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Home My WebLink About072-190-036r 72-19-36 LARRY TOMLINSON N/S Forbestown Rd, app 600'E Old 01' e Hwy,.Oroville Contr:Coln illage o omes (uutiI., O }EEC S A 7R SUPPOR U, RE COMPAC IO ES E CLAIMANT: ADDRESS: �W v OROVILLE, CALWORNIA / GENERAL CLA1,�4 Lincoln Village Mobilehomes 2628 Lincoln Blvd.. CITY & STATE: Oroville, CA. 95965 _— IMPORTANT: March 19' 1981 SEE INSTRUCTIONS DATE OF CLAIM: ON REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT _11/25/80 Not oing to put in_utilities fora mobileho_me__ (Permit_#5765-80P,E_-_—.---___._— — Receipt #44444 - AP 72-19-36) ! I i Total Permit Fee Paid ----------- $77.50 - --- ---r-- Retain plan check fee ----------- $10.00 - Balance --- $67.50 Plumbing permit fee paid $30.00 Retain filing ee--------------- 10.00 Amount of refund due $20.00 j Electrical permit fee paid ------ $37.50 I _I ------------- e ain tiling tee --------------- Amount Amount of refund due ------------------------ $27.50 I TOTAL REFUND DUE ----------------------------$47.50 $47.150 j I TOTAL $47.1 0. I I, the undersigned, declare under penalty of perjury that the services or articles claim gd`have been performed oralio; red, and that this I \\ _I claim is true and correct as stated. 16th 81 Oroville r 1.:•1,Lti�j"v`�� ' Dated this day of ..March 19 at calif.---,- .................................. . ..............f .............. ....................... ........................... �- Si aturr of Claimant 1, the undersigned, hereby certify 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 or Specific Bdard Approval[�:] (Checkone) for the same. Oroville 19th,,,,,,,,,,,,, March...,,..,, Dated this day o_ 15..81 at Calif. ................... r ................ Department Head or Authorized Deputy Dept. Exp. — --------- Code............................................ Code ................................................ PAYABLE FRONI............................................................................................ F UN DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY VENDOR DEPT. SUB. ! CLAIM ' INVOICE INVOICE' GROSS �I._." PROD. CODE & SUB. -- 0B.1i I I DISC. I ENCUfnB. SUB -D: ST. — I{ —�--- 1 — _-- COUNTY OF BUTTE OFFICIAL RECEWT. 1rp 44444 t 0- ro;;r s OFFICE OR DEPARTMENT IS UING RECEIPT � Received from The Sum of P % V For A 1A — Av Received: Received By—(2 CASH ❑ Title CHECK By WK ' COUNTY OF BUTTE - DEPARTMENT,OF PUBLIC WORKS PERMIT NO. • , S' 0 7'County Center Drive - Oroville, California 959E•5 -Telephone 916/534-4541 APPLICATION -AND PERMIT ASSE RCEL NUMBEF3, �l/J �G i p I DING PE T OW ER'TELEPHONE O m hS SQ. FT. OCC. BUILDING VALUATION OWNER'S MAI AD RE s I 1 d D - CON RA TOR'S AME 1 (�� Y \ lY ma-& TELEPHONE — CON'TRACTOR'S MAILING ADD— J__1hyor CONSTRUCTION LENDER UNKNOWN %-V\ LENDER'S MAILING ADDR ESS ARCHITECT OR ENGINEER LICENSE NO. ARCHITECT OR ENGINEER'S MAILING ADDRESS Fireplace Total Valuation $ Permit Fee Plan Checking Fee Penalty Permit fee $ $ {j 0 $ $ BUILDI G ADDRESS S rb PLUMBING PERMIT Filing Fee oo J QA Each Trap 2.00 Repair drainage or vent piping 2.00 Water piping tQD LOT NO.SUBDIVISION NAME PARCEL MAP Ja—'// Each qas water heater or vent 2.00 Gas piping system 1 -5 outlets USEOFSUCTURE SF [__1Duplex ❑ Mobi lehome Other SPECIFY Building sewer Lawn sprinkler system 42.00 !1 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities Installation❑ Other ❑ Describe work: — Permit Fee $ 130-1010 Contractor ELECTRICAL PERMIT Filing Fee I in)00 Main service 100 AMP ORV OR LESS5.00 i Main service EA. ADD'L too AMP 2.50 NEW CONST. DWELING OR ADDNS. ( ACCLBLDGS.CCUP.&) 20 sq It CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one):ULT I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professi s C de and y license is in full rc n effect. License No. Y Classification ❑ 1, 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 CONSTNON-RESID R BRANCHO CTRCTITS 2.50 ea NEw CONSTR. ( POWER APPARATUS &) NON-RESID. SINGLE OUTLET CIR. i RESOccD. SINGLE Ex. OR FIXTURES 50@� BAL@toc FIXED APPLNS. OR Ex. Occup.(0UTLETS (RESID.) EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 ,O Misc. Wiring 6.25 Permit Fee $ , Contractor MECHANICAL PERMIT FiIingFee 3.00 WORKMEN'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. �e 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. Heating Cooling Flood 2.00 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. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any w y accrue t sat ounty in consequence ofranting of this perm' X Z�-G�,,,1 D ! �_ �^c� nature of App 'cant — Owner Ontractor 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 $ Land Development Fee $ TOTAL PERMIT FEE $ CCCUP. GROUP I TYPE OF CONST. PARCEL PDi ND 95U E/ —his permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIREC OR OF PUBLIC BY P IT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date %/—►�f �� Receipt No._.. WHITE-D.P.W.. YELLOW -ASSESS R, PINK -INSPECTOR, GOLDENROD -APPLICANT .` , COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS — BUILDING,DIVISION l 4. 7 County Center Drive — 0roville'California 95965 — Telephone: 534-4541 PERMIT APPLICATION DATA SHEET F Permit No. OWNER A.P. No. /7-') —) 9-3 Proposed Building Use Permit fee based upon. Complete Contract Price l/�DPW Valuation Otiher explat ') Building Inspector. \�� / Date 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. .................... 7. Statement of Intent for Non -Heated & AC Buildings ................... 8. Fees of $.................................................. _-9. Letter of signature auth-oriza-tion............................................................. 10. Sanitation approval from Health Dept.... 11. Planning approval for ....... 12. Certificate of Workmen's Compensation Insurance ........................ 13. Contractors License Information (no., name style, 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 bldg. -inspector (d 9_) 16. Other _ T When you issue the permit, process as follows: Mail to owner Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspection. Other CApp Date Copy of plans sent Health Dept., Fire Dept., Other Dater During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at time of a lic ion, circle item.) ' 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone Mail Other By Date Plans checked by Date Plans approved by Date /l — 7---1 f o OTHER: Copy/DPW