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Home My WebLink About027-290-019.^ ---._- � ` - ` _ AP 27-29-19 Douglas A. Smith Jr. 8190 Grier Ave. Oroville Permit 5369-80P E (qtil./MH) ELEC. MOA GAS SUPPORT STRUC.REQ-, ;�7 ' E 0M 01aile M TOd, 19 Issue dz�� IM � `~~-- '~` cm I PERMIT NO. E PERMIT EXPIRES " OWNER Douglas A. Smith, Jr. CONTR. owner ASSESSOR PARCEL 27-29-19 LOCATION 8190 Grier Ave., Orovilld r Temp. Power Pole Called PG&E e Temp. Elec. Service 12- Called ZCalled PG&`E Temp. GasService Cal -led PG&E J FINALED (Date) Signature = OK = Not OK' = Not Applicable = Not Ready RESIDENTIA1 (Single and Duplex) Date UNDERFLOOR Plans OK except #'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main;'Soils-Steel-Elec. Grnd.- / /'' Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story,•2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -'Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 51. 52. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. 55. Glazing Area -Glass Protect ion -Skylights -Plastic._. ._. Shear Walls; Nailing -Bolts 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. - 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date FINAL (Plans) OK except N's 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date Date Card -BI Date PLUMBING (Permit) OK except N's 57. Smoke Detector 14. Water Ht.; Vent -Access -Combustion Air 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meth. Protection 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except k's 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor -Meeh. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 22. Size Boxes No. of Conductors -Stapled 70. Plb., Elec. & Mech. Equip. Listed for Location 23. Romex Installed Close to Edge of Studs & C.J. 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. Insulation- Foam- Looked in Attic 1:1 Yes 25. 2 Appliance Circuits in Kitchen &Conductor Size 73. Guard Rails Deck Construction -Post Caps 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or AI 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral ❑Yes ❑No 75. Following instld.: Drive E] Yes E] No; Walks El Yes El No; Planters ❑Yes ❑No 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77, A.C. Unit; Disconnect-Cirnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light 78, Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. Water Wall; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B -I Card B -I Date Card -BI Date Date Card -BI Date 81. Ventilation throughout House 82. Glass Protection Date MECHANICAL (Permit) OK except N's 83. Corrections from Previous Inspections 84. 85. 86. Gas Test -Meters Tagged; Gas -Electric Water & Sewer Connected -C/O to Grade -HD Approval Energy Compliance Certificate -Other Certificates 31. A.C. Ducts; Insulation & Support 32. Vent Fan; Exhaust above Insulation 33. Condensate Drain & Overflow; Size & Grade 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic Card -BI Date Card -BI Date Card -BI _ Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FRAMING(Plans) OK except p's 36. Sills; Proper Material & Anchors Comments at Final: 37. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound _ 38. Bearing Walls over Girders & Floor Nailing _ 39. Draft Stop in Walls (rat proof) _ 40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub _ '41. Header & Beam -Size & Bearing 42. Hangers -Post Caps -Anchors -Connectors 43. 44. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Ring. _ Fireplace Ties or Type A Flue -Fireplace Throat 45. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 46. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing (NOTE: An entry must be made each time youvisit jobsite) = OK = Not OK = Not -Applicable MOBILEHOMES = Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except N's oning Requirements–Setbacks–Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except k's 1. Zoning Requirements–Setbacks–Easements, Vis; Special MH Support–Sketch _ 2. Footings; Size–Depth–Spacing–Oonnectors wer; Location–Test–Fall-C/0–Concrete 3. Decks; Girders and/or Joists–Decking–Bracing–Stairs–Rails ,ter; Location–Test–Easement Needed (Sketch) 4, Wood Awn.; Posts–Beams–Rftrs.–Connec.–Shthg.–Rig.–Bracing EIe icity; Location–Clearances–Grnd.–/ 4 Amp–Concrete 5. Alum. Awn.; Columns–Connections–Splice–Decal–Enclosures , Location-Test–Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG tility Clearance 6. Carports; Windows–Doors 7. Elec. Card -BI DateCard-BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOB!HOME INSTALLATION (Plans) OK except H's Card -BI Date Date Card -BI Date POOLS (Plans) OK except N's Zo g Requirements–Setbacks–Easements 1. Setbacks–Easements . Footings; Size–Spacing–Marriage Line 2. Soils; Compaction–Structure Stability –4—en; MH Test–Demand–Valve–Connector 3. Pool Structure; Steel–Connections–Thickness–Dead Men–Lining Electricity; MH Test–Crossovers–Breakers–Clearances 4. Elec.; Receptacles and Lighting; Distances–GFI Drain; MH Test–Fall–Flex Connector 5. Elec.; Pool Lighting; 15 volts–GFI er; MH Test–Regulator–Connector 6. Elec.; Enclosures; Conduit Entries–Terminals–Listed W r and Sewer Connected–C/0 to Grade–HD Approval 7. Elec.; Bonding; Metal w/5'–Circulating Equipment–Heater AIY�Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5'–Circulating Equip.–Pool Lghtg. Boxes–Enclosures–Panel boards–Ins. to Main in Conduit Ex' s; Insp.–Sketch Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test–Water Supply Test Card -BI Date Card -BI Date Card B -I Date Z / y and -BI Date Card B-1 Date Card -BI Date Card -BI Date Card -BI Date COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of the California Administrative Code, Title 25, Chapter 51 under permit number S~?`l�' �`� for the following location: Owner /��.r�.,.�� .� •�,��/f _ Owner's Address Mobilehome Mfg. Model 3ca ce_ Year V ` Insignia No. �Q LvSI �� -7 Serial No. 1 '1 /1 t It is hereby certified for occupancy at the above described location and may be occupied. f. Director of Public Works Date 1 / ' r" J By kl . I THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED White - Owner, Yellow - Installer, Pink - D.P.W. COUNTY OF BUTTE _ DEPARTMENT OF PUBLIC WORKS c, 196 Memorial Way, Chico — Phone: 891=2751 7 County Center Drive, Orovi Ile — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE BUILDING OR PROPERTY ADDRESS 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 matter, or need additional explanation, please contact this office immediately. u.<' --'% Inspector ..�`- � `�`"`�`"��`� Date 9. Electrical A. Is service large enough toprovideadequate amperage -to mobilehome (must equal rating of mobilehome with a minimum ofX amp,),andlother facilities on lot, i.e., water pumps, garage, cabana., etc.? Yes ' _ ' B. 'Is there proper clearances around panels? Yes ✓No_ C. Is power supply cord or feeder assembly properly fused? Yes r No D. Is continuity test satisfactory as per the following procedure? Yes P- No 1. De -energize electrical wiring system of the mobilehome at the pedestal. 2. Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected. 3. Switch all breakers and switches in the mobilehome to the "on" position. 4. Connect one lead of a test instrument to the mobilehome grounding conductor and apply the other lead to each mobilehome supply conductor, including neutral. 5. All non-current, carrying metal parts of the mobilehome (aluminum siding, gas line, _water line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. 6. Upon completion of the above procedure, the power supply cord or feeder assembly -conductors shall be connected to the site service equipment. A further continuity test shall then be made between the grounding electrode and the chassis of the mobilehome. Upon satisfactory completion of theelectrical tests, the lot or site service equipment may be approved for;energizing. t 10. Is job card signed by Health Department for water and sanitation? r 11. If everything okay, sign off card and tag serices. MOBILEHOME DATA. - Manufacturer and/or Namestyle Length Width 2 Vehicle Serial No. State Identification No.�-CJ� i Additional Information or Comments: 1 9 MOBILEHOME INSTALLATION INSPECTION CHECK LIST 1. Is the mobilehome located with,,.-tequired separation from lot lines and buildings and generally conform to plot plan? Yes_!/No 2. 'Does the mobilehome have required clearances above ground? (Sec.5085) Yes_z,--4o, 3. Are footings and supports.properly sized', spaced, and braced as per approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes/ No 4. Is the mobilehome level? (Sec. 5088) Yes ✓ No_ 5. If mor than a single unit, are crossover connections properly installed? (Sec. 5088) Yes No 6. Water A. Is flex'b le connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5.566) Yes r/ No B. Test - Does water piping withstand working pressure or 50 lbs. air test? Yes'4-140 Backflow - If coach is not State of California approved, does station have backflow device and pressure -relief valve? Yes_ No 7: Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes,& --No B. Does it have minimum k" per foot slope and is it properly supported? YesA,::--to C. Are any leaks detected in drainage system after running 3-ga ons of water through each fixture including washing machine standpipe?.Yes No If coach is not State of California approved, does station have required trap and vent? Yes No 8. as Piping and Gas Vents Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum mobilehome connector not more than 6 ft. long? Note: All piping is to be at least as large as the mobilehome gas line inlet without reductions other than the mobilehome connector. Yes No B. Test OK as per following procedure? Yes_ No 1. Open all appliance connector valves. 2. Shut off appliance burner and pilot valves. 3. Air test with manometer to 10"-14" water column, or test with slope gauge (minimum 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without drop. 4. Connect gas meter to mobilehome with connector, turn on gas,. test connections with soapy water. C. Are all appliance vents properly installed? Yes. No' COUNTY OF BUTTE — DEPARTMENT OF PUBLIC .i ,7 County Center Drive -t Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT WORKS 7 6 �/ 40 X (209! X� Date 10/20/80 UlKt r H UF- F'Ut3LIU WUHKS /5194ature of Permitee or Agent BY Date Receipt No. 43:222,s- White-D.P.W. 3:222,s-White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant Building permit expires Date BUILDING Owner DOUGLAS A. SM 1 TN SQ. FT. OCC. BUILDING VALUATION Mailing Address 8190 GR I ER A V E O R O V I L L E, CA. 95965 Telephone No. Contractor TOM I S MOBILE & MOTOR Mai I i ng Address 6366 L I N C O L N I 'O R O V I L L E, CA. 959!fireplace otal Valuation T Io_c9NYI Permit Fee Building Address 8190 GR 1 ER AVE Plan Checking Fee &/ P W9i=_ Permit Fee O R O V I L L E 'CA. 95965 PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 A. P. No. 27-29-19Water Zoning & Planning piping 1.50 Each gas water heater or vent 1.50 F Sanitation Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans I Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5-00 Bldg. Plcrec'd I Parcel Ap roval Plans Ap royal Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ®-_ Permit Fee $ $ Foe— V7%LC-)OC$ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 500V OR LESS 100 AMP OR LESS 5.00 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service OVER 600V 25.00 100 AMP OR LESS Main service// EA. ADD'L 100 AMP 1.00 NEW OR ADDNST 1 ACCDWE•BLDGS.LING CCUP. Yl 22 Sq ft / 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: TOM I S MOBILE & MOTOR NEW RESID.CONSTBRANCH CIR T NON.RESI D, BRANCH CIRCUITS 2.50ea NEW CONSTR. POWER APPARATUS 8 NON-RESID. SINGLE OUTLET CIR.- Ex. Occup(OUTLETS OR FIXT1111 R 50 @ 250 1101 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID,) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 32702 License No. 3 Classification C61 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. 1 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. @ FEEPERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that 1 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 buildingonstruction, and hereby authorize representatives of the Countof Butte to enter upon the above-mentioned property for/fispectiion p6rposes. e rr ee 58 TOTAL PERMIT FEE $ This permit is herebyissued under theapplicable provisions of the Butte County Coe and/or resolutions do wrk indicated above for which fees have been paid. X (209! X� Date 10/20/80 UlKt r H UF- F'Ut3LIU WUHKS /5194ature of Permitee or Agent BY Date Receipt No. 43:222,s- White-D.P.W. 3:222,s-White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant Building permit expires Date MOB ILEHOME SUPPOft DATA t If other than single wide, , Mobilehome Mfr:HAMP:I"ON HOME BU I LOERS furnish Setup Model No. 131 Year 81 Width 24 (ft.) Box Length '52 (ft.) Tagalong or Expando Size ft. x ft. (SHOW.SUPPORT DETAILS BELOW) On all mob ilehomes manufactured after October 7, 1973; furnish manufacturer's installation manual and structural setup sheets (i,f.not..on file with the County of Butte). All center supports measured from front of mobilehome unless otherwise specified. HT IM .A 00 (ft.)(in:) (in.) (in.) Center support locations* (ft.)(in.) i t F/ _51L 97 (ft.)(in.) (ft.)I (in.) Center support footing sizes (in.) (in.) (in.) Z 30 (in.) (in.) i z x30 (in.) (in.) (in.)I (in.) Single f ' Tr#-. f J t171�'� 3 T *If center piers are other than drawn above, draw in -locations, spacing, and dimensions. " = LQu Footings (check one) iQX 1. Wood either pressure treated or foundation grade. 0 2. Other (specify) Supports .(check one) �X 1: Concrete block. 2. Other (specify) Tagalong or Expando, show -support details. I x -- Typical Support (in.) (in.) Footing Size Max. Pier Spacing 24" - Max. Overhang (ft..)(in.) 53�kl_ Cy-) BUTTE COUNTY BUILDING DEPARTMENT 3�3 APPROVED 1. Owner's name: 2. Installer's name:' TOMIS MOBILE & MOTOR BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET DOUGLAS A. SMITH 3. Is the site currently under permit? Yes / / No A / (If yes, furnish permit number ) OR Is the site an existing site? Yes / X/ No (If yes, furnish two (2) plot plans.) P 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes /-X/ No (If no, clarify. ) ( ) 5. What is the mobilehome electrical rating? ----------------------- 200 Amps 6. What is the mobilehome site service rating? ---------------- 200 Amps 7. What is the mobilehome site circuit breaker rating? ------------- 200 Amps 8. Is there any other electric load to be served by the mobilehome (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) site service? --------------------------------------------------- Yes / x / No / / WATER PUMB (Load) "'z�y-3G (Amps) (If yes, identify the load and size: 9. What is the mobilehome site gas pipe size? ---------------------- NONE (in.) 10. What is the type of gas service? -------------------------- '-- Natural / / LPG 11. What is the gas pipe length from meter or tank to the mobilehome? (ft.) 12. What is the mobilehome gas demand? ------------------------------ (BTU) (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) 71, COUNTY SOF BUTTE Department of Public Works. ; 7 County Center Drive Oroville ----- 534-4541 ING MOB ILEHOMES gl90 �• �1'� 959�� Location , e_0 Mobilehome Installation Permit No. FILL IN INFORMATION FOR ITEMS 1 THRU 10 Watts 1. Width Z`t x Box Length x 3 = 2. 2 Kitchen Appliance Circuits ................. = 3,000 3. 1 Laundry Circuit ............................ = 1,500 4. Ovens .................................. .... _ — 5. Cook Stove_Top ............................... = 9200 6. Hot Water Heater ............................. = y��O 7. Dishwasher & Disposal ........................ = 8. Clothes Dryer ................................ /�- = 6�0 9. Other (specify, i.e., motors, exhaust fans, etc.) Sub -total - Watts ..... A 916 9 First 10,000 watts @ 100% ................................. = 10,000 Remaining watts @ 40% ..................... = 7 66n1? 10. Air Conditioner watts @100%.. Lar�ogst Demand Central Heat System watts @ 65%.. = S ) TOTAL DEMAND WATTS REQUIRED ............. 07 "Demand Watts Required" - 230 ............ P7, 73Amps De -rate Mobilehome to ........ .. ...... /4- 3 AMPS BUTTE COUNTY BUILDING DEPARTMENT APPROVE COUNTY OF BUTTE -DEPARTMENT OF PUBLIC WORKSPER Ir o. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 ��J ��V APPLICATION AND PERMIT , AA ASSESSOR PARCEL MBE ZONING BUILDING PER OW ER / V` L P ON �+�� S0. FT. OCC. BUILDING VALUATION �x�N�/Oft��"/$/Jy}1 /A�bsA//yy1 9,5 /,.��y�•//� O V J V AC I'LV /�-�/ Ci O/vV V /WL./v V / ! , / &_r, CONTRACTOR'S NAME TELEPHONE ' CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER UNKNOWN Fireplace LENDER'S MAILI G ADDRESS. Total Valuation $ Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ e Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BU!.LDINSi, nADDRE. ` fJ PLUMBING PERMIT Filing Fee 1 /6100 Each Trap 2.00 Repair drainage or vent piping 2.00 O149VlL6E Water piping ado LOT NO. SUBDIVISION NAME rARCELMAP _73" 2-/0Gas Each qas water heater or vent 2,00 piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome[]�her SPECIFY Building sewer 49.0Q Lawn sprinkler system 2.00 TYPE OF WORK -,/ New [-]Addition ❑ Remodel [-]R Utilities Installation ❑ Other ❑ Describe work: Permit Fee $ a4 Co Contractor ELECTRICAL PERMIT Filing Fee 14100 Main service 100 OR ORSLESS 1 5.00 .00 Main service EA. ADD -L too AMP 2.50 .,S C7 NEW CONST OR ADDNS. ( ACCLBLDGS.LING CCUP.&) 2¢sgft 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 )s 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 acid Professions Code for this reason NNEW ON.RESID R BRANCH ciRCTITs 2.50 ea NEW CONSTR POWER APPARATUS &) NON.RESID, (SINGLE OUTLET CIR. Ex. Occu / 50 @ 2W p\OUTLETS OR FIXTURES BAL�IOt FIXED APPLNS. OR Ex. Occup.(OUTLETS (RESID,) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 SOU Misc. Wiring 6.25 1 1,oe) Permit Fee $ e so 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 FiIingFee 3.00 Heating Cooling Hood 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 a ree to save, indemnify and keep harmless the County of Butte against all Iia lilies, Iudgme cos and expenses which may in any way accrue again aid County 'n c nse ence of 1the�granting of this permit. %� ' y`� Date Signature of Applic n — 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 $ Land Development Fee $ TOTAL PERMIT FEE 37 $ -/ OCCNP, GROUP TYPE OF CONST. PARC % f/ PD ND ssuE This permit is hereby issued under sions of the Butte County Code and/or work indicated above• for which DIRECTO F PUBLIC BY PER 1 4 XPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. �✓ WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT •MOTE:—All Materials & Wori Accordance with Recognized of a quality prescribe for the Uniform �o�dldElectrical Code-, Plumbing " the Na v{ P1ans"► jhis set at. t on the iob J4k,B kr &ke. any cti-` ge". i Wrii�ten .1111 C u of Coun Vic �N orks' iship.-Shall Be irr d•'ptactices anti scifid use in the ieii l -Codes -and-.... A. #4 }ions MUST b` hou" - tr, p ! . ,. same `" ' o t o pub : ". �.� IA setback of 5 ftfrom the i C) `property lines and a setback 1 N � of 50ft. from the road centerline shall be clear of '= A permif �";�� be 1equired for the i,structures or equipment except installation of the mobileh ; "for a 2 ft. eave overhanq. rr� v!.� Utility connections shall be within I 4 ft. of the mobilehome, either '. directly behind or within the rear k half of the roadside (left) of the # mobilehome. BUTTE CoUtj ti SCALDING DEPARTMENT APPROVED 4 .' . r