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Home My WebLink About030-430-014r, �y " i d' 4 ,I n ,.a . . NP .; ..! .. ,,,�C[• .... ., ..... .... "ya V"a I/1H {. 1 JN,VJ. s.,1L � '�CI ' Nd'• . .; ati ' .... , ... .. a4:�i�i.... "_«-•Pn`,fi. ..t .yam �•�t !yi.: t',�.-•}b'+I�.:x. ^:�[' .-.: r; � ' 'fcv. x!4iT<' r "iIF.Tf' r; !' '.. I�Y'��,.. ice•.'.'...' t�t:i... li:>.."�,4! .j,';e#!.Ye''4'3w .. .�,n: .44•v AP 30-43ti. r- r9 v :t_ 1_ S SINNAL MORTGAGE CO./ "r 0 � 688 a La !"(: '`.' 4. Q 'O 4 ice• k .ifi T .�. I:I, . i:.l 'T}'1•+'±�`'E �' Vii,. ,. -2}.� .... � N ... •...`. .....M i' I I T: . . ..:k e a� I �1'� .;��...: se: _ a'.',. "'tit:': C.: ^A�ii.F:, :a",.•, ...{.; *%': ,. •''0♦ ;ip'i .4 .;. ::. .. - o J�I�rj�- 16 8 8 Leta ... t..!f}�� .. . ";' � .. .. - '�'. ,.';`. �•.:.' CJVI=.r�slll/O '' �`C"t 1. �Y.ti''fY' �l: y','. �:.'r Pe �F IY 4 t TV' I 77 t�-�(�/7-,'t',j.. ,':.Yi. IN Q p.Al ' .''9;+•11. ,'r r/n: v,�.(- '.r" 30-43-14 2 / t{�ly-A,'ij.'�1�:S�Gt,".: "k• B / u'. i u I •fes% II - (P 1� Contr: Steve Davi (replace power pole) _ I f fir':'- .. �•�� .;�.. • 1, ;.g„h:�"; ;•�{.: a. . ,b k. 1 , All ,!T r {. 1 JN,VJ. s.,1L � '�CI ' Nd'• . .; ati ' .... , ... .. a4:�i�i.... "_«-•Pn`,fi. ..t .yam �•�t !yi.: t',�.-•}b'+I�.:x. ^:�[' .-.: r; � ' 'fcv. x!4iT<' r "iIF.Tf' r; !' '.. I�Y'��,.. ice•.'.'...' t�t:i... li:>.."�,4! .j,';e#!.Ye''4'3w .. .�,n: .44•v AP 30-43ti. r- i• .i, v :t_ 1_ S SINNAL MORTGAGE CO./ "r 0 � 688 a La !"(: '`.' 4. Q 'O 4 ice• k .ifi T .�. I:I, . i:.l 'T}'1•+'±�`'E �' Vii,. ,. -2}.� .... � N ... •...`. .....M i' I I T: . . ..:k e a� I �1'� .;��...: se: _ a'.',. "'tit:': C.: ^A�ii.F:, :a",.•, ...{.; *%': ,. •''0♦ ;ip'i .4 .;. ::. .. - o J�I�rj�- 16 8 8 Leta ... t..!f}�� .. . ";' � .. .. - '�'. ,.';`. �•.:.' CJVI=.r�slll/O '' �`C"t 1. �Y.ti''fY' �l: y','. �:.'r Pe If sued ,2 1,7-,v17 UiyAlYNJU 'lT.3rA lrL=iC]N w :.a 77 t�-�(�/7-,'t',j.. ,':.Yi. IN Q p.Al ' .''9;+•11. ,'r r/n: v,�.(- '.r" 30-43-14 2 / t{�ly-A,'ij.'�1�:S�Gt,".: "k• B / u'. 1688 Leta Lane, Oroville Contr: Steve Davi (replace power pole) _ I f fir':'- .. �•�� .;�.. • r 00 Ji 4 � I 0JF rfI t. 1. , :.e �j _ •Y yy..•�y.. .. ... . , .... ..s ... .. ...,,.: n... ^ ... �..F-!-A"• r`..' 'x. , ::rot 'f,`-: �, . '!` �'Ya.,.., . �;:'r;.. � S''•• � .. i .. ... . .4 .r• .., :i.•� , F^F t• Cat if F a .¢r .+i..: 'p. ( j1FY NP-Ri. t M iR-0 . x !.. �. F� -r... d5. e%r, ..\::. :`;l.i.'.•" 'b . :'�+',,5':- d _ -. r _ _ ,. F� .:1:'.. :m ... .. .61. .'s .:Vf4 •ille �:':bi�.5t3=.w..,.. f. _.rt..,, e,JN .✓, :.. ... ':.tl _: �. `fa' INSPECTION RECORD BUILDING- APPROVALS Z_ 0C6P U.1 Z O= O= pm p� mJ U rc,t-. w I.- � WY It u a 3 A aZ o°� i,� ig Wig. fig, ;-� zm m LL IL SIG. o DATE , SIG.. . •: � .DATE iv SIG. } DATE =¢, SIG`. s: _ DATE SlG. DATE SIG. DATE : J z SIG. .. -. DATE.. - ,. ,.. . SIG. DACE _ �. - SIG. 2 DATE ! d DATE 4 SIG. DATE :SIG.. ., ,- : .`..:t..•, '- DATE PLUMBING APPROVALS PERMIT NUMBER' ' �.ROUGH-IN SIG. DATE DATE - 816. DATE SIG ; J. DATE 'SIG. DATE , is - i- LL. GAS PRESSURE;TEST WXTi -PIPING ';SEWER -LINE -'ARPL-'IANCES B VENTS - J ELECTRICAL APPROVALS K PERMIT NUMBER, SIG. DATE SIG. DATE SIG. DATE SIG. DATE81G. DATE ROUGH"IN RIES,& APPLIANCES '...FINAL.. MISCELLANEOUS APPROVALS - '- ',... '-;PERMIT NUMBERt ,. :... .�. �, r ....,.-: �- -•-::: DESIGNATION 61G. DATE SIG. DATE' SIG. DATE SIG. DATE SIO. DATE _ I i r"ik" `r i.ns arti`?'Srdii��#�15 3x'%N: ",tie o COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT N0. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541. APPLICADON ANO PERMIT ASSESSOR PARCEL NUMBER 1 ZONING AR BUILDING PERMIT OWNER Paul s TELEPHONE- 532'=1087 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1670 12th St Oroville 95965 CONTRACTOR'S NAME Steve TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER none UNKNOWN Total Valuation is Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee , $nonp Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 1688 Leta� Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 OrnVille -So Iaror 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 I SF ❑ Duplex❑ Mobilehome:q Other - SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W O.00e TYPE OF WORK New F] Addition❑ Remodel❑ Utilities Installation F-1 Other ❑ Describe work: replace Power pole _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6101 OR LESS 100 AMP OR LESS 10.00 /� /�/� 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW 9S" declare under penalty of perjury (check one): �.�'_.' ❑ I am licensed under provisions of Chapt. 9,.Di.v.3 of the"Business and Professions Code and my license is in -11611, force -and effect. License No. Classification li - ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ® I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Codeinsp for this reason 1 NEW CONST. DWELLING OCCUP.&I OR ADDNS. ( ACC. BLDGS. , /20sgftNEW CONSTR ULTI.OUTLET NON•RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20@60t eAL@30 FIXED \\ Ex. Occup. OUT ETS P(RESID.)LN REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 115.00 15.00 Permit Fee $ 50.00 Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self-Insure.I' ® I shall not employ any person in any manner so as to become subject to the W. C. laws of California. le subject Notice to Applicant: If after making this statement, should you beco 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 FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above 111liformation is correct. I agree to comply to all County Ordinances and State Lays to building construction, and hereby authorize representatives of thellCountyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte aid lia�iilities, judgm nts, costs, and expenses which may in any vi against said 1 Cobnty i conse1'quence of the granting of this permit. I �11 ��)� ��),�,y "`"'ill v Date relating against ay accrue Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 50.00 HAz cuA PARK SCHL FLD PAR JPD HD ssuE Th;s permit is Rereby issued under the applicable provi- sions or the BGi Coun y C9de and/or resolutions to do Work indieate'd aboveor, wl�ieh fees have been aid. / p OFAPUBLIC WORKS 2 �� V By �/ ate PERMIT EXPIRES Date _ Signature of Applicant — Owner ❑ Contractor ❑ Agerit ❑ An OSHA permit is required for excavations over 5'0" deep and demolition.;r ion of structures over 3 stories in height. I construct -ECT i - "Receipt No. 70838 WHITC-D.P'.W..'TELLOW-ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT rCOUNT•Y OFBUTTE,-'D,EPARTMENT OF-PUBLIC'WORKS- PERMITNO.. 7 County Center Drive - 0roville.-Calitofnia•95965 - Telephone: 9161538-7541 APPLICATION AND PERMIT' ---'Y ASSESSOR .PARCEL NUMBER, - ^ - 30-4 14 ZONING � BUILDING PERMIT 'OWNER - TELEPHONE '532=1087' ` SO FT: OCC.-. BUILDING VALUATION . . . OWNER'S MAILING ADDRESS - - - - 1670 1.2th St. Oroville.95965 CONTRACTOR'S NAME" - TELEPHO, N,E v. CONTRACTOR'S MAILING._ ADDRESS- j : -Fireplace, CONSTRUCTION LENDER UNKNOWN- Total Valuation $ -Filing--Fee, ,$ 10 LENDER'SMAILING ADDRESS'' - Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. .Pian Checking Fee` - $ Energy Plan Checking Fee $ - ARCHI CT OR ENGINEER'S MAILING. ADDRESS, Penalty . $ B U I L D I N G'A D.D,RESS Peflnit'fee PLUMBING PERMIT- Filing Fee _- 10.00 . Each Trap 2.00 •NAME' Solar or heat pump waterheater 20:00. •LOT NO. 'S UBDIVISION • PARCEL MAP Water .pl ping: - ^5.00 Each gas'water heater or vent '5.00 USE.OF STRUCTURE SF ❑ Duplex❑ MobilehomeK3. Other SPECIFY Gas,piping system 1 - 5 ouilefs S.OQ Building sewer 5.00` Mobile' Home S G 'W 0.00 e TYPE OF WORK New ❑ ' Addition ❑ Remodel•❑ . Utilitiesj] Installation❑ Other ❑ Describe work: replace, Power pole _ ". - Permit Fee Contractor ELECTRICAL PERMIT- •FiIIngFee 10.00 Main service e00v 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.bf perjury ,(,neck one): ❑ .I am licensed under provisions of Chapt. 9, Div.3 of the Business. and. Prof essl ons'Code and- my license' is in full force and effect. License No. CI'assification ❑ I, as the owne'r;'.or.my"employees with `wagesas their sole compen= sation, .will do the work, and the structure Isnot intended or offered for sale. (Sec. 7044) I, as the owner, am -exclusively contracting with licensed contract- ors. (Sec: 7044) ❑ 'I am exempt.under Sec. Business and Professions Code for this reason'--'--.. NEW CONST. DWELLING OCCUP.& OR ( ACC. BLDGS. - I �2¢3Q ft CONS. NEW RESID. RANCH TLETCIRCUI - .NON -R ESID BRANCH CIRC ITS 2,50 ea - PowER APPARATUS tr (SINGLE OUTLET-CIR. ' - Ex. Occup( o OR FIXTURES p( 20e50C - DAL IXED A Ex..,OCCUp. OUTLETS P(RESID ILNS.RE A.� 2.00 'Temporary, service., 10.00 Mobile Home Facilities 15.00 Misc. Wiring 9 15.00.1 15.00 15:00. Per ee $'50.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury -(check one):'. ❑ The permit is`for$100.00'(valuation)orIess...=.. �I have�placed,.on .fi.le with the County of Butte' Building Department '''a Certificate of•Workmen's Compensation a Certificate of: Consent.to-Self-Insure. ® : I shall. not employ, any, person in. any •manner so as to become subject to the W. C..laws'of'California. Notice to APpllcant: If atter 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 FilingFee 10.00 . Heating Goofing Hood 3.00, Ventilation permit Fee- Contractor I'certify that 1 have read this application and state that the above information is correct:; I.agree.to comply to•'all CountyOrdinanc§s and State. Laws* relating ;to`building construction; and hereby authorize, representatives ofAhe Countyot Butte to:enter-.upon .the atiovrnentioned property .for inspection purposes: i ... I; s0 gree to'save, indemnify and keep harmlessthe County Butte against: al '.Iia ilrties; judgm s; costs, and expenses. which may'in any way 'aCCfUe ,a ai-saiid• o ty i • consequence oof the granting of this permit. --: + Date. Signature of-ApoIicant — Owner.❑ '.Contractor:❑? A`gent ❑ An .OSHApermit,<is required for excavations oval 5'0. deep,and demoliiion.or construct ion oPdtructures-over &stones In height. Mobile Home Installation Fee $ Energy inspection Fee $ occ coNsr.rvPE.. TOTAL FEE .$_ "50::00` HA ZJ CUA PARK .SCHL LD PAR- ,PD -HD SSUE :. This permit is eby is ued under -si. OT he t Coun y C de and/or rk', In ca above o • w ich..fees. T 0 UBLI&WORKY,2 BY -PERMIT EXPIRES.. Date the applicable provi- -resolutions to do have been paid.- �: Receipt No 79838 WNITE-D.i-W., YELLOW -ASSESSOR, PINK-INSPECTOR,GOLD ENROD•APPL I CANT.. solo 0 i,_ Own, .M1'�' P '-a' r � Yt � I: � 1 >.f . ,}. f f �. - Y• Y �v ; f 7 a'. , I; + • '� f is 1 `.r � , r, , r ti� 'q :r �. :. .a, i r',. -t y. ,t yx'. 1+�; �•% r ,•l t-" s� '+ Swo ,rvivo 74 No { - 'may � '.`.: b It r - ao ,\• , 1 k `1 • � r - i ' �� 't?: { �- r a r - r� * y �' S i �i SI 1 � i l i r• ` S 1, 4 t _ �. a ;': ? F - - it i,. r9 Nt �r.4• � _ .\:4 .. ,, '.. � r� �y s - � .. �. �y,t -.� .D r: '• rr. �_� _ Id 'fl; �`� - t .. •' 2 �3�� Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. moire Dept. Other Date By The following data must be submitted prior to permit{issuance: (Circle hew 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___jnall_counterby ..date Contractor, designer, owner, was advised of above required data by_phone—mal l—counter by date Plans checked by Date Pians approved by Date Sets of plans on hold in - File cabinet AP folder Copy—DPW };:` J ,COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALVANIA.95965 - TELEPHONE: 916/538-7541 PERMIT;=APPLICATION` DATA SHEET----�., 1 �� S Permit No. Q OWNER �( (,(_ N (/ A o. O� 052 �3 Proposed Building Use �°G fv'�' Building Inspector Date o 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 ` A9. Driveway permit (constru ti a ov l qulred prior to occupancy) x -Inspection �'r t Pre-Inspec. request to �1 20. 21. Pre for required , Building Inspector (Date) Contractor's license information (No., Name Style, Classification) . . 22. Certificate of Workmans Compensation Insurance ................... 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization .................. '. ............. . _. 26. 27. When ou issue the it, as follows: Mai o owner. _ Mail to contractor. r� Telephoneand hold for pickup office Deliver w/inspector. Other] Applican�t 144 .Date � 'v Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. moire Dept. Other Date By The following data must be submitted prior to permit{issuance: (Circle hew 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___jnall_counterby ..date Contractor, designer, owner, was advised of above required data by_phone—mal l—counter by date Plans checked by Date Pians approved by Date Sets of plans on hold in - File cabinet AP folder Copy—DPW };:` _. 'J4_ r rr� \ ) pt .. �.: ry_ �_V � � ){ �'1` , ,. l� , y"�, � ,' �. -. i c r' _! ` �"_ ''fit^7.t `.'� _ — ..:,�r1 .... _. _ _. ` ._ - . � •r iior - '4 r. • _ `r ,.I 1 }:'yF' �:'tef�tl ti. .w -. - ,f 1' .i 'C _ �-- - . ._-..-.... .�. �, ._ ' - � ;J � .y C+ - �3�� ter. r .. fl. u �'. :. �Fi' J'•" r^rs}� ., _{ i _ COUNTY OF BUTTE - DEPARTMENT OF- PUBLIC WORKS PERMIT NO:. : 7 County Center Drive -. Oroville, California 95965 - Telephone: 916.%538-7541. `� �/ii�_6 APPLICATION AND PERMIT L E - ZONIN ASSE /O�R-PARCEL NUMB L�-% BUILDING. PERMIT OWN 6 U/S TELEPHO E -3 - )0 3 SO. FT. OCC. BUILDING VALUATION ER'S MAILING AID&R ��v I"t (/ \ C T.R ACTOR'S NA - -f aU� Q�iS CC�.iti$ , TELEPHONE - CONTRACTOR'S MAILINGADDRESS Fireplace CONST UCTION•-LENDER UNKNOWN Total Valuation is LENDER'S MAILING ADDRESS Filing Fee g $ 10.00 Permit Fee $ ARCH Tr_ CT OR ENGINEER ,A10 n e LICENSE NO. Plan Checking- Fee $ ARCHITECT,OR ENGINEER'S MAILING ADDRESS - Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS e a �- n Permit fee S PLUMBING PERMIT Filing Fee" 10.00 i Each Trap 2,00 � Solar or heat pump water heater. 20.00 LOT NO. SUBDI VISION 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 G W 10.00 e TYPE OF WORK New ❑ Addition ❑ Re odel Utilities' nstailation❑ 1pthe Describe work: l4l 1� Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600100 OR OR LESS 10.00 CONTRACTORS LICENSE LAW I declare under penalty of perjury p y p l y (check one): ❑. I am licensed under provisions of"Chapt. 9, Div. 3 of the 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) ❑ I, as the owner, 'am exclusively contracting: with licensed. contract- ors. (Sec:.7044), ❑ 'I am exempt�under;Sec. ,Business and Professions Code for this. reason Main service EA. AOO'L 100 AMP' 2,50 NEW CONST. ( DWELLING OCCU'M OR AODNS. ACC. SLOGS. '4¢sgft NEw CONSTR n LTI.OUT LET. NON-RESIO BRANCH' CIRCUITS . - 2.50 ea APPARATUS h) SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 2500 e ALd 30 Ex. OCCUp. .OUTLETS IIRESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 - Mi . Wiring 15.00 Q - l( Permit Fee $ WORKMEN'S COMPENSATION INSURANCE _ I declare under penalty of perjury (check one): ❑ The permit.is for $100.00 (valuation) "or less.” ❑ 1 have placed on file "with the County of Butte Building Department a Certificate.of "Workmen's Compensation Insurance or a Certificate" of.Consentto"Self-Insure. " . ❑ 1 shall not employ any person in any manner so as to become subject to the W. C..laws oVCalifornia: 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 certif that I have read- Y application and state that the above information is correct:_ I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot. Butte to enter upon, the above-mentioned property for inspection purposes.. I also agree to save; indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which,may .in anyway accrue against said County,in consequence of the granting of this permit. X Date 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. Mobile Home Installation Fee $ Energy Inspection.Fee $ Occ cONSTTYPE TOTAL FEE $; HAZ" CUA PARK' SCHL FU) PAR PD. HDI. ISSUE" This,permit is nereoy issued under sions of the Butte County Code and/or work indicated above. for. which fees DIRECTOR OF PUBLIC ,By ' PERMIT EXPIRES Date the applicable provi- resolutions. to do have ."been paid. WORKS" Q 1 Date Receipt No. WHITE-D.P.W., YELLOW-ASSE330R, PINK -INSPECTOR,' -GOLDENROD -APPLICANT TYPE OF OCCUPANCY. 474q4 - FIELD - INFORMATION -BUILDING USAGE:,Q� TENNANT : l co p S OCCUPIED D HAS ELECTRIC HAS GAS HAS SANITATION FACILITIES [� HEATED -COOLED PERSON CONTACTED OTHER'COMMENTS: ACTION RECOMMENDED: HOLD FOR ' IU%W PO t a OTHER: PRE INSPECTION, OWNER: pGt i c O KJ 1 S DATE O! d /go LOCATION: /6ga- te' �a G, h , OrOt) i (�� A. P. #3�.�L;L CONTRACTOR: st6 ye- U a ZONING PRE-INSPECTION`:"FOR:- C �0 (ac C W D P f O.(� . O f- ! DO ,D gery � OEI o DATE TO INSPECTOR �� PERMIT HISTORY : _______________________________ NONE AS FOLLOWS: ____________ ---- ____________ . r n� ; t 5o lv �. TYPE OF OCCUPANCY. 474q4 - FIELD - INFORMATION -BUILDING USAGE:,Q� TENNANT : l co p S OCCUPIED D HAS ELECTRIC HAS GAS HAS SANITATION FACILITIES [� HEATED -COOLED PERSON CONTACTED OTHER'COMMENTS: ACTION RECOMMENDED: HOLD FOR ' IU%W PO t a OTHER: PERMIT NO. P . E M MH UTIL. PERMIT NO. 4504-74P,E PERMIT EXPIRES OWNER __ Signal Mortigage CON TR. °LOCATION'(A.P. 30-43-14 ) 1688 Leta Lane, Oroville 1 i d i Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E JOB FINALED l (Date (Signature) a� Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E JOB FINALED l (Date (Signature) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD . BUILDING BUILDING (Cont'd) PLUMBING Setback Irewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall SidingTo out SIa6 Roof SheathingWater Piping Piers Roofing Sewer Gara a Fdn. Vents Fixtures Footings Garage Vents Water Htr. - StemwaII Slab Prov. for physically handicapped Heaters Appliances Carport Footings Conformance of ex. structure Gas Piping& Temp. Gas Slab• Final �rlL 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 Zi COUNTY OF'BUTTEee, 'DEPARTMENT OF.PUBLIC WO 7 County Center Dl-ve '� Oroville, California 95965• ' Telephone:. 534-4541 -APPLICATION•A PERMIT , AND duinonce represeniduves,or the t,ounty,ol tsutte to enter upon, ine ,' . abov mentioned properly for inspection -purposes. - Date' 49 Sign re o ermitee,or'Agent Rece'ipi. No. White-D.P.W. - Yellow -Asse's'sor.- Pink -Inspector -`Goldenrod-Applica' nt 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 0 UBLIC WORKS `. By Date 11- 7 _� ding permit-exjres Date...:...........a/-..��.7'd.... BUILDING_00, Owner _ ` o t2 SQ[;FT. OCC'. -, BUILDING.VA ATION Mai Iing Address, :`7. �QO Q _ Telephone No. Fireplace _ Contractor. Total. Valuation ' Mai.ling Address - Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ , Buildrng`Address PLUMBING No, @. FEE PERMIT FILING FEE $2,00 Z; Ci6 O 0 res CC� Each Trap 1.50 Repair drainage or gent piping 1.50 Water.piping 1.50 / Sd ,Sv Eacli gas water heater or vent 1.50 . A. :P. No ,Lon;ng.• PlsuAog, Gas piping system 1 - 5 outlets 1.50 Each, additional outlet _ 30 Ftt p i re Dept. 'Fire_ Zon ing sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W impro ments Lawn sprinkler system 2.00 Bldg."PI'ons Recd ' Parcel. rovol'• ons -Approval, Permit Fee $ $ O1 NEW:� -ADDITION [] UTILITIES- OTHER ❑ ELECTRICAL No' . PERMIT FI LING FEE' $3.00 Q'Q �: •. Main service incl. 1 meter' ' ;,. �.. Add itional`'meters,.;each 1:00 Sub -Panel (12'or less).(more.thonl; Single,Famil'y E J Duplex Q Mobil Home ® Others 0 Range, Cook -top or -Oven i.00 _ Water Heater or Space Heater . 1..00202 2. Light fixtures. bai_ �2 15 10 Receps.,�switches & fix'outlets Z CONTRACTORS LICENSE LAW I amyl. icensed.under..the•provisions of. Chapter 9, Div. 3, 'of 'the State of --California' Business-& Professions Gode under, the name i. style of: Hood, Ex. Fan or F. A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditionet.' heat pump Water pump ; Mobil Home.Facilities •. 5.00. S Temp. Power Pole . 5.00 7 4 License No '..'• CIassifical ion Mi sc.- wi ring I•am exempt .from the Contractors License: -Laws of the State of-Califomia. :.. Permit Fee WORKMEN'S COMPENSATION INSURANCE, .: °Ian, aware of the provisions of Section3Z00 of the California Labor_ Code which, requires every employer to.be insured against- liability - forWoirkmen'srCompensation. I'.have,pI4cedon,file with the County of Butte a certificate of. ' ❑-%Workmen's Compensation. Insurance. 1. -`certify ,that,,irl -the performance sof the work for which this permit ,is issued I shall,not employ -any person in any manner so as to. become.subject to the Workmen's Compensation Laws of. California: _ --MECHANICAL No. @ FEE. PERMIT FILING FEE $3.00 ' Heating Cooling .. Ventilation: Hood 2.00 Permit Fee • $ $ I. certify that I;have read�this'application_-a state that the above :- •information,.is,correct; I. agree,io, comply. to'all County Ordinances `and State Laws. relating -to building construction, and. hereby .,''TOTAL- PERMIT FEE $' O duinonce represeniduves,or the t,ounty,ol tsutte to enter upon, ine ,' . abov mentioned properly for inspection -purposes. - Date' 49 Sign re o ermitee,or'Agent Rece'ipi. No. White-D.P.W. - Yellow -Asse's'sor.- Pink -Inspector -`Goldenrod-Applica' nt This permit is hereby issued under the applicable provisions of the Butte County Code and/or, resolutions to do work indicated above for which fees.have been.paid. 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I i, i � • r �. ♦ 1 .i • f , {. � r i v Y i `t, t .�'eJ° ..J; '), '$.- .{„ .g- 17 �• f^"1`. .t- ,.'� Z..t __ir,.:f. ....`5•.�....w,.:.., i'�! 1� �-'� ':� Iii t ris' -,/ ,, .� �: "'.y G-Av 4 1 �i {., t� .tr. -, � `.i, t.7 'Y 7T' J T' •.q• i =" i. ;< ,? . 1' ,p'v' J {°. ,p . i 1 1.r. •.i j , , . _ ........ � •.1 ? c- :� , ,,-; .i' . _�. s,, v d _ ate_" ��! a.7. .� +� 1 �! I Jl r i f r +tri �� , '• �� t.� T . t i `' 71- . ,-1 �� .s ! '1 .1 r;.h t' I �td t',.:, .t - .� it �.., ! _ .C, ..t ., t I. 1 N,} .� , a i 1 C _ t 1 t J t t •� G�^ c 1. ; ,, S� , r I -� , 4 r -' 1 �. :.1„ S, .'+ y.. i i. . , t ,t '.` i p ;._ i. . r ."'.y.. r _.� t �, _+ i ; . t ' '� -"��%�."' ,.j -:'Z i.-ri. J '}., ,.. .A: •fi-� "f I (, ;.4 , a i. -,.�4. 1 ( . _-}- Y. :. .;., .,,, ,. r1 I �� 1 .'1 -.nl -N -14 1 i- �� " y., �` ' .{ j .t;` v .�. 11 t ! t t 1 ` r, ' n: . I • i .p' ' ✓ ;. , C' �. 1 �a i �J ( 7 } r"; 1 s: w� t , I ; , r d .t q t i`41 w� r j".i Ft i.. r1 xz I ,t� r 'r This set of plans and specifications MUST 6e kept on the job at all times and it is unlawful to make any changes or alterations on same without written permission from the Department of Public Works, County of Butte. The Bldg: -Setback shall 6e 5 ft. from the side property line and 50 ft. from the centerline -of the road, permitting a maximum of a 2 ft. save overhang. MISASJrPeErMe�wrs' WRo X 4 YRhAn Gonchl BUTTE COUNTY P If d_ BUILDING DEPARTMENT — 3o APPROVED Nd Punq CSN �� sq, fLN BUTTE.COUNTY.DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville,.CAL ' PHONE:.534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name: U N t B P_ P --r .2.. Installer's name: Ta n1 ► e R C. o �4 /2 TTS 3. Is. the site currently under permit? Yes No —L (If yes,. furnish permit number ) OR Is the site an existing site? Yes =V< No (If yes, furnish two (2) plot plans.) ' 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes No •./ / (If no, clarify 5. What is the mobilehome electrical rating? -------------=--------- Sd Amps 6. What is the mobilehome site service rating? --------------------- Amps 7. What is the mobilehome site circuit breaker ratin g? ---------- --- /e Amps 8. Is there any other electric load to be served by the mobilehome site service? --------------------------------=------------------ Yes / / No (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome.site gas pipe size?. ---=------------------ •�`'fl (in.) 10. What is the type of gas service? -------------- ---------------- Natural / LPG .kl. What is the gas pipe length from meter or tank to the mobilehome? (ft.) X12. What,is the mobilehome gas demand? --------------=--------------- (BTU) (This information not required if pipe length less than 6 ft.' on natural gas or less than ,50 ft. on LPG.) .. 10 - MOBILEHOME SUPPORT DATA Mobil ehome Mfr. fN A R o N A Setup Model No. Year Width 20 (ft.) Length 6B '(ft.) Expando Size ft.x ft. (Draw support details. below) _ On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets .(if not on file with the County of Butte). I odlew eoa(s 0 Sin le --�; Footings- (check.one) /iV1i.1..-Wood :either. . A pressure treated or :Center Center Support - fdn:'grade.:; .Support Footing Sizes Locations (in.) 2:.Concrete pad. 3.Other,-:specify It•) kim.) �In. Supports,.(check one) 1 Concrete block 2. Concrete piers - t 3. Steel piers -�► _ _ — _ / / , 4. Other, specify , I Typical Support Footing. Size .(in.) (in.)n. Pier ~ � Spacing .. .. . .. L in. r 4 : Max • )Overh(in.) (in.) /�X6. ang ln. *If center.piers are.other than drawn above, draw in locations; spacing -Land dimensions. 9. Electrical A. Is service large enough to.provide.adequate amperage to mobilehome (mdVe equal rating of mobilehome with a minimum of 100 amp) and other facilities, on lot, i.e., water pumps, ` garage, cabana, etc.? Yes No B.' Is there proper clearances around panels?- Yes No C. Is power supply cord'or feeder assembly properly.fused? Ye- No D. Is',continuity test..satisfactory,as.,per the following procedure? Yes --No 1. De -energize electrical wiring system of the mobilehome at the pedestal. 2.- 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 raobilehome supply conductor, including.neuLrai,. 5. 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. 6.. 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 between `the grounding electrode and.the chassis of the mobilehome.' Upon satisfactory completion of theelectrical tests, the lot or site service equipment may be approved for energizing. .10. Is job card signed by Health Department for water and sanitation? 11. If everything okay, sign off card and tag se' ices. MOBILEHOME DATA Manufacturer and/or' Namestyle Length ,S7Z - width Vehicle Serial No. 402-0 tt,- Lfp State Identification -No. /Gq7 15�Z ' 1 q .97- Additional. Information or Comments: �f i MOBILEHOME INSTALLATION INSPECTION_CHECK LIST 1. Is the'm6611enome located, wit 'required separation from lot lines and buildings and generally conform,.to plot plan? YesNo. 2. Does the mobilehome have required clearances above ground? (Sec.5085) Yes x. 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"- No 4. Is the rnobileh'ome ,level?. (Sec. 5088) Yes No 5. If more than a single.unit, are crossover connections properly installed? (Sec. 5088) Yes No 6. Water 'A. Is.f Pxible connector of adequate size and properly"installed (1/2" ID min.)?.(Sec. 5566) Yes No Test - Does water piping withstand working pressure or 50 lbs: air test? Yes No C. Backflow - If IoW' not State of.California approved, does station.have.backflow device and pressure -rel' alve? Yes No 7. Wastes and Drains A." Is connection made with Schedule 40`DWV and have flex connectors at each end? Yes X No B. Does it have minimum" per foot slope and is it properly supported? Yes '� No C. Are any.j eaks detected in drainage system after..runnin-gallons of water through each fixture including-washing,machine standpipe? Yes No D. If coach is not Se of California approved, does station have required trap and vent? Yes No 8 Gas Piping and.Gas Vents Connector.- Is mobilehome connected to,the gas supply with an approved,3/4" minimum mobilehome connector not more than 6 ft, long? Note: All piping is to be at least as large_as the mobilehome gas line inlet without reductions other than the mobilehome .connector. Yes No - Test OK aser followin p g procedure. Yes ` No . 1. Open all appliance-connector,valves. 2.' Shut off appliance burner and pilot valves. 3. Air test with manometer to 10"-14" water column, or ;test with slope gauge (minimum 6oz.-maximum 8 oz.) calibrated in 'tenth poun& increments.. Test 'for 10 min, without drop. 4. Connect.gas meter .to mobilehome with connector, turn on gas, test connections with _ soapy water.''` C. Are all appliancevents properly installed? Yes No o 0 .; ml K iazri.. �. +E yYf •Sn: :r`•.v i "[r. X1 COUNTY 'OF BUTTE,-.DEPARTMENT0F_ PUBLIC WORKS 7. County Center Drive '— . Oroville, California 95965 - L Telephone: 534-4541'. s =APPLICA_ 1 N AND PERMIT •:dutnorlce repre ientdtives oi-tne L.ounty of tsutte io enter upon the :,above-mentioned property for.inspection purposes. X - Date /0 7` Signature of Permitee or'Agent Recei White-D.P W Yellow -Assessor, -,-Pink-Inspector — Goldeneod-Applicant Thispermi'tis hereby-issued-underthe-applicable provisions of the,Batte''.County Code and/or resolutions to do work indicated•' above.fCr which fees have been paid. ' DIRECTOR- T PUBLIC.'WORKS-' .By Date 2 %� . . uitding permit expires Date BUILDING ..:_ Owner' �' x SO FT.:'.,O,CC: BUILDING VALUATION Mailing Address ` - _ C rap T•elephone;No .: •Fireplace. • Contractor' _ Total Valuation - 4 - Mailing Address s _ ' " Permit Fee: r 'PfanCheckingFee&/or_Penalty " - TelephonenNo Permit Fee .' `, $ Building Address •k 88 - :PLUMBING.- .. No. @ FEE PERMIT FILFNG 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 A: P No — _'- - / Zoning X. Pl:ann,ng- Gas pip rng'system 1--5 outlets'" 1.50; ' Each additional outlet 30 F Sale4ieri Fire Dept Fire Zone =Use,Permrt - Building'sewer 5:00 - EQA Parking: : -Plans Percel Declaratlom Parcel Map 60' R/Wr Improvements Lawn'sprinkler system 2.00 - _ - Y-' Plans Recd Rarce ,Approval • ' -, P_la s Approval - Permst Fee $ $ NEW ❑ ADDI'TLON ❑: UTILITI.ES ❑ •OTHER'--'. - -600V < ELECTRICAL•- No. @ FEE' - PERMIT FILING FEE -$3:00 -_ OR LESS Main SerVICe _ 100 'AMP'0R LE55 S.00 - - i Main service EA.'ADO'L-100 AMP- -2.50 Main service OVER 600V 100'AMP OR•LESS 25.00 _ - Single Family ❑ Duplex.❑� Mobil Home Others ❑ Main service" -EA, ADD'.L-loo AMP •1.00 - - - NEW CONST.,/DWELLING OCCUP. �&) 22sy ft ADDN5. % ACC. BLOGS• - - -' , - - CONST NEW O CNST-R'/MULTI-OUTL T -.-) 2.50ea_ BRANCH CIRCUITS) _ - - _ - x,'r_ - - - 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 - State50 of Californ i'a_Business. & Professions Code under.the name -style-of.:. _ Ex. Occup(OUTL-ETS OR FIXTURES) SAL. 104 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 $ $ r WORKMEN'S COMPENSATION INSURANCE_ -•_: I am aware of."the-provisions'of.Section 3700 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.Compensatiori.lnsurance. f I:.certrfy that in'fhe performance of, the. work.-for'which: this° permit is. issued I'sh'all not employ any •person in any manner so; as to become subject -to the Workmen's. Compensation Laws of California.- , -, @' MECHANICAL. No. FEE PERMIT FILING FEE _': $3.00: Heating Cooling , Ventilation Hood. 2:00 . Permit -fee $ $ I certify that"l•lave read 'this •:application and.'state.-that the above information_ -is correct: 1'60ree to comply to all County -Ordinances` ....and State. Laws relating to• building construction; and 'hereby ®.p0 TOTAL -PERMIT .FEE $ �d O •:dutnorlce repre ientdtives oi-tne L.ounty of tsutte io enter upon the :,above-mentioned property for.inspection purposes. X - Date /0 7` Signature of Permitee or'Agent Recei White-D.P W Yellow -Assessor, -,-Pink-Inspector — Goldeneod-Applicant Thispermi'tis hereby-issued-underthe-applicable provisions of the,Batte''.County Code and/or resolutions to do work indicated•' above.fCr which fees have been paid. ' DIRECTOR- T PUBLIC.'WORKS-' .By Date 2 %� . . uitding permit expires Date d ` �'L�^ •,,>•� -J�'_ �' y' �. "if ��4T6�1�,�,�,_._,y'tg.P"� �Y'y�` �� ,{� ,t .. '!i Tti a„r : �+ .' �r r` r r t l r • ,-. a - lit i• ' �r _-2:..•-.�I v $ 1- T .. t L. g` _ ~ _ � rJ t :It .J 1,� Y f• 1�,-°y � ,'. �' 3y .t t - - (- `.1. 1' � 4. Li:,}. F31. ._f �. :.i(-{ 1 yG ��. �' � 1'... G1{�;• •7 c RSC• _� t �� - -� 1 1�1:3r } , r �.a-�,h....._.• ,int FJ r'�.t9 f h _. k t A- i y r - ,r � �, =''? 1+ ?.:�✓' s �.;£ 1',.<'�.,Er�,,, «ah r �.3 7,f ��.. - '' � r - - ,, y -� _t•::.-i L ]- _,sem. .i ._ 2 f_: .""'RJ }'. � -I�rt k �;f t"µ.�17� - � . i•a �.� .l - .. - - C ft f' t�- � FF SY{ It 1 � -t •r -3a.- t V✓ ii �,s �' 1.- - _ �-J - � � - - _- ..- -. • �,r� <�r' ��-.... +. .. -.�- t t ,t c„ f 'a .•)cry ai ,t'� r•.E . � - t,_ _ t _'J,� G�, _ � i r _{ �h� a f� {F�{ r7 �«F rt �'' •E. ,••.. _'-_ t .. _' v..--..�- •"_ - .'- m-.. �.-•^,t d Jr •r 1fi.t,�!.f -iti''T 7 {•>> r�: i�,'i..3� -.,�. .fib - 1, `� _ �I.1 } 1 �i. 1c �'.,{�• 7r, i �• L �C. y.V-tt •� L � t' ..Y,-� ... ' ...0 •b1 .� ,� - { > >,.`,fra`r I,5- i r. >� tid�tt1�1• h t �3:L3� fl J '- .1-j«'t ^.' Y^'• .r . it �I 4t_, Y.li �1 •Ft ill �.t1Y .�.. rj�-'7j»t1 tF 1.3 1_ ti '. - r I. ' '..'�. t'r( U"'. {.. ;,y,, 77t' 3f t•-'3G Jr'L' � ..:Yv� a. •.i�•" r .�(:'3... ...... _ ,- _ ��,:- iT +< 't,, 1 '` r _ :• F" !�7•} L s ri �},, ; r 'r � 1+� }:.,41 lL t i •`' , 1 � : �, � � > I ,J r 1, F1 �+ -�h ' :Jlf� -;� L to :r rl..,x ,: , -:4 1 r-• 1�� lP 1 t;t _s .. _ r t{'r q'. $?;�. .J � -) �. sl. .•i. Sv. {'r + QlAWY -: .. 7 ✓. �. a;' .t , -'1 Y,i.', c•ty/'• �- v ��.t1" ,F'- �- 4 r7r4 M '.' i ,.. THERMALITO IRRIGATION DISTRICT 410 GAZAND lAVE NUE OROVILLE, CALIFORNIA 95965 TELEPHONE 533-0740 -•' CSA 26 SEWER SERVICE APPLICATION AND CONNECTION PERMIT Service Address: MAE tAtn Lane Owner's Name: W1111ma R. Price Date: 6.22-83 Address: 7 fn T.Ata trona U cJ Acct. No: 51264 A.P. No.: 30430-14 Phone: 533-5736 No. Units: 1 Applicant/Agent: N/A Agents ProofA/A Address: Fees: Phone: Application $ 20•' Arrearage Preliminary Review By: D. FArl Date: 6.22"83 CSA 26 550.. )0 Remarks:600 � o SC -0 R 1st mo. S.C. Other . Tap 60. )0 Total Fees 1530.0 ) Collected By: ` Date: 6-22-81 �. �y Field Review By: t-` Date: - - Remarks: ..r . fir7 .,J/)�'4g-a I jo �� Pio P. _ .. - r _ ,- A - r- A r iU , MONTHLY SERVICE CHARGES W"I'LL COMMENCE_.AUTOMATICAL-LY 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 co,instruction"- , prior to Mar. ;5, 1`97,4). 180 days after date above, or on clate,of D.P.IN. 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