Acct. No: -013r
Pent '1.0 e 0-A '15U-5
A.P. No::
Phone: -3 - % 3
No. Units:' lv
Applicant/Agent:
Agents Proof: 4.)
Address:
Fees: ?Aev �w rL3L L—
Phone:
Application $
•
Arrearage n 0(3
Preliminary Review By- + Dater - Z
CSA 26
Remarks:
SC 0R
1 st mo. S.C.
Other
Total Fees
Collected By:
Date: C �.
Field Review By: Date: -74
Remarks:
--
-
Ll
MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON:
Date of T(D approval of completed building sewer (early. connection)..
El 30 days after date above, or on date of D.P.W. approval of completed building sewer, which ever comes
first ("existing construction", prior to Mar. 5, 1974).
❑ 180 days after date above, or on date of D.P.W. approval of completed building
sewer, which ever comes
first ("new construction", after Mar. 5, 1974).
DISTRIBUTION: WHITE - TID, YELLOW - APPLICANT, PINK - DPW, GOLDENROD - DPW to TID
o
'
r l
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
— d'.
Sanitation
BUILDING BUILDING (Cont'd)
FIREPLACE
Setback
Firewall
Soil Piping
Forms
Parapets
1st Floor
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
StemwaII
Siding
To out
Slab
Roof Sheathing
Water Piping
Piers
' Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Garage Vents
Water Htr.
StemwaII
Slab
Prov. for physically
handicapped
Heaters
Appliances
Carport
Footings
Conformance of ex.
structure
Gas, Piping & T
Temp. Gas
Slab
Final
Sanitation
Patio
FIREPLACE
Final
Footings
Footing
Masonry Walls
Throat
Rou h
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
4
s
(NOTE: An entry must be made on this form each time you visit the job site.)
PLUMBING
ELECTRICAL
COUNTY OF BUTTE — DEPARTMENT OF PUC^WORKS
• 7 County Center Drive — Oroville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
/poi -/-7(
c•Uunn U IUVIVOcn i0 VOD UI Ll le liUUFILY UI C1Ulle to en[er upon ine
above-mentioned property for inspection purposes.
X " C-4 I/ k
1A .� , , ��Z�nate �4 /<f/ 61
Signature of PP�ejjrmitee or Agent
Receipt No. �Q
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 been paid.
P DIRWTOR OF PUBLIC WORKS
By Date-4---Y-7.
Catte 4 _ S7 I.,.
Building permit expires Date 4—S!-77 —77
BUILDING
Owner I TC44
SQ. FT. OCC. BUILDING VALUATION
Mai I i ng Address � V (04 14-T11
11
2C)` �J ILJUE f S
Telephone No.
Fireplace
Contractor k,
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee
Building Address
PLUMBING No. @ FEE
P
PERMIT FILING FEE $3.00
\J i LLC
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. 30 -- Cc& I
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
s
W-6
Fire Dept.
Fire Zone
I Use Permit
Building sewer 5.00 x,00
EQA
Parking
Plans
Parcel
Declaration
parcel Ma P
60' R/W
Im r
p ovements
Lawn sprinkler system 2.00
B''- °w, —:o-
Parcel Approval
Plans Approval
Permit Fee $
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER R
ELECTRICAL No.1 @ FEE
PERMIT FILING FEE J$3.00
<,J g LL
Main service 80000 AMP ORSLESS 5.00
( e
,J
Main service EA. AOO'L 100 AMP 2.50
Single Family to Duplex Mobil Home Others
❑ � ❑
Main service OVER 000v 25.00
10o AMP OR
Main service EA. ADD'L 100 AMP 1.00
0 AM
NEW CONST. DWELLING OCCUP. &)
OR ADONS. ACC. BLDGS. 120sq ft
NEW CONSTR (MULTI -OUTLET
NON.RESID, t BRANCH CIRCUITS) '2.50ea
NEW CONSTR POWER APPARATUS &)
NON.RESI D. (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)@�
BAL@l
Ex. QCCU 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
Workmen's Compensation Insurance.
y� r7-1/1 certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to 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 $
$
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
$
c•Uunn U IUVIVOcn i0 VOD UI Ll le liUUFILY UI C1Ulle to en[er upon ine
above-mentioned property for inspection purposes.
X " C-4 I/ k
1A .� , , ��Z�nate �4 /<f/ 61
Signature of PP�ejjrmitee or Agent
Receipt No. �Q
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 been paid.
P DIRWTOR OF PUBLIC WORKS
By Date-4---Y-7.
Catte 4 _ S7 I.,.
Building permit expires Date 4—S!-77 —77
.k,3;
THERMALITO IRRIGATION DISTRICT A t'.41
410 GRAND AVENUE�ff
OROVILLE. CAL)FORNIA 95965
TELEPHONE 533-0740
CSA 26 SEWER SERVICE "APPLICATION AND CONNECTION PERMIT
Service Address:
Owner's Name: f '
Date:
Address:
Act. No JL4: 4,---/
-''
A. P. No. l % i
Phone: �' " `�
No. Units
Applicant/Agent:
Agents Proof: i(I /•
Address:
.M
-�
Fees:
Phone:
Application $ /
Arrearage
Preliminary Review By:,^ Date: /
CSA 26
Remarks:
SC -OR
1st mo. S.C.
Other
�� J1ir-�" ,�. r� i-- /.r J /►/ P �"'
Total Fees
Collected By:
Date: '
Field Review By: r - .G'.+I.-�F. ��//(',gX.—,•-4,4Date: �/'' �(" ,� -
,c r i -
Remarks:
rV e-1. t, rl I : f, 11 .
,� �'; 14-1
MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON:
❑ Date of TID approval of completed building sewer (early connection).
❑ 30 days after date above, or on date of D.P.W. approval of completed building sewer, which ever comes
first ("existing construction", prior to Mar. 5, 1974).
❑ 180 days after date above, or on date of D.P.W. approval of completed building
sewer, which ever comes
7 first ("new construction", after Mar. 5, 1974).
DISTRIBUTION: WHITE - TID, YELLOW - APPLICANT, PINK - DPW, GOLDENROD - DPW to TID