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Home My WebLink About040-240-0631 f t t l x� HAROLD URNESS 40' -24 -IW W t 16 p i,t �F337 -8 B P,E ne single family ,e - �_ `�- - r ►i R Un4 Of ✓.� uue OROVILLE, CALIFORNIA GENERAL CLAIM CLAIMANT: Harold Urness ADDRESS: 1929 Cummings Lane CITY & STATE: Durham, CA 95938 IMPORTANT: August 28, 1985 DATE OF CLAIM: SEE INSTRUCTIONSON REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT Owner has decided not to do work. (Bldg Permit Appin. #3378-84B,P,E,M, Receipt #29147, dated 10/19/84, AP X640-24-62), Building permit fees paid -------------------- $228.00 Retain filing fee----------------- Retain plan checking fee ---------- $15.00 Retain energy plan c ec ing ee--- T5. Amount retained---------------------------- 40,00 Refund due ----------------------------------------------- $188.00 _ Plumbing permit fees paid--------------------$ 46.00 Retain filing fee---------------------------- 10.00 Refunddue ----------------------------------------------- $ 36.00 Electrical -permit fees paid ------------------ $ 51.60 Retain filing fee---------------------------- 10.00 Refund due----------------------------------------------- 41.60 _ Mechanical permit fees paid ------------------ $ 25.00 Retain filing fee---------------------------- 10.00 Refunddue----------------------------------------------- 15.00 Refund energy inspection fee----------------------------- 30:.00 TOTAL REFUND DUE ------------------------------------------ $310.60 $310,60 TOTAL $310 60 1, 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 2.8th....da of August........ 19 85• et.. Oroville carr. ................ Y ..................................................• ........................... Signature of Claimant ' —� 1. the undersigned, hereby certify that, to the best of my.knowledge, the services or articles specifie o e have been performed or de- livered and that there is a Budget Appropriation ❑ or Specific Board Approval ❑ (Check one) for the a a _ \.� Dated this /' . day of 19 j?, at G�,�/GC L .. .Cell(. .. �. .. De art .. ... ... ... ........ A ori zed Deputy Dept. Exp. Code............................................ Code ................................................PAYABLE FROM D DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSS AMT. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT S PERMIT y0& ASSESS ARC _ NU ER .— ��p 2 NG _ BUILDING PERMIT O WNE / C TELEPHONE SO. FT. OCC.1 BUILDING VALUATION - OWNER'S MAILING ADDRESS CONT ACTOR'S N3 TE EPHONE - CONTRACTOR'S MAI NG ADDRESS Fireplace CO NfSTRUC ON LENDE IT (4 ) , UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ � ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ^.I� Penalty $ ^ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ f BUILDING ADDRESS PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 Lor O. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home JSJGJWJ 10.00 eaf TYPE OF WORK New Addition[:] Remodel❑ UtilitiesInstallation❑ Other Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST'( DWELLING OR ADDNS. C ACC. BLD 1 2/22sq ft CONTRACTORS LICENSE LAW I ceclare 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. yZ7 9,�� Classification LC�/r � _� ❑ 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 NON -RESIT R. BRANCH CIRCUITS) 2.50 ea NEw CONSTR. ( POWER APPARATUS &) NON.RESID. SINGLE OUTLET CIR. 20®50a OR FIXTURES SALQ300 Ex. OCCUP. FIXED APPLINIS FIXED TS (RES. OR EX. OCCUp. OUTLETS (REST D,) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 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 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 FiIingFee 10.00 Heating , Cooling 61Vv Hood 3.00 Ventilation Permit Fee $ Contractor 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 Countyot Butte to enter on the above-mentioned property for inspection purposes. I also agre o save, indemnify and keep harmless the County of Butte against all liabil'Kies/judgments, costs, and expenses which may in any way accrue a ins ai ou y ncons u ce of the granting of this permit. y X Date to—/7 — O + , Signature of Applicant — Owner L] Conrracto� Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 sstoories in height. Mobile Home Installation Fee $ ' p OA TOTAL PERMI E $ 30V OCCUP. GROUP I TYPE OF CONST. PARCEL PD I jZISSUE 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. a9I�T� WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT