HomeMy WebLinkAbout059-073-010OUG E NI,
P St, S
59-073-m-10
4 DOUG ERMINI,&'ANDRIE IXAF
log Pifne St, Stirling 'C3 -.'t
p it J� 1
Pe:rm* #
it 31 -82B,��E jNe
w/SF)
s
".4
CWD
m
LLM C"l
PERMIT NO. 3132-82B,,P,E,M
PERMIT EXPIRES -
OWNER DOUG ERMINI & -ANDRIE LEAF
00
CONTR. Owner
A
ASSESSOR PARCEL 59-073-10
LOCATION 709 Pine St. Stirling City
7n,
F II 'El
PT
4�4- 94,-" , I 'V - .
71
'Ift
meterZ t
;By
-IECTIRI'C
!D�t
*--Addresso
me y Date
L C�
E A I C t�L4
Meter By Dat�,_Y,�
Temp. Gas Service
J4
CalledPG&E
tej
JOB FINALED (Da
Signature.
E)k
0 = Not OK f
- = Not Applicable MOBILEHOMES MISCELLANEOUS
= Not Ready
Date
MOBILEHOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements-Setba�ks-Easements
Date ---DECKS,
COVERS, CARPORTS, ETC. (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH S6ppoit-Sketch
2. Foot i ngs �'Si ze-Depth-Spac i ng-Connec tors
3. Sewer; Location -Test -Fall -C/0 -Concrete
3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Water; Local i on- Te st- Easement Needed (Sketch)
4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing
5. Electricity; Location-Clearances-Grnd.-t Amp -Concrete'
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Gas: Location -Test -Wrap: Nat. or/ P' LPG
6. Carports: Windows -Doors
7. Uti I i ty C learance
7. Elec.
Card -BI
Date Card -BI Date
Card -131 Date Card -131 Date
C6rd-BI
Date
Date Card -BI Date
MOBILEHOME INSTALLATION (Plans) OK except #'s
Card -131
Date
Date Card -Bl Date
POOLS (Plans) OK except #,s
1. Zoning Req u I rement s-Setbac ks- Easements
1. Setbacks -Easements
2. Footings; Size -Spacing -Marriage Line
2. Soils; Compact i on -Structure, Stab i I i ty
3. Gas; MH Test -Demand -Valve -Connector
3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining
4. Electricity; MH Test -Crossovers -Breakers -Clearances
4. Elec.; Receptacles and Lighting; Distances-GF1
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 -00 to Grade -HD Approval
7. Elec.; Bonding; Metal w/5'-Circul,ating Equipment -Heater
8. Gas and Electricity Tagged
8. Elec.', Grounding; Equip. w/5'�Circulating Equip. -Pool Lghtg.
Boxes -Enc losures-Pane I boards- Ins. to Main in Conduit
9. Exits; Insp.-Sketch
10. Cart. of Occupancy
9. Health Department Approval
10. Plumb; Cir. Test -Water Supply Test
Card B-1
Date Card -131 Date
Card -BI
Date Card -Bl Date
Card B-1
Date Card -BI Date
I Card -Bl
Date Card -Bl Date
U
%t = OK
0 = Not OK
- = NotApplicable
= Not Ready RESIDENTIAL (Single and Duplex)
Date
UNRnFLOOP (Plans) OK except #s
Date
F
NG �Continued)
Jr Zo��g requiremen S�_ Easements
4LrZ_PFWerty Line Firewall & Openings
SME
Z,4*Tg., Main; Soilslkee ec. Grnd.- Ftg. Depth
49;
54,,llbors-One 3' -Check Garage -3rd story, 2 exits
3. Fig., Garage; Soils -Steel- / /" Ftg. Depth
50��s;
Width -Headroom -R ise-Run-Land i ng -F ire Protection
4. Ftg., Porches & Decks; Soils -Steel- / /'' Ftg. Depth
511'
P>W'ood on Roof Overhang -Attic Vents -Rafter Outriggers
,A,,-Stemwalls, Main; Steel-Blockouts-Wrapped-Slab
52PSiding-Nailing-Veneer
6. Stgemwalls, Garage; Steel-Blockouts-Wrapped-Slab
53.
Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access
*'Pier§,Pireplace Ftg.-Steel
54.
Glazing Area -Glass Protect !on-Skyl i ghts-P last ic
$:_7
87,90kV.: Fall -Fittings -Test -2 way C/0 -Sewer. Test
55.
Shea4�al�; Naili 29 -Bolts 17
9. G�,�ipe; Size -Anchors
0
, EZ7
-5:L-
10f�Water Pipe: Test -Anchors -Regula tor-ServicezF�S;It,
47
,Z
11. Electric; Underground
12. PlqpAffl5s_& Ducts; Clearance -Material -Support -Ins.
ota
Z
=.14.;'Girders-Sills-Anchor
Bolts -Joists -Vents -Cripples
Card -BI
Date 61,40 �ard-Bl Date
Card -BI
Card -B11
Date Card -BI Date
Date Card -BI Date
Card -B 1 4+
-,,9bate j�41�1�Card-Bl Date
Date
Plans) OK except #'s
Card -BI 4t�"ate 6,2:7r1:::YCard-BI Date
Date r_
PLUMBING (P4&
11!�<except Ws
5601
Ex!,Zwoi-Door & Sidelight Protection -Landings
571
--Smoke Detector
CV41%
24, Wajer tL, glfnt--Access-Combustion Air
611�urnace;
Vents -Clearance -Comb. Air-Connector-
GZroge; Above Floor-Ducts-Mech. Protection
11��ater Pip6l�Anchors-Nail Protection
16. D.W.V.Q__J!P4ttngs & Anchors -Nail Protection
SY
Be room Exiting
�d
17. Shower Pan:Test, First Floor -Tub Access
6QVG.f-4.
& Bath Fixtures & Tub Access
18. �est Tub & Shower, 2nd Floor -Tub Access
61,4-tl_V-
Trim & Subpanel; Breaker Sizes -Labels
14WGas Pipe; Size & Anchors
6Q,/�top"
Rails
621,!!�ir"ce
or Stove; Clearances -Hearth
64.er1E!::_:2ut
lets at Wood Panel; Int. & Ext.
Card-Bl^,44�/_
Date J! :C,� :,-��rd-Bl Date
6544�Ki
xt. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI
r,� _Dat Card -BI Date
60F;-Elec-
-63L.��e
Outlets P. Receptacles at Kit. Counter
Door; Swing-Lan8ing-Closer
r
Date
NJ
ELE.C14111CAL (Permit) OK except hi's
e&--0r.i_a--0uct
in Garage -Damper
20A�ixtWe-VTransformer Clearance -Ins. Protection
69VXtr.
Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
I earage; Above Floor-Mech. Protection
9
21. *�SReceptacles Spacing -Lights & Switches at Doors
70KPIb.,
-
Elec. & Mech. Equip. Listed for Lor."ation
2?,t 4fz@,Bff%es & No. of Conductors -Stapled
44��.
6ceptacles in Garage; (G.F.1.)-Rom!.,�, Protec.
4= 'X-0mex Installed Close to Edge of Studs & C.J.
72.
I"tion-Pemrr--Looked in Attic 191YIRS
'l,'k" S,11±,::::�O�!�Found
made up w/Mech. Fasteners -Bond Gas & Water
731�"Guard
Rails & Deck Construct ion -Post Caps
25. A�-Appliance Circuits in Kitchen & Conductor Size
74.
Fdn, Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance
Looked under Floor AYes
126. SUl5re_e-dVq?MSije I / ga. C!�,Q Al-A.C. Wire Size ga. Cu or Al
27. Range Circ. /C..* a C u o�� ga. Cu or A 1,
Insulated Neutra es
75.
Following instld.: Drive _0 Yes ZN-oWalks E) Yes Ellqo;
Planters Dyes EJWo-
28. Service -Riser ConquctorsiC�rojoAAain Disconnect
76-SimecalTrown-Finish
2910 -Equip. Clearances; Pane I s-Motors-Mec h. Equip.
77--AvG,-tttr*,-Disconnect-Cirnces-Brkr.
& Cond. Size -115V Outlet
Closet Light -Shower Light
7§�,4ents
Above Roof; Plbg.-Appliance-Firepi.-Clearance to Opngs.
Za__W&tTr-7eTl; Disconnect, Electrical, Plumbing
80.
�grior Elec. Trim; G.F.I. Receptacle -Underground
Card B-1 !1Wr!rQate&'
Z!r -Bl Date
�Z Card
81gVre_q�tilation
throughout House
Card B-1
K VDate ard-81 Date
_ Q,
82,00islas
i on
Date
f -I / _100r
MECHANICAL (Perrr.it) OK except #'s
31. A.C. Ducts: Insulation & Support
83.
_s�61ect
&Q6rrectionsJrorn Previous lnspection!,,,��
-84.
)tWTAaf-"Meters Tagged; Ga§o�ric
85.*ftW
& Sewer Connected -C/0 to Grade -HD Approval
32. Vent Fan; Exhaust above Insulation
33. Condensate Drain & Overflow; Size & Grade
86,;-IlEnergy
Compliance Certificate -Other Certificates
17AP 4 4
34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet
35. Attic Access & Platform it Furnace in Attic
Card -BI
Card -BI
Card -BI
7%
Date Card -Bl Date
Date-/ Card -BI Date
Date Card -BI Date
Card -BI Date Card -BI Date
Card -BI
Date
Date Card -BI Date
FFIAMIN,9(Plans) OK except #'s
Comments at Final:
. ills;,Proper Material & Anchors
3 ; all , tuds-Nailing, Spacing & Bracing -Plates -Sound
Zy,oFff-earing Walls over Girders & Floor Nailing
e��Dra�St.p
�_X_404e:�<La-Slops;
in Walls (rat proof)
Furred Ceilings -Stairs -Chases -Tub
411ff�eader & Beam -Size & Bearing
4,,,P,' jpP9'er?::Post ciaLs-AnchorsAonnectors
4 '-Clng. Joi st-Rftr. TLa%_Q44rdin- Roof Brac.-Truss-Shthrip.-Rfrip.
44. Fireplace Ties o(Type YF?ue-J5IrepIace Throat
ccess; size Ofo-mex Protect ion -Draft Stop -Ins. Baffles
4 drm. Windows or Exiting Doors -Sill Hgt. & Dimensions
�ire Protection Framing
(NOTE: An entry must be made each time you �isit job site)
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico —'Phone: 891-275i
7 County Center Drive, Orovi Ile — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTI N NO
BUILDING OR PROPERTY ADDREAS
A routine inspection Indicates that the following violations of County Ordinance
exist at the above address' and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matteer,or need a ilional explanation, 'please contact this office immediately.
Inspector
Date (,::;p
14
RESIDENTIAL
ENERGY CONSERVATION STANDARDS
CONSTRUCTION COMPLIANCE CERTIFICATE
THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN
INSTALLED IN CONFORMANCE WITH CURRENT ENERGY CONSERVATION REGULATIONS
AT__�Z j�) '/' e 5'��
(location)
BUILD'ING PERMIT NO. 3 1 S,? rr A 6'P.. NO. (273 -ID
THE FOLLOWING HAVE BEEN INSTALLED AS PEk-APPROVED.,PLANS:
(Check each item or write N/A if not applicable)
INSULATION:
Slab Edge�_ VIA
Fdn. Walls
Floors
Walls
Ceiling/Roof
Ducts � A -J
Circulating Pipes /V
APPROVED HEATER A�IA
APPROVED WTR.HTR. )U/4
GLAZING:
Single Glazed
Special (Insulated)_
CERT. -& LABELED WDS.
& SLIDING DRS. -/UA
WEATHERSTRIPPED DRS.
BACK DAMPERED FANS
INTERMITTENT IGNITION DEVICES
CERT.. APPLIANCES /V
I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED
IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO
THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED.
Insulation Applicator Name.
Signature of
Insiklation Applicator,
State Contractors
License No.
General Cont rac tor /Owner Name -t- bov(� Ev'm ; r ;
Signature of .('please print)
Gkneral Contractor/Owne Date
— &/- P -3
State Contractors
License No.
(please print)
THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO
REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION
WITHIN THE DWELLING.
COUNTY OF BUTTE - DF-PARTME.NT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSO.B PARCEL NUMB R
Z. ING
�r %_�
BUILDING PERMIT
NE
Ila 61,ov J /V/
7'ELEPHONE
7
SO. FT. OCC. BUILDING VALUATION'
40 0
OWN S MAILING ADDRES6
/ Z�� Z��
7-4= 4�
10 61
CONTRACTOR'S NAME ]TELEPHONE
Z- Dae�
a o
.46
CONTRACTOR'S MAILING ADDRESS
Fireplace Owe),
0 0
CONSTRUCTION LENDER
AIQ�11(/ f-
UNKNOWN
I
Total ValuA(ion $
Filing Fee
$ 10.00
—
LENDER'S MAILING ADDRESS
Permit Fee
$ 2��6 45
ARCHITECT OR ENGINEER
Allod_IA7
LICENSE NO.
I
Plan Checking Fee
$ ;ZZ,00
Penalty
$
—
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$ PZ lh!F,
BUILDING ADDRESS
ZAIZ
PLUMBING PERMIT
F i I i ng Fee 10.00
_C��625EZla_)
Each Trap
2.00 IV
.CX
Solar Water Heater
20.00
Water piping
5.00 0
LOT NO.
UBDIVISION NAME
is
PAWCEL MAP
Each qas water heater or vent/ -,,,,"4 5.00 j7e
Gas piping system I - 5 outlets 5.00 3-,6
USE OF STRUCTURE
SF9?'.<upIex[] MobilehomeF-1 Other SPECIFY
Building sewer
5.00 0
Mobile Home S I G W
10.00 ea
I
TYPE OF WORK
New V��AdditionFl R emode 1 [:1 Utilities [:1 InstallationEl Other 0
Describe work:
Permit Fee
$ 06
Contractor eewA1,Cx_
ELECTRICAL PERMIT
Fi ling Fee 10.00
Main service 6001 OR LESS
100 AMP OR LESS
10.00 W, jg C)
Main service EA. ADD -L 100 AMP
2.50
NEW CONST DWELLING ?. 2. &)
OR ADDNS. ACC.BLDG
—
21/20sq ft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
El I am licensed under provisions of Chapt. 9, Div. 3 of the business
and Professions Code and my license is in full force and e f fect.
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
for this reason
NLLW CONSTIRL(MU1 TI -OUTLET
NON-RESID. BRANCH CIRCUITS) 2.50 ea
NEW.CONSTR. (POWER APPARATUS.&)
NON RESID. SINGLE OUTLET CIR
20@50c
Ex. OCCUP( OUTLETS OR FIXTURES BAL@ 300
FIXED APPLNS. OR
Ex. Occup. OUTLETS (RESID.) EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.010
Permit Fee $
Contractor 10_441y�_/c
MECHANICAL PERMIT
FilingFee 10.60
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
R The permit i's for $100.00 (valuation) or less.
E] 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-Inswe.
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.
H eating 44-0cl Ir'O"Is
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 ot
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
aga , t aid C ity in consequenQe of the granting of this permit.
X Date c�a?" -2�
Signature of epplicont - Owner Lg;�'�C t r El Agent
An OSHA permit is required for excavations deep and demolition or construct-
ion of structures over 3 stories in heig%f Ae-1
Mobile Home Installation Fee &0
TOTAL PERMIT FEE $
occ up
P
CONST.
JP,7LJ
PD
ISS E
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOV 7FPUBLIC
1_1�/
By-
PERJ" EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date/--., - -1--2
Receipt N 0.
WHITE-D.P. w., YELLOW-A;SES OR,�(NK 'liCTOR, GOLDENROD-APPL I CANT
5 -INSP
Return to DPW
AGRICULTURAL STAMIENT'OF ACKNOWLEDGEMENT
FOR RESIDENTIAL DEVELOPNENT
Section 26-8.1 of the Butte County Code requires this acknowledgement
be recorded prior to issuance of a building permit..
y- F F I I.- I A-' q. R Ll
quiqe - �E
ODIS R-MPUL.C-1.
act
446
DFR
The property described herein. is adjaceni to land or included
within an area,zoned for agricultural purposes, and residents of.
this property may be -'subject to'inconveniences or discomfort arising
from the use of agricultural chemicals, including, but not limited to herbicides,
pesticides, and fertilizers; and from the pursuit of agricultural operations'including,
but not ' limited to cultivation, plowing, spraying, pruning, and'harvesting.which occa-
sionally generate dust, smoke, noise, and odor. Butte County has established agricul-
tural zones which have as -a priority use for productive agricultural purposes,', and
residents within said zones and on adj'acent property should be prepared to accept such
inconvenience or discomfort from normal, necessary farm operations.
All that real property situate in the County of Butte, State of California,
described as follows:
4 t5 7-10 tviv . 1D. F
ST EIRLM/Cr CT -7-X R5 011 7'-416
17., e e c e
Of
T
Date: PROPERTY OWNERS:
S tatoi�-bf California)
) SS.
County of Butte _)
On this the 22nd.. day of October. 19 82
.before me, the undersigned Notary Public, personally
appeared
Douglas Ermini and Andrie Leaf
;PC
known to me to be the person(s) whose name(s) are
subscribed to the within instrument and acknowledged
t t ' they executed the'same for the purposes UA
ha
OFFICIAL therein contained.
I Vc, T7=nVA-M
SEAL Z
T 1- 11 A A f4:4 4 1
XAREN M. HOM Z ereunto se My CL" M" W
140TARY PUBLIC - CALIFORNIA Z seal.
PRINCIPAL OFFICE IN THE
COUNTY OF BUTTE
Comm. Exp. Oct. 21, 1983 X
Present A.P. NO.
END OF DOCUMEM
191
(!,-" -- I
RESIDENTIAL PLAN CHECKING GUIDE
(S.F DUPLEX, -&-MISC. ONLY.)
Bldg. Permit #
OWNER 2E-073-20
A.P. # I-
A. GENERAL V Z__
zoning requirements (sideyards and parking).
Valuation.
Signature by R.C.E. or Architect (if required).
B PLOT PLAN
,I-r"*omplete parcel size and dimensions.
_2e,.O- , Setba6kq, sideyards, easements, etc.
>50'Other buildings or structures.
Grading, fills, drainage.
C. FLOOR PLAN
Complete to scale plan with dimensions.
-2--' Required windows for light and ventilation (Sec. 1405).
---I Required wi dows for second exit (Sec. 1404).
_,3. in
-Jr-' Allowable glazing for energy requirements (20% max. per.State law).
---51 Human impact glass (Sec. 5406).
-A-.---Required room sizes, ceiling heights (Sec. 1407).
'Z- -8).
G.F.C.I.'s in baths and exterior outlets (Sec. 210
Light fixtures, switches, receptacles, and exterior receptacles for maintenance of
mechanical equipment.
Locations of water heater, heating &-cooling equipment, other electrical or gas
equipment, and plumbing fixtures.
1Q��.Garage firewall, door size, and closer (Sec. 503(d)(4)).
I - 3'0" exterior exit door (Sec. 3303d).
-1-2.1 Fireplace location.
Smoke detectors (Sec. 1413).
D. STRUCTURAL DETAILS
Foundation plan complete enough to construct building.
Floor construction details complete enough to construct building.
_�3 Elevations and wall construction details complete enough to construct building.
I
ioof construction details complete enough to construct building.
Fireplace construction details and calcs if over one-story in height.
u fficient data and details to satisfy energy insulation requirements (State law).
E. NISCELLANEOUS ITEKS TO LOOK OUT FOR
//j, CX plywood on exposed locations and overhangs.
'��S airway details (Sec. 3305).
.Guardrail details (Sec. 1716).
Brick or stone veneer (Chapter 30).
Exterior plaster - weep screeds (Sec. 4706 & 4708).
/ aProper roof pitch for roof covering (Chapter 32).
.__7 Rafter ties or bearing ridge beam.
SP-- Garage door or porch header sizes.
9,) Adequate bracing.
Living area over garage - complete 1 -hour separation required including supporting
walls and posts, etc *
Y. Two (2) exits on three-story dwellings (Sec. 3302).
CLAIMANT:
ADDRESS -
CITY & STATE: Stirling City, CA 95978
DATE OF CLAIM- ___Eekruary 1, 1983
SUBMIT CLAIM TO DEPARTMENT RECEIVING G
e"a* a&f&
OROVILLE, CALIFORNIA
GENERAL CLAIM
Doug Ermini
General Delivery
'h Q&TANT:
EE INSTIRUCTIONS
_� 6E
ON REVE E DE
E iV
0 1 E 4VC
DATE
DESCRIPTI'ON OF CLAIM JD�ESCRIBq_hLLY TOJIJID DEJ
AMOUNT
GROSS
i DISC. AMOUNT
owner has decided not 4toNq'Bldg 4fpe�l tappin. 1f432-82B,P,E
7 --
L
*
Receipt—#72125--dateUl
vok
Building permit iee_pvur --------- ------- $ -00
5io
*' 9%H e ------- $74.
Retain pLan ch
Retain fiW g f e ----- — - 10.00
n 'W -w -4$
Retain re-�Inspec ion 4,C71L7. $ 15. 00
Amount litaine 9 9 - qL_T%./ 4)
r,..ReXpd
d Lipliv ----- IN- - - --------.00
X N.
i L B. permit *etprid ------- N"/ ----- IVW4 0. 0 0
1 ing--fee i ---------- ---------- %N164 -
Vefund\d'e ---- 7 ------ �\ -- ------ A ----- V -------- -$ 30 00
A�ff 17--
Electr' ermit feA Id ------- -1 - ------ $ .'0
rNC P Pi
—I I ing fee --- w--; ------- ------
Refund��
due-;Z� ------- i% --------- - C *9 -------------- $ 1
A ---------------- $19!
TOTAL REFU
F - .
$190.50
I
\J
hit
TOTAL
$190.50
1, the undersigned, declare under penalty%f perjury that the services or articles claimed have been performed or delivered, and that this
c .i -m is true and correct as stated.
K
Dated this ..... day of....T 19, Calif.
at
C I a i m an t
1, the undersigned, hereby eertify that, to the best of my knowledge, the services or articles specified above have been Performed or de-
livered and that there is a Budget Appropriation E) or Specific Board Approval F_� (Checkone) for the some.
lstDated this .................................... day of ..�ebruary 83 Oroville Calif. p�
........................ 19 . ..... at .............................. 1 -.1 _7
'; , - �l ...................
t .:'
X �' t*�`en I ead or Au
Dept. Exp.
C: ode ............................................ Code ................................................ PAYABLE FROM .................. V ........... ------- ------------ FUND
DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY
VENDOR DEPT. P
CODE & SUB. ROJ.
SUB. CLAIM
0 BJ. 11,110.
INVOfCE INVOICE
NO. DATE
GROSS
i DISC. AMOUNT
ENCUIAB. SUB.DIST.
7 --