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028-170-159
om 1p G;DE RANDY c ROV�ILLE OLD 0 _3 _ 50� -3 3q 1,4S 6 ) 8, A CON9 CONT: D 4T W SITE PER D NEW MH NE NOTES RESID ENTIAL ?28-1-70--159 PERMIT Nl_�CREELMAN, RANDY GOLD MTN RD, OROVILLE C 'NT: D & A CONST NEW MH NEW SITE PERM FND THE HCD FORM 433A FOR THIS MH CANNOT BE RECORDED UNTIL ONE OF THE FOLLOWING HAS 9EEN TURNED IN TO THE BUILDING DIVISION: (1) LICENSE PLATE(S) OR DECAL (THE INSPECTOR MUST RETREIVE). (2) STATEMENT OF FACTS (ONLY ON NEW MH'S). INSPECTOR TO VERIFY SERIAL & LABEL #'S. SPECIAL CONDITIONS CHECKED BY — SRA — FLOOD CERTIFICATE REQ. — FIPE SPRINKLERS REQ. — SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTth OFFICE copy Address GAS Meter By DateZ.— I ELECTRIC Meter By Date ------------- JOB FINALED (DateL—, Signature .1 = OK 0 = Not CK Not Applicable MOBILE HOMES Not Ready Date M`OBI��ME UTILITIES (Plans) OK except #'s - -,r—Zoning Require ments-Setbacks- Easements _;� �hs; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/0 -Concrete _4_-W'ater; Location -Test- Easement Needed (Sketch) 5. E!pctricity; Location-Clearances-Grnd-K�mp-Concrete ,V'bas; Location -Test -Wrap;-/ /- P Nat. or / /"L"ft,/- I fLPG 7. Well Clearance & Discorinect 8. Utility Clearance Vale Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 11-5—rfln; Require ments-Setbacks- Easements 2. Fqojings; Size -Spacing- Marriage Line . Gas; MH si-Demand-Valve-Connector 41-re—ctricity; MH Test -Crossovers -Breakers -Clearances ,-S'Drain; MH Test -Fall -Flex Connector 6. Water: MH-Test-Regulalor-Connector ater a_9 Sewer Connected -C/O to Grade -HD Approval _&.-ITa—sand Electricity Tagged 9. Tie Downs Type- Installation Cert. xits; Insp.-Sketch Cert. of Occupancy 12-44wo4aoent-Foundation Only; License Decal Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 0 �,o /_ -2 -Lo --/ Z 1, 6 0 :. 7*% ;q, -Z Z,(D- 71, MISCELLANEOUS Date DECKS, COVERS, CARPORTS GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size- Depth- Spacing -Connecto rs- Steel 3. Decks; Girders and/or Joists -Decking -Bracing- Stairs- Rails 4. Wood Awn.: Posts -Bea ms- Rftrs. -Connectors Shthg.-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal- Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nail ing-Veneer-Stucco- Mesh 10. Roof; Shlhg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 1 . Setbacks- Easements 2. Soils; Compaction- Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GF1 5. Elec.; Pool Lighting; 15 Volls-GFI 6. Elec.; Enclosures; Conduit Entrie s -Terminals- Listed 7. Elec.; Bonding; Metal w/5'-Circulaling Equip. -Healer 8. Elec.; Grounding; Equip. w/5'Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Pane lboards- Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 V= OK 0 = Not OK - = Not Applicable * = Not Ready RESIDENTIAL (%4 Date Underfloor (Plans) OK except #'s Hangers -Post Caps -Anchors -Connectors 1 . Zon i ng -Setbacks- Ease ments- Flood -Slope Cling. Joist-Rttr. Ties- Purlin-Roff Brac.-Truss-Shting.-Rfng. 2. Ftg., Main; Soils-Elec. Grnd.-/ r Ftg. Depth Fireplace Ties or Type A Flue -Fireplace Throat Clearance 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ r Fig. Depth Attic Access; Size & Romex Protection- Draft Stop -ins. Baffles 4. Ftg., Porches & Decks; Soils -Steel-/ r Fig. Depth Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 5. Sternwalls, Main; Steel-Blockouts-Wrapped Garage Fire Protection Framing 6. Sternwalls, Garage; Steel- B lockouts -Wrapped Property Line Firewall & Openings 6a. Hold Downs and Special Anchors Ext. Doors -One X -Check Garage 3rd Story, 2 Exits 7. Slab, Steel -Wrapped Stairs; Width -Head roo m- Rise- R un-Landi ng- Fire Protection 8. Piers -Fireplace Ftg.-Steel Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 9. D.W.V.; Fall- Fitting -Test -2 Way C/0 -Sewer Test Siding -Nailing Veneer 10. UF, Gas Pipe; Size Anchors - Yard Gas Piping; Size Test Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 11. Water Pipe; Test-Ancho rs- Reg ulator-Service Test Glazing Area -Glass Protection- S kylig hts- Plastic 12. Electric Underground Shear Walls; Nailing -Bolts 13. Plenums & Ducts; Clearance -Material -Support -Ins. Brace Interior/Exterior Wall Panels 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies_ Insulation -Walls -Ceilings 15. Access & Ventilation Infiltration -Walls -Windows 16. Insulation Date Date Date Card B-1 Date Card B-1 Date Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s Ext. Steps -Door & Sidelight Protection- Landings 17. Water Htr.; Vent -Access -Combustion Air Baffle Smoke Detector 18. Water Pipe; Test & Anchor -Nail Protection Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor- Ducts- Mech. Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection Bedroom Exiting 20. Shower Pan; Test, First Floor -Tub Access G.F.I. & Bath Fixtures & Tub Access -Spa 21. Test Tub & Shower, Second Floor -Tub Access Elec. Trim & Subpanel, Breaker Sizes & Labels 22. Gas Pipe; Sixe & Anchors Stairs & Rails 70. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s Elec. Outlets & Receptacles at Kit. Counter 23. Fixture & Transformer Clearance -ins. Protection Garage Fire Door; Swing -Landing -Closure 24. Elec. Receptacles Spacing -Lights & Switches at Doors A.C. Duct in Garage -Damper 25. Size Boxes & No. of Conductors Stapled Wtr. Htr.; Vents -Clearance -Comb. Air Connector- P.R. V. in Garage; Above Floor-Mech. Protection 26. Romex Installed Close to Edge of Studs & C.J. Plb., Elec. & Mech. Equip. Listed for Location 27. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water Elec. Receptacles in Garage (FF.I.)-Romex Protection 28. 2 Appliance Circuits in Kitchen & Conductor Size GFI Ins ulation- Foam- Looked in Attic 29. Subfeed Wire Size / ga. Cu or AJ-A.C. Wire Size / / ga Cu or Al Guard Rails & Deck Construction- Post Caps 30. Range Circle / ga Cu or Al -Oven Circ. / / ga Cu or Al Insulated Neutral Q Yes ID No Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth 31. Service -Riser Conductors & Ground Main Disconnect Clearance Looked under Floor Q Yes 32. Equip. Clearances Panels-Motors-Mech. Equip. Following Instld./Drive :l Yes :1 No/Walks :1 Yes :1 No/Planters Yes j No 33. Clothes Closet Light -Shower Light -Spa Light Stucco Brown -Finish 34. Smoke Detector A.C. Unit Disconnect, Electrical- Plumbing 85. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s Ventilation Throughout House 35. A.C. Ducts Insulation & Support Glass Protection 36. Vent Fan, Exhaust above insulation Corrections from Previous Inspections 37. Condensate Drain & Overflow, Size & Grade Gas Test -Meters Tagged, Gas -Electric 38. Furnace -Vent Access -Comb. Air -Return Air Vent 115 outlet Water & Sewer Connected -C/O to Grade -HD Approval 39. Attic Access & Platform if Furnace in Attic Energy Compliance Certificate -Other Certificates 94. Address Posted Date Card B-1 Date Card B-1 Dale Card B-1 Date Card B-1 Date Date FRAMING (Permit) OK except #'s Comments at Final: 40. Sits Proper Materials & Anchors 41. Walls Studs -Nailing Spacing & Braces- Plates -Sound 42. Bearing Walls over Girders & Floor Nailing 43. Draft Stop in Walls (rat proof) 44. Fire Stops, Furred Cei lings- Stairs- Chase rs-Tubs 45. Headers & Beams -Size & Bearing 'ingle & Duplex) 0 Date FRAMING (Continued) 46. Hangers -Post Caps -Anchors -Connectors 47. Cling. Joist-Rttr. Ties- Purlin-Roff Brac.-Truss-Shting.-Rfng. 48. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 49. Attic Access; Size & Romex Protection- Draft Stop -ins. Baffles 50. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 51. Garage Fire Protection Framing 52. Property Line Firewall & Openings 53. Ext. Doors -One X -Check Garage 3rd Story, 2 Exits 54. Stairs; Width -Head roo m- Rise- R un-Landi ng- Fire Protection 55. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 56. Siding -Nailing Veneer 57. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 58. Glazing Area -Glass Protection- S kylig hts- Plastic 59. Shear Walls; Nailing -Bolts 60. Brace Interior/Exterior Wall Panels 61. Insulation -Walls -Ceilings 62. Infiltration -Walls -Windows Date Card B-1 Date Card -1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 63. Ext. Steps -Door & Sidelight Protection- Landings 64. Smoke Detector 65. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor- Ducts- Mech. Protection 66. Bedroom Exiting 67. G.F.I. & Bath Fixtures & Tub Access -Spa 68. Elec. Trim & Subpanel, Breaker Sizes & Labels 69. Stairs & Rails 70. Fireplace or Stove, Clearance -Hearth 71. Elec. Outlets at Wood Panel, Int. & Ext. 72. Kit. Fixt. & Appliance; Ground -Air Gap -Cooking Clearance 73. Elec. Outlets & Receptacles at Kit. Counter 74. Garage Fire Door; Swing -Landing -Closure 75. A.C. Duct in Garage -Damper 76. Wtr. Htr.; Vents -Clearance -Comb. Air Connector- P.R. V. in Garage; Above Floor-Mech. Protection 77. Plb., Elec. & Mech. Equip. Listed for Location 78. Elec. Receptacles in Garage (FF.I.)-Romex Protection 79. Ins ulation- Foam- Looked in Attic 80. Guard Rails & Deck Construction- Post Caps 81. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor Q Yes 82. Following Instld./Drive :l Yes :1 No/Walks :1 Yes :1 No/Planters Yes j No 83. Stucco Brown -Finish 84. A.C. Unit Disconnect, Electrical- Plumbing 85. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 86. Water Well, Disconnect, Electrical, Plumbing 87. Exterior Elec. Trim, G.F.I. Receptacle- Underground 88. Ventilation Throughout House 89. Glass Protection 90. Corrections from Previous Inspections 91. Gas Test -Meters Tagged, Gas -Electric 92. Water & Sewer Connected -C/O to Grade -HD Approval 93. Energy Compliance Certificate -Other Certificates 94. Address Posted Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: 30 COUNTY OF BUTTE - DEPARTMENT OF DEVtLOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville,' California 95965 • Telephone (530) 538-75 1 PERMIT NO. (Rev.12/96) APPLICATION AND PERMIT U / Z6 l� ASSESSOR PARCEL NUMBER 028-170-159 ZONING MR BUILDING PERMIT OWNER RANDY CREELMAN TELEPHONE SO. FT. OCC. BUILDING VALUATION 990 R 49,620-00 GW E 53 IuGRANADA AVENUE. SANTA CLARA CA 95051 CONTRACTOR'S NAME TELEPHONE COOW&Oht !ON CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 2 •0 Permit Fee 414.50 2 $ 207.25 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 2-3-00 BUILDING ADDRESS GOLD Mol-RUAIN R-00, FORBESTMM, CA Energy Plan Checking Fee $ PERMIT FEE $ Lor O. �+ S BONISIONS ME `P.M. f-68 10.02 A.C. PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe work: M.H. ON PERMANENT FOUNDATION NEW M.H. , NEW SITE Gas piping system 1 - 5 outlets 15.00 5.00 Building sewer 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 ov OR LES Main Service . , OR LESS 23.00 -1 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 f II force and effect. �� � _ 1 License Class LIC. NO. (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 Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUR OR ADDNS. ( so _ r",oN F'�O,..T MULTI.OIlTLET Ta 97.50 &POWER NGLE o� CIR. Ex. Occup. OUTLET OR FORURES 20 x'00 BAL @ .50 Ex. Occup. Outt ,=-.)0E,a 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 43.9 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' c mp nsation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be competed 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 Date Jt— Signature cN Applic nt - ❑ Owner ontractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 49R 99 HA2. – D FEES IMP FLOOD COF PARCEL I PD HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have ByMnwL��_Date PERMIT EXPIRE ON the applicable provisions Resolutions to do work been paid. Date ReceiptNo. 337358/271.0 WHITE-D.D.S.-B.D. CANARY-ASS�� GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California. 95965 - Telephone (530) 538-7541 PERMIT NO. (Rev.12'6) U?ol� APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ' ZONING n n I BUILDING PERMIT OWNER 1'1dGf-eP r1 � TELEPHONE SO. FT. C. BUILDING VALUATION W OWNERS MAILING ADORES �3 C -\C a CONTRACTOR'S NAMEELEPHONE T CONTRACTORS MAILING ADDRESS 1740 Feather River Blvd. Oroville 95965 CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Fein Fee $ 20.00 Permit Fee - 56 $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee BUILDING ADDRESS q-a-be C Energy Plan Checking Fee $ PERMIT FEE S LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filen Fee 20.00 9 Each Trap7.00 U 2' SEOFSTRUCTURE )O'0 SF ❑ Duplex ❑ Mobilehome 1A Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation W Other ❑ Describe Work: �Nn t, y-, r M LPERMIT Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 FEE S ELECTRICAL PERMIT Filing Fee 20.00 Main Service zoo'. LE 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. License Class^A-�OWNER-BUILDER DECLARATION Lic. No. 457364 b�3--I 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 200A 1000A TGNO 46.00 NEW CONST. DWELLING OCCU CUP. OR ADDNS. ( & ACC. BLDS. SO 3.SItFT ULTI NO"ESID. =11, 97,50 I POWER APPARATUS 8 SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES 20 BAL 0 I.5o Ex. Occup. GFl�E�°rs FIXED o� 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 wo compensation, as provided for by section 3700 of the Labor f e performance of the work for which this permit is issued. Xi 1 have and will maintain workers' compensation Insurance, r fired by Section 3700 of the Labor Code, for the performance of work for this permit is issued. My workers' compensation insurance carrier and p • y number are: Carrier Atlantic Mutual MECHANICAL PERMIT Fling Fee 20.00 Heating 0 ff Hood 6.50 Ventilation OERMIT FEI= $ Policy Number (The above sections need not be complete the er f work f I of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the ork f w Ic this er it is issued, Ishall not employ any person in any ma er so as to become subject to workers' compensation laws of California, a agree that f I should become subject to t1w workers' compensation provisio s of section37 of bor Cod , I I forthwith comply with those pro ions. X Date Signature of Applicant - ❑ Owner Contractor ❑ Age An OSHA permit is required for excavate s over 5'0" and em or onstrur&on of structures over 3 stories in height. dile Home Install 'on Fee $ Ener Ins on ee $ Energy p OCC CONST. -- T AL FEE $ HA D. FE I r, CO C0. ND This rmit is hereby Issued under the applicable provisions the Butte County Code and/or Resolutions to do work dicated above f r whic fees have n paid QCAr ✓✓ Date PERMIT EXPIRES ON Date Receipt No. 1 -3 S&- 375 - WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK SPECTOR GOLDENROD -APPLICANT 17 «�.�-v�`+�:5•.h�• � _Amt: rw 3;� `�ki� �a �v;: i",%�a.d�'YrE+y� s*+r�"I `.N,`i gx-,�_i, t.� COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 PERMIT APPLICATION DATA SHEET OWNER: CX1 e.9–A YY1a Y\ ASSESSOR PARCEL NU BER: Ua - Proposed Building Use: Building Inspector: Date: ' G At time of permit application, I wa a i ed th 044 iii g data must be submitted prior t rmit processing and/or issuance: Date Received By ❑ 1. All items have been submitted..................................................../....../,............................................ ,W2. Plot plans, 3/4 sets, signed by the preparer of plans. or...� ... ..: �>� –{ L] 3. Complete plans, 3/4 sets, signed by the preparer of plans................................................................... ❑ 4. Engineered plans and calculations, 3/4 sets, with wet signature on plans. All engineering must be shown on I— . ............................................................................................ ❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ............... ❑ 6. Energy Design Compliance and supporting documentation................................................................ ❑ 7. Statement of Intent for Non -Heated and A/C Buildings...................................................................... ❑ 8. Hazardous Material Form.................................................................................................................... ❑ Manufactured Home Data and I stall tion Instructions including Tie Down Specifications .............. Feesof $ �0'....................................................................................... �Y ❑ 1 Impact Fees as shown on the attached schedule ................................................... ........................... 2. California Department of Forestry Plan Approval/Fees..1.�c:..'.:..G..�..... .Z�`l•..lc�:.1.1rv) 13. Flood Elevation Certificate . ............... .................Q-Y�j..)..1............................................ Sanitation and Plot Plan Approval l Environmental Health Department.......... 5. City of Chico Plumbing Permit............................................................................................................ ❑ 16. Plot Plan and Business License Approval from the City of Biggs ....................................................... ❑ 17. Planning Approval for (A) Use: O (B) Parking: ........... 2 18 �� 2 Jam' Contact Land Development about Ll Improvements, ❑ Drainage, ❑ Legal Parc 9. Encroachment Permit for Driveway (construction approval prior to occupancy).��.e l.v.......... Pre -Inspection for required. Request to Building Inspector Contractor's License Information (Number, Name Style, Classification) ......................................... Workers' Compensation carrier and policy number.................................................................. ..... 23. Owner -Builder Verification (L] Given to Owner, ❑Mailed to Owner) ............................................. ❑ 24. etter of Signature Authorization............................................................... ... 1/ . Recorded Copy of Agricultural Acknowledgment Statement.....%I............1 �/...Q. i I.......... 26. Letter of Intent on Building Use/Detached Accessory Building Form ............................................. ❑ 27. Manufactured Home Utility Clearance................................................................................................ Existing violations and/or expired permits. . 2 ❑ 43371' irant Deed I H. Title, _ _heck to H.C.D. $1 IQ a - Z�l 0., ................. 30. Other When you issue thgperrmt, process as follows: ❑ Mail to Owne ❑ Mail to Contractor. T 1 h d h m f • k t _ e'-1 ff' ❑ D 1'h I I a IF one an o or ptc up a _ o ice. a tver wit nspector. V aD Applicant: 1 Z1n911 - Date: ' Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution Date: By: Copy of Plans sent ❑ Health Department, ❑ Fire Department, ❑ Other 1. Index permit Application for the above items numbered: 2. Additional items required: Contracto .designer, owner, was advised of the above requiredata b Contractor, designer, owner, was advised of the above required data by: Date: phone,❑ I, ❑ Building Division counter, By: phone, mail, ❑ Building Division counter, By: Contractor, designer, owner, was advised of the above required data by: Q phone, ❑ mail, ❑ Building Division counter, By Contractor, designer, owner, was advised of the above require data by: ❑ phone, (j mail, (j Building Division counter, By Plans reviewed by: 2 J6, Date." 2 Z Plans reviewed by: Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Yellow Copy - Department of Development Services - Building Division aJb/ F402 By: ❑ Plan Check List Date: Date: Date: Date: Date: TO: FROM: SUBJECT: Building Department Environmental Health Sanitation Clearance E.H. USE ONLY Plot Plan Attached C:_. Floor Plan Attac 0 Sent to B.D. / La4 6�ez/mct" - — 6 ce d ln)�. & d fi)� �e 0 o - /-p:), Owner Location AP# Plan Approved for: Sewage Disposal WaterSupply: Public Private Well Clearance for dwelling. Other - 63�) ir Q 0 V" W L2�3 I Ile Hold final for: Final clearance O.K. for: NOTE: vironmental 8/96 Ith Specialist �-z �-, /o / Date COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE CA 9$965 TELEPHONE (916) 538-7541 SCHEDULE OF FEES DUE OWNER \Glc e `' \Sl^ ' \ PROPOSED BUILDING USE 1. BUILDING PERMIT FEES Balance Du $ 6-1 -- Additional Fees Due ........... $ -- Additional Fees Due ........... $ -- Revised Plan Checking Fee ....... $ W3. 2SCHOOL DISTRICT FEES �( �U r aid at District Office) evJ HERIFF FEES (paid at Building Division) dential ........ x $360.00 = $ ,6 Units Commercial (sq.ft.).. x $0.03 = $ Sq.Ft. 4. URBAN AREA FEES (paid at Building Division) Residential -(per unit) . x< =$ #Units Amt. Commercial (sq.ft.) .. x =$ Sq.Ft. Amt. 5. RECREATION DISTRICT FEES (paid at District Office) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK $89.00 (paid at Building Division) 8. WATER TENDER FEES (Battalion # $200.00 (paid at Building Division) 9. CSA 87 TRAFFIC FEE $2500.00 (paid at Building Division) 10. OTHER A.P. DATE RECEIPT # DATE REC 3�1 z-�����'� 33 95e:J 11141- a At time of permit application, I was advised the above fees are required to be paid prior to issuance of the building permit. These fees may be changed during the plan checking process. APPLICANT `J ` h1X ��`�Q� DATE ` '0 , Pursuant to Government Code Section 66020, you are hereby notified that items 2,3,4,5,6,8,9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Div. 2nd Copy - Applicant 3rd Copy - Owner (Rev. 2/97) rA The attached Fire Sam requirements must be oomph%I as specified and approved by-C.D.F. 1 VO I i I `ie 0 -SPY acs e,. ®� Q PAD s-�RUGly P�.�'�� �• pa0 r! 0"r- �� / REVIEWED BY x,03- �HOs gH p19Opi�v ai G � BUTTE CO. FIRE DEPT. ®�E�H GyC OF E H�CALIF. DEPT. of FOREST RY aP �-(H p GE • s . fV001k�Eae AP'lyG�u / ❑ approved as submitted /'" fit• UGl HP VA approved with conditicrls E AH �A per attache sheet. _ DatA Signature 1 - '? L. --' NOTE: See The Attached BU E: COUNTY esioem . Gonstru tion 3UIL®ING ®EPARTMEN .. wireme i �• APP,ROVED' . N . ., . MQBILEHOME INSTALLATION DATA ' 1) Owner's Name: XPe-1MQ-Q 2) Assessor's Parcel Number. un -- r1o`"r1 3) Installer's Name: INTEGRITY HOMES; INC. 4) Is the site currently under permit? Yes [ ] No [ X] Permit No. 5) Is the site an existing site? Yes [ ] No[ ] (If yes, fumish two plot plans). 6) What is the electrical rating of the mobilehome? \00 Amperes. 7) What is the mobilehome site circuit breaker rating? Cy--_) Amperes. 8) What is the electrical rating of the mobilehome site? t31 0C) Amperes. 9) Is the main service remote from the mobilehome site? Yes [ ] No (] If it is, what is the rating? Amperes. 10) Is there any other electrical load to be served by the mobilehome site electric service (ie well, garage, etc.)? Yes [K] No[ ] If yes, please identify the load and size: a) The mobilehome site: Load- W60 Amperes- � b) The main service: Load- Amperes - 11) Type of gas service at mobilehome site: Natural [ ] Propane [x] None [ ] 12) Size of gas pipe at the mobilehome site from the meter or tank: 3/4". 13) What is the gas pipe length from the meter or tank to the mobilehome? 14) What is the mobilehome gas demand? B.T.U. *(This information is not required if the pipe length is less than 6 feet on natural gas or less then 50 feet on propane). THE OTHER SIDE OF THIS FORM MUST BE COMPLETED IN ORDER TO PROCESS THIS PERMIT APPLICATION act ���E Co�N ILDlNG ��p1Y ARTA4�NI 4PPROV „ MOBILEHOME SUPPORT DATA Mobile Manufacturer: 0,A-<irnpjnn Manufacture Year: oZp� If other then single wide, fumishSe up Model Number: a ao Width: a3 (ft) Length: Lop (ft) Tagalong or Expando Size X On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets. FOOTINGS: Wood pressure treated or foundation grade [X] Other: SUPPORTS: Concrete block (y] Other: Provide Tie Down'Specifications for all Mobilehomes: Pier Footings Sizes and Location SINGLE WIDE MULTI -WIDE Line 1 Line I Line 2 Line 2 Main Beams Line2...........................................................................................:.... e 2 Line 1 Line 3 cine 2 ................................................................................................ Main Beams ................................................................................................ Line 2 Line 1 .............................................. eS Tag or Triple e 4 inc 1 Line 1 Piers: Line 1 Openings Size minimum: ]XI I Size minimum:]XI I Spacing maximum: Each side of openings " From ends -max: with width over: " Line 2 Piers: Line 4 Piers: Size minimum: x Size minimum:]XI I Spacing maximum: g' b " Spacing maximum: " From ends -max: -x! o From ends -max: " Line 3 Roof Loads: Size minimum Location (from rear): Line 5 Roof Loads: Size minimum Location (from rear): BUTTE COUNTY t ,3U1LDING DEPARTMIENI 0 0 a: nRPIN OUTLET 14'-0'—� '-------.. -.---'----t ELECT MAIN 17"-�''-'------..---'f"—'---{' GAS INET /"-0" -� ' '--- --,f 10'..9 3/4 I I H4fEN INLET S' -10'—I ----•--t jI0FRLt'ISSUr___...______.. 1 _I L_, .-... I �. 1 -GEM -'-'-'---I 4600-.-.-.- L 1 I i I I I I I I � •�� _ — i z4'-; 114I j I-KRM L-4600'-'-' 4600--'i-. 4600 _4600-. .-.- .-i-.46011-.-...- -.-4600-• -'- — MITINGLINE> I -' --- T� ---- --'- '-J-331DI---'- ---' - ----' -i _ 1 -4600-• ---� 4600---•--�— 4600-• -- 1• [CRM > r -4E00 --'-'-4600-•--+-----!^'-4S'10---. •-'- � �. � j n• -u v4• I i I I •_ I 1 I 1 I 2+•-I 114 1 111 I I i i i i 1 � 4 f- -- -• � I I 1 I I-BEFIM l..-46fY1••-•-•-460D---I-.--�..460D--.-i--.-�..4600-._—.---. .4600---'--�'— 4600-A -'----- rL_j L_ J 15501_._L550! -- -----__-----'----.--__. ---'----___ L _ i I V-6 1121 •--I J,N3W-L8Va3® ONicnonv, fIER PLRCEKNT GENUTL WIFS I. [his plan hes been Calculated with a 20 pound roof load. 2. All I -Beam piers have a ma■imum spacing ui B feet u/c with end piers located no .are than 2-0 from each end of the I -Beam. 3. See installation manual for pier cenfiguratians. 4. Alternatemethods of foundation and tie down construction may be used in lieu of the Chap ion Installation Manual providcd the method hes been designed and stamped by a registered Architect or Engineer and the nethod mets local and/or state building codes. S. All dimensions taken from rear edge of floor. IgiES: SiBICS Infiniti CHAMP I ON HOME EU I DER 5 CO. I" By Curtis 640oPPLM RVI, P.O. BOX 429, I.fNDSR, CA 93241 slntc IB' = I'-0' TITh IHIE 02-09-2000 PIER FOUNDATION 0 Model #220 933 Square Feet 23'-4'x40' Optional Den 1o' -i., AepUccm tletloom • 2i AP# CDF FIRE SAFE REQUIREMENTS Ger_-6LPvtf. boy NAME ®i- 3io� PERMIT # Under authority of PRC 4290, the following checked items are required by the Butte County Fire Department and are made a part of this permit. These requirements are minimums and will be superseded by Butte County local regulations which equal or exceed these standards. Field inspections will be made by the Butte County Building Department for compliance. ] 1272.00 Maintenance of Defensible Space. To ensure continued maintenance of properties in conformance with these standards and measures and to assure continued avail- ability, access and utilization of the defensible space provided for in these standards, annual maintenance must be provide for by the land owner. Driveway Standards. 1273.02 Surface. All driveway surfaces and structures (bridges, 1 1273.07 culverts and other apparteaant structures which supple- ment the roadway bed or shoulders) shall provide unob- structed access to conventional drive vehicles, includ- ing sedans and fire apparatus weighing up to 40,000 pounds. 1273.03 Grade. Not to exceed 16 percent unless paved. 1273.04 Driveway Radius �(] 1. No roadway shall have a horizontal inside radius of / curvature of less than 50 feet and additional sur- face width of 4 feet shall be added to curves of 50- 100 feet radius; 2 feet to those from 100-200 feet. 2. The length of vertical. -curves in roadways exclusive I of gutters, ditches and drainage structures designed to hold or divert water shall be not less than 100 feet. 1273.05 Turnarounds. If required, will have a minimum turning I radius of 40 feet from the center of the road. [�] 1273.05 Turnouts. Shall be a minimum of 10 feet wide and 30 feet long with a minimum 25 foot taper on each end. �] 1270.10 Width. All driveways shall provide a minimum 10 foot I traffic lane and unobstructed vertical clearance of 15 feet along its entire length. Page 1 of -1', n . 4, d AP# CDF FIRE SAFE REQUIREMENTS Ger_-6LPvtf. boy NAME ®i- 3io� PERMIT # Under authority of PRC 4290, the following checked items are required by the Butte County Fire Department and are made a part of this permit. These requirements are minimums and will be superseded by Butte County local regulations which equal or exceed these standards. Field inspections will be made by the Butte County Building Department for compliance. ] 1272.00 Maintenance of Defensible Space. To ensure continued maintenance of properties in conformance with these standards and measures and to assure continued avail- ability, access and utilization of the defensible space provided for in these standards, annual maintenance must be provide for by the land owner. Driveway Standards. 1273.02 Surface. All driveway surfaces and structures (bridges, 1 1273.07 culverts and other apparteaant structures which supple- ment the roadway bed or shoulders) shall provide unob- structed access to conventional drive vehicles, includ- ing sedans and fire apparatus weighing up to 40,000 pounds. 1273.03 Grade. Not to exceed 16 percent unless paved. 1273.04 Driveway Radius �(] 1. No roadway shall have a horizontal inside radius of / curvature of less than 50 feet and additional sur- face width of 4 feet shall be added to curves of 50- 100 feet radius; 2 feet to those from 100-200 feet. 2. The length of vertical. -curves in roadways exclusive I of gutters, ditches and drainage structures designed to hold or divert water shall be not less than 100 feet. 1273.05 Turnarounds. If required, will have a minimum turning I radius of 40 feet from the center of the road. [�] 1273.05 Turnouts. Shall be a minimum of 10 feet wide and 30 feet long with a minimum 25 foot taper on each end. �] 1270.10 Width. All driveways shall provide a minimum 10 foot I traffic lane and unobstructed vertical clearance of 15 feet along its entire length. Page 1 of -1', r` N '.)4, (7 , f S ' D /' 3%y to e�EL" �J l�i9y✓0 AP # PERMIT # NAM '] 1273.10 Turnouts. Driveways exceeding 150 feet in length, but less than 800 feet in length, shall provide a turnout near the midpoint of the driveway. Where a driveway exceeds 800 feet, turnouts shall be provided no more than 400 feet apart. [1/,L 1273.10 Turnaround. A turnaround shall be provided. at all building sites on driveways over 300 feet in length and shall be within 50 feet of the building. 1273.11 Gates [J 1. Gate entrances shall be at least two feet wider than the roadway it serves. [� 2. The gates must be located at least 30 feet from the roadway and shall open to allow a vehicle to stop without obstructing traffic on that roadway. 3. Where a one-way road with a single traffic lane provides entrance, a 50 foot turning radius shall be used. Fuel Modification 1276.01 Setback for Structure Defensible Space. [ ] 1. All parcels 1 acre and larger shall provide a mini- mum 30 foot setback for buildings and accessory buildings from 411 property lines and/or the center of the road. [ ] 2. For parcels less than 1 acre, local jurisdiction - shall provide for the same practical effect. See Other Requirements below. [� 1276.02 Disposal of Vegetation and Fuels. Disposal, including I chipping, burying, burning or removal to a landfill site approved by the local jurisdiction, of flammable vegetation and fuels caused by site development and construction, road and driveway construction and fuel modification shall be completed prior to completion of road construction �r fi:ial inspection of a building permit. Page 2 of 3 AP # PERMIT # Other Reguirements [ ] If Building Setback is 15 to 30 Feet: - Class A or B roof - Enclosed eaves 6iwoy NAM [ ] if Building Setback is Less Than 15 Feet -Choose any 3 of the following: - Metal or no doors -on side toward property line with insuffi- cient setback - Class A or B roof with enclosed eaves - Interior automatic sprinkler system per NFPA 13D - Glass area not to exceed 110% of wall area toward property line with insufficient setback - Siding from the following list: Stucco - 3 coat Hardi-Board or Plank Masonry Masonry veneer Metal Other Butte County Fire Department approved materials /;� N�>//J_ C% Date Signature Page 3 of 3 School District A.P. Number Property Owner Property Locatioi Subdivision BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One jform. per Building) L1 ( Building Department No. tea.-ooy Lot No. j ......................... ................................................................... ...................... ; )_ Residential Development Sq. Footage v No of Living Mobile ome Addition/ : 'Supplemental to (Group R) Units Installation Conversion Permit # *(No foundation inspection): ................................................................................................................... Commercial/Industrial New Addition Representative "(Floor Plans reviewed by School District Personnel) District Identification No. .020067 II School District certfies that (Street Address) has complied with the requirements of Resolution No. representi g 9 - square feet. s (State) z 6.5-9 d by AB 2926 J FULL MITIGATIOfI fJ- Sq. Footage (Including Exterior Roofed Areas) Date (Applicant) 29& (Phone Number) (Zip Code) S Date Of $ Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with Government Code Section 660201a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the imposition of the fees in any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.xls (10/98)dmm AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DMSION 7 COUNTY CENTER DRIVE OROVII.LE, CA 95965 COPY of Document Recorded 20 -Dec -2001 2001-0060901 Has not been compared vith original BUTTE COUNTY RECORDER/ AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or. discomfort 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 occasionally generate dust, smoke, noise, and odor. Butte County has established agrculti,►al purposes and residents within said zones and on adjacent 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: _�AQCEL. 41 AS SttoLoa 64 JAZ' cEYZT-ll4 PP2cz1. mA91I 1zscoazq-b I 11A "TKE OFFICE OF 'THE Q.E LULOEV, O F 'T -NE C -O t�Lnl'T `3 Or 8u'T'f E r STIPC"T — OF` CAL1FbW(A I Ori! F'E C32Xt.A9—q L4/ ICV s i I N (A$ ot- MAPS I P<T wiB. Date-/,,? — %S~ G ( PROPER OWN RS: RArdOt? -D. "_B_A A "L1p N A, M. C*4EL- A: State of California ) Countyof '343 r)ko Carl ) On 62C IS, f before me, Voincl k -am 'Cly ,-J140yYy PU6 6 C personally appeared Dori nq M . 0Y Q 61 /ta n T y D (' Y EF ( Ma YJ Personally l nomm to a (or proved tome on the basis of satisfacto evidence) to be the person(s) whose name(s) Aare subscribed to the within instrume d acknowledged to me that they ecuted the same in /their uthorized capacity(ies), and that by bisLhaobei signature(s) on the instrument, the person(s) or the entity upon beh of which the person(s) acted, executed the instru WITNESS my hand and official seal l @uu 1., 0. rraennaaaeeaeamememusmmemrmen� Signature l ►' Seal: o• • ' HEMA KAMDAR - COMM. NO. 1299537 NOTARY PUBLIC - CALIFORNIA:0 S� • �-M .: SANTA CLARA COUNTY e COMM. EXPIRES APRIL 2, 2005 �mmmmeramrmrammaeeeemmrmmremeremmerrmmarmmmmari s I l '00 �Fc� off, 9 180 1 i I .�tip too, Butte County Environmental Health L� c G.w F, t PLANNING DIVISION -BUILDING PLAN APPROVAL e) rz.— Use: Date: Landscaping: Other:' Signature:,_, Cti'am ;jon�Forie�B;4,t�l�ers`;' P.: VVSwiN �d Master Bdrm Living Room Bdrm #2 11' 2 17'-6" 10'-1" Model #220 23' x40' Optional Den 10'-r' Meplcei&-I m•:� ENCROACHMENT PERMIT 01-31661 COUNTY Of BUTTE u OEPARTMENT Of PUBLIC WORKS 7 County Center Drive u Oroville, CA 95965 u Phone: (530) 538-7681 u Fax: (530) 538-4356" Download Forms: www.buttecounty.net/publicworks NOTIFY COUNTY 24 HOURS BEFORE WORK IS TO BE DONE Phone: (530) 538-7339 JPermitNumber District R, 6 ;] APPLICATION I / WE, the undersigned, hereby apply to the County of Butte for an encroachment permit to do the following work under or over the County roads and highways, all in accordance with County ordinances and general laws. All information except signature must be typed or legibly rinted. 1. Applicant's Name: ^ e �1a. Company Name: 2. Address: `�-� 2 G-�--� (,� t ► p „r- 3. Phone: n, t ' 4. Assessor's ParcelQNum ► 5. Location of Work to be Done: Com©,'A M� (Lick F01(F0i�QS ,off 0 l�r l Y to Rd. 6. Applicant's Signature: `� 7. Date: 111016-1- 016iCONTRACTOR°S CONTRACTOR'SINFORMATION or's Name:j�YYL2 QS a� [Contracloes 11. Fax: tor's Number.13. Certificate of Insurance: es Noor's Signature:zed Agent: TYPE OF WORK TO BE DONE 16. Please check: Curb: ❑ Gutter: ❑ Sidewalk: ❑ It> ve_t,,.s a -LA 17. Driveway (List Type): 18. Other. PERMIT GRANTED In compliance with the above request, and subject to all terms, conditions (including those printed on the back of this form) and special conditions written below, permission is hereby ranted. 19. Conditions Underground Service Alert U.S.A. must be notified two working days prior to any excavation. 800-227-2600 20. O All work shall conform to accompanying: Detail ❑ Plans ❑ Special Conditions O 21. Date Issued: 22. Expiration Date: 23. Surety: Yes C3 No 17 Mike Crump, Director of Public Works By: "Note: If permits are faxed to any number besides (530)538-4356, they can be delayed up to one week. Page I oft General Conditions — See Page 2 GENERAL CONDITIONS 1. ;t :s ur.Cers,ccc arc agreed 'hat tre Ccunry has prior right to the use of its rights of way. It is further understood and agreed by the Permittee that the doing of any wcrx urger tris permit snail constitute an acceptance of all the provisions contained herein and failure on the Permittee's part to comply -with 'a'ny provision will oe cause for ;evocation of this permit. Except as otherwise provided for public agencies and franchise holders, this permit is revocable at any time. This permit is to be on job at all times while the work is being done. 2. All work shall be done subject to the supervision of and to the satisfaction of the Public Works Department of the County of Butte. The Permittee shall, at all times, during the progress of :he .verk. keep the County Highway in as neat and clean a condition as is possible and upon completion of the work granted herein, shall leave the County Highway in a thoroughly neat, clean, and usable condition. 3. The Permittee agrees by the acceptance of this permit to property maintain any encroachment placed by the Permittee on any part of the County Highway and to immediately repair any injury to any portion of the highway, which occurs as a result of the encroachment, until such time as the Permittee may be relieved of the responsibility of such encroachment by the County Department of Public Works. 4. It is further agreed by the Permittee that whenever construction, reconstruction, or maintenance work upon the highway may require the installation provided herein shall, upon request of the County Department of Public Works, be immediately moved by and at the sole expense of the Permittee. 5. No material used •`cr fill or backfill in the construction of the encroachment shall be borrowed or taken from within the County right of way. 6. At least one lane of any public road, under the jurisdiction of the Board of Supervisors of Butte County, and other public roads junctioning or intersecting therewith, shall be kept open for travel by the general public at all times. No public road under the jurisdiction of the Board shall be closed to travel by the general public without special permission, in writing, from the Board of Supervisors. 7. The Permittee, by the acceptance of this permit, shall assume full responsibility for all Lability for personal injury or damage to property which may arise out of the work herein permitted or which may arise out of the failure on the part of the Permittee to do the work provided for under this permit In the event any dawn of such liability is made against the County of Butte or any department, official, or employee thereof, the Permittee shall defend, indemnify, and hold them and each of them harmless for such claim. 8. All excavations shall be backfilled and compacted immediately after work therein has been completed. Trenches shall not be left open farther than 300 feet in advance of pipe laying operations or 200 feet to the rear thereof, unless otherwise permitted by the Engineer. Unless otherwise permitted under the Special Conditions, backfill shall be place and mechanically compacted in such a manner that the relative compaction throughout the entire fill within the County road right of way shall conform to the percentage of compaction as stated below. Permittee shall notify foreman 24 hours before backfilling and/or paving. a. The relative compaction from the bottom of excavation to a plane five feet (5) below finish surface grades shall'be no less than ninety percent (900/0) as determined by Test Method No. Calif. 216-0 of the Materials and Research department, State of California. Transportation Department, Division of Highways, or other approved test method. b. The relative compaction from a plane five feet (5') below the finish surface grade to said finish surface grad shall be no less than ninety-five percent (95%) as determined by the above testing method. Permittee shall bear all costs and responsibility for compaction tests. C. Material for use as trench backfill in any existing or proposed roadway section shall be sand, shall be place in 8' lifts, and be compacted to a relative compaction of not less than 95°%. Materal for use as backfill in roadside gutter excavations shall be the native material and be compacted to a relative compaction of not less than 90°%. Any pavement cutting shall be scored, or saw cut before trenching. Minimum depth of cover over all underground facilities shall be 30 inches,.except drainage culverts. All installations, parallel with roadway, shall be placed as close to the right-of-way line as possible. No portion of the backfills) shall be compacted by ponding or jetting. All pavements, curbs, gutters, sidewalks. borrow ditches, pipes, headwalls, road signs, trees, shrubbery, and/or other permanent road facilities impaired by or as a result of construction operations at the construction site(s), or at other ground(s) occupied by materials and/or equipment, shall be restored immediately upon backfifling or the excavat;cn to the original grades and cross sections, and to a condition as goos as, or better than, existed prior to the oorscn;ction. AL surfacing materials of roadways and driveway approaches cut or damaged by or as a result of construction operations, shall be replaced within ONE WEEK following the backfilling of excavation, weather pernittiny, with compacted layers of surfacing materials at least as thick as the existing, and no less than two inches (21 of asphalt concrete over eight inches (8') of aggregate base, according to current California State Specifications. 9. Whenever necessary to secure permission from abutting property owners, such authority must be secured by the Permittee prior to starting work 10. The future safety and convenience of the traveling public shall be given every consideration in the location and type of construction. Permittee shad cause to be placed, erected, and maintained all warning signals, lights, barricades, sgns, and other devices or measures essential to safeguard travel by the general public over and at the site of work authorized herein. 11. If the constnCuon work covered by this permit is to be done by a private contractor hired by the applicant, applicant shall notify contractor as to the special conditions and requirements contained herein. AND WHEN'RECORDED MAIL TO: CC`S/ 2 1— 0 0 6 0 9 0 1 BUTTE COUNTY BUILDING DIVISION w Recorded I RFC FEE 7.00 7 COUNTY CENTER DRIVE Official Records I CONFORM .00 OROVILLE, CA 95%5 \ i Countyy Df I BUfTc I CANDACE J. GRUBBS 1 Recorder I ROSEMARY DICKSON I Assistant 1 Myles 01:03PM 2 0 -Dec -Mi 1 Page 1 of 1 AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT I FOR RESIDENTIAL DEVELOPMENT l Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or. discomfort 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 occasionally generate dust, smoke, noise, and odor. Butte County has established agricult- al pu.-poses and residents witlim said zones and on adjacem 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: ?1x26EL 41 AS S t Loo o t -A 71AA-r CExzv�I k 9P2CEt. tAP, Zrx-o rx-0 1►�A -me oFFice OF "THE 99Lu2QM o F 17" F- eo"rXr%� OF T!,UTTE, '5 -[KT - OF' CALILF-U (A I Or -1 FE M9AAlAaA &4/ 19ZS ` 1 M 30c�1�' Gib o r "Nps , .NrP� elf. Cs) tog'. Date O PROPER OWN RS: RAnsO� 'D. ' R�OLM�► _M N State of California ) County of '3Cl Y 0 CCCLY-cl ) On I)eC % IS, 900 before me, -wo rr►Ol ka mrfaLY , -t-i /7`1-0yy PU h 1 i C. personally appeared _Dnn na M C -r C el tna n X Rav)d y 'D ry a- ( Ma 11 Personally knoum to m (or proved to me on the basis of satisfacto evidence) to be the person(s) whose name(s) j/are subscribed to the within instrume d acknowledged to me that they ecuted the same in /their uthorized capacity(ies), and that by thei signature(s) on the instrument, the person(s) or the entity upon beh of which the person(s) acted, executed the instru WITNESS my hand and official seal. - �^ �uuuuueLeooeun®u®ssaec�u�nz9womi� Signature Yamo( 11'YJ�` f' Seal: °:'� HEMA KAMDAR e ' COMM. NO. 1299537 � NOTARY PUBLIC • CALIFORNIA ai �-�-; SANTA CLARA COUNTY p A.P. # Ca$-� I -In — I COMM. EXPIRES APRIL 2, 2005 �uoue�oua®uenusrmes®�ersaaoo�ewe�e�� COUNTY OF BUTTE - DEPARTMENT OF D ELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, ornia 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev.12*) U�� APPLI ISI AND PERMIT G ) . /-- � ASSESSOR PARCEL NUMBER ... 20NIN0 n n I BUILDING PERMIT OWNER TELEPHONE SO. FT. 94PC. BUILDING VALUATION OWNERS MAILING ADDRES CONTRACTOR'S NAME T ELEPHONE 11-9641 CONTRACTORS MAIUNG ADDRESS 1740 Feather River Blvd. Oroville 95965 CONSTRUCTION LENDER Fire lace LENDER'S MAILING ADDRESS Total Valuation b ARCHITECT OR ENGINEER LICENSE NO. Filin Fee $ 20.00 Permit Fee b ARCHITECT OR ENGINEERS MAILING ADDRESS Plan CheckingFee BUILDING ADDRESS Gc,kckb Energy Plan Checking Fee LA PERMIT FEE b LOT NO. SUBDIVISION'S NAME W1ME f��_� PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE 1A.o�A SF ❑ Duplex ❑ Mobilehome R Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each qas water heater or vent 15.00 TYPE OF WORK n� Other ❑ New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation Describe Work:. �C��C/1ill p 11 �O� (�M '�ri< . Gas piping system 1 - 5 outlets 15.00 Buildingsewer 15.00 Mobile Home S I G I W 1 1 920.00 PERMIT FEE $ J ELECTRICAL PERMIT Fling Fee 20.00 ov OR Main Service . OR LESS 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. License Class G47 Lic. No. 457364 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 1, 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 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: G ! have and will maintain a certificate of consent to self -insure for workers'— Ior•-th"e compensation, as provided for by section 3700 of the Labor �f performance of the work for which this permit is issued. YJ I have and will maintain workers' compensation Insurance, as req IrG ed by Section 3700 of the Labor Code, for the performance of work for yyhich this permit is issued. My workers' compensation Insurance carrier and p icy number are: Carrier Atlantic Mutual 7 Main Service YOGA TO 1000A 46.00 _ NEW CONST. DWELLING OCCUP. s0 OR ADONS. ( d ACC. BLDS. 3.5¢F{. NEP}= ' MULTiO4.1, f @7,50 POWER APPARATUS & SINGLE OUTLET CIR. 20 Ex. Occup. OUTLET OR FIXTURESBAL I.50 FUCAPPLNS. Ex. Occup.ounED .ETs Es1D. OR EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE b MECHANICAL PERMIT Fling Fee 20.00 Heating _Conlin Hood 6.50 Ventilation PERMIT FEi= $ Policy Number 4005201Q9 i (The above sections need not be complete theperrrJ f work of\ �(�ilya4ic�n of one hundred dollars ($100) or less.) GG O 1 certify that in the performance of the Work for\w Ic this er it 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 t workers' compensation provisions of section 37 of � bor Co�dMltlf�L forthwith comply with those provisions. X Date/ Signature of Applicant - O Owner � Contractor ❑Age An OSHA permit is required for excavati s over 5'0" and em or onstruction of structures over 3 stories in height. bile Home Installaiion Fee b Energy Inspegtion 1`ee b occ -IV TrvE �� HA 0. FEES TO AL FEE $ CDF CEL ispermit is hereby Issued under the applicable provisions the Butte County Code and/or Resolutions to do work ' dicated 4bove f r whic fees have b en paid O Q2,�3�) 8y Date PERMIT EXPIRES ON I pate) Receipt No. I WHITE-D.D.S.-B.O. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT SITE PLAN REVIEW APPLICATION % q .+ Date: AP# Permit Number (if applicable) (p APPLICANT INFORMATION Parcel Size: 1 6 O Z A (L Owners Name: G 2 e LM AA.) , rZ A tj b 1j Owners Address: 333 y CsrZA NAK�P A-yts SA. JrA C1-4 12A l n Telephone No.: Situs Address: Proposed Use: Residential ❑ New Single Family Residential ❑ Single Family Addition Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling ❑ Temporary Mobile Home (Aunt Minnie) ❑ Temporary Travel Trailer ❑ .iVfulti-family Non-residential ❑ New Commercial ❑ Commercial Addition ❑ New Industrial ❑ Industrial Addition ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial Remodel Other ❑ Septic ❑ Well ❑ Agricultural Exempt Building ❑ Other: Brief Explanation (if necessary): DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval Site Plan Stamped Approved B% Date I- 1— O Z -- Page 1 of 5 ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: \1 - ❑ Snow Load Area: ❑ Land Conservation Act Minimum Acreage: ❑ Verify residence can be built per contract ❑ Nitrate Action Plan (See Environmental Health for standards) ❑ Watershed Protection Overlay Zone (See attached standards and requirements) ❑ Expansive Soils (Test for expansive soils and if verified proper foundation design required) 9 SRA - (CDF to determine specific requirements) ❑ 100 -Year Flood Plain: (See atta5hed) • Flood Zone: ��(( • Flood Panel No.: 10 Sm C, Index Date: ❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit ❑ Minor Variance ❑ Variance ❑ Detached Building Use Form ❑ Encroachment Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: ; Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2of5 Zoning Code Streets & Highways Fire Prevention Subdivision Map Front —SC J_ Side I Side Street Rear (� Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2of5 il J Standard Fees ❑ Fire ❑ School* ❑ Parks/Recreation ❑ Roads Iff Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Impact ❑ Other Amount Formula ------------------------------------------------------------------------------------------------------------------------- Subdivision Map Special Fees ❑ Water Tender ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) * Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of the building permit. Parcel Created By ❑ Deeds: Date of Creation: Deed of Reference: Parcel Frontage on Publicly Maintained Road: Complies with County Standards for Deed Creation: Comments: Legal Access Provided: ❑ No Legal Access Required ❑ No ❑ No ❑ Yes, Road Name:_ ❑ No ❑ Yes ❑ Yes ❑ Yes ❑ Parcel Deemed to be legal ❑ Verify Legal Parcel ❑ Verify Legal Access ❑Provide Deed of Creation ❑ Obtain a Certificate of Compliance ❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment ❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23). ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements - Page 3 of 5 11 Subdivision Map,Parcel Map: ?vlap Date of Recording: Lot: ❑ Use Permit/Minor Use Permit Permit Number: f hr-, Book: C� 8- L 8 Page: Date of Approval: ❑ Comply with the following Conditions of Approval: ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 ❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance on slopes steeper than 30%. The Erosion Control Plan must be prepared by a registered civil engineer or other qualified professional and be submitted to and approved by the Department of Public Works. ❑ A plan prepared by a certified arborist, botanist or landscape architect that shows the existing on-site mature trees, located in any area proposed for buildings and vehicular access, and provides for methods to protect the trees identified to be preserved, shall be provided to and approved by the Planning Division prior to the issuance of building permits and/or prior to grading or vegetation removal. The removal of mature trees shall be minimized, where possible. A mature tree shall be defined as a tree with a trunk measuring 4 inches in diameter, 4 feet from ground level. Mature trees removed shall be replaced on a 3 -to -1 ratio, utilizing existing oak tree stock. Each tree to be preserved shall be surrounded by a circular zone (minimum 40 -foot radius) identified by an orange fence during construction activities. No vegetation removal, soil disturbance, or other development activities shall occur within the fenced area. ❑ ikleasures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated with residential development. Approved dust control measures are found in the fugitive dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. Page 4 of 5 s ✓ � 4La � Y - t `HC l � Q r l� Summary of Specific Requirements: q� j O Ci��i p� 1-105 I T G C) This information provided in this summary is based on the application information and on the best available data at the time of review. C:\My Documents\Budding Permit Site Plan Reviewl.doc Page 5 of 5 ATE OF CALIFORNIA - THE RESOURCES AGENCY GRAY DAVISravo jEPARTMENT OF FISH AND GAME SACRAMENTO VALLEY AND CENTRAL SIERRA REGION 1701 NIMBUS ROAD, SUITE A RANCHO CORDOVA, CALIFORNIA 95670 Telephone (916) 358-2900 0 ro Mr. Larry Painter Butte County Planning Division 7 County Center Drive Oroville, CA 95965 Dear Mr. Painter: January 24, 2002 The Department of Fish and Game (DFG) has reviewed the request to relocate the building site on parcel AP 028-170-159. In a letter dated June 6, 1995, the DFG did not object to a similar modification to a neighboring parcel. Provided the same conditions apply, the DFG would not object to this building site modification. If you have any questions, please contact Mr. Henry Lomeli, Associate Biologist, at (530) 892-8470 or Mr. Ron Bertram, Senior Biologist, at (916) 358-2869. Sin Banky-L Curo8' Regional Manager cc: Mr. Ron Bertram Mr. Henry Lomeli Department of Fish and Game 1701 Nimbus Road, Suite A Rancho Cordova, CA 95670 p E -CE WE ,i JAN z 9 zooz11 ' BUTTE COUNTY PLANNING DIVISION I I I I 1 ,00(.4 ph-, U 1 PLANNING DIVISION-BUILDING PLAN APPROVAL Use: O Date: Z--1- O 2 Parking: Landscaping: Other: Lo C,�,, Signature: ti COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 APPLICATION AND PERMIT PERMIT NO. 01-3106 ASSESSOR PARCEL NUMBER 028-1 ZONING MR BUILDING PE MIT OWNER RANDY 12-RERIN AN TELEPHONE SQ. FT. OCC. Bt DING VALUATION - OWNER'S MAILING ADDRESS 3334 G�NADA AVE, S-ANTA Q CA. 95051 -A -RA CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER UNKNOWN Fireplace Total Valuation $ Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Ch king Fee $ —Ener g Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Pen ty $ BUILDING ADDRESS ' GOLD NTAIN RD FORBESTOWN PERMIT FEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15,00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SFO Duplex O Mobilehome 6Other SPE FV Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W !@20.00 TYPE OF WORK New O Addition ❑ Remodel ❑ Utilities O Installation a Other Describe Work: RM FN PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( 111101 LESS ) 200A OR LESS 23.00 Main Service ( 200A TO t000A ) 46.00 NEW CONST. DWELLING OCCUP. OR AODNS. ( & ACC. BLOS. ) SO. 3.5C FT. CONTRACTORS LICENSE I de lare under penalty of perjury (check one) I am a licensed under provisions of Chapter 9, ivision 3 of the Business an Professions Code and my license is in full forc and effect. License No. �4{"1 Classification O I, as the owner, or my employees with wage as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec 7044) ❑ I, as the owner, am exclusively contractin ith licensed contractors. (Sec 7044) O I am exempt under Sec. , Business and Professions Code forthis reason NEW CONST. MULTI.OUTLET .NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR riXTURES ) BAL @ r.00 Ex. Occup.FIXED APPWS. OR ( OUTLETS IRESID.i EA. ) 5.00 Temporary Service 23.00 obile Home Facilities 20.00 c. Wiring 23.00 WORKER'S COMPEN ATION INSURANCE 1 declare under penalty of perjury (check e): O This permit is for $100.00 (valCo 1 or less. I have placed on file with the Co ty of Butte Dept. of Development Services, Building Division a Certificate f Workmen's Compensation Insurance or a Certificate of Consent to Self-i,ure. O 1 shall not employ any person in y manner so as to become subject to the Worker's Compensation laws of Califor ia. Notice to Applicant: If after maki this statement, should you become subject to the Worker's Compensation provisio s of the Labor Code, you must forthwith comply with such provisions or this permit ill be revoked. PERMIT FEE $ Contra c or ME ANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certify that I have re/thisplication and state that the above information is correct. I agree to comply to aounty Ordinances and California State Laws relating to building constructionby authorize representatives of the County of Butte to enter upon the aboveed property for inspection purposes. 1 also agree to savefy and keep harmless the County of Butte against all liabilities, judgments,d expenses which may in any way accrue against said in consequengranting of this permit. X h A &Date Signature of Applicant - O Owner Contractor ❑ Agent An OSHA permit is required for excavations over 5"0" deep and demolition or An construction of structures over 3 stories in height. Mobile Home Installatio Fee $ Energy Inspection Fee $ ocC CONST. TYPETOT FEE S HAZ. D. FEES IMP FLo DCDF PARCEL PDCounty This permit is hereby issued under of the Butte County Code and/or above for which fees have DIRECTOR OF PUBLIC By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. WORKS Date (De tel 337358/$271.00 Receipt No. 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 95965 - Telephone (916) 538-7541 PERMIT NO. Iry IAPPLICATION AND PERMIT l ei�1�4 ASSESSOR PARCEL NUMBER Q ZONING BUILDING PERMIT OWNER N TELEPHONEIR SO. FT. OCC. BUILDING VALUATION _ _ _ OWNER'S MAILING ADDRESS 333A -_ CLARA CA 95051_ __ _ __ __�r ___ __ CONTRACTOR'S NAME R.CONSTRUCTION TELEPHONE 533-9663 / CONTRACTOR'S MAILING ADDRESS RATHER 05965 CONSTRUCTION LENDER J UNKNOWN Fireplace Total Valuation $ Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee • $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy�Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS GOLD FOUNTAIN RD, FORBESTOWN PERMIT FEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap ,7.00 / Solar or heat pump water heater 23.00 Water piping 15.00 'LOT NO. SUBDIVISION'S NAME \ PARCEL MAP /' / Each gas water heater or vent 15.00 USE OF STRUCTURE\ `-- ` - / SFDuplex ❑ Mobilehome YJ Other ' \ -a r 7 O �+.. SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G I W ` 20'00 TYPE OF WORK \ New (JAddition ❑ Remodel ❑ Utilities ❑ Installation EX Other `\ Describework: NEW MH NEW SITE PERM FNDN \ \ +� PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( 8001 OR LESS ) 200A OR LESS 23.00 Main Service ( 200A TO t000A ) 46.00 NEW CONST. DWELLING OCCUP. ORADONS. ( & ACC. BLDS. ) SQ. 3.50 FT, CONTRACTORS LICENSE LIjW \ I de lare under penalty of perjury (check one) / I am a licensed under provisions of Chapter 9,/Division 3 of the Business and\ Professions Code and my license is in full force and effect. License No. 4!-41 Classification s ❑ I, as the owner, or my employees with wagesras their sole compensation, 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 contractors. (Sec 7044) 1:11 am exempt under Sec. / Business and Professions Code forthis reason / NEW CONST. MULTI -OUTLET -NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWERAPPARATUS ) & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) B20@1.00 Ex. Occup.FIXED APPLNS. OR •"( OUTLETS IRESID.I EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): 0 ❑ This .permit is for $100.00 (valuation) or less. 1 have placed on file with the Coyfnty of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -inure. ❑ I shall not employ any person in yny manner so as to become subject to the Worker's Compensation laws of Califoria. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisio/.s of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation E PERMIT FEE S Contractor I certify that I have read this pplication and state that the above information is correct. I agree to comply to all Butt�County Ordinances and California 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. 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 against said County in consequence/of the granting of this permit. X Date O Signature of Applicant ❑ Owner IWContractor ❑ Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ DCC CONST. TYPE TOTAL FEE $ HAZ. I D. FEES IMP I 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. DIRECTOR OF PUBLIC WORKS 1� Y By Date PERMIT EXPIRES ON /Dare! 337358/$271.00 Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT -9'-:* �,.x1-"-�I''.'."r�-7.."'�'r<wm�v-..-._,,,,��.----.....--------s.�—. :--.:y.ec.-.-.++ia.^.�,a•-wx - ,,.t+ti- . -.. 61. COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541, APPLICATION 0413 PERMIT PERMIT NO. 'Oi=3146 ASSESSOR PARCEL NUMBER R +/ ZONING MR BUILDING PERMIT OWNER a RANDY CREWMAN TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 3334 r-ANADA AVE, SANTA IRA CA 05051 CONTRACTOR'S NAME - TELEPHONE 533-0643 CONTRACTOR'S MAILING ADDRESS p5965 CONSTRUCTION LENDER -- -" UNKNOWN Fireplace Total Valuation Is Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS GOLD MOUNTAIN RD, FORRESTOWN PERMIT FEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15,00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 r USE OF STRUCTURE SF ❑ Duplex ❑ Mobilehome ® Other SPECIFY Gas piping system 1 5 outlets 15.00 Building sewer 15.00 Mobile Home S G I W 20 •CO TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation Eli Other ❑' Describe Work: NEW MH NEW SITE PERM FNDN PERMIT FEEF—$ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( 2100VORLESS ) 2ODA OR LESS 23.00 Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. OR AODNS. ( a ACC. BLDS. ) $ 3.50 FTD.. CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) 1 am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and my license is in full force and effect. ', License No. �►� Classification X5:1 std} ❑ I, as the owner, or my employees with wages as their sole compensation, 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 contractors. (Sec 7044) ❑ I am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET -NON.RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) B 20 @ 1.00 50 Ex. Occup. FIXED APPLNS. OR p• ( OUTLETS (RESID.) EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities20.00 Misc. Wiring J]�23.00 WORKER'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. I have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. O 1 shall not employ any person in any manner so as to become subject tot he Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE S Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling H Hood 6.50 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 Butte County Ordinances and California 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. 1 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 against said County in consequence of the granting of this permit. X _aa .0: 144 Date O Signature of Applicant - ❑ Owner Wcontractor ❑ Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ ocC CONST. TYPE TOTAL FEE $ HAZ- I D. FEES I IMP FLOOD I CDF PARCEL PD No 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. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES ON IDetel 7 L e Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT t.. ...V' .. , COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 APPLICATION AND PERMIT PERMIT NO. 01-"3106 ASSESSOR PARCEL NUMBER 028-170=130MR ZONING BUILDING PERMIT OWNER RANDY CRIMMAN TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS u- n_ AMP SANTA CLARACA 05051 CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS 1740 ,+ RIVEROMILLF05965 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS WLD MOMArN RD, FOESESTOWN PERMIT FEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15,00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE gg SF ❑ Duplex ❑ Mobilehome IRJ Other SPECIFY Gas piping system 1 5 outlets 15.00 Building sewer 15.00 Mobile Home S G I W @20.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑K Other ❑ Describe Work: NEW MH NEW SITE PERM FNDX I PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( "'"I's' I 200A OR LESS 23.00 Main Service ( 200A TO I000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( & ACC. BLDS. ) SO. 3.5C FT. CONTRACTORS LICENSE LAW( ►declare under penalty of perjury (check one) 1 am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and my license is in full force and effect. t J �A, License No. C.-�'1) Classification _z ❑ 1, as the owner, or my employees with wages as their sole compensation, 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 contractors. (Sec 7044) ❑ I am exempt under Sec. Business and Professions Code for this reason NEW CONST. MULTI -OUTLET .NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( & SINGLE OUTLET CIR. ) Ex. Occup. ( OUTLET OR FIXTURES ) e20 @Iso Ex. Occup. FIXED APPWS. OR f ' .- ( OUTLETS (RESID.) EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. I have placed on file with the County of Butte Dept. of Development Services, Building Division 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 Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 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 Butte County Ordinances and California 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. 1 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 against said County in consequence of the granting of this permit. X vat; a., Q,,, ").��_,� Date / Signat Applicant C1 Owner Contractor ❑ Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ GCC CONST. TYPE TOTAL FEE $ HAZ. I D. FEES IMP I 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. DIRECTOR OF PUBLIC WORKS BY Date PERMIT EXPIRES ON IDetel v .� lal M . v Receipt NI WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 COPY of Document Recorded 06 -May -2002 2002-0023233 Has not been compared with original BUTTE COUNTY RECORDER SPACE ABOVE THIS LINE FOR RECORDER USE ONLY NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH, INSTALLATION ON A FOUNDATION SYSTEM Recording of this document at the request of the local agency indicated is in accordance with California Health and Safety Code Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all persons thereafter dealing with the real property. RANDY D. CREELMAN AND DONNA M. CREELMAN REAL PROPERTY OWNER/LESSOR 3334 GRANADA AVE. MAILING ADDRESS SANTA CLARA SANTA CLARA CA 95051 CITY COUNTY STATE ZIP 329 GOLD MOUNTAIN RD. INSTALLATION MAILING ADDRESS, IF DIFFERENT FORBESTOWN BUTTE CA 95941 CITY COUNTY STATE ZIP SAME UNIT OWNER (if also property owner, write "SAME") MAILING ADDRESS CITY COUNTY STATE ZIP BUTTE COUNTY BUILDING DIVISION LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 COUNTY CENTER DRIVE MAILING ADDRESS OROVILLE, BUTTE, CA 95965 CITY COUNTY STATE ZIP 01-3106 (530)538-7541 BUILDING PERMIT NO. TELEPHONE NUMBER 5-3-02 S NATURE OF LOCAL GENCY 0 DATE NONE DEALER NAME (if not a dealer sale, write'NON E") NONE DEALER LICENSE NO. UNIT DESCRIPTION CHAMPION 2000 ID220-2 MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER 0901-220-1226OA/B 40 X 23 TRA498554/5 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION ASSESSOR'S PARCEL NUMBER A.P. # 028-170-159 SEE ATTACHED HCD FORM 433(A) REV. 8/91 WHITE -County Recorder CANARY - HCD PINK -Applicant GOLDENROD -Building Dept. BUILDING PERMIT NUMBER: 01-3106 Address or location of unit: 329 GOLD MOUNTAIN RD., FORBESTOWN, CA. 95941 Legal Description of Real Property: A.P.# 028-170-159 SEE ATTACHED (x) Mobilehome/Manufactured Home () Commercial Coach Has been affixed to the real property above by installation on a foundation system pursuant to Health and Safety Code Section 18551. Owner's name: RANDY D. AND DONNA M. CREELMAN Owner's address: 3334 GRANADA AVE., SANTA CLARA, CA. 95051 INSIGNIA OR HUD NUMBER: TRA498554/5 SERIAL NUMBER OR V.I.N.: 0901-220-1226OA/B MANUFACTURER'S NAME: CHAMPION YEAR: 2000 OFFICIAL APPROVING INSTALLATION: DATE: 5-3-02 PHONE: (530) 538-7541 H.C.D. 513C I EXHIBIT "A" DESCRIPTION THE LAND REFERRED TO HEREIN IS SITUATED IN THE STATE OF CALIFORNIA, COUNTY OF BUTTE, AND IS DESCRIBED AS FOLLOWS: PARCEL 1: PARCEL 4, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON FEBRUARY 4, 1985, IN BOOK 98 OF MAPS, AT PAGE(S) 68. AP$: 028-170-159-000 PARCEL II- A NON-EXCLUSIVE PUBLIC EASEMENT FOR INGRESS AND EGRESS AND PUBLIC UTILITY PURPOSES OVER THAT PORTION OF GOLD MOUNTAIN ROAD AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECOP.DER OF TETE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON FEBRUARY 4, 1985, IN BOOK 98 OF MAPS, AT PAGE(S) 68. EXCEPTING THEREFROM ALL THAT PORTION LYING 'WITHIN THE BOUNDS OF PARCEL I, DESCRIBED HEREIN. PARCEL III1 A 60 FOOT EASEMENT FOR ROAD AND PUBLIC UTILITY PURPOSES, LOCATED IN SECTIONS 2 AND 11, TOWNSHIP 18 NORTH, RANGE 5 EAST, M.D.B. & M., BUTTE COUNTY CALIFORNIA, MORE PARTICULARLY DESCRIBED AS FOLLOWS: A STRIP OF LAND 60.00 FEET IN WIDTH LYING 30.00 FEET ON EACH SIDE OF THE FOLLOWING DESCRIBED CENTERLINE: BEGINNING AT A POINT IN THE CENTERLINE OF SWEDE'S FLAT ROAD (COUNTY ROAD) THAT BEARS SOUTH 3 DEG. 50' 27" EAST, 688.68 FEET FROM THE CENTER OF SAID SECTION 2; THENCE FROM SAID POINT THE FOLLOWING COURSES AND DISTANCES: SOUTH 19 DEG. 40' 49" EAST, 172.61 FEET; SOUTH 32 DEG. 23' 53" WEST, 206.42 FEET; SOUTH 5 DEG. 41' 50" EAST, 325.51 FEET; SOUTH 1 DEG. 05' 22" EAST, :348.46 FEET; SOUTH 0 DEG. 36' 18" WEST, 2647.74 FEET; THENCE NORTH 89 DEG. 05' 42" EAST, ALONG THE SOUTHERLY BOUNDARY LINE OF SAID NORTHEAST QUARTER, 1244.00 FEET; THENCE NORTH 80 DEG. 36' 06" EAST, 884.04 FEET; THENCE SOUTH 47 DEC. 47' 34" EAST, 210.74 FEET; AND NORTH 89 DEG. 50' 40" EAST, 215.73 FEET TO A POINT ON THE EASTERLY BOUNDARY LINE OF SAID SECTION 11 AND THE END OF SAID LINE. EXCEPTING THEREFROM ALL THAT PORTION LYING WITHIN THE BOUNDS OF PARCEL I, DESCRIBED HEREIN. I m STATE OF CALIFORNIA DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT DIVISION OF CODES AND STANDARDS RRGISTRATION AND TITLING SECTION STATEMENT OF FACTS This unit is a: Mobilehome Commerical Coach F1 ating Home Truck Camper Decal (License) No. (s) Trade Name Serial No. (s) I/ We, the undersigned, hereby state that the unit described above: 0— a --t C -a e ld Wb-L�AA C Pn! oat no - 6 Affiant further agrees to indemnify and save harmless the Director of Housing and Community Development, State of California, and subsequent purchasers of said unit, for any loss they may suffer resulting from registration of the above- described unit in California, of from issuance of a California certificate of title covering the same. I / We certify under penalty of perjury that the foregoing is true and correct. Executed on ' a M at: oroville ,California (Date) (City) (State) Signature of each affiant Printed name of each affiant Address 1740 Feather River Blvd. City Michelle Freel, Office Manager Oroville , State California HCD 476.6 (Rev 11/86) 05,121/01 12:25 BIDWELL TITLE CUSTOMER SEPUti�E 4 5305330125 RECORDING REQUESTED BY MID VALLEY TITLE & ESCROW CO. / M'D WHEN RECORDED MAIL T0: BANDY D_ CREELMAN DONNA M. CREELMAN 3334 GRANADA AVENUE SANTA CLARA, CA 95051 A . P. N.: 028474-159 Order No.: 193634PE NO.678 P005 111111311110111111111111111 MQMO—OOA095& Recorded 1 REC FEE 18.08 Official Records I TAX 14.38 COI BUTTE I CAN= ��� ������JJo. GRUBBS rder I ROSENA Y DICKSON I R sistant I Fay 89: 13 -Dec -2008 I Page 1 of 2 Above This Line for Recorder's Use ONy GRANT DEED Escrow No.: 183654P&3/0RO-C THE UNDERSIGNED GRANTOR(s) DrECL1RL(s) THAT DOCUMENTARY TRANSFER TAX IS: COUNTY $14.30 computed on full value of pro erty conveyed, or ] computed on full value les 3 value of liens of encumbrances remaining at time of sale, X ] unincorporated area; [ 3 City of _, and FOR A VALUABLE CONSIDERATION, Receipt of which is hereby acknowledged, JO&N FREEMAN, an Unmarried Man hereby GRANTS) to RANDY D. CREELMAN and DONNA M. CREELMAN, Husband and Wife as Joint Tenants the following described property in the UNINCORPORATED AREA, County of Butte State of California; See Exhibit "A" attached hereto and made a part hereof. �toae&��- XNN FRE AN Document Date: November 21. 20M STATE Of CALIF1011N W )SS COUNTY OF BUTTE ) on DECENDER 12, 2000 beforeme, PENNY C. ENGLAND, NOTARY PUBLIC persomPy appeared JOHN FREERAN personolly known to me (or proved m me oa the basis of sadsfanory r4k=e) to be the person(s) wbose name(s) is/are subscribed to the widstn inswvrnem and acktkowledged to nx dW hc/dwthcy exewtW the same in hls/hrrMck authorized capacity(in) and that by his/herrtheir sigaat mo) on the inarrmeat tAs perusn(c) or trio entity upon behalf of whi�j xeMperson(s) acted, at:uoed the immmtnt. WITNESS my ha and otrtrW seal. a Signature �� This area for official cataria) sea!- PENNY C. ENGLAND FPENNYC.MA" CaaeixiDn 01240914 Mfr Cps t01"y Pkbktnt4Dat4MkCPS1ft" PAk4 . Womb CoentissionExp. OEC. 3,1003bn em. DEC. i. i?rJQ3 Mail Taff Statet=ts to; SAME AS ABOwE or A=css mutat Ictow a - 05/06/2002 08:05 5305330125 INTEGRITY HOMES INC PAGE 02 -• c = �}Ta vs-r•--•�: —mss_=�:'•:�-::.�a••::___:�-.BTATEOFCAIIFORN{A :•.:.__:c::;::_ _ .. .. NUMBER: BUSINESS. TRANSPORTATION AM)OOU4• ING AGENCY 8.6 613 4 2 DEPARTMENT OF HOUSING AND MM LOITY DEVELOPMENT. DIVISION OF COM IM 71W MANDARDS _ . 3019 TNOR7 3HT A0 O38fF7Z3,MjAMfAC` M37= ''., �.• - MANUFACTURER CERTIFICATE -OF ORIGIN Fn r. Cd..f K r c ne A rum 6rATF MEMPUTFR ORIGINAL MCO NO. MANUFACTURED HOME OR MULTtA MT MANUFACTURED HOUSING NUMBER OF SFO (S(NGLE_FAMILII�IIVELLING) _� MUINH (MULTI_UMT MAtIUF/►CTURED HOy$ING,-- TRANSPORTABLE SECTIONS Z COACH: -CO COACH. OCCUPANCY GROUP -ter„ .n �w.w- ,.o -..• .. ...... .._......, ..:. _ ._ .....-. , :r,..♦ ..-. MANUFACTURER NAME:.— -----•• . --- - - - - -- --- - -'_ -- _..... _ MANUFACTURER LICENSE NUMBER- .. .=r'• ... Champion Home Builders Co. ... r'6' ..r .: c:i..r_; ;/. - 90086 MANUFACTURER ADDRESS: SUGGESTED RETAIL PRICE: P.O. Box 429 Lindsay CA 93247 39,840.00 o. (St") MANUFACTURER TRADE NAME: MODEL NAME ANDIOR NUMBER: DATE OF MANUFACTURE: ...... .__---'------------ID224-2----. _. •=09-01-00 NAME OF DEALER OR i NSFEff E (OYNiERSHIP TRANSFERRED TO):.: DudRCl el ZnC. .: CALIF_ DEALER NUMBER OR TRANSFEREE DESIGNATION: DATE OF TRANSFER: par , _..—� --'--—"_----•---.__-- ----_ _—.._._._...._--_::_ _._`__c:_..09-01-00. __....._. •BA%Integrity Hames, Inc. 91096 DEALER OR TRANSFEREE ADDRESS: 1740 Feather River Blvd. ville 95 Soe� Srte I INVENTORY CREDITOR NAME: OONSFAO'FINANCE -SERVICING INVENTORY CREDITOR ADDRESS: ' 711 BIXIiCME AVE, SUITE 600 ST. LOUIS MO 63105 .. .......-- __...._....._.. _.._... _ . __._�. _.. _ . ._.. _.... (CityStieel ) State) SECTION MANUFACTURER SERIAL NUMBER NCO IMSIGNIA OR HUD (ABEL NUMBER LENGTH VVIOTH WEIGHT I (1 g(INCHES) INCHES) POUNDS i 0901-220-12260B TRA498554• 480 140 14386 2 0901-220-12260A TRA49A55S 480 140, 15416 ( I the copy of the Certi •care of 9rigin rezairt ampto IF 0ull, emj TRANSPORTER NAME: TRANSPORTER ADDRESS: I Istre") 17 North Enterprise C. Tulare 's I 93274 (r�1 DESTINATION FOR UNIT DESCRIBED ABOVE: (NAME)' (Sor"? (city) (StM.1 (zip) I ai191 ands PvWy d p.r)vy w -4W OW Wr. of to SUM W CaUmm th.t IM .Do» 1008 N Vue rM mv..1 E.. A.o w..^.9-01-00 r n, c fi •) rn . (Ome) (CM - - • SIGNATURE OF AUTHORIZED AGENT: r. . , :. .. . �6 1 C 013TWOUMN: � ORIGINAL (PINIQ ._ FORVORC TO THE INVENTORYCREDROIE UNLESS IS NONE. THEN FORWARD TO THE PURCHASER (DEALER OR TRANSFEREE). COPY 1 MMITE) FORWARD TO THE DEPARTMENT AT P.O. BOX 1848• SACRAMENTO. CA 95012-1020• VATHIN FIVE (5) DAYS OF RELEASE. COPY 2 (YELLOW) DELIVER TO THE TRANSPORTER TO ACCOMPANY THE UNIT TO ITS DESTINATION. COPY 3 (GOLDENROD) TO BE RETAINED BY THE MAWFACTURER. NCO 403.0 - SiOe 1 .(7/97) 30'x3 PI HOLES FOR 1/2' x 2 1/2' C.11 18'x24'x3/4' PLYVOOD 3/4' PLYVOOD SHEETS_ m1 bull FHVS SEISMIC PIER. L FOUNDATION PADS ALTERNATIVE PLYWOOD FOUNDATION PAD NUT TD SCALE OUTLINE OF MOBILE COACH n n ORSTl16E oma acAMSNa ci 2' DIA 4 - 014 TEX STS STD PIPE E�,, OR J BEAM 0 3/16' PLATE n lrgl �1E , ,�.I�, � (� TE LEGS Cry CL] �] CSI n I I � o, U MARRIAGE LINE SUPPORT PER MANUFACTKW c p I I r}, UTUCRER'S INSTALLATION INS MIRNIMUM=4 ru �L) o 41 Q H -i a w > C, x o 1� m q ULA W +' c J W N e LA Y �0 T � T L a Ep 4 1p 4 SEISMIC PIER L FOUNDATION PADS I I Dp I T I 4 4 4 4 DUTLNO OF COACH 4 4 4 4 28'. OR 32' 24'. 25'. PLAN DOUBLE WIDE scale: MOBILE COACH I' - 15' 30'x3 PI HOLES FOR 1/2' x 2 1/2' C.11 18'x24'x3/4' PLYVOOD 3/4' PLYVOOD SHEETS_ m1 bull FHVS SEISMIC PIER. L FOUNDATION PADS ALTERNATIVE PLYWOOD FOUNDATION PAD NUT TD SCALE OUTLINE OF MOBILE COACH n n 8' SHORT TUBE ci ci 2' DIA 4 - 014 TEX STS STD PIPE 4 - 3/6' OR J BEAM 0 3/16' PLATE n n TORTE q tf TE LEGS /O/ ►�/ o 0 CHI n T v O � o, U CO F„� c p Tn \/ 1 W H a �L) o 41 Q H -i a w > -12'. 14'. OR IB' --J PLAN SINGLE WIDE MOBILE COACH Scale: 1" - 15' ..Unum 1 MAA 3' x 3• PLATE MAX TUBE HEI ` IQLTS/8. 8' SHORT TUBE v E- 14' U74G TUBE 2' DIA 4 - 014 TEX STS STD PIPE 4 - 3/6' OR J BEAM BOLTS TIGHTEN 3/16' PLATE TO 190 CLAMP TORTE `/- SEISMIC 3/4' TH TE LEGS ROE TYP3/1 O P'4 5/16' PLATE X 1 1/4• BOLT VITH HARDENED WASHER SEISMIC PIER Not to Scote C.P. SEISMIC PIER«tl - PATENT #5595366 NMI 1b vo-- t II Mj:vKDR TG 13 R-rmm= 2 - 31W x V BOLTS Z FIELD DRILL HOLES v E- OPTION OF a) 4 - 014 TEX STS COACH C cul %D OR J BEAM 1/4'x2'x4' 3' x 3' ANGLE 3' VIDE PLATE 4 - BOLLTSTS `/- SEISMIC PIER i TYPICAL BEAM CONNECTIONS Not to Scate 12 SO IN OVERSUE FOR CHIPPING 5/8' X 1 3/8' FLANGED STAINLESS STEEL ANCHOR INSERT - n 4x4 -4x4 VVF 14 ci PRECAST FOUNDATION PAD Not to scale GEN3MI, -NOTES: R CAIDORNLA CODE OF HEGUlA'IIONS• TITLE: 25 AND U.H.C. 1994 EDMON. 1. DESIGN LOADS: L;UWMZS ' SIZE ' WIDES Bo Pd 40 Pof Y B 4 90Pd 40 Pd B 4 130 Pd 140 Pd rM Y B 4 2. THE DESIGN LOADS SHALL HE COMMENT WITH ROOF LIVE LOAD. WIND LOAD. AND ARaC ZONE AS ESIAMM= FOR PERMANENT BUILDING WITHIN A SPECIFIC LOCAL 3. THIS FOUNDATION SYSTEM 19 CONSIDERED TO CONSTITUTE A PERMANENT FOUNDATION. 4. ALL FO07DFGS Ails TO BE SUPPORTED IY VMK UNSATURATED UNDISTURBED COHESIVE SOIL FOOlIINO9 ARE DESIGNED FOR 1000 PSF TOTAL LOAD K LL PRESS= AND BHALL HE COMPATIBLE WITH LOCAL SOIL. CONDITIONS. 6: STBIIC VILAL. ans- a. SHAWL COM�pg�[ TO ASTM Aad - 88 KM XDaKM. D. SHALL HE FAHRIGTm 1CCORDjM TO A19C SPECIFIGITIONS. a SHALL BE WELDED ACCORDING TO AWS SPIXMCA71ONS: Ni I'W Ii'MCM.DDRAWLOW CARBON WELDABLE E 4L ALL METAL COMIFQNLTJm. NTS INCLUDI NG NAIB t SCREWS RIC. ARL TO BE PROTlL'IIVE COA 8. TTIF PIER SUPPORT ASgmmaS SNAIL HE COATED WITH SE33MANN W11iiAMS Cal -RCI OR APPROVED XQWALSNl'. 7. w8vA SLSSViCi9 (" TESTING AND 4L IATZRAL : 1700 LBS. UL71MA72 LOAD D. VZRTICAL, i 13000 ULTIMATE LOAD 8. THIS SUPPORT STOTEM D FOR PLACING MANUFACTURED BU DINGS CONSTRUCTED WITH IONGITUDDEAL OR CROSS JOMI3. 9. TM SUPPORT BYSTEN PAN 19 DESIGNED TO BE CONSTRUCTED ON A FAIRLY LEVEL SITE WITH NO RUSTING BOLL PROBLZMS. IF SETTLEMENT OCCURg DUE TO POOR SOIL. SEE NOTE U. 10.SUPPORT SYSTOI FOR CHASSL4 BEAM SUPPORTS SHALL BE LOCATED AND 3JZ6D FOR THE LAID 18 SHORN IIf TBE YOBIIZ HOME INSTALLATION DNSTRUCTIONS. 11. IN ARRAS WHERE DVIERE TIIAL.RRASSlTIZM>QNT (D.�.) CAN OCCUR. MANVFICTVRFD HOMES THE E F THE Sl1D WADI D.3. OUR. B 1 74'. OR VHE N IT WILL ADVERSELY AFFECT Tile USE O1 T� MANUFACTURED HOUR. 12. STANDARD PIER ! FOOTING SPACING PER MOBH�Z COACH MANUFACTURER'S INSTALLATION MANUAL WITHOUT MANUFACTURER 8 DWALLATION MANUAL, SPACING OF STANDARD PIFRS AND PAD SUPPORTS TO BE DETERUDIM BY STATE X01102 BOXES PARR ACI. 13.720 SYSTEM 19 ADAPTAM WITH HOLLOW YASONET BLOCE pWM. FOUNDATION PAD NOTES* 1. THE FOUNDATION PAD SHOWN ON Tffi3 PLAN 13 A PRECAST CONCR= FOUNDATION PAD. THE PLYWOOD FOUNDATION PAD MAY BE USED AS AN ALTERNATE. 2. FOUNDATION PADS SHALL BE PLACED ON LEVEL UNDOTURBED SOI. 3. A. 3000 Pffi AT 28 DAYS AS TESTED AND HAM. BY* STARLITZ WMGHT CONCRETE. B. PRS PAD ORIENTATION WHERE EVER POS=Z IS THAT THE LONG DIMENSION OF THE PAD HE PEMMICULAR TO THE COACH BEAN (AS SHOWN ON THE PLAN). C. WB30M FIELD CONDITIONS REQUIRE PAD ROTATION, NO MORE THAN HAT) OF THE REVISIONS BY 04/12/99 LP 05/1$/00 YW PADS OF THE PADSt� PARALlm- !'0 LORE CAN � COACH B THAT THE LONG DIMENSION Z CD v E- o "� a) z 1---1 _ cul %D COACH SM.. NOTES: c _o �D _ r V 1 ►-� u cv) m W �D ., �z c o 0 Hsi L) O 0 � ` T v O � o, U CO F„� c p Tn \/ 1 W H a �L) o 41 Q H -i a w > C, x o 1� m q ULA W +' c J W N e LA Y �0 Ln Lrl LAJ a w L a H E0 r Q .oaaoai000vars�� 4+ PADS OF THE PADSt� PARALlm- !'0 LORE CAN � COACH B THAT THE LONG DIMENSION Z CD 4. ITPMLTTQN 0-4 0 A. 3/4 INCH A.P.A. 48/24 ES'IZRIOR P.31-83 CC. PLUGGED, NER-QA397.PRP-108. _ r COACH SM.. NOTES: � Z O) � 1. MAXIMUM LENGTH OF SDfGIZ WIDE COACH - 68 FEET. W 0 2. MAXDPit4 !MICTE OT DOUBIZ WIDE COACH - 70 FEE*. Q 3. UNIJW APPROVED By THARP FLOOR TO RIDGE HEIG8f NOT TU LXCEm:A. 8 FU7 FOR SINGLE WIDE COASSOC. 00 B: 10 I= FOR 80 FT-DOUBIZ WIDE CQKC , .a _ CO C. 12 FELT FOR 94. 26. k 28 FELT DOUBIZ WIDE COACHES. Q c (Q 4. FOR TFMZ WIDE COACHES. FOLLOW HAIM PLACEMENT PATTERN A3 ASHOW)N ON THE DOUBLE WIDE MOBILE COACH PLAN. C4 z z F, ^ U) 5. FOR ANY COACH SIZE OTM THAN AS SHOWN ON THIS PLAN OR R177MCED ABOVE, LAYOUT z OJ SHALL BE REVIEWED AND APPROVED BY THARP k ASSOC.. INC. �' W Nn co Z V) 13 .AX SIZE NO Tr Q•� U C\2 1-r-, I. SPACING SHOWN ON THM PLN ARE FOR COACHES WITH 10 INCH AND 12 INCH BUMS OR 8 INCH PACO CORRUGATED BEANS. a� 2. FOR AN S �MR$ ADD NOT DAN ^ ADDITIONAL ROW OF C.P. ANCHOR PIERS. BEAM SHOULD O .oaaoai000vars�� 4+ • a�`nA'a"'e'tco°' moa+ ocl AI•ROVRD SEISMIC PIER AND statti<TmWucRxsaxor>o FOUNDATION PAD .+...e�.�..Qr,.�....� •'e,�N� UTTE COUNTY 3UILDING DEPARTME?a�� ELEVAELEVATION �' NOT TO SCALE .. A f P D n` j r n "t, I'M X11 "'��-CCC .�.,�� ), U%111'I AI 1Y 11 �g rl /e_ W V) z 0 A r� 0 0-4 VQ DATE, 09/08/97 SCALE- AS SHOWN DRAWN YMW JOB #, 95-36-80 SHEET, OF 1 SHEETS