HomeMy WebLinkAbout031-281-072LI
31-281-72
Ted inge
eathe Ave v"ille `
r: Ye �Bi r?OOroville
9-80B,PJ"' single
31-281-72
David Harrod
880 Feather Ave., Oroville
FeiuiiL # 337-8lb,Y,F;M new4single
familyry
31=281--7f2
Permit�:Q6-82B(wood burning stove/SF)
0
It
kO
tPERMIT NO. 337-81B,P,E,M
l PERMIT EXPIRES 2
1
OWNER Dave Harrod
.a
CONTR. owner
ASSESSOR PARCEL 31-281-71�,
LOCATION 880 Feather Ave., Oroville
I
i Temp. Power Pole
' Called PG&E --
emp. lec. Service g�I
Called PG&E
Temp. Gas Service
Ca/LED(Datel-A
i
JOB FI
Signatur
i
r
J = OK
0 = Not OK
— = Not Applicable MOBILEHOMES
* = Not Ready
' MISCELL'ANEO'US
Date
MOBILEHOME UTILITIES (Plans) OK except k's
1. Zoning Requirements—Setbacks—Easements
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's
1. Zoning Requirements—Setbacks—Easements
b
2. Soils; Special MH Support—Sketch
_
2. Footings; Size—Depth—Spacing—Connectors
3. Sewer; Location—Test—Fall-C/0—Concrete
3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails
4. Water; Location—Test—Easement Needed (Sketch)
4, Wood Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.—Rfg.—Bracing
5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete
5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures
6. Gas; Location—Test—Wrap:/ /"L"ft./ /"Nat.or/ /"L"ft./ /"LPG
6. Carports; Windows—Doors
7. Utility Clearance
7. Elec.
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date
Date Card -BI Date
MOBILEHOME INSTALLATION (Plans) OK except b's
1. Zoning Requirements—Setbacks—Easements
Card -BI
Date
Date Card -BI Date
POOLS (Plans) OK except #'s
1• Setbacks—Easements
2. Footings; Size—Spacing—Marriage Line rZ7-i
2. Soils; Compaction—Structure Stability
3. Gas; MH Test—Demand—Valve—Connector '
3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining
4. Electricity; MH Test—Crossovers—Breakers—Clearances'
4. Elec.; Receptacles and Lighting; Distances—GFI
5. Drain; MH Test—Fall—Flex Connector
5. Elec.; Pool Lighting; 15 volts—GFI
6. Water; MH Test—Regulator—Connector
6. Elec.; Enclosures; Conduit Entries—Terminals—Listed
7. Water and Sewer Connected—C/0 to Grade—HD Approval
7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater
8. Gas and Electricity Tagged
B. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg.
Boxes—Enclosures—Panel boards—Ins. to Main in Conduit
9. Exits; Insp.—Sketch
10, Cert.,of Occupancy
9. Health Department Approval
10. Plumb; Cir. Test—Water Supply Test
Card -BI
Date Card -BI Date
Card B-1 Date Card -BI Date a
Card B -I
Date Card -BI Date —
Card -BI
Date Card -BI Date
'
b
ry • k
J = OK
0 = Not OK
- = Not Applicable -
* = Not Ready RESIDENTIAL jSingle and Duplex)
'
Date UNDERFLOOR Plans OK except #'s
Date FRAMING (Continued)
oni requirements -Setbacks -Easements
48:"
Property Line Firewall & Openings
Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth
-49—ext.
Doors -One 3' -Check Garage -3rd story, 2 exits
3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth
br
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
4. Ft hes & Decks; Soils -Steel- / /" Ftg. Depth
/X
_Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
411'-Stemwalls, Main; Steel-Blockouts-Wrapped-Slab
Siding-Nailing-Veneer
—6-6temwalls, Garage; Steel-Blockouts-Wrapped-Slab
-5S^
Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access
- —Bier Fireplace Ft,. -Steel
-54
Glazing Area -Glass Protection -Skylights -Plastic
W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test
46 Shear Walls; Nai ing-Bolts
-17-'Gas Pipe; Size -Anchors
10. Water Pipe; Test -Anchors -Regulator -Service Test
�L
11. Electric; Underground
12. Plenums & Ducts; Clearance -Material -Support -Ins.
qP713. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
Card -BI
Date Card BI Date
Card -BI
Date I Card -BI Date
Card -BI
Date Card -BI Date
Card -BI Date -1 (- Card -BI Date
Date FIN
OK except N's
Card -BI Date r Card -BI Date
Date PLUMWNG (Permit) OK except q's
t. Steps -Door & Sidelight Protection -Landings
Smoke Detector
QjZ W Ht.; Vent -Access -Combustion Air
; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
1 ater Pipe; Test & Anchors -Nail Protection
1 W.V.; Test-Fttngs & Anchors -Nail Protection
edroom Exiting
47,--&ftwer Pan; Test, First Floor -Tub Access
G.F.I. &Bath Fixtures & Tub Access
est Tub & Shower, 2nd Floor -Tub Access
61.
.
Elec. Trim & Subpanel; Breaker Sizes -Labels
St ' s & Rails
9. Gas Pipe; Size & Anchors
ire ce or Stove; Clearances -Hearth
ec. Outlets at Wood Panel; Int. &Ext.
Card -BI Date Card -BI Dateit.
Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI Date Card -BI Date
Elec. Outlets & Receptacles at Kit. Counter
Date ELECTRICAL Permit OK except q's
Fire Door; Swing -Landing -Closer
uct in Garage -Damper
ix ure & Transformer Clearance -Ins. Protectionr.
Htr.; Vents -Clearance -Comb. Air -Connector
In Garage; Above Floor-Mech. Protection
lec. Receptacles Spacing -Lights itche t Doors
_Ib.,
Elec. & Mech. Equip. Listed for Location
2 Size Boxes & No. of Conductors St
eceptacles in Garage; (G.F.I.)-Romex Protec.
Ue:RoOx Installed Close to Edge of Studs & C.J.
quip. Ground made up w/Mech. Fasteners -Bond Gas & Water
72•
Appliance Circuits in Kitchen & Conductor Size
ubfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or
Guard Rails &Deck Construction -Post Caps
7T.
Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance
Looked under Floor Blies
27. Range Circ. / / ga.Q AI -Oven Circ. / / ga. Cu or Al,
Insulated Neutral es E) No
75.
Following instld.: Drive es L] No; Walks YYes ❑ No;
Planters Iles E) No
ervice-Riser Conductors & Gr -Main connect
�'
E
76.
S ucco; Brown -Finish
29. Equip. Clearances; Panels-Motors-Mech. Equip.
.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
-30-Clothes.Closet Light -Shower Light
'4g -'Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
UT Well; Disconnect, Electrical, Plumbing
Exterior Elec. Trim; G.F.I. Receptacle -Underground
Card B -I Date / Card -BI Date
W.
Ventilation throughout House
Card B-1 Date Card -BI Date
Glass Protection
Date MECH AL (Perrr.it) OK except N's
We'Correct
from Previous Inspections
84.
Gas Test -Meters Tagged; Gas -EI i
C. Ducts; Insulation & Support
85.
W r r Connected -C/0 to Grade -HD Approval v'
Vent Fan; Exhaust above Insulation
gmrnergy
Compliance Certificate -Other Certificates
33. Condensate Drain & Overflow; Size & Grade
34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet
-85. attic Access & Platform if Furnace in Attic
Card -BI
Date/—//::2Z Card -BI Date
Card -BI Date / Card -BI Date
C -BI
Date rd -BI Date
Card -BI J5 Date Q Card -BI Date
Card -BI
Date Card -BI Date
Date FRA G(Plans) OK except q's
mal:
3W . S' Is; Proper Material & Anchors
W IIs; Studs -Nailing, Spacing & Bracing -Plates -Sound
_
—Ao-ppring Walls over Girders & Floor Nailing
3 aft Stop in Walls (rat proof)
-
Fire Stops; Furred Ceilin s -Stairs -Chases -Tub
. -
der & Beam -Size & Bearing
- -
gers_Post Caps -Anchors -Connectors - -
Cing. Joist-Rftr. Ties -Purl in - Roof Brac.-Truss-Shthng.-R fnq
fireplace Ties or Type A Flue -Fireplace Throat
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
drm. Windows or Exiting DoorsSill Ht. &Ctimeosinnc
Garage Fire Protection Framing
(NOTE: Anentrymust be made each time youvisit jobsite)
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
19;j Memorial Way, Chico — Phone: 891-2751
7 County Center. Drive, Orovi Ile — Phone: 534-4541
'kyway antd Ellliioottt Road, Paradise — Phone: 872-2961, Ext. 57
000°3MNQ40QH H(gV0Q
° BUILDING OR PROPERTY ADDRESS
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 ag explanation, please contact this office immediately.
/
Inspector
crp
m
RES IDENT IAL
ENERGY CONSERVATION STANDARDS
CONSTRUCTION COMPLIANCE CERTIFICATE
THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN
INSTALLED IN CONFORMANCE—� WITH� CURRENT ENERGY CONSERVATION REGULATIONS
AT K0
(location) /
BUILDING PERMIT NO. j )7 �! AP' N0. 3
THE FOLLOWING HAVE BEEN INSTALLED AS PER—APPROVED—.PLANS:
(Check each item or write N/A if not applicable)
INSULATION:
Slab Edge N A
Fdn. Walls /V
Floors /✓tm
Walls' Pi- l\ 77
Ceiling/Roof 12-2-2-
Ducts
1-22Ducts iv 0
Circulating Pipes k—ff
APPROVED HEATER
APPROVED WTR.HTR.
GLAZING:
Single Glazed A14
Special (Insulated)_ f).&AeLt
CERT. & LABELED WDS.
& SLIDING DRS.
WEATHERSTRIPPED DRS. A -e •
BACK DAMPERED FANS p✓,
INTERMITTENT IGNITION DEVICES i
CERT. APPLIANCES A/ p..
I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED
IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO
THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED.
Insulation Applicator Name 'D -D,
Signature of (please print)
Insulation Applicator
State Contractors
License No. q60. 37D
General Contractor/Owner Name
Signature of (please print)
General Contractor/Owner ` Date
State Contractors
License No. Y 6D ^ 3 2 y
THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO
REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION
WITHIN THE DWELLING.
COUNTY OF BUTTE - QEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive-_0roville, California 95965 -'Telephone 916/534-4541 7 —
APPLICATION AND PERMIT �C
ASSESSOR PARCEL NUMBER
.- /—
z0
/
WILDING PERMIT
O W N En
TELEPHONE
SO. FT. OCC.1 BUILDING VALUATION
OWNER'S MAILING ADDR
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace 6 C)o
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
Filing Fee
$ 10.00
LENDER'S MAILING LIDDRESS
Permit Fee
$ 4!
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
,$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDING ADDRESS
g� Q
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Repair drainage or vent piping
5.00
Water piping
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Each qas water heater or vent
5,00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
SF Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer
Lawn sprinkler system
5.00
TYPE OF WORK
New ❑ Addition ❑ Remo el ❑ Utilities ❑ InsVI lation ❑ her
Describe work: U 1-11 I r
-0—.te�,t/.�
t .� i
��
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
00V OR LESS
Main service 600 AMP OR LESS
1
5.00
Main service EA. ADD'L 100 AMP
2,50
NEW CONST. (DWELLING OCCUP.ej�
OR ADDNS. ACC. BLDGS.
2P sq ft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (Check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business90
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
NEW CONSTR -OUTLET 2.50 ea
NON-RESID BRANCH CIRC TS
NEW CONSTR POWER APPARATUS 6
NON-RESID. SINGLE OUTLET CIR.
@ 25¢
Ex. Occup(OUTLETS OR FIXTURES 100
IXED APPLNS. OR
EX. OCCup.(OUTLETS (RESID.) A. 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring / 7.50
Permit Fee $
Contractor
MECHANICAL PERMIT
FiIirig Fee 10.00
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.
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 shall be deemed revoked.
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.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said Co my in consequence of the granting of this permit.
•y
X Date —
Signature of Applicant — Owner Contractor ❑ Agent ❑
An OSHA permit is required for excavati s over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
AV
TOTAL PERMIT FEE.AF$ ___—
occuP. GROUP
I TYPE OF CONST.
I PARCEL
PD
I ND
I ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated ove for which
IREC PUBLIC
By.
PERMIT EXPIRES Date
the applicable pro\.i-
resolutions to do
fees have been paid.
WORKS
Date nL— I —
Receipt No. Qj
WHITE-D.P.W., Y SS --INSPECTOR, GOLDENROD -APPLICANT
r
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT O.
• 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 ' 3
APPLICATION AND PERMIT
ASS ESSC\R/ ARCEL 7S/-7MBER�
\•J(
ZONI4r,
BUIL ING PER I
OInE�
�'NVE p����
TELEPHONE
S33-7V�
SQ.FT. OCC. BUILDING VALUATION
2-P
7'K/✓,co
OWNER'S MAILING ADDRESS
3_5W o2 49,>ao
P
3 Go . o0
CONTRACTOR'S NAME
A /C
TELEPHONE
/LQ
L (�/V
cooOD
CONTRACTOR'S MAILING
G ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
3'��Q� O C '
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ -po
A CHITECT O EN INFER na-�
SSOG�i�i c JS
LICENSE NO.
Plan Checking Fee
$ (�S, po
Penalty
$
ARCHITECT OR ENGINEER'S_MAILING ADPRESS
QQI/�L(
Permit fee
$
BUILD NG ADD ESS
g�� /_LS
PLUMBING PERMIT
Filing Fee 10:00
Each Trap
gi 2.00 &.vo
Repair drainage or vent piping
5.00
DpwIt-&G
Water piping
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
,--/ USE OF STRUCTURE
SF I Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer
_a0
Lawn sprinkler system
5.00
S _,
hcay—
t
TYPE OF WORK
,�,�
New 9" Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe work:
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
00V OR
Main service 100 AMP .ORSLESS
5.00 J •0Co
Main Service EA. ADD"L 100 AMP
2.50 215-0
NEW CONST. DWELLING O�Kl05S:N)
OR ADONS. ACC, LDG ���SS VV
B
20 sq ft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ 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.
PLicense 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)
❑ 1 am exempt under Sec. , Business and Professions Code
for this reason
NON -RESIT R. BRA cH CTRCT Ts 2.50 ea
NEW CONSTR. / POWER APPARATUS I&
NON-RESID. (SINGLE OUTLET CIR,
EX. OCCUp OUTLETS OR FIXTURES gA�•2
IXED APPLNS. OR
EX. Occup. �p UTLETS (RESID,) EA. 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring
7.50
ALT
Permit Fee $ ,
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.
I shall not employ any person in any manner so as to beccme 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 Fj00
CO
4C -4T (/ P
Cooling QRZ%
-OrJ
Hood
3.00 �,Cv
Ventilation
Permit Fee
$ �3 ��p
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.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit. (/
X Date f "� D
-�-�---1-
Signature of Applicant - Owner Contractor Agent r!work
An OSHA permit is required for excavation over 5'0" dee and demolition or construct-
ion of structures over 3 stories in height. 1-7 al
Mobile Home Installation Fee $
TOTAL PERMIT FEE
occ . iouP
TYPE OF CONST.
PA cEL
P MD rssuE
1
This permit is hereby issued under
sions of the Butte County Code and/or
indicated above for which
DIRECT F PUBLIC
ByDate
PE EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Receipt No. = %O1 IT
WHITE-D.P.W.. YELLOW -ASSESSOR, PINK - INS ECTOR, Dja PPL. CANT
THERMALITO IRRIGATION DISTRICT
ri. 410 VRAND AVENUE
OROVILLE, CALIFORNIA 95965
TELEPHONE 533-0740
157
CSA 26 SEWER SERVICE APPLICATION AND CONNECTION PERMIT
Service Address: i1 X 6 Feather Ave.
Owner's Name: Ye Olde Barn Builders Date: January 27, 1981
Address: 3571 Oro IM Bangor 1,9" Acct. No:
A.P. No.: 31-281-72
Phone: 533-7495 No. Units: 1 �-
Applicant/Agent: NSA Agents Proof:
Address:
Fees:
Phone: Application` $ 6 00
J� Arrearage
Preliminary Review Date: Date: January 27, 1981 CSA 26
Remarks: *SCOR Regional Fiiclity Chatge and CSA #26 Connection SC -OR
Charge to be clue and payable prior to connection to the sewer 1st No. S.C.
collector system. Charge to be amount in effect for connection
feetat time of.connection to the system. Other
\ 11
I
6 -1o2 -Fl_ Total Fees 6 00
,✓ t� V��d-o//� e5lq-o'2C,� g1' 0 0-01 (7"e Collected By: 107/81
Date:
Field Review By: Date: — i / - P ,
r
Remarks:
/v r -f i
MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON:
Q Date of TID approval of completed building se e early .cq irgction). '
`
El 30•days,after,date •above, or-on.date �of-D.P W.•approvaIf- p p1e;%ISeAt
building.sewer,.whi:ch..ever-comes
�
-first-(!'existing-construction' priorto•Mar.-5,.19?di��St� l;
is r
❑ -180-days-after -date-above; or-above;-of-D:P:W.. approval-of-completed•building. sewer, .which.ever_comes
first-("new•construction'" after•Marr5, 1974):—
PO MST EXPIRES Aid£.YEAR FROM DATE - U1, ISSUE
DISTRIBUTION: WHITE - TID, YELLOW - APPLICANT, PINK - DPW, GOLDENROD - DPW to TID
CLAIMANT: —
ADDRESS: _
CITY& STATE Oroville, CA. 95965 .IMPORTANT:
October 15, 1980 SEE INSTRUCTIONS .
DATE OF CLAIM: ON REVERSE SIDE
SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES
eou&*
OROVILLE, CALIFORNIA.
GENERAL CLAIM
Henry T. Runge Jr.
14 Sabine Rd.
i
DATE
DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY)
I AMOUNT'
( INVOICE INVOICE
NO. I DATE
j Owner decided not to build. (Permit Appin. #3199-80B,P,E,M -
I GROSS
I AMOUNT
--F-Retain
-- 1P__t#-3-9289—AF 31— 8T_72_
Building permit fee paid ----- $204.00
i
plan c ec ee--------
Amount of refund due -------------------$136.00
;
I
Plumbing permit fee paid ----- $ 26.00
,
Retain 1 ing tee ------------
Amount of refund due -------------------$ 23.00
I
Electrical permit fee paid --- $ 28.60
etain tiling tee ------------ ,
Amount of refund due -------------------$ 25.60
Mechanical permit fee paid --- $ 13.00
Retain filing fee ------------ 3.00
Amount of refund due -------------------$ 10.00
Total Permit Fees Refund due -----------$194.60
Land Development Fee Refund due -------- LL5.00
-----------------------
TOTAL REFUND DUE $219.60
$219!.6o
I
I
i
I
TOTAL
$2191.60
'
i
I, the undersigned, declare under penalty of perjury that the services or articles claimed have been I
gn p y p � y performed or delivered, d, and that this 1
claim is true and correct as stated.
Dated this / / de of ,,,0-- 19 '�=, at, •`1`�t—�.,, Calif.
.................................. Y ...................... ...... ........... ......... o„/.......................... ........
Signature of Cla..imant
I, the undersigred, hereby certify that, to the best of my knowledge, the services or articles specified above have been pe onned or de-
livered and that there is a Budget Appropriation 0 or Specific Board Approval ❑ (Check one) for the same.
,,.,aa ,_. 15th ,.r October _80 Oroville /^_.:r
.................................... . . ............................. .............................. I ---....................................................................................
Department Head or Authorized D eputy
Dept. Exp. • j
Code Code .................. PAYABLE FROM ........................ ........... FUND
1 DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY
VENDOR ! DEPT. I
CODE & SUB. j PROD.
SUB.
OBJ.
( CLAIM
NO.
( INVOICE INVOICE
NO. I DATE
!
i DISC.
I GROSS
I AMOUNT
ENCUMB.
I I
SUB -DIST.
i
i
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT O.
VJ 7 County Center Drive - Orovilie, California 95965 - Telephone 916/534-4541 i O.
APPLICATION AND PERMIT &J, a
ASSE�Oj2 PAR E NUMBER
J�7/ �.,..
ZO ING
BU16MNG PERMIT
owN R
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNER' INA ILING ADDRr
I
J
TRACTO 'S N
TELEPHONE
.�
CONTRACTOR'S M_ILIITG ADDRESS
STR TIO LENDER
UNKNOWN
Fireplace
Total Valuation $
+�
L NDER•S MAILING ADDRESS
tipJt I 'a
Permit Fee
$
ARCHITECT OR ENGINEER
1p re-
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDING A .D �OEss
PLUMBING PERMIT
Filing Fee 3.00
Each Trap
2.00 6QO
Repair drainage or vent piping
2.00
Water piping
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Each qas water heater or vent
2.00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
SF Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer
10b
Lawn sprinkler system
2.00
"Z710_,C_
,-� TYPE OF WORK
New R Addition ❑ Remodel ❑ Utilities ❑ InstallationC Other ❑
Describe work:
Permit Fee
$ p
Contractor
ELECTRICAL PERMIT
Filing Fee 3.00
Main service 100 AMP OR00V OR LESS5.00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. DWELLING
OR ADDNS. ACC. BLD n)
20sgft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ 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
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
NON -RESIT R BRANCH CIRCTITS 2.50 ea
NEW CONSTR. ( POWER APPARATUS &�
NON.RESID. SINGLE OUTLET CIR.
Ex. Occu 50 @ 25C
OR FIXTURES BAL�10C
P�ouXED
A
FIXED APP LNS. OR
EX. QCCup.�OUTLETS (RESID.) EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 6.25
Permit Fee $
Contractor
WORKMEN'S COMPENSATION INSURANCE
1 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.
IVI 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.
MECHANICAL PERMIT
Filing Fee 3.00
Heating T
44, On
Cooling
Hood
2.00
Ventilation
Permit Fee
$ 7
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.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in con ence of th granting of this permit.
X Date _ ,`� -?_,&o
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 $
Land Development Fee $ ^
TOTAL PERMIT FEE
OCCUP, GROUP
—3
I TYPE OF ONST.
V'
PARC L
ND
I ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF PUBLIC
By
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Receipt No. � 2.-2=d- 9
WNITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
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