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35-214-40 -q
WILLIAM SPEC
4539 Baggett R�.y Orovill& _
Permit #3136-76E (complete rewire
& ser. ch) Contr: Young Electric
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& drain in Kit.�c_laundry area & inst.
new siding/SF)
035-214-004 93-402
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SPEER; WILLIAM -' -
4539 BAGGETT RD.,.OROVILLE /
GAS LINE,WTR HTR '&- WALL HTR/SF
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COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, Califdrnia•95565 - Telephone (916) 538-7541 PERMIT No.
APPLICATION AND PERMIT ' /0
ASSESSOR PARCEL NUMBER
XHUNU 035-214-004
ZONING
BUILDING PERMIT
OWNER
Ju 9 WILLIAM SPEER
TELEPHONE
'S0, FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS {y
4539 BAGGETT RD OROVILLE 95966
CONTRACTOR'S NAME
OWNER
TELEPHONE
CONTRACTOR'S MAILING ADDRESS Stix
Fireplace
CONSTRUCTION LENDER "F
UNKNOWN
Total Valuation is
Filing Fee $
20.00
LENDER'S MAILING ADDRESS t
Permit Fee $
ARCHITECT OR ENGINEER
s
LICENSE N0.
►
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
4539 BAGGETT RD
PERMIT FEE $
.OROVILLE
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
I
Each gas water heater or vent
15.00 R5,00
USE OF STRUCTURE
SF ON Duplex ❑ Mobilehome ❑ Other
SPECIFY
I
f
Gas piping system 1 5 outlets
15.00 15.00
Building sewer
15.00
Mobile Home �S G 1 W
@20.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other 11
Describework: GAS' PIPING; 14ATER HEATER, WAMAFURNACE
PERMIT FEE $
W.00
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service ( 800V OR LESS)
200A OR LESS
23.00
Main Service (• 200A To 1000A )
46.00'
i
NEW CONST. DWELLING OCC P.
OR ADDNS. ( & ACC. BLOS. )
SO.
3.50 FT.
" l J
CONTRACTORS LICENSE LAW, ;
I declare under penalty of perjury (check one) !
❑ 1 am a licensed under provisions of Chapter 9, Division 3 of the Business and
Professions Code and my license is in full force and effect. 1
License No. Classification
I, as the owner, or my employees with wages as their sole compensation, 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 contractors.t(Sec 7044)
❑ 1 am exempt under Sec. Business and Professions Code
forthis reason
NEW CONST.MULTI-OUTLET,
•NON-RESID. ( • BRANCH CIRCUITS )
@7.50
( POWER APPARATUS )
& SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES )
BAL @ 1.50
Ex. Occu FIXED APPWS. OR
p (OUTLETS IRESID.1 EA. )
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
WORKER'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ This permit is for $100.00 (valuation) or less.
❑ 1 have placed on file with the County of Butte Dept. of Development Services,
Building Division 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 Worker's
Compensation laws of California.
Notice to Applicant: If after making this statement, should you become subject to the
Worker's Compensation provisions of the Labor Code, you must forthwith comply with
such provisions or this permit will be revoked.
PERMIT FEE $
Contractor
MECHANICAL PERMIT
Filing Fee 20.00
Heating WAIL FURNACE
L5.00
Cooling
Hood
6.50
Ventilation
PERMIT FEE $
35.00
Contractor
I certify that I have read this application and state that the above information is correct.
1 agree to comply to all Butte County Ordinances and California State Laws relating to
building construction, and hereby authorize representatives Of the County of Butte to
enter upon the above mentioned property for inspectiori purposes.
I also agree to save, indemnify aneep harmless the County of Butte �against all
liabilities, judgments, costs, d ex en which may in any way accrue ffgainst said
Count In c nseq^ue'ce o h ra frog - of this permit.
X Date G"...�b
Signature of A pscant j% Ow er' C1 Contractor ❑Agent
An OSHA permit is required for excavations over 5"0" deep and demolition or
construction of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 85.00
1 1
HAz-
I D. FEES
IMP
I FLOOD
I CDF
PARCEL PD
HD
ISSUE
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.
j s
DIRECTORIOF PUBLIC WORKS
By Date
PERMITEXPIRESON 28 DCc qq
(Dare)
�• � / i'�
Receipt No. t_ > / '7 /
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
J
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
X J%X@X X 035-214-004
ZONING
BUILDING PERMIT
OWNER
XSRXX WILLIAM SPEER
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS
BAGGETT D 0 OVILLE
CONTRACTOR'S N453
AME
OWNER
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee $
20.00
LENDER'S MAILING ADDRESS
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
4539 BAGGETT RD OROVILLE
PERMIT FEE $
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15,00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Each gas water heater or vent
15.00 15.00
USE OF STRUCTURE
SF OY Duplex ❑ Mobilehome ❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
15.00 15.00
Building sewer
15.00
Mobile Home S G I W
@20.00
TYPE OF WORK
New 1:1Addition ❑ Remodel ElUtilities 1:1Installation ❑ Other EX
Describework: GAS PIPING, WATER HEATER, WALL FURNACE
PERMIT FEE $
50.00
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service ( 1OOVORLESS )
200A OR LESS
23.00
Main Service ( 200A To 1000A )
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( & ACC. BLDS. )
3.50 FTSO..
CONTRACTORS LICENSE LAW(
I declare under penalty of perjury (check one)
❑ I am a licensed under provisions of Chapter 9, Division 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 compensation, 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 contractors. (Sec 7044)
O 1 am exempt under Sec. , Business and Professions Code
forthis reason
NEW CONST. MULTI -OUTLET
•NON.RESID. ( BRANCH CIRCUITS )
@7.50
POWER APPARATUS )
& SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES)
B2@100
Ex. .Occup. FIXED APPS. OR
p (OW
UTLETS (RESID.) EA. )
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
WORKER'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ This permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Dept. of Development Services,
Building Division 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 Worker's
Compensation laws of California.
Notice to Applicant: If after making this statement, should you become subject to the
Worker's Compensation provisions of the Labor Code, you must forthwith comply with
such provisions or this permit will be revoked.
PERMIT FEE $
Contractor
MECHANICAL PERMIT
Filing Fee 20.00
Heating WALL FURNACE
15.00
Cooling
Hood
6.50
Ventilation
PERMIT FEE $
35.00
Contractor
I certify that I have read this application and state that the above information is correct.
I agree to comply to all Butte County Ordinances and California 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 an eep harmless the County of Butte against all
liabilities, judgments, costs, d ex nses which may in any way accrue against said
Count in c nsP e o r in f this permit.
X Date
Signature of A cant Ow er ❑ Contractor ❑Agent
An OSHA permit is required for excavations over 5"0" deep and demolition or
construction of structures oveer/3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $
HAZ.
D. FEES
IMP
FLOOD
CDF
PARCEL PD
HD
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
Indic d above for w 'ch fee have been paid.
D7CT OF UBLIC WORKS n
By Date
PERM EXPIRES ON Z)4gc— 9L�
(Date)
Receipt NO. 5r �'i
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE - Deoart6ent 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 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 for construction of
the proposed property improvement (yes or no)
2. 1.(have/have not) signed an application for a building permit
for the proposed wo k.
3. I have contractef with the following person (firm) to provide the proposed
construction:
Name'
Address City
Phone Contractors License No.
4. 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 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.Number
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 toour off.ice'before we are per-
mitted to issue the permit.
t—'f- �i�'l �i"�— .rn•'�
'mo=d
i.
�a
sa[
•
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Date Inspector �—
REV 1 /92 r
COUNTY OF BUTTE
BUILDING DIVISION
:x
R=s
DEPARTMENT OF DEVELOPMENT SERVICES
..;
1469 Humboldt Road, Chico, CA - (916) 891-2751
'
};
7 County Center Drive, Oroville, CA - (916) 538-7541
Sf
747 Elliott Road, Paradise, CA - (91'6) 872=6307
CORRECTION NOTICE
Y`
OWNERERMIT NO.
'
<<
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the
r.
above address and should be corrected. Please notify this office when correction of work
..,x
is completed. If you have any questions pertaining to this matter, or need additional explanation,
please cgFdact this office immediately.
t—'f- �i�'l �i"�— .rn•'�
'mo=d
i.
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sa[
•
_ 3l
Date Inspector �—
REV 1 /92 r
a 06RMIT N0. . 3608-,76B,P
PERMIT EXPIRES
OWNER. William Speer
( CONTR. owner
LOCATION (A.P. 35-214•-Vy )
.4539 Baggett-Marysville Rd-, Oroville
4
s
a
t
Temp. Power Pole
Called PG&E
Temp. Elea Serv.%
Called PG&E
Temp. Gas Serv.
Called PG&E '
JOB 11117177 FINALED
(Date)
(Signature)
. COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION REPWORD
BUILDING BUILDING (Cont'd)
PLUMBING
Setback
Firewall
Soil Piping
Forms
Parapets
1st Floor l"
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
StemwaII
Siding
To out ov
Slab A
Roof Sheathin
Water Piping
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
. Stemwa I I
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Carport
Footings
Prov. for physically
handica ed
Conformance of e
structure x 1
Appliances
Gas Piping & Test
Temp. Gas
Slab
Final
Sanitation
Patio
FIREPLACE
Final
Footings
Footing I.
ELECTRICAL
Heint. steel
Final
Fixtures
Bond Beam
FIRE RINKLERS
Motors
Framing
Test
Water Htr.
Stucco
Final
Subpanels
Mesh
MECHA ICAL
Grd. Fault Prot.
Scratch
Heating
Service
Brown
Cooling
Temp. Pole i
Finish
Ducts
Underground
Interior Lath
Ventilation
Permanent
Door Closer
Final
Final
DATEllq' /
REMARKS OR CORRECTIONSOr
,`
(NOTE: An entry must be made on this form each time you visit the job site.)
if ^ :. i " ,b.. 6 `• = '" tr:"ip�'.7. a v r
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — '16roviIle, California 95965
Tgl ephone: 534-4541
APPLICATION AND PERMIT -WAN* Y
i'y — uuuc — aIllal UF/UII Lim
above -m n o ed property for ' pe do purposes.
X Date 61119A
Signature o ermit a or Ag t
Re eipt No. _
N te-D.P.W. — Yello essor — 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
By- Date
$vi Ide t permit expires Date
BUILDING
OwnerSQ.
Mailing Address "/53
FT. OCC. BUILDING VALUATION
�
�
el ephone No.
Fireplace
Contractor ` G C-1
Total Valuation
Mailing Add ess Rr�' S O
Permit Fee
Plan Checking Fee &/or Penalty
0� iv i i Tele
1 r
one No.
Permit Fee $
Building Address"� c -T e
PLUMBING No.1 @ I FEE
PERMIT FILING FEE $3.00
_
01 {
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 & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
Fees I
W.C.
Sartitta'ti0n
kireDept.
FireZone
Use Permit
Building sewer 5.00
EQA
—Plans
ParkinDeParcelon
Parcel Map
60' R/W
Improvements
Lawn sprinkler system 2.00
Parcel Approval
Plans Approval
Permit Fee $
$
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ['
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00 ` ,aD
�� /
/n
Cwt. Fe'TCi ' t.�idt e3 2 LG` /}/VfrE,
Main service ioo AMP OROR LESS5.00
Main service EA. ADD'L too AMP 2.50
Single Family Duplex ❑ Mobil Home ❑ Others ❑
Main service tp0EAMP OR LESS 25.00
Main service EA. AOD`L too AMP 1.00
NEW CONST. // DWELLING O ^
'\
OR ADDNS. %ACC. BLDG, �' 20 sq ft •Vy
NEW CONSTR. MULTI-OUET
NON•RESID. ( 'BRANCH CIRCUITS) 2.50ea
NEW CONST. POWER APPARATUS &)
NON • R
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)@ �
BAL�1
EX. OCCU FIXED APPLNS. OR
P'(OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
^
License No, 2903 / 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 w requires every employer to be insured against liability
for 71. men's Compensation.
ve placed on file with the County of Butte a certificate of
orkmen's Compensation Insurance.
I certify that in the performance of the work for which this
permit is issued I shall not em
p Io an employ y person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
1 certify that I ve read this application and state that the above
information is c rrect. I agree to omply to all County Ordinances
and State s relating to u' Iding construction, and hereby
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
_
Hood 2.00
Permit Fee $
$
TOTAL PERMIT FEE
$
i'y — uuuc — aIllal UF/UII Lim
above -m n o ed property for ' pe do purposes.
X Date 61119A
Signature o ermit a or Ag t
Re eipt No. _
N te-D.P.W. — Yello essor — 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
By- Date
$vi Ide t permit expires Date
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Uroville, California 95965 /
Tel ephone- 53¢4541
APPLICATION AND PERMIT
X t Dat ,
Signature of Permitee or/Ag nt
Receipt No. 7
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR (F PUBLIC WORKS
Date '7--7_ % j(
Iding permit expires Date 2-7 77
BUILDING
Owner'
SQ. FT. OCC. BUILDING VALUATION
Mailing Address t4S 39 .QlIW PeTi r M69 3 Vj it e
s ,�,� Telephone No.
�"�f `
�V�
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee&/or Penalty
Telephone No.
Permit Fee $
p�
9 6,�� ' r
Building Address44,53!1 1
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00 , (1D
Each Trap 1.50 , Q()
Repair drainage or vent piping 1.50
Water piping 1.50 ,S'D
Each gas water heater or vent 1.50
Com-^ ,�
A. P. No. �J
Zoning 8 Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
Fees
W.C.
Seftke� OA
FireDept.
FireZone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
I Parcel
Declaration
parcel Ma P
60' R/W
Im provements
Lawn sprinkler system 2.00
J d
Parcel Approval
Plans Approval
Permit Fee $ Q
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ®
ELECTRICAL No.1 @ FEE
PERMIT FILING FEE $3.00
tt
R LAGS. 111..' LU 6IN� VJnrelL R t '�
Main service 100 AMP LESS 5.00
` - eL1AfetA17.'1jJ
I eW (�I
d
Main service EA. ADD'L too AMP 2.50
Single Family Eq Duplex ❑ Mobil Home ❑ Others ❑
Main service 100EAMP OR LESS 25.00
Main service EA. ADD'L too AMP 1.00
NEW CONST. OR ADDNS. ( ACCLBLDGS.DWELING CCUP. &) 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) LL.1
BAL@1
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
' l 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.
fj I certify that in the performance of the work for which this
!� permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
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
authorize representatives of the County of Butte to enter upon the
shove -mentioned nrnn crffr i ..#1....
., o ..
MECHANICAL No. @ FEEPERMIT
FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
TOTAL PERMIT FEE
$
This permit is hereby issued under the applicable provisions
of
X t Dat ,
Signature of Permitee or/Ag nt
Receipt No. 7
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR (F PUBLIC WORKS
Date '7--7_ % j(
Iding permit expires Date 2-7 77
E. Other
1. Maintenance and repair:
2. Fire hazards:
3., -Safety hazards:
4:•:Weather protection:
5. Underfloor and attic ventilation:
6. Comments
F. Commercial Buildings
1. Roof covering:_
2. Distance to property lines:
3. Physically handicapped:
4.• Restroom floors and walls:
5. Exits: _
6. Improvements:
7. Zoning:
8. Comments:
G. Field Problems or Violations
1. Problem or violation (give complete description):
2. What action taken (give complete description):
—3.-.-What.action_ recommended:
A. Information only - file.
B. Hold for ten (10) days, then write letter.
C. Write letter.
D. Other:
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS
SPECIAL INSPECTION REPORT
Owner: LA/We wg, A. P. #
Address:
Tenant:
Building Location:
Type of Inspection requested:
Date of Inspection
Inspector .�v-ds�r.�c!
/ /.1. Housing / / 2. Financing 3. Change of Occupancy to
/ 4. Other (specify/)
7 Q
y�
Presdnt use of building:
A. Sanitation (Housing) A -e I
1. Water closet:
2. Lavatory:
3. Bathtub or shower:
4. Kitchen sink:
5. Hot and cold water to fixtures:
6. Heating facilities:
7. Natural light and ventilation:
.8. Room and space requirements:
9. Bedroom window or door for second exit:
10. Infestation of insects, vermin, or rodents:
11. Connection to sewage disposal:
12. Connection to water supply:
13. Rubbish and garbage facilities:
14. Comments•
B. Structural
1. Piers and footings:
2: Floor construction:
3. Wall construction:
4. Ceiling and roof construction:
5. Fireplaces:
6, Comments:
C. Electrical
1. Service and ground:
2. Receptacles:
3. Fusing:
4, Comments:
. 0,
D. Plumbing
1. Fixtures connected and vented:
2. Gas water heater:
3.,,' -'Gas heating vents:.
omments :
(continued on back)