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Home My WebLink About069-250-023i ' ' _ •• k Howard Ingram, Jr. n j, 5333 Treasure Y e' Hill Dr., lot 195,KR# ' B, Oroville - j contr: Better B1drs.Const., Orovill ' Permit #347=80B,P;E" (nQew' s'iri 1 ° J family) "AL na•n - rh ^•• t•�sx eevH.!ay. , . • Y c�069--,2501023~��PERMTT#97,1 61 tFINCH;�Joh`n�'r° 33Treasure.,Hi11l, r� i- e3 W ,emry� r fi Cont, Jeff George' f 'Reroof/SF r'"� ;y'y♦s; ).},+� ��>a i r � - .. ' eV /`S.. W'� rwAM /�wi .tr•V � l•A• � � i A c . f - •. 1 , i Pew RNA - 1 .y _ .^ _. _e q••--.s'•........gF.c.•n:l.:'FR.n , 'aN s , sof.. c. w. c • , STs+ 't•.V i1R" -•59n •+r .r Cxt 069-250-023 !21 >. , •_ '. ..� `'FINCH,'`Johri� 4F,s`�,��'��- .' =5333 Treasure.Hi^llr'�Dr. Or Villd', Cont: Jeff George R6ofingt' d , Reroof/SF ' ,; • V. J • F 1 i • yf COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, Cija 95965 - Telephone (916) 538 - fn PERMIT NO. 754 (Rev. 12/96) APPLICATION AND PERMIT 7 ' �' ASSESSOR PARCEL NUMBER • 06%2n25=0! -2M3 ZONING PT -1 L�I BUIhG PERMIT OWNER .LoTIN VTNCH TELEPHONE SO. FT. OCC. BUILDING VALUATION Q n OWNERS MAILING ADDRESS32 F t t+ u 5131 . a - CONTRACTOR'S NAME JEFF r. F M TELEPHONE ' CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation Is ARCHITECT OR ENGINEER UCENS[ NO. —Filing Fee $ 20.00 Permit Fee $ S ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGATJg3 TREASURE. HILL DR, OROVILLE .l3 Energy Plan Checking Fee $ $ PERMIT FEE $ 65.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑X Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑X Describe Work: REROOF COMP Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI GI W 920.00 PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.00 Main Service loon oa 'ss 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. n License Class - �l Lic. No. Azaa7SL O 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 TO 46.00so WEE200A CCU000A NEW CONST. DWELLING OCCUP. SO OR ADDNS. a ACC. BLDS. 3.50FT. N CONS. NOEWN-RESID.TBRANLcT,,I OUTLET @7.50 POWER APPARATUS a SINGLE OUTLET LIR. Ex. Occup. OUTLET OR FIXTURES BAL@'.S O Ex. Occup. OUTLETSPREs u.DeA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S 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' compensation insurance carrier and policy number are: Carrier S- A:aA-r C,nnn!, MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number r -A J. S en i -- (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 workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X ; t>< d � C, , / Date �' 24/0 7 Signature o Af pplicant - ❑ Owner Q,"Contractor ❑ Agen ' t 11 An OSHA 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 TOTAL'FEE $ y +� HA2. 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 indicated above for which fees have been paid. � 9" tty rl Date (( ;W-111 PERMIT EXPIRES ON�-f 4�/J T Date Receipt No. 222533 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISI N 7 County Center Drive - Oroville, C+ 95965 - Telephone (916) 538-754 PER IT NO. (Rev. 12/96) APPLICA ION AND PERMIT _ ASSESSOR PARCEL NUMBER 069-25-0-023 ZONING P BUIL GPERMIT OWNER JOHN FINCH -T-1 TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS CONTRACTOR'S NAME JEFF CTDRC�F ROOFING TELEPHONE ' CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAIUNG ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENS E NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING AM TREASURE HILL DR, OROVILLE Ener Plan Checking Energy g Fee $ $ PERMIT FEE $ LOT NO. SUBDNISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑XDuplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK �( New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: REROOF COMP Gas piping system t - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 800V 0' LES9 Main Service 20.AORLESS23.00 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. License Class t`_— 1-111) Lic. No. 6ga��`f OWNER -BUILDER DECLARATION 1 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 20IA TO LIIIA 46.00NEW CONST. DWELLING OCCUP. SO OR ADONS. ( s ACC. BLDS. 3.50,T; NEW CONST. MULTI.OUTIET NON•RESIO. c c c 97.50 POWER APPARATUS 8 SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES BA20 L@ I.50 Ex. Occup. ouiiTS REw.SID.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 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' co p nsation ins ance carrier and policy number are: Carrier -,-e t oVA^_—> Policy Number �R (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 workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith uoly with those provisions. � X Date � 1//y;z _ -- Signa re pplicant - D Owner ConUactor ❑ Age grJJ An 01HA per it is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height.6z.___-ate7� MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ HA2. D. FEES IMP FLOOD CDF PARCEL PO HD 6SUE 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. �% `q iC q[ PERMIT EXPIRES ON VDate Receipt No. 9225T! WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD•APPLICANT PERMIT NO. 347-80B,P,E,M PERMIT EXPIRES 6WNER Howard Ingram, Jr. CONTR. Retter R1drs_Const_, Oroville '.LOCATION (A.P. 34-84-23 ) 5333 Treasure Hill Dr., lot 195,KRIMB, Oroville r' R• tE g((,y 4:. k+ e1 • f) !l y i Temp. PowerPole Ca l l edfP G& E Temp.yyElec. Serv. y`= Called PG&E ~ Temp Gas Serv. n. Called PG&E JOB FINALED (Da ) (Signature) P stucco 5 i vz",r4�- LFinal / I Suboanels S'- C;lFo-_h'D Mesh /MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish C Ducts - Underground Interior Lath Ventilation Permanent Door Closer Final 'oma% Final MOBILEHOME UTILITIES ------------------ Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping MOBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE o2 REMARKS OR CORRECTIONS 67 995C -4E4 5, ,�/ :per✓r �� t`I�fF/ht 1'- 0 /NS%7�LL�' &C. �p S i� p RL U�- fao T -E -S7- ^^W S oST- ®S 614C)6z_tTXUSs � SES DeAS "S `tW u— s 7-u c��- Tb TW F&n- (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE — DEPARTMENT OF (PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets st Floor Main Bldg. Restroom Finish 2nd Floor Footings 16_ Windows 3rd Floor A 41 StemwalI Siding To out Slab Roof Sheathing * Water Piping Piers Roofing Sewer Garage Fdn. Vents VFixtures ,- Footings StemwaI I Garage Vents "- --- Insulation Water Htr. Heaters C Slab Carport Footings Prov. for physically �� handica ed Conformance of ex. structure ----------- Appliances nix, P'� Gas Piping & Test Tem . Gas Slab Final Sanitation Patio FIREPLACE Final Footings 3- Footing OLECTRICAL Masonry Walls Throat �� Rou h Reinf. Steel d Final to " O Fixtures 4_0 6 Bond Beam FIRE SPRINKLERS Motors r— Framin !J Test Water Htr. — _-^ F -D GJ stucco 5 i vz",r4�- LFinal / I Suboanels S'- C;lFo-_h'D Mesh /MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish C Ducts - Underground Interior Lath Ventilation Permanent Door Closer Final 'oma% Final MOBILEHOME UTILITIES ------------------ Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping MOBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE o2 REMARKS OR CORRECTIONS 67 995C -4E4 5, ,�/ :per✓r �� t`I�fF/ht 1'- 0 /NS%7�LL�' &C. �p S i� p RL U�- fao T -E -S7- ^^W S oST- ®S 614C)6z_tTXUSs � SES DeAS "S `tW u— s 7-u c��- Tb TW F&n- (NOTE: An entry must be made on this form each time you visit the job site.) 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 VVI I (location) BUILDING PERMIT NO. R97 -8G,(; A:P. NO. THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS: (Check each item or write N/A if not applicable) INSULATION: GLAZING:. Slab Edge. A)A Single Glazed AJJ9 Fdn. Walls AUS► Special (Insulated) Floors CERT. & LABELED WDS. Walls & SLIDING DRS. Ceiling/Roof WEATHERSTRIPPED DRS. Ducts ✓ BACK DAMPERED FANS Circulating Pipes INTERMITTENT IGNITION DEVICES APPROVED HEATER �— CERT. APPLIANCES APPROVED WTR.HTR. 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 Q,u MavQgj 0" OeTAAS6,Y9 Signature of (please int) Insulation Applicator License No. Q;2 j2 General Contractor/Owner Name \oA j N 31i►.Qg please print) Signature of _ General Contractor/Owner\JaDate 9 -015-8 Q State Contractors License No. THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO REQUESTING FINAL INSPECTION.AND SHALL BE•4POSTED IN A CONSPICUOUS LOCATION WITHIN THE DWELLING_ 1. j . Owner}�� Mailing Address Contractor QEzwl Mailing Address _91& Building Address 5:5.3 r COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 n Telephone: 534-4541 ��—� APPLICATION AND PERMIT . _ BUILDING IL -1-01 SO. FT., I OCC. I BUILDING VALUATI Telephone No. Sty 6 ®s = GJ (� Fireplace / Telephone No. Total Valuation �(� Permit F (pd (�_ Plan Checkin Fee /or Penalty 8 a,ll;,0 4 (3 (oT A. P. No. 3Y 5r 'Z., rZoning & Planning Fb6s W4Gl S FireDept. Fire Zone Use Permit EQA Parking Parcel Parcel M 60' R/W Improvements Plans Declaration P — Bldg. Plah--Rec'd I Parce roya/S.rl Plans Ap val NEW 1,�Rt ADDITION ❑ UTILITIES ❑ OTHER ❑ Single Family 19 Duplex ❑ Mobil Home ❑ Others ❑ PLUMBING PERMIT FILING FEE Each Trap Repair drainage or vent piping Water piping Each gas water heater or vent Gas piping system 1 - 5 outlets Each additional outlet Building sewer Lawn sprinkler system Permit Fee ELECTRICAL PERMIT FILING FEE Main service 8011 OR LESS 100 AMP OR LESS Main service EA. ADD'L 100 AMP Main service OVER 600V 100 AMP OR LESS Main service EA. ADD'L 100 AMP @ FEE c�<E9e $3.00 a.6b . O O 1.50 07150 _Z1* 00 1.50 1.50 .30 5.00 2.00 $3.00 5.00 2.50 25.00 1.00 FEE 400 CONTRACTORS LICENSE LAW am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style le of: 1LJli �� 1✓�u�/ Ex rWs NEW CONSTR MULTI.OUTL�TNON-RES,..RANCH CIR 2.50ea NEW CONSTR POWER APPARI NON-RESID. SINGLEOUTLT Ex. Occup{OUTLETS OR FIXTURES g L l 24 APPLNS. OR Ex. OCCU (OUTLETS P• 1 OUTLETS (RESID.) EA) 2•00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification l�swa'�nf Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of I epr t- h. i of the California Labor Code which re vires eve em I er t be ' s r d a a' t I' b'I't MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 �'. � Hepting 16,0 X,.,, ,OZ q ry p oy o rn u e g Ins Ia I I y for Workmen's Compensation. I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. ie 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. 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. X Dated notur f Permitee�or Agent I / eceipt No. ite-D.P.W. — Ye o - sesso — 1;P4 Inspector • Goldenrod -Applicant Cooling ,,_ I I 1 45-0 1 Ventilation Hood 1 1 2.0017. Ob Permit Fee $ . t5z $ %!p Land Development Fee TOTAL PERMIT FEE 3 This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above which fees have been paid. C 0 O4PU.IC WORKS B Date Building permit expires Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION .. ;� . 4 7 CNvnty Center Drive — Oroville, Caiijornia 95965 -- Telephone 534-4541 PERMIT APPLICATION DATA SHEET Permit No. O� OWNER �t'U�afk>�� Nla %�+^- R A. P. No. Proposed Building Use 1�54rC) Permit fee based upon: Complete Contract Price DPW Valuation yOy))ther (explain) Building Inspector. �� +Y�». Date /./ S/X' At time of permit application, I 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............................................................... 3. Complete plans in duplicate/triplicate................................................... 4. Complete engineered plans and calcs..................................................... / 5. Plans with Energy Design Compliance Statement ............................ 6. State Energy Forms No. .................... Statement of Intent for Non -Heated & AC Buildings ................... 8. Fees of $ 4a. <�.................................................. Letter of signature authorization............................................................. 10. Sanitation approval from P J6 Uv Health Dept.... 11. Planning approval for 12. Certificate of Workmen's Compensation Insurance ........................ 13. Contractors License Information (no., name style, I classification) ............................... 14. Improvements may be required. Contact Land Development Section of Dept. Public Works (see addressbelow)................................................................................................. 15. Pre -inspection for required. Pre-inspec. request to 16. Other bldg. inspector (date) When you issue thepermit, process as follows: Mail to owner Mail to contractor. lephone -•,-V- and hold for pick-up at Coffice. Deliver w/inspection. Other , y Applicant11�. \ J Date J -j ? -r3,1 Copy of plans sent Health Dept., Fire Dept., - Other Date During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at time of applic circ 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by _ie!flelephone Mail Other By Date Plans checked by Date Plans approved by Date 090 OTHER: Cnnv/npw A $ APPLICATION. FOR SEWER CONNECTION AND SERVICE FROM NORTH BURBANK PUBLIC UTILITY DISTRICT ,�/ �/ �� 4inv /►' hereinafter referred tows "Applicant", being the property owner for which sewer service is d sired, hereby requests the North Burbank Public Utility District, hereinafter re- ferred to as "District" to connect Applicant's sewerage disposal line to the North Burbank Public Utility District's Sanitary Sewer System �ann�dd o provide sewerage service. Location of property: .�3�/1?�r.,a�h� ,X.6 Number of dwellings Mr.n.tPA nn nrnnPrty Subd' 'ion Lot lock W"In District ❑ Out of District Kind of Service Resid.ential. ❑ Rental ❑ Residence . ❑ Duplex ❑ Apartment ❑ Industrial Number of hookups this application to cover Number of outlets per hookup Hookup fee New Service Total amount payable Service to be in accordance with the conditions hereinafter set forth and the ordinances and rules and regulations adopted, or to be adopted, by the Board of Directors of District, all of which applicant agrees to abide by and fully perform. Applicant agrees to pay for such service at.rates of tolls and charges as established by the District f rom ti to time. Date v Sig ture f Applicant and Owner 7 79 Mailing Address CONDITIONS OF ACCEPTANCE OF SEWERAGE SERVICE 1. The District, its officers or employees, shall not be liable for damages to persons or property oc- casioned through the installation of any sewer connection, or sewer service provided. for by District. 2. In accepting this application District does not hold itself liable to the Applicant for failure to per- form any of the obligations imposed upon it or assumed by it under this application if such failure shall be caused by inevitable' accident, Act of God, fire, strikes, riots, war, lack of capacity in District's sewerage disposal plant or lines to handle the sewerage or any other cause beyond the reasonable control of the Dis- trict. 3. District will not be liable for and Applicant shall hold District free and harmless from damages. re- sulting from interruptions in service or stoppage in lines and District assumes no liability for damages to persons or property occasioned through defective sewerage lines, meters or other facilities. 4. All inflow pipelines to the main sewer lines of the District's shall be of such size, quality and material as will meet with the District's approval. All connections to the main sewer line 'of the District shall be made in accordance with the specifications of the District and shall be made by the District at Applicant's sole cost and expense. 5. Applicants are informed that it is necessary to secure permits from the County prior to interfer- ing with or disturbing rights of way of the County such as alleys or streets. 6. No storm drains or storm w to I1 be di ted into District's Sanitaxy�/Sewer System. This application accepted thi ay of. = , 19y Payment on above application recei d by cash ❑ c ❑ $_ _ NORTH BURBANK PUBLIC UTILITY DISTRICT By By Telephone 583.2000 North Burbank Public Utility District 1960 Elgin Street OROVILLE, CALIFORNIA 95965 6-80 DISTRICT APPROVAL AND VERIFICATION OF INSPECTION BUILDING SEWERS This verification form must be submitted to the Butte County Department of . Public Works - Building Department prior to issuance of a building or occupancy permit, whichever is applicable. Prior to final approval by Butte County of a Building or an Occupancy Permit, a copy of this verification form, signed off by North. Burbank Public Utility District, must be submitted to Butte County. Applicant: HOWARD INGRAM Applicant Address: 22472 Orelcana Dr., Mission Viejo, CA 92691 Applicant Phone No.: (714) 8303860 Property Location (s): 5333 Treasure Hill Drive Kelly Ridge Estates Lot 195, Unit 4B A. P. No. (s): 034.84,.0-023,0 Fees Paid: SC -OR Faciltty Charge $325.00 paid 7/25/79 and NBPUD Connection Fee Application for service approved: _ /-wV-Jo in '�--, yr " �• .,4._.�c ,/ North Burbank Public Utility District Inspection(s) made and successful test(s) observed: Location: M - Date: North Burbank Public Utility District release to close permit: Date: By: ��' r.Y � ��I! er � � i, � ".I�F i + � ll i ,� t � j4 � 4 "tl �� 1-iX �s �� ! a�' � i 'GI � O,t ''fl ��f yr��P�� "; 1�i �''xa� Y ,. � i G i i t^ P i { i u d . Y r . �' �: N�! ' ei, . 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