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Home My WebLink About047-260-160— '29324,9 -26-16 OLO-A6 kow, Howar d H '99 Chi -CQ, WY- li� (d emo is f a COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovllle;iCalifornla 95965 - Telephone: 916/538-7541 k APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 47_26-:160 � ZONI G BUILDING PERMIT OWNER HOWARD HORN TELEPHONE 342-8545 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS y' P.O. BOX 6254 CHICO CONTRACTOR'S NAME SITE ODNST TELEPHONE 342-8545 CONTRACTOR'S MAILING ADDRESS + P.O. BOX 6254 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ .00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty BUILDING ADDRESS 29 H W q Permit fee 35.00 !$ $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE + SF [J Duplex❑ Mobilehome❑ Other i SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00 ea TYPE OF WORK New Addition Remodel ❑ Other F] ❑ � ❑ Utilities❑ Installation Describe work: I Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 i Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. AOD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW of p f y (Check One): I declare under penaltyperjury I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in fu l force and effect. License No.. ��q� 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.;(DWELLING OCCUP.SI\ OR ACDNS. A'CC. BLDGS. l yzQsgft NEW CONST FLU OUTLET NON•R ESID BRANCH CIRC ITS 2,50 ea (POWER APPARATUS IN) SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES .200090 FIXED LETS P(RESID.)REA.) Ex. Occup. 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 Filing Fee 10.00 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. 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 said County in consequence of the granting of this permit. {-This X % �(Q -�l. / / % �' ! !i Date I 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 $ Energy Inspection Fee $ EHAZ CONST TYPE _ TOTAL FEE $ 35.00 CUA I PARK I SCHL I FLD I CDF I PAR I PD 1 HD. Issue permit is hereby issued unoer the applicable provi- sions of the Butte County. Code and/or resolutions to do work indicated abo q for which fees have been aid. CC// �/ p ?TOR OF PUBLIC WORKS l By. A ! Date p PERMIT EXPIRES Date Receipt No. 97408 WHITE-D.P.W.. YELLOW -ASS ES30R, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER . 47-26-160 ZONI G '4 BUILDING PERMIT OWNER HOWARD HORN TELE HONE 342-8545 SO. FT. OCC. BUILDING VALUATION FS1 1-500 OWNER'S MAILING ADDRESS P.O. BOX 6254 CHICO CONTRACTOR'S NAME SITE CONST TELEPHONE 342-8545 CONTRACTOR'S MAILING ADDRESS P.O. BOX 6254 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10,00 LENDER'S MAILING ADDRESS - Permit Fee $ 25.00 ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING A DRESS O C,1+1GZ) Permit fee 35.00 $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping , 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF [� Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other] Describe work: DEMO Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100v OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury ) p y p I y (Check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Co/d�e and my license is in ful force and effect. License No. ��3�7C_ __ — 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) ❑ 1, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ 1 am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING OCCUP.&) OR ADONS. ACC. BLDGS. '/zQsgft NEW CONSTR.ULT'-OUTLET NO N.RESID BRANCH CIRC ITS 2.50 ea (POWER APPARATUS e) SINGLE OUTLET CIR. Ex. Occup(O TS OR FIXTURES 3AL SOC 9AL9 30 FIXED Ex. Occup. OUTLETS (RESID )REA.1 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 FiIirig Fee 10.00 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 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 agains said County in consequence of the granting of this permit. X Date ad Signature of Applicant — Owner ❑ Conrroctor ❑ 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 _AZ. CONST TYPE TOTAL FEE '$ 35.00 _-F I CUA PARK I SCHL I FLD I CDF PAR 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 indicat d abov for which fees have been paid. OR OF PUBLIC WORKS By Date 8`.20-9/ PERMIT EXPIRES Date 7,0— 97— Receipt No. 974nR WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT' COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR A CEL NUMEIER ZONING BUILDING PERMIT OWNER vV eD [1-04V TELEPHONE SO. FT. CC. BUILDING VALUATION OWNER' r) .D KESS CONT CTOR'S ME, tI l TELEP ONS. -3412 CONTRA OR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ C;P <7D6 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING, ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SFDuplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00 ea' TYPE OF WORK New ❑ Addition ❑ Remodels�❑ Utilities [IInstallation[]Other Describe work: Z2E,&0 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service eooV OR LESS 100 AMP OR LESS 10.00 Main service EA. ADO'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 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 NEW CONST. DWELLING oCCUP.a OR ADDNS. ( ACG. SLOGS. , h2SQft NEW CONSTR.MULTI-OUTLET NON.RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES oeoe e2oAL930C FIXED Ex. Occup. OUTLETS P(RESI0 ILNS REA.) 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. ❑ 1 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. ❑ Ishall 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 10.00 Heating Cooling Hood 3.00 Ventilation Penult 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. 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 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 $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ HA2. I CUA I PARK SCHL I FLD F I PAR I PO j HO • ISSUE This permit is hereby issued unaer 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 PUBLIC WORKS By Date PERMIT EXPIRES Date Receipt No. � 'N,TE-D.P.W.. YELLOW-ASDE330R• PINK -INSPECTOR. GOLDENROD -APPLICANT Demolition Permits, Asbestos Notification Statement Date O q AP# Pursuant to section 19827.5 of the California Health and Safety Code, all demolition permit applicants are required to fill out this form. "19827.5. A demolition permit shall not be issued by any city, county, city and county, or state and local agency which.is authorized to issue demolition permits'as to any building or structure except upon the receipt .from the permit applicant of a,copy of each written asbestos notification regarding the building that has been required to be submitted to the United States Environmental Protection Agency or to a designated state agency, or both, pursuant to Part 61 of Title 40 of the Code of Federal Regulations, or the successor to that part. The permit may be issued without the applicant submitting a copy of the written notification if the applicant declares that the notification is not applicable to the scheduled demolition project. The permitting agency may require the applicant to make the declaration.in writing, or it may incorporate the applicant's response on the demolition permit appli— cation." Attached is a copy of my written asbestos notification to the United States Environmental Protection Agency for the demolition project located at Signature of Applicant c I hereby declare that a written asbestos notification to the United States ry Environmental Protection Agency,is not applicable to this demolition project. Signature of App 'cant 2/19/91 MAIL TO ASBESTOS NOTIFICATION EPA/NESHAPS Region IX 1235 Mission St. A-3-3 San Francisco, Ca. 94103 DATE: PROJECT JOB # (Please see reverse side) AqQnaio: gI,SQ 21rstifiod: ❑To -I ❑ CiIiforaia Air Roaourcos Board ❑ cal OSML ❑ Building Dapaxt=.nt ASBESTOS DEMOLITION/RENOVATION NOTIFICATION OPERATOR: 3. FACILITY NAME: EPA USE ONLY Please'check one: DateRec V Pstmrk Renovation CITY STATE School Demolition requiring ZIP PHONE( ) 10 day notice Del/ND Demolition requiring ADQUTE? 20 day notice ADDRESS Code#: Revision of Original CITY STATE (Form on reverse side) Doc#: IDE—PLEASE READ BEFORE USING THIS FORM 1. OPERATOR: 3. FACILITY NAME: (Contractor) ADDRESS STREET ADDRESS CITY STATE CITY STATE ZIP PHONE( ) COUNTY ZIP 2. OWNER 4. FACILITY DESCRIPTION ADDRESS CITY STATE AGE SIZE ZIP PHONE( ) PRIOR USE 5. Project Start Date: Completion Date: 6. Estimate of Friable Asbestos: ON PIPE: Linear Feet SURFACE OF OTHER COMPONENTS: Square Feet Nature of Materials: 7. DESCRIBE METHODS OF REMOVAL: 8. PROCEDURES USED TO COMPLY WITH 40 CFR 61.147 & 152: 9. NAME & LOCATION OF DISPOSAL SITE: ANY FURTHER PERTINENT INFO CAN BE INCLUDED BY ATTACHING ADDITIONAL SHEETS QUESTIONS??? FOR FURTHER INFORMATION CALL (415) 556-6415 8am/4pm M -F INSTRUCTIONS Fog USE OF ARERTOR nEMn TTT0N /REND VATTON NOTTFTCATTON FO RENOVATION: means altering in any way one or more facility components. NOTICE MUST BE POSTMARKED AS EARLY AS POSSIBLEBEFORE PROJECT DEMOLITION: means the wrecking or taking out -of load -supporting structural members of a facility toaeth r with any related handling operations 10 Day notice for MORE than 160 sq.ft.or 260 linear ft. asbestos 20 Day notice for LESS than 160 sq.ft.or 260 linear ft. asbestos, includes facilities which contain no asbestos. FACILITY: means any institutional, commercial -or industrial structure, installation; or building. Renovations on single family residences and apartment buildings with 4 units or fewer are exempt from notification to EPA. PROJECT JOB #: Your OWN IN-HOUSE I D for a specific jobsite. Optional, but expedites communication -concerning notifications. LOCAL AGENCY: Most areas in Region 9.have local NESHAP delegated agencies. In these areas notice must be provided to both EPA and the local agency. 1. OPERATOR/CONTRACTOR: Full.information concerning person doing the work. 2. PROPERTY OWNER: Complete in full. 3. FACILITY NAME: Must have complete address OR directions to the jobsite. 4. FACILITY DESCRIPTION: Current use of building. Project location in the facility. Other descriptive information as necessary. 5. START AND COMPLETION DATE: Provide month, day and year. Must be revised if dates change. (see revision form below) 6. Estimate of amount to be removed (must be in square or linear feet). Revisions(see form below) must be made for additional amounts uncovered. 7. Examples of methods: glovebag, scrape, remove in sections, etc. 8. Examples: Adequate wetting prior to and during work, double bag, etc. DRY REMOVAL MUST RECEIVE PRIOR WRITTEN APPROVAL FROM EPA OR THE LOCAL DELEGATED AGENCY IF MORE SPACE IS NEEDED THAN PROVIDED, ADDITIONAL SHEETS SHOULD BE ATTACHED TO REVISE A NOTIFICATION ALREADY ON FILE WITH EPA, USE FORM PROVIDED BELOW PROJECT NAME PROJECT JOB 4 ORIGINAL NOTIFICATION DATE Revision Notice $1 2 3 4 5 please circle This is to advise that the above referenced notification presently on file has been revised. Please note the revised portion listed. CHANGES FOR THIS REVISION: 1. NEW Location 2. NEW Scope of Work 3. ADDITIONAL Quantity of Asbestos 4. -NEW Start Date 5. NEW Completion Date GV; NEW Disposal Site PROJECT ( ) CANCELLATION COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET Permit No. OWNER TTUVv"/�� % A. P. No.' . Proposed Building UseI2E--Z a Building Inspector Date aL At time of permit application, I was advised.the following data must be submitted prior to permit processing and/or issuance: 1. All items have been submitted.. 2. Plot plans in duplicate/triplicate, signed by prepares of plans. 3. Complete plans in duplicate/triplicate, signed by preparer of plans. 4. Complete engineered plans and calcs, with wet signature on plans. 5. Hazardous Material Form. 6. Energy Design Compliance and supporting documentation. 7. Statement of Intent for Non -Heated and AC Buildings. 8. Engineered truss details and layout in duplicate (required prior to plan check). 9. Mobilehome installation data including manufacturer's installation instructions. 10. Fees of $ 11. Chico Urban Area fees paid. 12. Park fees paid. 13. School District fees paid. 14. Sanitation approval from Health Department. 15. City of Chico plumbing permit. 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: 18. Improvements may be 'required. Contact Land, Development Section of DPW. 19. Driveway permit (construction approval required prior to occupancy). 20. Pre -Inspection for required. 21. Contractor's license information (No., Name Style, Classification). 22. Certificate of Workmans Compensation Insurance. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner o). Recorded copy of Agricultural Acknowledgment Statement. —.,-2 5. Letter of si nature authori a o T 27. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other Applicant GENERAL INFORMATION Date BUILDING DEPARTMENT OFFICES HEALTH DEPARTMENT OFFICES Chico. . . . 196'Memorial Way Chico. . . . 196 Memorial Way Phone: 891-2751 Phone: 891-2727 Hours: 8:00 a.m. - 12:00 a.m. Hours: 8:00 a.m. - 9:00 a.m. Orovi I le 7 County Center Drive Orovi I le . . . 7 County Center Drive Phone: 538-7541 Phone: 538-7281 Hours: 8:00 a.m. - 5:00 p.m. Hours: 8:00 a.m. - 10:00 a.m. Parad i se . 747 Elliott Road Paradise . . . 747 Elliott Road Phone: 872-6307 Phone: 872-6308 Hours: 8:00 a.m. - 12:00 a.m. Hours: 8:00 a.m. - 9:00 a.m. PLANNING DEPARTMENT —.7 County' Center Drive, Oroville — Phone: 538-7601 — Hours: 10:00 a.m. - 3:00 p.m. Original — Applicant �.. ;y ._3�7. r -1.10E„ Tl'IvV T^' Pi JA 1' ': 4,a 7 (V i 'Y-i:t: -4— !e ` '4ki /' COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION s 7 COUNTY CENTER DRIVE - OROVILLE+CALIFOWNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET Permit No. OWNER l I U A. P. Proposed Building Use 19 Building Inspector } y Date ad At time of permit application, 1 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 duplicate/triplicate, signed by preparer of plans .. 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... T. Statement of'Intent.for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid :.................................................... 13. School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required ... Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) .. . Recorded copy of Agricultural Acknowledgment Statement ......... —L� 25. Letter ofsi nature authori a 'o _ ��,� 27.` - When youdssue the permit, process as follows: Mail to owner. Mail to contractor. t Te!ephone and hold for pickup at office. Deliver w/inspector. Other Applicant.Date C� / Copy of ! .az-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By 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: / w Contractor, designer, owner, was advised of above re4ired data by_phone---- rnaiI—counter'by .date Contractor, designer, owner, was advised of above required data by—phone —mal l—counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW % & SENT BY:SITE CONSTRUCTORS INC. 08-20-91 02:20PM 9163429754-3 9165382140 # 1 #503287 SITE CONSTRUCTORS, INC. CHICOCA CO,CAX59592727 (916) 342.8545 FAX (818) 342-8754 August 20 1991 Telefax Letter\ (1-538-2140) x i • T„o Whom It May Concern: This letter authorizes.Karen Maloney to sign forms and permits on behalf ,of Site Constructors, Inc. Very truly yours,. SITE./60 STRUCTOR5, INC. R' and A. Horn Vice President• iRAH : as r i 3