HomeMy WebLinkAbout078-220-028��8-aao-oas
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036-550-0.28 PERMIT#96 0680
i SERRAO, Michael & Diane
2222 Las Plumis' Ave: , Orovi,lle
_1 F, Cont; Alladn Roofing,/
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COUNTY OF BUTTE? -DEPARTMENT OF DEVELOPMENT SERVICES.- BUILDING DIVISION
7 County Center Drive - Oroville, Califorgia 95965 - Telephone (916) 538-754 rPERMIT NO.
APPLICATION AND PERMIT to
ASSESSOR PARCEL NUMBER
ZONING
Ri
BUI G PERMIT
OWNER y -t
1, DIANE Q t
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
2222 1 A T t'. F
CONTRACTOR'S NAME
AT T T 'T
TELEPHONE
- CONTRACTORS MAILING ADDRESS
Fireplace
' CONSTRUCTION LENDER
UN OWN
t
Total Valuation Is
Filing Fee
$ 20.00
LENDER'S MAILING ADDRESS
Permit Fee
$ 37.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Penalty
$
BUILDING ADDRESS 2222 LAS PLINAS AT"
PERMITFEE
$
PLUMBINGPERMIT
Filing Fee 20.00
Each Trap
7.00
LAT NO.
SUBDI'VISION'S NAME
PARCEL MAP
Solar Or heat pump water heater
23.00
Water piping
15.00
USEOFSTRUCTURE
SFXO Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
TYPE OF WORK
ss
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Q
Describe Work: P��1'
-
Mobile Home IS I GI W1
920.00
PERMITFEE
_
Contractor
ELECTRICAL PERMIT
Filina Fee 20:00
Main Service a OR LESS
( 200A OR LESS )
23.00
Main Service ( 200A TO I000A )
46.00
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. r,
License Class 0 _ 1 Lic. No. : -P? 3 s
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.
❑ 1, 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
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( d ACC. BLDS. )
SO.
3.5Q FT.
NEW CONST. MULTI -OUTLET
NON-RESID. ( BRANCH CIRCUITS )
@7.50
/ POWER SINGLE OUTAPPARATUS
l &LET CIR. )
Ex. Occup. (OUTLET OR FIXTURES )
BZL Q I.50
FIXED APPLNS. OR
Ex. Occup. (OUTLETS (RESID.) EA)
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMITFEE
$
Contractor
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.
f I 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„ -i mpensation_insuran� carrier and policy number are:
Carrier 1�f f
Policy Number 5/
(The above sections need not be ompleted if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ I 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.
Date ��
Slgnetur of AplAcan ❑ Owner Q` Contractor ❑ Agent
An OSFY4 permit is required for excavations over 5'0" deep and demolition or construction
of structures over 3 stories in height.
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMITFEE $
Contractor
Mobile Home Installation Fee $
Energy Inspection Fee $
OCC
CONST. TYPE
TOTAL FEE $ 57.00
7
HAZ.
I D. FEES
I IMP
I FLOOD
CDF
PARCEL I PD
HD
I ISSU
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
!
BY ; / .<..i,' rf
PERMITEXPIRESON �f
f
the applicable provisions
Resolutions to do work
been paid.
Date
J 11 , t
'(Date)
Receipt No. 195121
WHITE-D.D.S.•B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD.APPLICANT
COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive - Oroville, California 059965 - Telephone (916) 538-754 -��E VIT NO.
APPLICATION AND PERMIT js
ASSESSOR PARCEL NUMBER 036-550-028
ZONING
BUI GPERMIT
OWNER
RT
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS
2222 TAS PHIMAS AVE 0ROVITLE 95966
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation is
Fling Fee
$ 20.00
LENDER'S MAIUNG ADDRESS
Permit Fee
$ 37.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Penalty
$
BUILDING ADDRESS 2222 LAS PLLHAS AVE
PERMITFEE
$97.00
PLUMBINGPERMIT
Filing Fee 20.00
Each Trap
7.00
LOT NO.SUBDNISDN'S
NAME
PARCEL MAP
Solar Or heat pump water heater
23.00
Water piping
15.00
USEOFSTRUCTURE
SFX❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ['
Describe Work: REROOF
—
Mobile Home S I G I W
920.00
PERMITFEE
$
Contractor
ELECTRICAL PERMIT
Filinq Fee 20:00
Main Service a OR LESS
( 200A OR LESS )
23.00
Main Service ( 200A TO I000A )
46.00
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 'n full force and effect. -�y
License Class _ Lic. No. 3 C7C J
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
NEW CONST. DWELLING OCCUR
OR ADDNS. ( a ACC. BUDS. )
s0.
3.5¢ FT.
NEW CONST. MULTI -OUTLET
NON-RESID. ( BRANCH CIRCUITS )
97.50
POWER APPARATUS
(a SINGLE OUTLET CIR. )
Ex. Occup. (OUTLET OR FOCTURES )
zo @ 1.00
BAL SO
Ex. Occup. ( OUFIXED APPU4S.TLETS (R S D.)EA )
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMITFEE
$
Contractor
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.
I 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' mpe satiorT.insuranc carrier and policy number are:
Carrier
MECHANICAL PERMIT
Filing Fee 20.00
9
Heating
Cooling
Hood
6.50
Ventilation
PERMITFEE
$
Contractor
Policy Number –
(The above sections need not be bompleted 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
Ort comply with those provisions.
Date
S atur of Applica - ❑ Owner Contractor ❑ Agent
An OS permit is required for excavations over 5'0" deep and demolition or construction
of str ctures over 3 stories in height.
Mobile Home Installation Fee
$
Energy Inspection Fee Is
Occ
CONST. TYPE
TOTAL FEE $ 57.00
HAZ. I
D. FEES
I IMP
I FLOOD
CDF
PARCEL PD HD
ISSUE,
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
1
By
PERMITEXPIRESON �/j/
I
the applicable provisions
Resolutions to do work
been paid.
Lj
Date 66
`-7
(Date)
Receipt No. 195121
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
./r � `• l a ^ i ` '�' �r .,,.� y� yrs—
���� Z Jr• ,��
0
� G
6-S
1WRISDICTION
E COUNTY
BUILDING OFFICIALS
Block Parcel No. 3 �"- S- y
Rapid Evaluation Safety Assessment Foran
BUII.DING DESCRIPTION:
Name:
Address: D S�—�'�
No. of stories:
Basement: Yes ❑ No 'f, Unknown ❑
Primary Occupancy: Dwelling
Other Residential ElCommerc, ❑ Office ❑
Industrial ❑ Public Assembly ❑ School ❑
Government ❑ Emer. Serv. ❑ Historic ❑
Other
OVERALL RATING: (Clceck One)
INSPECTED (Green) �}
Ex[erior only
Exterior and Interior
LIMITED ENTRY (Yellow) ❑
UNSAFE (Red) ❑
LNSPECTOR:
Inspector IDi-j?,—e- v A -
Affiiiation -
INSPECTION DATE:
Mo/day/year____! -:L.5
Time / � i CD airy r
Instructions: Review structure for the conditions listed below. A "yes" answer to 1, 2, 3,�5 is
grounds for posting entire structure UNSAFE. If more review is needed, post LIM'IT: D r_ RY.
A "yes" answer to 4 requires posting AREA UNSAFE and/or barricading around the hazard.
Hazards such as a toxic spill or an asbestos release are covered by 6 and are to be posted and/or
barricaded to indicate AREA UNSAFE.
More
Review
Condition Yes No Needed -
1.
Collapse, partial collapse, or building off foundation
❑
❑
❑
2:
3.
Building or story noticeably leaning
Severe racking of walls, obvious severe damage and distress
Cl
❑
C�
❑
4.
Chimney, parapet or other falling hazard
❑
❑
❑
5.
Severe ground or slope movement present
❑
❑
6.
Other hazard present
❑
Rec mmendations:
No further action required
❑ Detailed Evaluation required (circle one)
❑ Barricades needed in the following areas:
Structural Geotechnical Other
❑ ntlier. kAke.L TpLul
Posted at this Assessment 0"Yes No
Comments:."'
DATE �" %�2 — 9S
TIME 12 S0
ESTIMATED DAMAGE
BY A
DAMAGE REPORT
FOR INITIAL ASSESSMENT
FLOOD -JANUARY 1995
o-va
3
PUBLIC INFORMATION OFFICER
538-6953
Name Reporting Party
Address/Location rdur
Telephone Number s y -- �5 6 9D City County Ll-'/
Type of Damage
(Note: Emergencies Refer to 911)
Building Description
[ V Commercial/Usage
[ 'Residential Type and 44:1rdts
[ Currently Occupied se
[ ] Abandone acant
Electric
Any electrical submerged Yes [ ] No
Obvious damage (failure, downed wires, arcing) A -n
Gas
Natural ropane
VDVious problems (odor, leaks, leaks, propane tank floating/submerged)
On[ \A Off [ ]
Structure
On/Off Foundation
Flooding abevefbetaw floor 1�.0
Obvious leaning, tilting
Severe Damage/Collapse
Debris Hazard
Sanitation '7� e} c'-�
Plumbing working YZ
Running water
r ,
Well Flooded
Obvious Sewage Problems
Chemical/Fuel h,
Wet, flooded, lost chemicals a
Type pesticide, fertilizer, other chemicals
Amount
Fuel tanks (above or below ground)
Obvious hazards
Agriculture Loss j
Crop Damage f
Livestock Lost
Building Damage
Roads (Public)
Road Name
Obvious Damage/Hazards
Location/Landmarks
Traversable (Sedan, 4 wheel)
Involved Utilities (downed wires)
Levees Public [ ] Private [ ]
Waterway Name
Location of damage/problem
Obvious hazards
Nearest Landmarks
Overflow/freeboard
Covies:
( ( OES [ 1 Agriculture
( I Health ( ) Fire
[ 1 Building ( I Sheriff
x
PERMIT NO. 5632-76B
PERMIT EXPIRES
OWNER Wm. Pliler
CONTR. owner
LOCATION (A.P. -36-55-28
2222 Las Plumas.Ave., Oroville
Temp. Pow Pole
Called G&E
Temp. E c. Serv.
Cal d PG&E
Temp Gas Serv.
lied PG&E
NALED
(Date)
(Signature)
i ►.1 �-�� i 1J'Ze� Tom, �ti3C'_��T� ��T t �ei� c
h
To INC- As. S aTL�
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING
BUILDING (Cont'do
PLUMBING
Setback %
Firewall
Soil Piping
Forms r
Parapets
1st Floor
Main Bldg. %
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
Stemwall %
Siding
To out
Slab %
Roof Sheathing
Water Pipingr
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Stemwal I
Garage Vents
Insulation
Water Htr. i
Heaters
Slab
Carport
Footings
r peccllhysic ly
handicapped
Conformanceex.
structure
Appliances
Gas Piping &Test
Temp. Gas
Slab v
Final
Sanitation
Patio A
FIREPLACE
Final
Footings
Footing it
ELECTRICAL
Masonry Walls
Throat l (
Rou h
Reinf. Steel
Final_� /!
Fixtures
Stucco
Final
Subpanels
Mesh
MECHAI41CAL
Grd. Fault Prot.
Scratch
Heating
Service
Brown
Cooling
Temp. Pole
Finish
Ducts
Underground
Interior Lath
Ventilation
Permanent
Door Closer
Final
Final //
DATE / REMARKS OR CORRECTIONS
/%/6 E!
/ 11eC A- F/rS
IINc r
/vim
1-"7cs� � � fr�r C7�
e
(NOTE: An entry must be made on this form each time you vi31t the job site.)
COUNTY OF BUTTE - DEPARPAENT OF PUBLIC WORKS
7 County Center Drive - Uroville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X z, Date /
Signature of Permitee or Agen
Receipt No. _
White-D.P.W. — Yellow- ssessor — Pink -Inspector — Goldenrod -Applicant
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.
DIRECTOR OF PUBLIC WORKS
By ^���'-�-�� Date
ft�permit expires Date
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mai I i ng Address / k� cqw,--e—
ey
Tele e
honN
i repl ace
Contractor 4vTotal
Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee
Building Address a'�
PLUMBING No.1 @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No. S _
tU
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
F
aarmtatrorr
FireDept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel'
Parcel Map P
60R/W
Improvements
Lawn sprinkler system 2.00
Parcel Approval
Plans Approval
Permit Fee $
$
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00 0
C
Main service 1V OR LE
jp0 AMP ORSLESS 5.00
r
Main service EA. ADD -L 100 AMP 2.50
Single Family Duplex ❑ Mobil Home ❑ Others ❑
Main service OVER 600V
100 AMP OR LESS 25.00
Main service EA. ADD•L 100 AMP 1.00
NEW CONS:F OR ADDNST (`BL GS.LING CCUP. &\
ACC20sgft
/
NEW CONSTR. MULTI -OUTLET
NON•RESID. BRANCH CIRCUITS) 2.50ea
NEW CONSTR. (POWER APPARATUS &
NON-RESID. SINGLE OUTLET CIR.
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
Ex. Occup(OUTLETS OR FIXTURES)@L�¢
BAL@1
Ex. OCCU FIXED APPLNS. OR
P• OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring �- 6.25 ,
VI am exempt from the Contractors License Laws of the State of California.
Permit Fee $ , 2,j—
$ Z,
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
�I 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
MECHANICAL No.1 @ FEEPERMIT
FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
TOTAL PERMIT FEE
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X z, Date /
Signature of Permitee or Agen
Receipt No. _
White-D.P.W. — Yellow- ssessor — Pink -Inspector — Goldenrod -Applicant
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.
DIRECTOR OF PUBLIC WORKS
By ^���'-�-�� Date
ft�permit expires Date
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS `/ V
7 County Center Drive - "Urovilde, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT %
above-mentioned property for inspection purposes.
X I Date G
Signature oofPermiteee or Agent
/SJ
Receipt No. ' 93
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
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.
DIRECTOR OF UBLIC WORKS
By
Date /b
wilding permit expires Date /0—//—
BUILDING
Owner ! I - !AA -4 �' E Y
SQ. FT. OCC. BUILDING VALUATION
Mailing Address -a- • L L- n S Av e -
L.L
Telephone No.
'a--
Fireplace p .®
Contractor
Total Valuation
^",
Mailing Address W N t f��
Permit Fee o
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee $9,00.$pg
Building Address ,L�y s v�
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No. SS - r�, 0o Zoning & Planning
3
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
F s
4,141SaF44a4isw
Fire Dept.
Fire Zone Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
Declaration
Parcel Ma p.
60' R/W
Improvements_Lawn
sprinkler system 2.00
Bld 'd
Parcel Approval
Plans Approval
Permit Fee $
$
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ❑
ELECTRICAL No.1 @ I FEE
PERMIT FILING FEE $3.00
V c- 4 AGC
Main service 600v OR LEss
100 AMP OR LESS 5.00
Main service EA. ADD'L 100 AMP 2.50
Single Family Duplex ❑ Mobil Home ❑ Others ❑
Main service OVER s00v
100 AMP OR LESS 25.00
Mair, service EA. ADD'L 100 AMP 1.00
t
NEW CONST. DWELLING OCCUP. &
OR ADDNS. ( ACC. BLDGS. 20sgft
NEW CONSTR. MULTI.OUTLET `
NON.RESID. BRANCH CIRCUITS! 2.50ea
NEW CONSTR. (POWER APPARATUS &
NON -RES,D. SINGLE OUTLET CIR.
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
Ex. Occup(OUTLETS OR FIXTURES) 50 BA@�
Ex. OCCU FIXED APPL, OR
p•(NSOUTLETS (RESID,) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑ I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
I 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.
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
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
.1
TOTAL PERMIT FEE
$
above-mentioned property for inspection purposes.
X I Date G
Signature oofPermiteee or Agent
/SJ
Receipt No. ' 93
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
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.
DIRECTOR OF UBLIC WORKS
By
Date /b
wilding permit expires Date /0—//—