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HomeMy WebLinkAbout040-180-018COUNTY 6F'bUTTE Oroville; California GENERAL CLAIM CLAIMANT: Durham Recreation and Park.District. ADDRESS: P.O. Box 364 CITY & STATE: Durham, CA 95938 DATE OF CLAIM: 9/24197 SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERV/CES IMPORTANT.• SEE INSTRUCTIONS ON REVERSE SIDE j DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT PERMIT APPLICATION TAKEN BY MISTAKE - CLERICAL ERROR.(SCHOOL PROPERT ) (A.P. #040-180-045, B.P. #97-1790, RECEIPT #224002, DATED 8/21/97. TOTAL FEES PAID.. .....$80.50 . ........................ ..... TOTAL AMOUNT TO BE RETAINED ........................ 0.00 TOTAL AMOUNT TO BE REFUNDED .........................$80.50 TOTAL $80. 50 t I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is true and correct as stated. , Dated this 9th day of Sept 19 97 at Durham , Calif./ 2 " Signature of Claimant I, the undersigned, hereby certify that, to the best of my knowledge, the services or article s i ' d above ha a en p rformed or delivered and that there is a Budget Appropriation [ I or Specific Board Approval [ I (Check one) for th s Q Dated this 24TH day of . SEPT. , 19—U, at OROVT_ . ,E Calif. Depa ment Head or Authorized Deputy Dept. Code 440-002 Exp. Code 4210500 PAYABLE FROM CONSTRUCTION PERMITS FUND Dept. Code Exp. Code PAYABLE FROM FUND Dept Code Exp. Code PAYABLE FROM FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSS AMT. v.— . — CLAIMANT'S NAME MAILING ADDRESS ASSESSOR PARCEL #: RECEIPT NUMBER(S) REFUND CLAIM APPLICATION Durham Recreation and Park District P.O. Box 364 Durham, CA 95938 040-180-045 224002 Request a refund of fees paid on the above receipt number(s) for the following reasons: On August 21, 1997 a.permit was pulled for elect to serve 4 fight -Toles, ...irrigation. -.timers- and -futur s:nack's:hack ' This permit was pulled at the Chico office. On August 26, 1997 we received a call from Alice from the Oroville office saying this project is on school property and the county doesn't hold jurisdiction,on Z. sc oo property so the permit should never have been issued by the county.. _ �k Please refund any applicable fees in the following categories: (Check those categories which you wish to have refunded.) (x) Building Permit Fees . ( ) Sheriff Fees ( ) SRA Fees (CDF Fire Planning) ( ) Urban Area Fees Disposition of Plans: ( ) Plans returned to me at counter ( ) Please mail plans to me at above address. ( ) Please dispose of plans. SIGNATURE DATE September 9, 1997 PLEASE DATE AND SIGN THE ATTACHED COUNTY OF BUTTE GENERAL CLAIM FORM. DO NOT COMPLETE ANY OTHER INFORMATION ON THAT FORM. ' . FOR BUILDING DIVISION USE: Receipt Information: Number: �2 T� Date: r�' � Issued To: k Amount: Fees Retained: Processing Fee: $ Bldg Filing Fee: $ Plbg Filing Fee: $ Elec Filing Fee: $ Mech Filing Fee: $ Energy P/C Fee: $ Plan Check Fee: $ Inspection Fee: $ SRA Fee: - $ Total Amount Retained. TOTAL REFUND DUE $ COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 55965 - Telephone (916) 538-754 L ! PERMI N (Rev. 12/96) APPLICATION AND PERMIT / 7 ASSESSORPARCELNUM E O w ®4 S—. o zDlO_ `� BUIL GPERMIT OWNER DistE\EJPHr a��� ,f> _ j�Q�C_t_ T ) n SO. FT. OCC. BUILDING VALUATION OWNEA'S MAIUNG FR�SSL oo V\ CONTRACTOR'S NAME TELEPHONE ' CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEERLICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS ^ � � (t��� �` Energy Plan Checki g Fee $ PERMIT FEE S LOT NO. • SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT I Fling Fee 20.00 USEOFSTRUCTURE y� j SF ❑ Duplex ❑ Mobilehome 6, Other � S w ?W\,1( sPECIFv Each Trap 7.00 Solar or heat um water he er 23.00 Water piping 15.00 Each as water heater or ent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other rr_ Describe Work:] <��__G� i If` Gas piping system 1 - sj6utiets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ -S/y,C._CJC S' ��"�-� ELECTRICAL PERMIT Fling Fee 20.00 OOOV Main Service zoos oRoR LELEssS9 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.Pow License Class LIC. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. .Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUR OR ADDNS. ( & ACC. BUDS. SO 3.5¢FT. N CO NON -R SNDT RANCH C113CUI @7,50 37,� ER APPARATUS 8 SINGLE OIJTLET CIR. Ex. Occup. OUTLET OR FIXTURES zo @ 1.00 BAL @ .30 PPLINS Ex. Occup. ouTrs RESID.OEA. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' gomm ensajian ins ance carrier and policy number are: Carrier {{-�--��. ��^^(cT^C MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number —L 7'YA-an-- 0117 (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ . 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the wo rs' compensation provisions of section 3700 of the Labor Code, I shall f with co pl with se prod isions. Of -- ------ /� Date o2�L-- Sire of Applicant - ❑ Owner ❑ Contractor 21\Agen1� permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE p TOTAL FEE $ b FES IMP I FLOOD I CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provisions in the Butte County Code and/or Resolutions to do work indicate above for which fees have been paid. e-�:�('.'0 By ate Q� PERMIT EXPIRES ON O -_)� /r�U Date Receipt No. Z 0 -- WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT -..�„R.r,p I:fr r Yr. r-• r.�.-n, �• �_.•..;,,'°•t•{,'I�,oa,"`�.nc'•9;+rf.,�rr•`r^7�Y?r •w.+y�••y'�fyiV AFe-.,F•r....,. ;�. ..•-Y 'x.«4��•' x+1.,Wr� ,7� .,..n,,, *.tt•4,.rH+ti. ..+'l :v -w r k t;�ur^NfSf 4 .1' 'CO UNTY OF BUTTE DEPARTMENT "OF: :VELOPMENT SERPIC BUILDING DIVISION _ . 7 COUNTY CENTER DRIVE : OROLEXAMFORNTA 95965 - TELEPHONE (916) 538-754Y7- 1 7�� PERMIT APPLICATION DATA SHEET,,. 1 OWNER: CtAC- A�SSESSOR PARCEL NUMBER: Proposed Building Use: V44C ` Building Inspector: Date:k. 9 ;r'd� 5 ", At time o permit application, I was advised the following data must be submitted prior toSipermit processing and/or issuance: Date Received By Allitems have been submitted .------------------------------------------------------------------------- �--------- ❑2. Plot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------ 03. ----------------------------------------------------------- ❑3. Complete plans, 3/4 sets, signed by the preparer of plans. ----------------------------------------------------- 04. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. -------- ❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes!------------------ 116. ----------------- ❑6. Energy Design Compliance and supporting documentation. ---------------------------------------------------- ❑ 7. Statement of Intent for Non -Heated and A/C Buildings. --------------------------------------------------------- 118. -------------------------------------------------------- ❑8. Hazardous Material Form. ------------------------------------------------------------------------------------------ ❑9. Manufactured Home data and installation instructions including Tie Down Specifications .------------------ ❑ 10. Fees of $------------------------------------------------------------------------------------- ❑ 11. Impact fees as shown on the attached schedule. ------- ❑ 12. California Department of Forestry plan approval/fees. ❑ 13. Flood elevation certificate.------------------------------- 1114. ----------------------------- ❑14. Sanitation and plot plan approval Health Department. Ell 5. City of Chico plumbing permit. --------------------------------------- ❑ 1;6. Plot plan and business license approval from the City of Biggs. ❑ 17. Planning approval for (A) Use: (B) Parking: --------------- --- El 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ----------------- ❑ 19. Encroachment Permit for driveway (construction approval prior to occupancy). --------------------- ❑20. Pre -inspection for required Request to Building Inspector on ❑21. Contractor's license information. (Number, Name Style, Classification). --------------- ❑22. Workers' Compensation carrier and policy number. --------------------------------------- ❑23. Owner -Builder Verification (Given to owner ❑, Mailed to owner 0) - ----------------- 1124. Letter of signature authorization. ------------------------------ 025. Recorded copy of Agricultural Acknowledgment Statement. 026. Letter of intent on building use. -------------------------------- 027. Manufactured Home utility clearance. ------------------------- 028. Existing violations and/or expired permits. ------------------- ❑29. ❑433 A ❑Grant Deed, ❑ M.H. Title, ❑ Checkto H.C.D $ Va0. Other: .-Q-Q� m%/� wc�A,- When you issue the permit, process as follows ❑ Mail to owner, []Mail to contractor (Date) ❑ Telephone and hold for pickup at 4office. ❑ Deliv with inspector. + pplic . ate: 1S °lh�� Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ollution Date: By: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By: Index permit application for the above items numbered: ❑ Plan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above required data by ❑ phone,- ❑ mail, ❑ Building Division counter, by Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by _ Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by _ Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Plans reviewed by: Date: Plans approved by: Date: Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: Yellow Copy - Department of Development Services, Building Division. Date: Date: Date: Date: