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HomeMy WebLinkAbout031-290-029A . P . 31-29-29 Robert Razee y 664 Plumas Ave., Oroville ;KING,, John,..Enterprises 939:_ COigTR: S John ,Voorhees Orov' ]�l e . _-_ _P_ermit_340_71B (extend ki )' 31-29-29 !652 & 664 Plumas Avenue, Thermalito Permit #1831-76P(building sewer install ` ation/SFL% 1� (2 homes) j —�-6� j 31.-29-29 j s �• Permit#3240-86B(new garage)"//� ;31_ - •f rt RAZEE Rob.92-1748B 664 Pluinas Ave t (reroof/SF) nue Orovillef. • l li 1 q t . li �CWDC**4 - - cm i 61 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovllle, Callfornle 95965 - Telephone: 916.'538.7541 APPLICATION,AND PERMIT FA PERMIT NO. 9� �r ASSESSOR PARCEL NUMBER 31129-29 ZONING AR BUILDING PERMIT OWNER ROBERT RAZEE TELEPHONE SO. FT. OCC. BUILDING VALUATION �/� 16 SQ .OU OWNER'S MAILING ADDRESS 664 PUMAS AVE OROVIUZ CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation 1 $ 960.00 LENDER'S MAILING ADDRESS Filing Fee $ 15.00 Permit Fee $ 22.50 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 664 PLUMAS AVE OROVIUY, Permit fee $ 37. PLUMBING PERMIT Filing Fee 15.00 Each Trap 1 5.00 Solar or heat pump water heater 1 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 1 7.00 Each qas water heater or vent 1 7.00 USE OF STRUCTURE SF k] Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home I S I G JW @ 15.00 TYPE OF WORK New❑ Addition; Remodel _' Utilities ❑ Installation❑ Other ❑ Describe work: RE TH QW Permit Fee $ Contractor 1 ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 18.50 200A OR LESS Main service 20GATO 1000A/ 37.50 CONTRACTORS LICENSE LAW I declare under penalty 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. ,--f License No. Classification L%I 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 CONST. DWELLING OCCUP.h 3.64 sq.ft. OR ADDNS. (ACC. BLDGS. NEW CONSTR ULTI.OUTLET NO N•R ESI D- BRANCH CIRC ITS @ 5•00 POWER APPARATUS e (SINGLE OUTLET CIR. Ex. OCCUp(OUTLETS OR FIXTURES 20 760 EX. OCCUp. OUTLETS FIXED P(RESID )REA.) I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ — 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. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating Cooling g Hood 6.50 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 County in c1on equence of the granting of this permit. X rr� /r -, Date '—.2 `" signature of Applicant — Owne Contractor El 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 S Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 37.50 HAz 1 11 FEES I IMP I FLOOD CDF PARCEL PD I HD 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 PUB IC WORKS .- 77 f By / I .. Date �Z!_. PERMIT EXPIR S /bate — — Receipt No. 116136 WHITE-D.P.W.. YELLOW-ASSCSSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville. California 95965 - Telephone: 916.'536-7541 APPLICATION AND PERMIT PERMIT NO. Q,Q -7 ASSESSOR PARCEL NUMBER 31=29-29 ZONING AR BUILDING PERMIT OWNER ROBERT RAZES TELEPHONE SQ. FT. OCC. BUILDING VALUATION 16 SQ COMF 960.00 OWNER'S MAILING ADDRESS 664 PLUMAS AVE OROVILLE CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation I $ 960.00 LENDER'S MAILING ADDRESS Filing Fee $ 155,00 Permit Fee $ 22.50 ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 664 PLUMAS AVE OROVILLE Permit fee $ 37.50 PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME 771 PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF �p Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S G W @ 15.00 TYPE OF WORK New L Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: RRROOF WITH COMP Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A OR LESS 18.50 Main service 20cATO 1000A) 37.50 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 .Jo. Classification ,lVlEX. LLAAJJ 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 CONST. DWELLING OCCUP.B\ OR ACDNS. ACC. BLDGS. // 3.60 sq.ft. NEW CONSTRESIC, RANCH CIRCUITS) NON -RESIDE BRANCH CIRC ITS @ 5.00 /POWER APPARATUS D (SINGLE OUTLET CIR. EX. Occu o Occup(OUTLETS OR FIXTURES 20 76 qAL_ CCD 46 FIXED APPLNS. Occup. OUTLETS ((RESID ) EA.) R I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring g '15.00 Permit Fee $ — 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. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating Cooling g Hood 6.50 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 se=ouy n ence of the granting of this permit. X l—,� `'— �% Date Signature of Applicant — Own 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. g Mobile Home Installation Fee S Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 37.50 HAZ DFEES I IMP FLODD CDF PARCEL I PD HD ISSUE This permit is hereby issued under the applicable provi- � cions of the Butte County Code and/or resolutions to do work indicated a ve for which fees have been paid. T�(,I'.R •TOR PUBLIC WORKS By V Date PER IT PIRES Date — — Receipt No. WNITE-O.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT o COUNTY OF BUTTE.- DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovllle, California 95965 - Telephone. 916 '536-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMB (' 20NIN 2 BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC.. BUILDING VALUATION A OWNE ' I I G ORES CONT ACTOR'S M TELEPHONE CONT C R'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 15.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS V/YI Permit fee $ 7. 50 PLUMBING PERMIT Filing Fee 15.00 Each Trap I 5.00 Solar or heat pump water heater 1 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each oas water heater or vent 7.00 USE OF STRUCTURE Sr'-�- DuplexlJ Mobilehome[ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 1 15.00 Mobile Home SG W @ 15.00 TYPE OF WORK New _ Addillopa,_ R del L= Utilities _i /Installation[ Other ' Describe work: J 6� f� Q/ t Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600VORLESS 200A OR LESS 18.50 Main service 200ATO1000Ar 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. i License No. Classification 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 fog this reason- NEW CONST. DWELLING OCCUP.&\ OR ADONS. ACC. SLOGS. I 3.66sa.ft. 11 1- CONSTR r• ULTI.OUT LET NON -RESIT BRANCH CIRC 'ITS @ 5.00 POWER APPARATUS e SINGLE OUTLET CIR. Ex. Occup( OUTLETS OR FIXTURES I20 76d FIXEI, EX. Occup. OUTLETS IRESI D IRE A.) j 3.00 Temporary service .- 1 15.00 Mobile Home Facilities w 15.00 Misc. lyirin g 15.00 Permit Fee. $ — '--WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): (—I The permit. is fo-r 5100.00 (valuation) or less. U I have placed on file with the County of Butte Building Department a Certificate of Workmeh'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. Contractor MECHANICAL PERMIT FiIingFee 15.00 Heating Cooling Hood 6.50 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 County in consequence of the granting of this permit. X Date Signeture 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 CONST TYPE SO .TOTAL- FEE s3 I IHA2 0FEEs I IMP I FLOOD I COF I PARCEL PD HD ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By EXPIRES Date applicable provi- resolutions to do have been paid. WORKS DatePERMIT Receipt No. WHITE-D.P.W.. TELLOW-ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DQpar_t_ment of Public _Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return thisinformation 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. 1. I personally plan -to provide the major labor and materials for construction of the proposed property improvement (yes or no) c 2. I (have/have not)signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors- License No. 4. I plan to provide portions o-fthis work, but. I have hired 'the following pe-rson to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I 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 Security umber Date 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. r PERMIT NO. 3240786B PERMIT EXPIRES -� OWNER ROBERT RAZEE CONTR. unknown ASSESSOR PARCEL 31-29-29 LOCATION 664 Plumas Avenue, Oroville, w Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E Temp. Gas Se Called P( JOB FINALE Signature J r OK 0 = Not OK Not Applicable MOBILEHOMES MISCELLANEOUS = Not Ready Date MOBILEHOME UTILITIES (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements _ 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; Locatior-Test-Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. i Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements Card -BI Date Date Card -BI Date POOLS (Plans) OK except k's 1. Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Liming 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 $. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes- Enc losures- Pane Iboards- 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 B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -Bl Date Card -BI Date J = OK 0 = Not OK = Not Applicable :I: Not Ready RESIDENTIAL (Single and Duplex) Date UNDERF OR Plans OK except #'s __ _oning requirements -Setbacks -Easements 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Dept 3--PT-g, Garage; Soils -Steel- / Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 5. Stemwalls, Main; Ste I-Blockouts-Wrapped-Slab p-1 emwalIs, Gar : Steel-Blockouts-Wrap - 7. Piers -Fireplace Ftg.-Steel 8. D.W.V. Fall -Fittings -Test -2 way C/O -Sewer Test 9. Gas Pipe; Size -Anchors _ _ 10. Water Pipe: Test -Anchors -Regulator -Service Test 11. EI lric: Underground 12. lenums &_Ducts; Clearance -Material -Support -Ins. (0�p .Girders -Sills -Anchor B Its gist -Vents-Cripples Card -BI Date r3�a Card -BI Date 15a 31 Q Date Card -BI Date Date PLUMBING (Permit) OK except #'s 14. Water Ht.: Vent -Access -Combustion Air 15. ater Pipe: Test & Anchors -Nail Protection 16. D. .V.: Test -Fttngs &Anchors -Nail Protection 17. Sh er Pan; Test, First Floor -Tub Access tI Test Tub & Shower, 2nd Floor -Tub Access 19. Gas ipe: Size & Anchors tntinued) Line Firewall & Openings •s -One 3' -Check Garage -3rd story, 2 exits idth-Headroom-Rise-Run-Landing-Fire Protection on Roof Overhang -Attic Vents -Rafter Outriggers 5x/Sid ing-Nai I ing-Veneer 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. A( 54. Vlazing Area -Glass Protection -Skylights -Plastic 55. Shear Walls: Nailing -Bolts �oi- n uac�/-/�pj •t Card -BI Date Card -BI Date 3 S' ; Proper Material & Anchors 3 1s: Studs -Nailing, Spacing & Bracing -Plates -Sound 38< Bearing Walls over Girders & Floor Nailing 3 top in Walls (rat proof) _ urred CeilTnStairs-Chases-Tub Header & Beam -Size &ngmostCap-As-Connectors 4 CIng. Joist_RIir. Ties-Purlin-Roof Brac.-Truss-Shthnq.-Rfng. P ies or Type A Flue -Fireplace Throat Size & Romex Protection -Draft Stop -Ins. Ba_ff_Ie_s _ n ows or Exiting Doors -Sill Hgt. & Dimensions 47 Garage Fire Protection Framing Date FItyAlans) OK ELECTRICAL Permit OK except #'s 5 Ext. Steps -Do 20. 5 e etecto 58. Furnace; Vent; Elec. Receptacles Spacing -Lights Switches at Doors 0 Card -BI Date Card -BI Date Card -BI Date :pt #'s Sidelight Protection -Landings sarance-Comb. Air-Connector- loor-Ducts-Meeh. Protection Z=8, ?Math tures & Tub Access 61. Vi1c. Trim & Subpanel; Breaker Sizes -Labels 62. Atairs & Rails II 63.1 Fireplace or Stove; Clearances -Hearth II 64. `Elec. Outlets at Wood Panel; Int. & Ext. Card -BI - ---- Date -BI_ Date Card -BI FRAM (Plans) OK except #'s _Card Date Card -BI Date 3 S' ; Proper Material & Anchors 3 1s: Studs -Nailing, Spacing & Bracing -Plates -Sound 38< Bearing Walls over Girders & Floor Nailing 3 top in Walls (rat proof) _ urred CeilTnStairs-Chases-Tub Header & Beam -Size &ngmostCap-As-Connectors 4 CIng. Joist_RIir. Ties-Purlin-Roof Brac.-Truss-Shthnq.-Rfng. P ies or Type A Flue -Fireplace Throat Size & Romex Protection -Draft Stop -Ins. Ba_ff_Ie_s _ n ows or Exiting Doors -Sill Hgt. & Dimensions 47 Garage Fire Protection Framing Date ELECTRICAL Permit OK except #'s _ 20. Fixture & Transformer Clearance -Ins. Protection_ 21. Elec. Receptacles Spacing -Lights Switches at Doors 22. _& Size B es & No. of Conductors -Stapled 23. Ramex I tailed Close to Edge of Studs & C.J. 24. Equip. Gro d made up w/Mech. Fasteners -Bond Gas & Water 25. 2 Appliance ircuits in Kitchen & Conductor Size 26. Subfeed Wire S e / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 27. Range Circ. / ga. Cu or AI -Oven Circ. / / ga. Cu or At, Insulated Neutral Yes -!No 4 28. Service -Riser Con uctors & Ground -Main Disconnect_ 29. Equip. Clearances: Panels-Motors-Mech. Equip. 30. _ Clothes Closet Ligh -Shower -L ight 65. Xit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 66. E c. Outlets & Receptacles at Kit. Counter 67. Garloe Fire Door; Swing -Landing -Closer 68. A.C. uct in Garage -Damper 69. Wtr. H .; Vents-Clearan:e-Comb. Air-Connector-P.R.V.- In Gara e; Above Floor-Mech. Protection 70. Plb., EI c. & Mech. Equip. Listed for Location 71. Elec. Re eptacles in Garage; (G.F.I.)-Ramex Protec. 72. Insulatio -Foam-Looked in Attic E] Yes 73. Guard R Is & Deck Construction -Post Caps 74. Fdn. Ve& Crawl !-tole Door -Drainage & Wood -Earth Clearance Looked nsler Floor ❑ Yes 75. Followi g instld.: Drive ❑ Yes ❑ No: Walks ❑ Yes [ Planterlil ❑Yes ❑No 76. Stucco Brown -Finish 77. A.C. nit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 78. Vent Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs 79. Wat r Well; Disconnect, Electrical, Plumbing 80. Ext rior Elec. Trim; G.F.I. Receptacle -Underground Gard B I Date Card -BI Date _ 81. Veritilation throughout House Card B -I Date Card -BI Date 82. Glass Protection 83. Corrections from Previous Inspections _ Date MECHANICAL (Permit) OK except #'s 84. Gas -est-Meters Tagged; Gas -Electric 31. Ducts. Insulation & Support _ _ _ 85. Water & Sewer Connected -C/O to Grade -HD Approval 32. Ven Fan: Exhaust above Insulation_ 86, Energy Compliance Certificate -Other Certificates 33nddpsate Drain & Overflow. Size & Grade Card -BI Card -BI Date 34. Furnac -Vent: Access -Comb. Air -Return Air Vent -115V outlet 35. Attic As & Platform if Furnace in Attic c es _ Date Card -BI Date - Date Card -BI Date - ---- oe Card -BI ate Card -BI Date Card -BI Date FRAM (Plans) OK except #'s Com lents at Final: 3 S' ; Proper Material & Anchors 3 1s: Studs -Nailing, Spacing & Bracing -Plates -Sound 38< Bearing Walls over Girders & Floor Nailing 3 top in Walls (rat proof) _ urred CeilTnStairs-Chases-Tub Header & Beam -Size &ngmostCap-As-Connectors 4 CIng. Joist_RIir. Ties-Purlin-Roof Brac.-Truss-Shthnq.-Rfng. P ies or Type A Flue -Fireplace Throat Size & Romex Protection -Draft Stop -Ins. Ba_ff_Ie_s _ n ows or Exiting Doors -Sill Hgt. & Dimensions 47 Garage Fire Protection Framing _ ^ (NOTE Anentrymust be made each time youvisit jobsite) Card -BI Card -BI Card -BI Date Date Date No; r COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT RMIT NO /f�� �?Tlw _ .�I1 ASSESSOR PARCEL NUMBER - a�-do2� --o ZONING BUILDING PER IT OWNER 'y" TELE PHON E 53�- � SQ. FT. OCC. BUILDING VALUATION OW E 'S ILIN CD E55 W(,Xe���� A OR'S NAME Q:,T TELEPHONE NTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 2 gets) ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ 7 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee ; A2 . PLUMBING PERMIT Filing Fee '10.00 (� l Trap 2.00 8/_bEach Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water ISipirig 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE ❑ ❑��,�p SF [I Duplex Mobilehome Other r SPECT (—o Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G W 10.00ea TYPE OF WORK Newk Addition❑Remodel❑ Utilities[] Installation❑ Other ❑ Describe work: �7� x afl. ��i �-�� Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 1000V OR 0 AMP ORLESS10.00 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 Buslnes$ and Professions Code and my license is in full force and effect. )cense 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 CONST. DWELLINGoCCUP.lL� , OR ADDN5. ACC. BLDGS. /z ¢sq ft TLET NEW CON5TRESIC, RANCH CIRCUITS)2,50 ea NO N.R ESID BRANCH CIRC 1T5 POWER APPARATUS &) SINGLE OUTLET CIR. Ex. OCCUp(OUTLETS OR FIXTURES 200500 BALD 30t. FIXED Ex. Occup. OUTLETS P(RESID )LNS KEA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. byirin g 15.00 Permit Fee $ 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. Contractor MECHANICAL PERMIT Filing Fee 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 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 saidthe granting of this permit. X Zgm.11eaDate Signature of Alplicant — 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 $ TOTAL PERMIT FEE $ j/j occu P. CONST.TYPE I JFLooTAPrFLJ P11 P1 ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC BY _Z� PE T EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date ll—y-- Receipt No_ t2 l ::E%F WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - Department of Public Works 7'County Center Drive, Oroville, CA 95965 Phone: 916-534-4541• OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -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. 1. I personally plan to provide the major labor and materials f construction of the proposed property improvement (yes or no) 2. I (have/have not) signed an application for a building permit for the proposed work. 3 4. I have contracted with'the following person (firm) to provide the proposed constru,,ion : �/� _ Name �i , _, of /(/� A5� 47, "I Address 4z City PhoneCo ractors License No. V7 S 7 - I 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. I will provide some of the woriz but I have contracted (hired) the following persons to provide the work indicated: , Name Address Phone Type of Work Signed: Property Owner Social Security Wumber Date 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. A r COUNTY OF' BUTTE - DEPARTMEN'T.OF. DUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, OF 95965 - TELEPHONE: 916/534-4541 PERMIT APPLICATION DATA SHEET /� / Permit No. OWNER_ /f /�G12EE' A. P. No._o�/- Proposed BuiIding Use Z��—= t_- BciIding Inspector 1),&2- Date /i% "99-, d� 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 duplicatere./triplicate, signed by pr of lans. 4. Complete engineered plans and calcs, with wet signature on pans. 5. Plans with Energy Design Compliance Statemert. . . . . . 6. CUSD "Fees Paid" Stamp on Floor Plan . . . . . . . . 7 Statement of Intent for Non -Heated and AC Builcings. 8. Fees of $ , , , , , , , 9. Letter of signature authorization. _ �10. Sanitation approval from ._ _ - • ".Ealth Dept. • 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . . tea. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ ), _15. Improvements may be required. . . . . . . . , 16. Mobi lehome Installation Data. . . . . . . . . . 17. Pre -Inspection for Pre-Inspec. request to Required. Building Inspector (Dote) 18. Recorded copy of Agricultural Acknowledgment Statement. 19. Driveway Permit. 20. Plot plan approval from city of 21. 22. When you issue the permit, process as follows: Mail to owner, Mail to contractor. �1 Telephone and hold for pickup at—off ice, Deliver w/inspector,. Copy of plans sent Health Dept., Fire Dept., Other - Date 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 dEta by_phone_-nall_coun3� r by date Contractor, designer, owner, was advised of above required data by_phone_malacoyter by date Plans checked by Copy—DPW Date Flans approved by Sets of plans on hold in File cabinet A.P folder Date — Flours: 10:00 a.m. - 3:00 p.m. PERMIT NO. 1831-76P PERMIT EXPIRES owNER Robert Razee CONTR. owner LOCATION (A.P. 31-29-29 6`64 Plumas Ave., Oeoville Temp. Power Pole Called PG&E _ Temp. Elec. Serv., Called PG&E _ Temp. Gas Serv. _ Called PG&E _ JOB FINALED(D:teL (Signature) THERMALITO IRRIGATION DISTRI(T5ffi 410 BRAND, AVENUE OROVILLE, CALIFORNIA 95965 TELEPHONE 533-0740 CSA 26 SEWER SERVICE APPLICATION AND CONNECTION PERMIT Service Address: Owner's Name: 4�: ,-A— Date:. Address: Acct. No: A.P. No.:3./ V. Phone: No. Units: / Applicant/Agent: % 4 Agents Proof: %�- Address: Fees: Phone: Application $ / Preliminary Review By: Dater Arrearage % CSA 26 Remarks: SC -OR 1st mo. S.C. Other ; Total Fees A)O Collected By: Date: _ Field Review By: Date: Remarks: MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON: 0� Date of TID approval of completed building sewer (early connection). 0 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 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Forms Parapets Main Bldg. Restroom Finish Footings Windows Stemwal I Siding Slab Roof Sheathing Piers Roofing Garage Fdn. Vents Footings Garage Vents StemwalI Slab Prov. for physically handicapped Carport Footings Conformance of ex. structure Slab Final Patio FIREPLACE Footings Footing Masonry Walls Throat Reinf. Steel Final Bond Beam FIRE SPRINKLERS Framing Test Stucco Final Mesh MECHANICAL Scratch Heating Brown Cooling Finish Ducts Interior Lath Ventilation Door Closer Final DATE REMARKS OR CORRECTIONS_ Soil Piping 1st Floor 2nd Floor 3rd Floor Topout Water Piping Sewer / Fixtures Water Htr. Heaters Appliances Gas Piping & Test Temp. Gas Sanitation Final Fixtures Motors Water Htr. Subpanels Grd. Fault Prot. Service Temp. Pole Underground Permanent Final (NOTE: An entry must be made on this form each time you visit the job site.) ELECTRICAL _ COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS " 7 County Center Drive — Uroville, California 95965 Telephone: 534-4541 APPLICATIONAND PERMIT authorize representatives of the County of Butte to enter upon the above -men i ned roperty for inspection purposes. X Date Sign ture oP.rmiitLe 0r Agen ? Receipt No. l S 7,7 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. DIRECTOR OF PUBLIC WORKS Bylf— ` Date 'Ir --1 S-- 7 e, Buffildiag permit expires Date /-1--) Y-- 77 BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mai I i ng Address Te phone No. 7 _ // 2 Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty ' Telephone No. Permit Fee $ Building Address 1 k µ R S Ave_ PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 3.oD < L4, -e . 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. 31— 2 9 — .Z Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F S&M+ta+ien Fire Dept. Fire Zone Use Permit Building sewer 5.00 SOa EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W ImprovementsLawn sprinkler system 2.00 aW-W'mn-Ree'd Parcel Approval Plans Approval Permit Fee $ 06 $ Q� NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER �� ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Al11 I-1_4 7_7 d r� Main service j00 AMP ORLESS5•d0 Main service EA. ADD•L 100 AMP 2,50 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Main service OVER 00 AMP oR LESS 25.00 Main service EA. ADD•L 100 AMP 1.00 NEW CONST. DWELINGOR ADDNS. ACCLBL GOCCUP. &) 20sgft _ NEW CONSTR. MULTI -OUTLET NON-RESID, BRANCH CIRCUITS)2.50ea 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 State of California Business & Professions Code under the name style of: Ex. Occup(OUTLETS OR FIXTURES)�� BALIai Ex. Occu P'(FIXED APPLNS. OR 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 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this rpermit is issued I shall not employ any person in any manner o 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 $ $ 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 d authorize representatives of the County of Butte to enter upon the above -men i ned roperty for inspection purposes. X Date Sign ture oP.rmiitLe 0r Agen ? Receipt No. l S 7,7 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. DIRECTOR OF PUBLIC WORKS Bylf— ` Date 'Ir --1 S-- 7 e, Buffildiag permit expires Date /-1--) Y-- 77 -� PERMIT NUMBER - B 340-71 •k 'cr P E 288-71 F •y + PERMIT EXPIRES �-�Q 3'IOWNER Robert Razee coNTR: S. John Voorhees, Oroville g LOCATION.(A.P. 31-29-29 " .. 664 Plums Ave.,.Oroville r F • is \': - ;• 7y: • Aj rQ' COUNTY OF BUTTE Department of "Public Works Zoning BUILDING IN PECTION EECORD Setback /, Forms Foundation Piers & Girders i Fireplace Rgh. Plumbing Bond Beam Lath & Plaster Rein. Steel Gas Piping & Test Found. Vents Framing Pimg. Topout Rough Elec. ' Wtr. Htr. Furnace Kitchen Vent Firewall Garage Vents Sanitation & Water ELECTRIC GAS BUILDING ' .Temporary ,! — Z.2 �1-7 Temporary � Cert. of Occup. Final Final Final DATE REMARKS OR CORRECTIONS t• COUNTY OF BUTTE :^ DEPARTMENT OF PUBLIC WORKS 7 County Center Drive--Oroville, California 95965 Phone: 533-1230, Ext. 259 APPLICATION AND BUILDING PERMIT M� Pe[mittee Owner _ '.r i, <<-:..-- Mailing Address � - a�...t ,hr-���" e.. h A. P. No. Fire Zone t Zoning g _ Cant[actef� r Mailing Address /%77 �� ,r,,- _ /i = r'�-_.-- s,, _ r t_ BLDG. Address' - 8!--i'�--n^a-►" _ Sanitation Plannin Plans Fees s-- W. C. R W Encroachment NEW 0 ADDITION X70 REPAIRS 0 OTHER 0 Others r �'.�--.—✓�' .r�..ls �^. F O U N D A T I O N MATERIAL EXTERIOR PIERS Single Multi USE OF STRUCTURE Family 21 Duplex 0 Dwelling 0 Others Width at Top Width at Bottom Depth in Ground SQ. FT. OCC. BUILDING VALUATION R.W. PLATE (Sill) SIZE SPACING SPAN Girders a i r" joists - 1st Floor Joists- 2nd Floor Fireplace Joists - Ceiling Total Valuation Exterior Sttids Permit Fee Interior Studs F Plan Checking Fee &/or Penalty Roof Rafters Total Permit Fee r . / Bearing Walls V �, U UNTRAGTORS LICENSE LAW A. LICENSED CONTRACTORS COMPLETE THE FOLLOWING: I am licensed under the provisions of Chapter. 9, Div. 3, of the State of California Business & Professions Code under the name style of......`` .............. 1/ �, .A/ .............. `� ....`... :. ... .............. .............. License No.,.,�....,,...../ ,,Z,,:; Classification,,,,,/ ................................... % and certify that the aforesaid license is in -full force and effect. .... B. OWNER -BUILDER & OTHERS COMPLETE THE FOLLOWING: I am exempt from the Contractors License Laws of the State of California under Sec. 7031.5 because (check one): Q I am the owner of the above property and I will contract to have all of the above work performed by licensed contractors. (Sec. 7044). Q I am the owner of the above property and do not intend to offer it for sale for one year from the date of completion of the improvements. (Sec. 7044). Basis,, if any, for other statutory exemption ................................. . 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 liabil- ity for Workmen's Compensation. I have placed on file with the County of Butte a certificate of compliance or proof of exemption pursuant to Section 3800. I certify that I have read this application and state that the above information is correct. 1 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. X ......................... j................. ... Date .......... ......... .. SIGNATURE OF PERMITTEE OR AGENT ....� �J Receipt No.............t� .....:.....�...... -" ...................... This BUILDING PERMIT is hereby issued under the appli- cable provisions of County resolutions and/or ordinances. DIRECTOR OF PUBLIC WORKS By......................................... '. :�...:......:.................... Date ................................ Permit Expires Date,,,,,,,,,,,,,,,,,,,, J Permittee Owner v /- Mailing Address A e', Each % .Contractor Each L00 Mailing Address BLDG. Address Each :..50 I- � COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - OroviIle, California 95965 PHONE: 53.3-1230, Ext. 259 APPLICATION AND ELECTRICAL PERMIT (f DESCRIPTION OF WORK PERMIT FILING FEE NEW F --j ADDITION T ' METER SERVICE 0 SuoDlementary Filine Fee OTHERS: Remarks: USE OF STRUCTURE Single Muld Family 5t1 ' Duplex Q Dwelling Q OTHERS: - Remarks: 52.00 1.00 Fee Main Service Sub -panel (12 or (more than P less) 12) Each 7 � t3 Range, Dryer or Water Heater Each L00 Oven; Cook Top or Space Heater ' ��� Each :..50 /r G'W Li Light Fixtures g First 20 .20 Each Additional .10 G iFirst Rece�tacles„ Switches & Fixture Outlets 11— 20 20 Each Additional :10 Hood, Exhaust Fan or F.A. Furn. Motor Each .50 Evap. Cooler, Gar. Disp. or Dishwasher Each .50 Air Conditioner or Heat Pumo Misc. TOTAL FEE CONTRACTORS LICENSE LAW A. LICENSED CONTRACTORS COMPLETE THE FOLLOWING: . —r 0 . I am licensed under /the provision`s/,of Chapter 9, Div. 3, of thhe� State of California Business dr Professions Code under the name style of ........ `'%....... .al..�...ae:....... `!..�..'.Y..A. . �..r....... ...:'..:,4i .. /`x.... .. ..... ...................................................................... _.. License No. /.jhS� r -i Classification. /� / and certify that the aforesaid license is in full force and effect. ................................................................... . B. OWNER -BUILDER & OTHERS COMPLETE THE FOLLOWING: I am exempt from the Contractors License Laws of the State of California under Sec. 7031.5 because (check one). I am the owner of the above property and I will contract to have all of the above work performed by licensed contractors. (Sec. 7044). I am the owner of the above property and do not intend to offer it for sale for one year from the date of completion of the improvements. (Sec. 7044). Basis, if any, foaother statutory exemption .................................................. ........................................................................ .._ ......_. 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 liabil- ity for Workmen's Compensation..I have placed on file with the County of Butte a certificate of compliance or proof of exemption pursuant to Section 3800. I certify that I have read this application and state that the above in- formation is correct. I agree to comply with all County ordinances and State Laws relating to building construction, and hereby authorize repre- This ELECTRICAL PERMIT is hereby issued under the appli- sentatives of the County of Butte to' enter upon the above mentioned cable provisions of County resolutions and/or ordinances. property for inspection p/uJ.poses. X �/�`:f- v �Date DIRECTOR OF PUBLIC WORKS ...............:................................................................... �, f� SIGNATURE OF PERMITTEE OR AGENTy/- V` ,� B .....'. �.. ...t-- :� �.......... Dat % ........ t.1�.�.... ✓, y .................. Receipt No. _................ ......................................