HomeMy WebLinkAbout026-070-029H. B. Daugherty
2371 Bohemia Ave., Oroville `
'Permit 44-76P,E(uti1.,MH)'
t ` ELEC . S
'GAS
SUPP T STRUCTUREQ.
COMPACTION TEST RE /v
26-7-
Permit #3542- 6MHI 2��w
Issued q -
Permit #3892-76B(reinstall aw ing/MH)
PW
P Ji:m--w-� -
/side. -Bohemia--;- 300'--W:--of-Irwin;Pale
a Permit # 1115-82 E (elect to well for s
future to . de e3 Dment)
-a----►�:. '----26--07-29
Pevy' k7 16�82P,E til, MH) re e
ELEC /
GAS o,/e
SUPPORT STRUCTURE RE j--COMPACTIONTESTREQ, N D h
26-07-5 _
contr , qoln Village MH's, Oro.
Per -- -#1135-82MHI
ssued
e
-- 026=070=029 `--
JIMINEZ
2371 BOHEMIA AVE, ORO E
Cont: POOL BUILDERS
POOL MASTER 01-516 t
W
�� I' t
s®
r
NOTES RESIDENTIAL
026-070-029 ', V 04-1431
JIMINEZ
2371 BOHEMIA AVE, OROVILLE
Cont: POOL BUILDERS
POOL MASTER 01-516
r
f
t
SPECIAL CONDITIONS
CHECKED
BY
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
JOB FINALED (Date) 4� 4
F Signature Nj
"V=OK
0 = Not OK
- = Not Applicable
* = Not Ready
MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
Zoning Requirements-Selbacks-Easements
1.
Zoning Requirements -Setbacks -Easements
Footings; Soils -Size -Depth -Spacing -Connectors -Steel
2.
Soils; Special MH Support Sketch
Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
3.
Sewer; Location -Test -Fall -C/O -Concrete
Wood Awn.; Posts- Bea ms- Rftrs.-Connectors
Shthg.-Frg-Bracing
4.
Water; Location -Test -Easement Needed (Sketch)
Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
5.
Electricity; Location-Clearances-Grnd-/ /Amp -Concrete
Carports; Windows -Doors
6.
Gas; Location -Test -Wrap;-/ /" L'ft.
/ P Nat. or / /"L"ft./ /'LPG
Electric
7.
Well Clearance & Disconnect
Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
8.
Utility Clearance
Siding; Nailing -Veneer -Stucco -Mesh
10.
Roof; Shthg-Roofing
11.
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Size -Spacing -Marriage Line
3.
Gas; MH Test -Demand -Valve -Connector
4.
Electricity; MH Test -Crossovers -Breakers -Clearances
5.
Drain; MH Test -Fall -Flex Connector.
3
6.
Water; MH Test -Regulator -Connector
4.
7.
Water and Sewer Connected -C/O to Grade -HD Approval
5.
8.
Gas and Electricity Tagged
9.
Tie Downs -Type -Installation Cert.
10.
Exits; Insp.-Sketch
_7.-fecZCoL04,
8.
11.
Cert. of Occupancy
9.
12,
Permanent Foundation Only; License Decal
10.
Plumb.; Cir. Test -Water Supply Test
Date
Xht Niche
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
MISCELLANEOUS
Date
DECKS, COVERS, CARPORTS GARAGES (Plans) OK except #'s
1.
Zoning Requirements-Selbacks-Easements
2.
Footings; Soils -Size -Depth -Spacing -Connectors -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; Nailing -Veneer -Stucco -Mesh
10.
Roof; Shthg-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
NAL (Plans) OK except #'s
et s- Easements
oils; Compaction -Structure Stability
3
ool Structure; Steel -Connections -Thickness
Dead Men -Lining
4.
Elec.; Receptacles and Lighting, Distance-GFI
5.
Elec.; Pool Lighting; 15 Volts-GFI
ec.; Po es; Conduit Entries -Terminals -Listed
Metal w/5' -Circulating Equip. -Heater
_7.-fecZCoL04,
8.
Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes- Enclosures- Panelboards-Ins. to Main in Conduit
9.
Health Department Approval
10.
Plumb.; Cir. Test -Water Supply Test
11.
Xht Niche
Date
VI Card B-1 ate Card B-1
IDate
Card B-1 Date Card B-1
J = OK
0 = Not OK
- = Not Applicable = Not Ready RESIDENTIAL (Single & Duplex)
Date
Underfloor (Plans) OK except #'s
1.
Zoning -Setbacks -Easements -Flood -Slope
2.
Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
3.
Ftg., Garage; Soils-Steel-Elec. Grnd.-/ P' Fig. Depth
4.
Ftg., Porches & Decks; Soils -Steel-/ P' Fig. Depth
5.
Stemwalls, Main; Ste el- Blockouts-Wrapped
6.
Stemwalls, Garage; Steel- Blockouts-Wrapped
6a.
Hold Downs and Special Anchors
Date
7.
Slab, Steel -Wrapped
Hangers -Post Caps -Anchors -Connectors
8.
Piers -Fireplace Ftg.-Steel
48.
9.
D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
Attic Access; Size & Romex Prote --tion-Draft Stop -Ins. Baffles
10.
UF, Gas Pipe; Size Anchors - Yard Gas Piping; Size Test
51.
11.
Water Pipe; Test -Anchors -Regulator -Service Test
Property Line Firewall & Openings
12.
Electric Underground
54.
13.
Plenums & Ducts; Clearance -Material -Support -Ins.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
14.
Girders -Sills -Anchor Bolts -Joists - Vent s-Crippies
57.
15.
Access & Ventilation
16.
Insulation
64.
Smoke Detector
Date
65.
Card B-1 Date Card B-1
Date
66.
Card B-1 Date Card B-1
Date
67.
PLUMBING (Permit) OK except #'s
17.
Water Htr.; Vent -Access -Combustion Air Baffle
18.
Water Pipe; Test & Anchor -Nail Protection
19
D.W.V.; Test Fittings & Anchor -Nail Protection
20.
Shower Pan; Test, First Floor -Tub Access
21.
Test Tub & Shower, Second Floor -Tub Access
22.
Gas Pipe; Sixe & Anchors
74.
Garage Fire Door; Swing -Landing -Closure
Date
75.
Card B -t Date Card B-1
Date
76.
Card B-1 Date Card B-1
Date
77.
ELECTRICAL (Permit) OK except #'s
23.
Fixture & Transformer Clearance -Ins. Protection
24.
Elec. Receptacles Spacing -Lights & Switches at Doors
25.
Size Boxes & No. of Conductors Stapled
26.
Romex Installed Close to Edge of Studs & C.J.
27.
Equip. Ground made up w/Meth Fasteners -Bond Gas & Water
28.
2 Appliance Circuits in Kitchen & Conductor Size GFI
29.
Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or Al
30.
Range Circle / / ga Cu or AI -Oven Circ. / / ga Cu or Al
Insulated Neutral Q Yes Q No
31.
Service -Riser Conductors & Ground Main Disconnect
32.
Equip. Clearances Panels-Motors-Mech. Equip.
33.
Clothes Closet Light -Shower Light -Spa Light
34.
Smoke Detector
89.
Glass Protection
Date
90.
Card B-1 Date Card B-1
Date
91.
Card B-1 Date Card B-1
Date
92.
MECHANICAL (Permit) OK except #'s
35.
A.C. Ducts Insulation & Support
36.
Vent Fan, Exhaust above insulation
37.
Condensate Drain & Overflow, Size & Grade
Date
38.
Furnace -Vent Access -Comb. Air -Return Air Vent 115 outlet
Date
39.
Attic Access & Platform if Furnace in Attic
Date
Card B-1 Date Card B-1
Comments at Final:
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FRAMING (Permit) OK except #'s
40.
Sills 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 Ceilings -Stairs -Chasers -Tubs
45.
Headers & Beams -Size & Bearing
Date
FRAMING (Continued)
46.
Hangers -Post Caps -Anchors -Connectors
47.
Cling. Joist-Rftr. Ties-Purlin-Roff Brat.-Truss-Shting.-Ring.
48.
Fireplace Ties or Type A Flue-Fireolace Throat Clearance
49.
Attic Access; Size & Romex Prote --tion-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 3' -Check Garage 3rd Story, 2 Exits
54.
Stairs; Width -Headroom -Rise -Run -Landing -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 -Skylights -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 B-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 -Meth. 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 -Ai, 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 (F.F.I.)-Romex Protection
79.
Insulation -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 J Yes D No/Walks J Yes J No/Planters J Yes D 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:
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAM (530)538-2140
WEBSITE: www.buttecounty.net\dds
PERMIT NO.
BP041431
LICENSED CONTRACTORS 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
Issued Date' 06/02/2004 APN• 026-070-029-000
'
the Business and Professions Code, and my license is in full force and
effect.
License/Class : �—� S Lic se Number: 3 3 q`)
Site Address: 2371 BOHEMIA AVE PAL
Date: —Z-6 � Contractor: 0
6 O( 6,V-4_
Map Index:
Description: POOL MASTER 01-516
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
Owner: JIMINEZ LOUIS M & VESTA J JT
to its issuance, also requires the applicant for such. permit to file a
2371 BOHEMIA AVENUE
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's Stale License Law (Chapter 9 commencing with Section
OROVILLE, CA
7000) of Division 3 of the Business and Professions Code) or that he or
95966
she is exempt therefrom and the basis for the alleged exemption. Any
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ 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 (Sec. 7044, Business and Professions
Applicant: POOL BUILDERS
Code: The Contractors' State License Law does not apply to an
-
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
1351 MANGROVE AVENUE
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
CHICO, CA 95926
year of completion, the owner -builder will have the burden of
530-899-8988
proving that he or she did not build or improve for the purpose of
SKIMMERCH@AOL.COM
sale.).
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
Contractor: POOL BUILDERS
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
1351 MANGROVE AVENUE
❑ 1 am Exempt under Article 3 of the Business and Professions Code
CHICO, CA 95926
530-899-8988
Date: Owner:
SKIMMERCH@AOL.COM
License #• 833994
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
•
Architect'
is issued.
I have and will maintain workers' compensation insurance, as
Engineer:
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier: t_ K� N ,o
Total Square Ft: 0 S. F.
/�5,TI+T-
Policy #: (f — o / 2- 0 & o
Valuation: $0.00
Census Code:
❑ 1 certify that in the performance of the work for which this permit is
issued, 1 shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date: Z T
,
`
Applicant: ✓
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
'
hundred thousand dollars • ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the
This permit is hereby issued under the applicable provisions of the Butte County .oda anwor
Resolutions to do work indi for which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
%Q/� . o /t
(Ate:
Name:
BY
6�49S'
PERMIT EXPIRES ON:
Address:
Dat
❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Saf ty Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge itis unlawful to alter the substance of any official form or document of Butte County. thereby
authorize representatives of Butte County to enter upon the mentioned property for inspection purp es.
/above
�?L f/Z
Print Name: C- (4— VV 12 o `S� \ , VI�t.�L�i Signature:
Date: l� OCG
❑ Owner ❑ Contractor ❑ Agent for Owner gent for Contractor
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAM (530)538-2140
WEBSITE: www.buttecounty.net\dds
PERMIT NO.
BP041431
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perl'ury that I am licensed under
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
Issued Date: 06/02/2004 APN: 026-070-029-000
the Business and Professions Code, and my license is in full force and
effect.
License/Class : Lic se Number: 3 3 `71
Site Address: 2371 BOHEMIA AVE PAL
Date: —Z—b �f Contractor.
6
Map Index:
Description: POOL MASTER 01-516
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
Owner: JIMINEZ LOUIS M & VESTA J JT
to its issuance, also requires the applicant for such permit to file a
2371 BOHEMIA AVENUE
signed statement that he or she is licensed pursuant to the provisions of
the Contractors State License Law (Chapter 9 commencing with Section
OROVILLE, CA
7000) of Division 3 of the Business and Professions Code) or that he or
95966
she is exempt therefrom and the basis for the alleged exemption. Any
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ 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 (Sec. 7044, Business and Professions
Applicant: POOL BUILDERS
Code: The Contractors' State License Law does not apply to an
Pp
owner of property who builds or improves thereon, and who does
such work himself or h€rself or through his or her own employees,
1351 MANGROVE AVENUE
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
CHICO, CA 95926
year of completion, the owner -builder will have the burden of
530-8998988
proving that he or she did not build or improve for the purpose of
SKIMMERCH@AOL.COM
sale.). I
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
Contractor: POOL BUILDERS
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
1351 MANGROVE AVENUE
❑ 1 am Exempt under Article 3 of the Business and Professions Code
CHICO, CA 95926
530-899-8988
Date: owner:
SKIMMERCH@AOL.COM
License #: 833994
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
Architect'
'
is issued.
I have and will maintain workers' compensation insurance, as
Engineer:
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier:/��'r(�T r ftvN t3
Total Square Ft: 0 S.F.
Policy #: (f — o / Z o o
Valuation: $0.00
❑ I certify that in the performance of the work for which this permit is
Census Code:
issued, I shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date:
Applicant:
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the applicable provisions of the Bette County Fodp anwor
I hereby affirm that there is a construction lending agency for the
Resolutions to do work indi dab�ve for which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
Name:
By:(Ate: i4zo
Address:
PERMIT EXPIRES ON: 1�7s
Dat
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Saf ty Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection pure es.
{� `
(4-1/a- �
Print Name: c G � l , IQ VSignature: �c.r.Citi•�-•w� k�—
1/ h_2. PJ , a
Date: �. 7 _/0�
` /
(
❑ Owner ❑ Contractor ❑ Agent for Owner 414-Qgent for Contractor
BUTTE. COUNTY PERMIT
DEPARTMENT OF DEVELOPMENT SERVICES NO.
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS BP s, ,!14
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 BIN #
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OF APPLICATION
CONTRACTOR
OWNER
Name
Lo U -3 m i tV
Address
a.9 '7'1o ve.
City
C� J ►
Stat
Zip r�
Phone
3 L) _ D�} 53
Fax
E-mail
Planner
CONTRACTOR
Name 00L-1; 1
Address 3 0 ,�; o _5vo r ex +rv� Lo., "2,5
City C'I. C'0
Staterp4r,.
Zip
Phone 7 q q —$ c, g q
Fax g9 9_ g cl n
E-mail .
S Ftp M w►e rich
Lic. # 3 3q
Class
APPLICANT NAME
ARCHITECT/ENGINEER
Name
City
Address
Zip cl61 }3
City
Fax g 9 q 8 g$
State
Zip
Phone
Mag6k
Fax
E-mail
Planner
State License Number
APPLICANT NAME
Name O d L D ��
Jct
Address i
3d v >e>���e�F Loa � Is
City
State o_&
Zip cl61 }3
Phone r g$
Fax g 9 q 8 g$
E-mail
LOCATION
AP# D
Property Address
A371 k3AP-M Lk b
Cross Street
�t2 w I rJ
WORKER'S COMPENSATION
Policy Number
X7-3 —fit 2060
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
/,n
APPLICANT SIGNATURE �
X
For office use only:
Zoning
If9pl—fiFlood
Zone
I X I
SRA
I Yes
I No
Occ.
Type Const.
Subdivision Name
Mag6k
I Page
L
Planner
Date Approved:
�j61A
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc
Page 1 of 2
ep Dc ption or e W r
cel -5-/
Sq. Footage
❑ Structure Built vdthout Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
R v by: Amount: Bldg
SRA
Receipt #: Sheriff
l!G O SMIP
Dat ' Other
✓ Total
REV 4-30-04
SUBMITTAL REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply
for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE
LEGIBLE AND IN INK.
Residential, New, Remodels, Additions, and Accessory Structures:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER!
❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPER!
❑ 3. 3 Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed
calculations.
❑ 4. 2 Engineered truss details and layouts (if required) (NO FAXES!).
❑ 5. Letter from Engineer or Architect for truss design review.
❑ 6. 2 Energy compliance design and supporting documentation: (Note: Not required for additions to
mobile or modular homes.)
❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑ 8. Detached Accessory Building Form, filled out by the property owner (if required).
❑ 9. Sanitation and site plan approval from the Environmental Health Department.
❑ 10. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in
triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer.
Mobile, Manufactured, or Modular Homes:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER!
❑ 2. 2 Data sheets and installation instruction manual.
❑ 3. 2 Marriage line, information.'
❑ 4. 2 Flo6rplans.
❑ 5. 2 Engineered Tie Downs or Foundation plans.
❑ 6. Sanitation and site plan approval from the Environmental Health Department.
❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
Commercial, New, Additions and Remodels:
❑
1.
4 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑
2.
4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations,
with code analysis.
❑
3.
2 Engineered truss details and layouts (if required) (NO FAXES!).
❑
4.
Letter from Engineer or Architect for truss design review.
❑
5.
2 Energy compliance design and supporting documentation (if required).
❑
6.
2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑
7.
Statement of Intent for Non -heated and A/C (if required).
❑
8.
Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in
triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet-signedy the engineer.
❑
9.
Letter of intent.
❑
10.
Hazardous Material Form.
❑
11.
Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, contact a Permit
Application Assistant at (530) 538-7541.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMSSUILDING F0RMS\BIdgApp1SubRgmts.doc Page 2 of 2 REV 4-30-04
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPME T SERVICES -BUILDING DIVISION
7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140
PE IT APPLICATION DATA SHEET g
OWNER: ASSESSOR PARCEL NUM
roposed
diUg Use: POOCounter Technici - : t/ `--1 Date: /
t ms wired in order to apply for a permit. All boxes MUST be checked OR marked N in der to apply.
1. Site plans, 3 or 4 sets, signed by the preparer of the plans. .
0 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans.
❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and. signed calculations.
❑ 4. Engineered truss details and layouts in duplicate. No faxes!
❑ 5. Letter from Engineer or Architect for truss design review.
❑ 6. Energy compliance design and supporting documentation in duplicate.
❑ 7. Statement of Intent for Non -heated and AIC for Non -Residential Buildings.
❑ 8. Manufactured homes: (A) Data'sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in
duplicate. r
❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these
must be stamped and wet -signed by the engineer.
❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate
❑ 11. Site plan and business license approval from the City of Biggs
❑ 12. Letter of intent for non-residential buildings
❑ 13. Detached Accessory Building Form filled out by the owner
14. Hazardous Material Form
v 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico 2�Oroville, as applicable.
❑ 16. Other \
Remaining items needed to issue the permit. (May require additional plan review upon•'receipt of the following items.)
❑ 17. Fire Sprinklers ..........................
❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by
❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........
❑ 20. Erosion Control Plan Required........................................................................ ........
❑ 21. -Fees as shown on the attached Schedule of Fees Due Sheet ..............................
❑ 22. City of Chico Plumbing permit......................:.........:.......................................
❑ 23. California Department of IForest plan approval ❑ paid. Sent by: .............
❑ 24. Planning approval (A) UseD(B)Parking: (C) Parcel Check:
❑ 25. Contact Land Development about _ Improvements, _ Drainage .........................
❑ 26. NPDES Form.............................................................................................
❑ 27. Encroachment Permit for driveway from the Public Works Dept ...........................
❑ Pre -Inspection for required.......
03'.
ontractor's license information. (Number, Name Style, Classification) ...................
orker's Compensation Carrier and Policy Number ..........................................
❑ wner-Builder Verification (_ Given to owner, _Mailed to owner) .....................
❑tter of Signature authorization.........................:...........I..............................
❑ 33. Recorded copy of Agricultural Acknowledgment Statement .................................
❑ 34. Manufactured home utility clearance...............................................................
❑ '35. Existing violations and/or expired permits......................................................... ?
❑ 36. Deed Restriction.........................................................................................
❑ 37: ❑ Grant Deed, ❑ M. H. Title/Statement of Facts, ❑ Letter from Legal Owner, 'D Check to H.C.D. $
❑ -38. Other:
❑ 39. Other:
When issued Telephone and hold for pickup.
I have be n infor d of thea a items and requirements for obtaining a building permit.
Applicant: 1 G� /) Date: 5-11716
1. Index per ' plication for the above items numbered: _ l 1 �V Plan Check Lel r
I items required
Contractor designer, owner, was advised of the above data by phone, ❑ mail, ❑ counter, Date:
or, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counte , Date:
Plans reviewed by: Date: Plans approved by: Date:
Structural reviewed by: Date: Structural approved by: Date:
Note transfer by: Date:
Yellow: Building Division
E.M.3E ONLY
Piot Plea Aneched, _
,tyRoaa Plan AtsasAed
Soert to B.D. !
TO: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
60 I MIL
Owner -� Location AP#
Plan Approved for: Sewage Disposal Water Supply: Public Private Well
Clearance for dwelling. Other V,�
Hold final for:
Final clearance O.K. for:
NOTE:
Environmental Health Specialist
z 8/96
Date
ZA\) G+1 eR7/
D7 6
S. 8 9 S's, 3"y.,*.
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0'" C A FO R N! A
TE i k
Ol'tie R. DaugherIg is owners Dij. Y OF Bl", T
I, c1c, he reby certify that we dre
consent Is necessary to pass C w, M rah 4? 1 S - 71 ' 7 k -. c-. f v r e v d k r t i Yr a d.,
hereby ccn5ent to the jo re- pcwdYion 4" a-o+o-','Said' 514i4
46
c�
OERMIT N0. 1116-82P,E (MH)
+' PERMIT T PIRES /Al
OWNER LOU JIMINEZ
CONTR. owner
ASSESSOR PARCEL 26-07-29
LOCATION S/S Bohemia, 300'W Irwin, Palermo
r.
f
Temp. Power Pole
Called PG&E
Temp. Elec. Ser,ice
Called PG&E
Temp. Gas Service
Called PG&E
J INALED(Dat 2 ' f2—,
N Signature
F'
F'
u
e
J OK
0 = Not OK
= Not Applicable
* = Not Ready
MOBILEHOMES MISCELLANEOUS
Date
MOBILEHOME UTILITIES (P s) OK except N's
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's
oning Requirements—Setbacks—Easements'
So'Is; Special MH Support—Sketch
1. Zoning Requirements—Setbacks—Easements
2. Footings; Size-Depth—Spacing—Connectors
All -Sewer; Location—Test—Fall-C/0—Concrete
3. Decks; Girders and/or-Joists—Decking—Bracing—Stairs—Rails
e
t.:jra:1er; Location—Test—Easement Needed (Sk54hL
4, Wood Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.—Rig.—Bracing
ctricity; Location—Clearances—Grnd. Amp—Concrete
5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures
orF-st—Wrap:/ /"L"ft./ /"Nat. or/ /"L "ft./ /"LPG
6. Carports; Windows—Doors
tility Clearance
_
7. Elec.
d -BI
Date and -BI Date
Card -BI
Date Card -Bl Date
Card -BI
Date Card -BI Date
Card -BI
_
Date Card -BI Date
Date
MOBILEHOME INSTALLATION (PI OK except N's
Date
_
POOLS (Plans) OK except N's
P-loning Requirements—Setbacks—Easements
1. Setbacks—Easements
4--F_o6tings; Size—Spacing—Marriage Line
2. Soils; Compaction—Structure Stability
mand—Valve—Connector
lectricity; MH Test—Crossovers—Breakers—Clearances
3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining
4, Elec.; Receptacles and Lighting; Distances—GFI
rain; MH Test—Fall—Flex Connector
5. Elec.; Pool Lighting; 15 volts—GFI
L§, -Water; MH Test—Regulator—Connector
6. Elec.; Enclosures; Conduit Entries—Terminals—Listed
B.s.IW rr and Sewer Connected—C/0 to Grade—HD Approval
7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater
city Tagged
8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg.
Boxes—Enc losures— Pane lboards—Ins. to Main in Conduit
ts; Insp.—Sketch
. Cert. of Occupancy
9. Health Department Approval
10. Plumb; Cir. Test—Water Supply Test
PA B-I44E
,�� �
Date r 4rd-BI Date
Card -BI
Date Card -BI Date
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
//3_s-- -TZ
V4.23 4-8-C-9.0
I
V= 014
0= -lot OK •
- = Not Applicable RESIDENTIAL (Single
= Not Ready
and
_
Duplex)
Date
UNDERFLOOR Plans OK except 4's
Date
FRAMING (Continued)
1. Zoning requirements -Setbacks -Easements
48.
Property Line Firewall & Openings
2.
Fig., Main; Soils-Steel-Elec. Grnd.- / /" Fig. Depth
49.
Ext. Doors -One 3' -Check Garage -3rd story, 2 exits
3.
Fig., Garage; Soils -Steel- / /" Fig. Depth
50.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
4.
Fig., Porches & Decks; Soils -Steel- / /" Fig. Depth
51.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab
52.
Siding -Nailing -Veneer
6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab
53.
Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access
7.
Piers -Fireplace Ft .-Steel
54.
Glazing Aiea-Glass Protection -Skylights -Plastic
8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test
55.
Shear Walls; Nailing -Bolts
9. Gas Pipe; Size -Anchors
10.
Water Pipe; Test -Anchors -Regulator -Service Test
11.
Electric; Underground
12.
Plenums & Ducts; Clearance -Material -Support -Ins.
13.
Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Date
FINAL (Plans) OK except q's
56. Ext. Steps -Door & Sidelight Protection -Landings
Card -BI
Date
Date Card -BI Date
PLUMBING (Permit) OK•except N's
14. Water Ht.; Vent- Access -Combustion Air
57.
58.
Smoke Detector
Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
15.
16.
Water Pipe; Test & Anchors -Nail Protection
D.W.V.; Test-Fttngs & Anchors -Nail Protection
59.
60.
Bedroom Exiting
G.F.I. & Bath Fixtures & Tub Access
17. Shower Pan; Test, First Floor -Tub Access
18.
Test Tub & Shower, 2nd Floor -Tub Access
61.
Elec. Trim & Subpanel; Breaker Sizes -Labels
19.
Gas Pipe; Size & Anchors
62.
Stairs & Rails
63.
Fireplace or Stove; Clearances -Hearth
Card -BI
Date f Card -BI Date
64.
65.
Elec. Outlets at Wood Panel; Int. & Ext.
Kit. Fixt. & Appliance; Grrid.-Air Gap -Cooking Clearance
Card -BI
Date Card -BI Date
66.
Elec. Outlets & Receptacles at Kit. Counter
Date
ELECTRICAL Permit OK except q's
67.
Garage Fire Door; Swing -Landing -Closer
68.
A.C. Duct in Garage -Damper
20.
Fixture & Transformer Clearance -Ins. Protection
69.
Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
21.
22.
Elec. Receptacles Spacing -Lights &Switches at Doors
Size Boxes, & No,: of Conductors -Stapled
70.
Plb., Elec. &Mech. Equip. Listed for Location
23.
Romex Installed'Close to Edge of Studs & C.J.
71.
Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
24.
Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water
72.
Insulation -Foam -Looked in Attic ❑Yes73.
25.
2 Appliance Circuits in Kitchen &Conductor Size
Guard Rails & Deck Construction -Post Caps
26.
Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al
74.
Fdn. Vents & Crawl Hole Door, Drainage & Wood -Earth Clearance
Looked under Floor ❑ Yes
27.
Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al,
Insulated Neutral ❑Yes ❑No
75,
Following instld.: Drive ❑ Yes ❑ No; Walks El Yes ❑ No;
Planters Dyes ❑No
28.
Service -Riser Conductors & Ground -Main Disconnect
76.
Stucco; Brown -Finish
29.
Equip. Clearances; Panels-Motors-Mech. Equip.
77,
A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
_
30.
Clothes Closet Light -Shower Light
78.
Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
79.
Water Well; Disconnect, Electrical, Plumbing
80.
Exterior Elec. Trim; G.F.I. Receptacle -Underground
Card B-1
Date Card -BI Date
81.
Ventilation throughout House
Card B -I
Date Card -BI Date
82.
Glass Protection
Date
MECHANICAL (Permit) OK except q's
83.
Corrections from Previous Inspections
84.
Gas Test -Meters Tagged; Gas -Electric
31.
A.C. Ducts; Insulation & Support
85.
Water & Sewer Connected -C/O to Grade -HD Approval
_
32.
Vent Fan; Exhaust above Insulation
86.
Energy Compliance Certificate -Other Certificates
_33.
Condensate Drain & Overflow; Size & Grade
34.
Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet
35.
Attic Access & Platform if Furnace in Attic
Card -BI
_Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date
Date Card -BI Date
FRAMING(Plans) OK except q's
36. Sills; Proper Material & Anchors
Card -BI
Date Card -BI Date
Comments at Final:
37.
Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound
_
38.
39.
Bearing Walls over Girders & Floor Nailing
Draft Stop in Walls (rat proof)
40.
Fire Stops; Furred Ceilings -Stairs -Chases -Tub
_
41.
42.
43.
44.
Header & Beam -Size & Bearing
Hangers -Post Caps -Anchors -_Connectors_
Cing. Joist-Rfir. Ties- Purlir -Roof Brac.-Truss-Shthng.-Rfng.
Fireplace Ties or Type A Flue -Fireplace Throat
45.
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
_
46.
Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
47.
_
Garage Fire Protection Framing
(NOTE: An entry must be made each time you visit jobsite)
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
1196 -Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, OroviIle— Phone: 534-4,541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
//3Y- 74-z-
BUILDING OR PROPERTY ADDRESS
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center"Drive, OroviIle— Phone: 53414541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
w:w�gp"-
ING OR PROPERTY ADDRESS
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
—s':...__..•-% Date
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
• 7 County Center- Drive, Orovi Ile — Phone: 534-,4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
BUILDING OR PROPERTY ADDRESS
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
Inspector`�1 (�� Date
I
COUNTY OF BUTTE - 1.
DEPARTMENT OF PUBLIC WORKS
OROVILLE, CALIF. - 534-454COUNTY CENTER DRIVE
1
CERTIFICATE OF OCCUPANCYThis mobilehome has been installed i
tthre irements
of the California Administrative Code, Title 25, Ch pier 5e under permit
number // or the following location:
Owner
Owner's Address.p
Mobi'YehomeMfg.-'T�,,g,�Q� v2 y x�b
, ''" ♦ Model AA -w Year `,'Q
y" Insignia'1Vo. ..1, Jr
Serial No. F111,/
It is hereby certified for occupancy at the above described location and
.1ay be occupied.
Director Public Works
Date
THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED
White - Owner, Yellow - Installer, Pink - D.P.W.
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Cente; Drive- Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND, PERMIT
PERMIT NQ.
ASSESSOR PARCEL NUMBER/.. ��—��
(�/rte
ZONING
ILD G PERMIT
OWNER tA�
TELEPHONE
SQ. FT. OCC.. BUILDING VALUATION
OWNER'S MAILING ADDRE
ie i)4 .)91 1 19 QA&7 U
ONTRACTOR'SNAME
e. LN v I LL de 9/I/lel�s�
TELEPHONE
� J
CONrNTRAC OR' MAILIN ADD�Jfq� EStS `,,l I GG
�lnn1 �NI��M •LlILi�V. �� !A1%- CA, 7��L_:�
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ 16,00
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDING ADDRESS
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Repair drainage or vent piping
5.00
Water piping
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
SF ❑ Duplex[] Mobilehome�F<J Other
SPECIFY
Building sewer
Lawn sprinkler system
5.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Instal lationOther ❑
Describe work: ( 7J1�� (� j
_
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 10Dv OR100AMP OR OR LESS
1
5.00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. DWELLING OCCUP,SI\
OR ADDNS. ACC. BLDGS. I
20sgft
CONTRACTORS LICENSE LAW
I declare and r penalty of perjury (check One):
am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professio s Code and y license is in ful o ce nd effect.
License No. Classification _
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEWC
CONSTIR
NON-RESID BRA CH CIRC ITS
NEW CONSTR. / POWER APPARATUS 61
NON-RESID, %SINGLE OUTLET CIR. /
Ex. OCCUR(OUTLETS OR FIXTURES s ��
(FIXED APPLNS, OR
Ex. Occup. OUTLETS (RESID.) EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 7.50
Permit Fee $
Contractor
MECHANICAL PERMIT
FiIirig Fee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
�ve placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: if after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Heating
Cooling
Hood
3.00
Venti lation
Permit Fee
S
Contractor
-13
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
Lail Iiabili ies, judgments, costs, and expenses which may in any way a crue
st s d County in con ue a of thegranting of this pe it.
Date
re of Applicont — Owner E, Contractor Agent ❑
An OSHA permit is required for excavations ov, 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee
$
TOTAL PERMIT FEE $
OCCUP. GROUP
I TYPE OF CONST.
PARCEL
PD
I No
I 155
This permit is hereby issued under the applicable provi-
sions of the Butte County Code and/or resolutions to do
work indicated above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
/Date` Z
By / C (J
1' EXPIRES Date
Receipt No. COI 6 I
WHIT -D. P. W., YELLOW-ASSES50 R, PINK -INSPECTOR. GOLDENROD -APPLICANT
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS
7 County Center Drive, Oroville, CA.
PHONE: 534-4541
MOBILEHOME INSTALLATION SHEET
1. Owner's name: 4 y ..� 1 %%)�/ A
2. Installer's name: Z/ N o b► V ► Lb -9
3: Is the site currently under permit? Yep No
(If yes, furnish permit number ) OR
Is the site an existing site? Yes / / No
(If yes, furnish two (2) plot plans.)
4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and
clear of all setbacks and easements? Yes 7V/ No
(If no, clarify )
( )
5. What is the mobilehome electrical rating? ----------- Amps
6. What is the mobilehome site service rating? --------------------- r�,� Amps
7.. What is the mobilehome site circuit breaker rating? ------------- =2 Amps
8. Is there any other electric load to be served by the mobilehome
777 site service? -----------------------------=--------------------- Yes No
(I£ yes, identify the load and size: (Load), (Amps)
9. What is the mobilehome site gas pipe size? ----------------------
10. What is the type of gas service? ----------------------------- Natural -=k7 LPG-/---�—
11. What is the gas pipe length from meter or tank to the mobilehome? (f t.)
12. What is the mobilehome gas demand? ------------------------------ —" (BTU)
(This information not required if pipe length less than 6 ft. on natural gas
or less than 50 ft. on LPG.)
Widfh•�(ft.) Box Length (o'/ (ft.) Tagalong or Expando Size !� ft. x 6 ft.
(SHOW SUPPORT DETAILS BELOW)
On all mobilehomes manufactured after October 7, 1973; furnish manufacturer's installation
manual and structural setup sheets (if not on file with the County of Butte).
All center
supports measured from front of
MOBILEHOME SUPPORT DATA
Mnhilphnme Mfr_ li
V U
If other than single wide,
furnish Setun Model No._
�Go ` Year RIC
Widfh•�(ft.) Box Length (o'/ (ft.) Tagalong or Expando Size !� ft. x 6 ft.
(SHOW SUPPORT DETAILS BELOW)
On all mobilehomes manufactured after October 7, 1973; furnish manufacturer's installation
manual and structural setup sheets (if not on file with the County of Butte).
All center
supports measured from front of
mobilehome unless
otherwise specified.
(in.) (in.)
H
Footings (check one)
� x -- Typical Support
(in.) (in.) Footing Size
Single
1. Wood either
pressure treated or
(ft.)(in.)
(in.) (in.)
foundation grade.
Max. Pier Spacing
(ft.)(in:)
(ft.)(in.)
(in.) (in.)
❑
2. Other (specify)
Center support
Center support
Supports (check one)
locations*
footing sizes
(in.)
1: Concrete block.
��
❑
2: Other (specify)
L—�
(ft.)(in.)
(in.) (in.)
Tagalong or Expando,'
show support details.
l-- Max. Overhang
(ft.) (in.) (in.) (in.) (ft.)(in.)
BUTTE COUNTY
- UILDING DEPARTMENT'
f
APPROV
*If center piers are other than drawn above,
draw in -locations, spacing, and dimensions.
(ft.)(in.)
(in.) (in.)
H
� x -- Typical Support
(in.) (in.) Footing Size
(ft.)(in.)
(in.) (in.)
Max. Pier Spacing
(ft.)(in.)
W
r
l-- Max. Overhang
(ft.) (in.) (in.) (in.) (ft.)(in.)
BUTTE COUNTY
- UILDING DEPARTMENT'
f
APPROV
*If center piers are other than drawn above,
draw in -locations, spacing, and dimensions.
COUNTY OF BUTTE.- DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT NO.
Z
ASSESSOR PARCEL NUMB R
Ice
ZONING
A
'
BUILDING ERMIT
OVMER
TELEPHONESQ.
FT. OCC. UILDING VAL ON
OWNER'S MAILING DDRE S -
3 `I VN t Of v I
CONTRACTOR'S NAME
TELEPHONE
CON ACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
r
UNKNOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
'
LICENSE NO.
Plan Checking Fee
,$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDING ADDRESS P
J � �O
c
PLUMBING PERMITFilin
9 Fee 10.00
Each Trap
2.00
Repair drainage or vent piping
5.00
SL-,
Water piping
LOT NO. SUBDIVISION NAME
PARCEL MAP
660 ^^1 g '
Eachqas water heater or vent
5.00
Gas piping system 1 - 5 outlets
USE OF STRUCT E
SF ❑ Duplex❑ Mobilehome❑ Other
SPECIFY
tit rw sewer
inkler system
5.00
TYPE OF WORR
New F-1 Addition❑ Remodel❑ Utilities [:1 installation[] Other
Describe work: , , e
ILA 64 1 A►.� .lJ
"""""" _ ---ttt
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 100 OR LESS
100 AMP OR LESS
5.00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. ( DWELLING OCCUP.Ei)
OR ADDNS. l ACC. BLDGS.
20 sq ft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Businesss0
and Professions Code and my license is in full force and effect.
License No. Classification
[� I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONSTR. TI.OUTLET 2,50 ea
NON.RESID BRANCH CIRC TS
NEW CONSTR. / POWER APPARATUS 6
NON-RESID. %SINGLE OUTLET CIR. /
@ 259!
Ex. OCCUp�OUTLE TS OR FIXTURES BAL@1
Ex. OCCUp.�OUTLETS FIXED P(RESID,)REA. 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 7.50
( )J�
I I L15__
Permit Fee $ -Sl-
Contractor
MECHANICAL PERMIT
FiIingFee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
AI shall. not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Heating
Cooling
Hood
3.00
Ventilation
permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
I ais a ree to save indemnify?nd keep harmless the County of Butte against
all Ii bi ities, Ju me ts, costs, and expenses which may in any way accrueJ___]
ag in t aid Cou ty in onsequence of the granting of this perm!".
X �/� Date 3 � 2
Signature of AppliC t — Owner K Contractor ElAgentwork
An OSHA permit is %red for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Q
OTAL PER IT FEE $
OCCUP. GROUP
I TYPE OF CONST.
PARCE
PO
HD
seUE
This permit is hereby issued under
sions of the Butte County Code and/or
indicated above for which
DIRECTO F PUBLIC
By
PE IT EXPIRES Date_
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
r
O ��
Receipt No. ?j
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE= DEPARTMENT OF PUBLIC WORK?►� PERMIT NO.
' 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-441
APPLICATION AND.PERMIT (I
ASSESSOR PARCEL NUMBER
�7_
ZONING
BUIL G PERMIT
OWNER .�'7
.10 U �l ► Jn'1 c h)c 2
TELEPHONE
5340AS3
S0. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
X 20 1 J3®y Ur
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LPtioFA -
UNKNOWN
Total Valuation $
Filing Fee
$ 4"8"
LENDER'S MAILING ADQPF-*S
�'`'''�
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ t
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDING ADDRESS
� � f UL �0%�C ,� I A �C�� LA fi
t
PLUMBING PERMIT
Filing Fee 10.00
��� I �
Each Trap
2.00
Repair drainage or vent piping
5.00
Water piping
LOT N/
SUBDIVISION NAME t
PARCEL MAP
&.Q --W '
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
SF ❑ Duplex❑ MobilehomeOther
SPECIFY
Building sewer
r
Lawn sprinkler system
5.00
TYPE OF WORK
New F-1 Addition❑ Remodel❑ Utilities% Installation Other ❑
Describe work: O't� OB
Z �Vv1 I0-, j-14.& k AC I& L: W %F -g ( X7�
Permit Fee
$ Q —
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V OR LESS
100 AMP OR LESS
�00 t
L��J
�✓ t 1
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. (DWELLING OCCUP.y)
OR ADDNS. ACC. BLDGS.
22 sq ft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
F1NON-RESID.
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and m license is in full force and effect.
y
License No. - Classification
'1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CON STR -OUTLET 2,50 ea
NON-RESID BRANCH CIRC ITS
NEW CONSTR IPOWER APPARATUS S)
SINGLE OUTLET CIR ,
5002511
Ex. Occup OUTLETS OR FIXTURES BAL®1
Ex. Occup.(OU LETS P(RESID )REA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 7.50
Permit Fee
$
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
Jam' to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shal I be deemed revoked.
Heating
Cooling
Hood
3.00
Ventilation
Permit Fee
S
Contractor
1 certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte t enter upon the above-mentioned property for inspection purposes.
1 also ree to save, indemnify and keep harmless the County of Butte against
all li ities, j "gents, costs, and expenses which may in any way, accrue
agai said, o my n consequence of the granting of this permit
X �� Date 5 c.
Signature of Appli - OwnerX Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 storiesin height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE $
OCCUP. GROUP
I TYPE OF CONST.
PARCE
PD
No SSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DARE TOR OF PUBLIC
BY
PE T EXPIRES Date_
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Dates— f �-- [��L
Receipt No. / riR. Z�z-
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
L
1pgt In, to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT OFFIG;ei S ;;c) '=►
FOR RESIDENTIAL DEVELOPMENT
Section 26-8.1 of the Butte County Code requires this acknowledgement
be recorded prior to issuance of a building permit. MAY tt�
The property described herein is adjacent to land or included ELEANOR 0,. BECKER
�ZLERK=REC>ROER
within an area zoned for agricultural purposes, and residents of —
this property may be subject to inconveniences or discomfort arising 1 . ��8 IE
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 occa-
sionally generate dust, smoke, noise, and odor. Butte County has established agricul-
tural zones which have as a priority use for productive agricultural 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:
S 6 P2
Date:
PR APA TAY 0 RS
State of Calif. ) On this the 6th day of MaY , 19 82 ,
SS. before me, the undersigned Notary Public, personally
County of Butte ) appeared
LOUIS JIMENEZ co
CD ...
�o�ae�ama6oe�veeeonou�aeaeeoo�eoeaooecale9�oAl�onYyo� known to me to be the person(s) whose name(s) is
OFFICIAL SEAL, subscribed to the within instrument and acknowledged
,ate LeANNE M. KIBODEAUX
- NOTARY P ,9LIC. that he executed the same for the purposes •°o
• y � CnUaORNIA �
COUNTY OF BUTTE therein contained.
Commission Pn
-MY
�nirOs euwo13, aoaeeuuome IN WITNESS WHEREOF, I hereunto set my hand and official
seal.
Notary Public
Present A.P. N0. END OF DOCUtviEN7
DESCRIPTION EXHIBIT "A" ' ORDER NO. 25592-0
All that certain real property situate in the County of Butte, State o-
p
California, described as follows:
A portion of Lot 10, in Block 81 of Subdivision No. 1 of the Palermo Citrus
Tract, according to the Official Map thereof recorded in the office of the h
Recorder of the County of Butte, State of.California, on September 17, 1888,.
more particularly described as follows:
That portion of said Lot 10, shown as Parcel No. 2 on Parcel Map for H. B.
Daugherty and 011ie R. Daugherty and recorded on the 22nd day of March 1977,
at 2:23 p.m. in Book 60 of Maps at page 78 in the office of the Recorder of
the County of Butte, State of California.
PER�,!lIT N0. 3344-76P,E
PERMIT EXPIRES
OWNER H. B. Daugherty
CONTR. owner
LOCATION (A.P. 26-7-5
2371 Bohemia Ave . , orovi]]e .
f
Temp. Yower Pole
Called PG&E
Te p. Elec. Serv.
Called PG&E
emp. Gas Serv.
3 -
Ca l l ed-d&�
Z
JOB
f
FINALED
(Date)
(Signature)
9. Electrical
A. Is service large enough to provide adequate amperage to mobilehome (must equal rating of
mobilehome with a minimum o 00 amp) and other facilities on lot, i.e., water pumps,
garage, cabana, etc.? YesNo_
B. Is there proper clearances around panels? .YesA No
C. Is power supply cord, or feeder assembly properly fused? Yes No
D. Is continuity test satisfactory as per the following procedure? YesNo
1. De -energize electrical wiring system of the mobilehome at the pede tal.
2. Make sure that the power supply cord or feeder assembly conductors, including neutral
conductor, have been disconnected.
3. Switch all breakers and switches in the mobilehome to the "on" position.
4. Connect one lead of a test. instrument to the mobilehome grounding conductor and
apply the other lead to each niobileliome supply conductor, including neutral.
5. All non-current., carrying metal parts of the mobilehome (aluminum siding, gas line,
water line) ,.including fixtures and appliances, shall be tested for continuity from
such equipment and the grounding conductor.
6. Upon completion of the above procedure, the power supply cord or feeder.assembly
conduc:tors.shall be connected to the site service equipment. A further continuity
test -shall then be made between the grounding electrode and the chassis of the
mobile -home. Upon satisfactory completion of the electrical tests, the lot or site
service equipment may be approved for energizing.
10. Is job card signed by Health"Department for water and sanitation?
11. If everything okay, sign off card and tag services.
MOBILEHOME DATA�• 7u�`% 7,1
Manufacturer and/or Namestyle
Length GO Width E --
Vehicle Serial No.(P�� V
State Identification No.
Additional.Informati.on or Comments:
. _ .; _ ...
MOBILEHOME INSTALLATION INSPECTION CHECK LIST
1: Is the mobilehome located* h required separation from lot lines and buildings and generally
conform to plot plan? Yes3( No
2. Does the mobilehome have required clearances above ground? (Sec. 5085) YesNo
3. Are footings and supports properly sized, spaced, and braced as per approved plans? (Note
possible variation at spring shackles.) (Sec. 5082 & 5083) Ye_s__� No
4. Is the mobilehome level? (Sec. 5088) Yes No�
5. 1 single unit, arecrossover connections properly installed? (Sec. 5088)
Yes No
6. Water
A. Is flexible connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566)
Ye SA_
No
B: Test - Does -water piping withstand working pressure or.50 lbs. air test? Yes* No
C. a ifornia approved, does station have backflow device
and pressure -relief valve? Yes No
7. Wastes and Drains
A.. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes No
B. Does it have minimum k" per foot slope and is it properly supported? YesX No
C. Are any leaks detected in drainage system after running 3 -gallons of water through each
fixture including washing machine standpipe? Yes - NOX
D. coa a iforn a approved, does station have required trap and vent?
Yes No
8. Gas Piping and Gas Vents
A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum
mobilehome connector not more than 6 ft. long? Note: 'All piping is to be at least as
large as the mobi ehome gas line inlet without reductions other than the mobilehome
connector. Yes A No
Test OK as per following procedure? Yes No
1. Open all appliance connector valves. .
2.. Shut off appliance burner and pilot valves.
3. Air test with manometer to 10"-14" water column, or test with slope gauge (minimum
6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without
drop.
4. Connect gas meter to mobilehome with connector, turn on gas, test connections with
soapy water.
C. Are all appliance vents properly installed? YesNo
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING BUILDING C 4 P PLUMBI G
Stucco
( on )
N
Setback
Firewall
Soil Piping
Forms
Parapets
1st Floor
Main Bldg.
Restroom Finish
2nd Floor �—
Footings
Windows
3rd Floor
Stemwall
Siding
To out
Slab
Roof Sheathing
Water Piping 2
Piers
Roofing
Sewer cs2 7
Garage
Fdn. Vents
Fixtures
Footings .
Stemwa I I
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Carport
Footings
Prov. for physically
handica ed •
Conformance of ex.
structure
Appliances
Gas Piping &Tet
Temp. Gas /
Slab
Final
Sanitation -
Patio
FIREPLACE
Final
Footings
Footing
ELECTRICAL
Stucco
Final
Mesh
MECHANICAL
Scratch
Heating
Brown.
Cooling
Finish
Ducts
Interior Lath
Ventilation
Door Closer
Final
DATE p / �+REMARKS OR CORRECTIONS_
Rough
Fixtures
Motors
Water Htr.
Subpanels
Grd. Fault Prot
Service
'T ,
Temp. Pole
Underground
Pennanen
Final
(NOTE: An entry must be made on this form each time you visit the job site.)
I
f
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE
OROVILLE, CALIF. - 534-4541
CERTIf
KATE OF OCCUPANCY
This mobilehome has been installed in accordance with the requirements J
of the California ^ ��inistrative Code, Title 25, Chapter. 5, under permit
number -a' �/� for the following location:
Owner
Owner's Address
���-�'��fr-��Model � � fear%�4
Mobilehome Mfg.
�r 9/ Serial No.�`�a
Insignia No. 'z `
It is hereby certified for occupancy at the above described location and
may be occupied.
Director /o Public Works � �l
BJP.
Date 7 y
THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED
o
I
f
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE
OROVILLE, CALIF. - 534-4541
CERTIf
KATE OF OCCUPANCY
This mobilehome has been installed in accordance with the requirements J
of the California ^ ��inistrative Code, Title 25, Chapter. 5, under permit
number -a' �/� for the following location:
Owner
Owner's Address
���-�'��fr-��Model � � fear%�4
Mobilehome Mfg.
�r 9/ Serial No.�`�a
Insignia No. 'z `
It is hereby certified for occupancy at the above described location and
may be occupied.
Director /o Public Works � �l
BJP.
Date 7 y
THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED
COUNTY OF BUTTE —r DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — "Orpvillt, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
9C X Date b ` 2 ,�'r7 4
Signature of PPermipe or Agent
Receipt No. Ly 7 d� _
White-D.P.W. – Yellow -Assessor – Pink -Inspector – Goldenrod -Applicant
the butte County Code and/or resolutions to do work indicated
above for which fees have bee aid.
DIRECTOR 0 UBLIC WORKS
BY Date 7 0¢" 2
ilding permit expires Date - -7-F-7
BUILDING
Owner 4 ea—� � r"" i
1 hJ � �
SQ. FT. OCC. BUILDING VALUATION
Mai I i ng Address D, 0
Telephone No.
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee
Building Addresswe)
a37/
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
1 L L o- }1Ytf3
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No %—
Zoning 8 Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
Fees
S
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
I Parcel
Declaration
Parcel Ma P
60' R/W
Improvements
P
Lawn sprinkler system 2.00
Bldg. ans Recd
Parcel vol
Plan prowl
Permit Fee $
$
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHERELECTRICAL
LvIc
No.1 @ FEE
PERMIT FILING FEE J$3.00
di L L ,4 % O/✓ o ,�fi1 •`� +f 3 7
600V OR LESS
Main service 100 AMP OR LESS 5.00
Main service EA. ADD'L 100 AMP 2.50
Single Family ❑ Duplex ❑ Mobil Home141 Others ❑
Main service OVER 1100 AMP OR LESS 25.00
Main service EA. ADD•L 100 AMP 1,00
NEW CONST. DWELING O
OR ADDNS. ( ACCLBLDGS.CCUP. &) 2(tsgft
NEW CONSTFR. MULTI.OUTLET
NON-RESID. BRANCH CIRCUITS) 2.50ea
NEW CONSTR. (POWER APPARATUS &,'
NON.RESID. SINGLE OUTLET CIR.
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
Ex. Occup(DuTLETS OR FIXTURES)@252
BAL@1
Ex. Occup.FIXED APPLNS. OR
(OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
ISI I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑ 1 have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
® 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 the Workmen's Compensation Laws of
California.
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
1 certify that I have read this application and state that the above/Ww
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
authorize representatives of the County of Butte to enter upon the
ahovP-mantinnar1 nrnnnrhi fnr 1 nfin..
STLLA%i0✓
6
TOTAL PERMIT FEE
$ 3a to
This permit is hereby issued under the applicable provisions
of
9C X Date b ` 2 ,�'r7 4
Signature of PPermipe or Agent
Receipt No. Ly 7 d� _
White-D.P.W. – Yellow -Assessor – Pink -Inspector – Goldenrod -Applicant
the butte County Code and/or resolutions to do work indicated
above for which fees have bee aid.
DIRECTOR 0 UBLIC WORKS
BY Date 7 0¢" 2
ilding permit expires Date - -7-F-7
1
�• - COUNTY OF BUTTE/ MENT OF PUBLIC WORKS
7 County Ce�,,ve — Uroville, California 95965
Tel ephone: 534-4541
APPLICATION" AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X Date 7b
Signature of Per eeee or Ag
Receipt No. Al 9 7
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF BLIC WORKS
;W?Hdi?ng��permit
Dateexpires Date 77
BUILDING
Owner 1.J p r,� 6 jt a V-
SQ. FT. OCC. BUILDING VALUATION
Mailing Address -7I , o , IJ r�
F9 L eM' d
Tel ephone_No.
S3 3
Fireplace
Contractor
Total Valuation
Mailing Address LV
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee
Building Address O H@. 4 AIle-PLUMBING
No. @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping O
onirg Verificafion Only
Each gas water heater or vent 1.50
A. P. S6-7—
�Zoni�
g
Gas piping system 1 - 5 outlets �d
Each additional outlet .30
F s
Sa
Fire Dept.Fire
Zone
se Permit
Building sewer f.am o
EQA
Parking
Plans
eclaration
Parcel Ma P
60' R/W
lmrove ents
P
Lawn sprinkler system 2.00
Bldg. Ions Recd
Parcel Approval
Pla s pprovol
Permit Fee $ pU
laC
NEW ❑ ADDITION ❑ UTILITIES IR1 OTHER ❑
ELECTRICAL No.1 @ FEE
PERMIT FILING FEE $3.00 3.0c
Main service 610v OR LESS
100 AMP OR LESS 5.004) '
Main service EA. ADD'L 100 AMP 2.50
Main service 1100EAMP OR LESS 25.00
Single Family ❑ Duplex ❑ Mobil Home IM Others ❑
Main service EA. ADD'L 100 AMP 1.00
NEW CONST. DWELING
OR ADDNS. ( ACCLBLOGS.OCCUP. &) 20sgft
NEW CONSTR. MULTI.OUTLET
NON-RESID. BRANCH CIRCUITS) 2.50ea
NEW CONSTR. POWER APPARAT
NON-RESID. ( US &SINGLE OUTLET CIR.
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
Ex. Occup(OUTLETS OR FIXTURES)50 @2S4
109
Ex. Occu FIXED APPLNS. OR
P• OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00 IS -00
License No. Classification
Misc. Wiring 6.25
® I am exempt from the Contractors License Laws of the State of California.
Permit Fee $ �23. 00I
s —D7(—>o
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑ I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
1 certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
TOTAL PERMIT FEE
$ 5� o0
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X Date 7b
Signature of Per eeee or Ag
Receipt No. Al 9 7
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF BLIC WORKS
;W?Hdi?ng��permit
Dateexpires Date 77
NOT COMPARED WV DECLARATION REGARDING LOTS OR PARCELS
ORIGINAL DOCUMS47
I certify that as owner of the property acquired by deed in Volume
Page Official Records of Butte County, (AP#
I am requesting permission to build or install an additional living unit on this
property. I will not divide the aforementioned property for sale, lease, rent, or
financing unless all.applicable land division laws and map requirements are com-
plied with.
I am conversant with the present zoning regulations affecting the aforementioned
property, and declare that I shall not violate same. I represent that theproposed
use of the additional living unit isAl
m d_� itt& bYk =,,�/�
w of f w.-- 1N __ n
and that further I shall not change this_proposed use of the additional living unit
unless and until I receive written approval therefor from the County of Butte.
I fully understand that pursuant to Chapter 20 of the Butte County Code and §11535
et seq of the Business and Professions Code that if I, in the future, sell, lease
or finance the area on or adjacent to said improvement without fully complying with
the applicable laws and ordinances, that I shall be guilty of a misdemeanor and
therefore, subject to the aforesaid penalties and imprisonment pursuant to law.
Further, this statement shall be properly acknowledged and recorded at the request
.,of the County,of`Butte.
�e6L
138 ?Ml ISM
35452
STATE OF CALIFORNIA ) ss
COUNTY OF�'i� 1
Owner
Ki V 0M _Z ��Mlmdm�
..
L— 19- 7�
Date
On this day of 197_Zbefore me,
a Notary Public in an for r the County
' State of California, residing therein, duly commis-
sioned and sworn, personally appeared/ /��i��,,�. known
to me to be the person whose name 2 subscribeff ion e within instrument and
acknowledged to me that he executed the same.
IN WITNESS WHEREOF I have hereunto set my hand and affixed my official seal in the
County of the day and year in this certificate first above
written.
-- -
"'=..
Or SEAL
WAINDA E. FARRIS .
`
NO'Alir NU&UC.CALIFORNIA
_ ..
My Commission
PRINC;?i.L OFFICE IN
SAN DIEGO COUNTY
Expires July 18, 1111
S96-1275
NotaryPiublic
0
MOBILEHOME
LUPPORT, DATA
Mobilehome Mfr. ISl� �% U �`-`C/
'"' Setup Model No.
��7 Year
Width (ft.) Length (ft.;
-Expando Size .y ft.x ft.
(Draw support details
below)
On all
mobilehomes manufactured after October
7, 1973, furnish manufacturer's installation
manual
and structural setup sheets (if not on.fAe
with the County of Butte).
- Sin le
Footings (check.one)
--
1. Wood either
i
pressure treated or
Center
Center Suppo t
fdn. grade.
Support
Footing Size
Location
(in.)
2. Concrete pad.
x -
/ / 3. Other,: specify
in:)On.
--
- - — - - --
Supports (check one)
1. Concrete block
-
x
/ / 2. Concrete piers
(ftp .(in
(in.)(in)
i
3. Steel piers
4. Other,.specify
Typical
Support
-n—.
) Footing
in. in.
Size
V3 .
(in.)(n.)
Max. Pie
SpacingrP.�in.
r
in.,
(in.) (in.)
Max.
% Q Overhang
*If center
piers are other than drawn above,
draw in locations,
spacing, and dimensions.
0
BUTTE _COUNTY DEPARTMENT OF PUBLIC WORKS
7 County Center Drive, Oroville, CA.
PHONE: 534-4541
r
MOBILEHOME INSTALLATION SHEET
1. Owner's name:
2. Installer's name:
3. Is the site currently under permit? Yes w/ No
( If yes, furnish permit number 331-1 6 ) OR
Is the site an existing site? Yes / / No
(If yes, furnish two (2) plot plans.)
•4. Will the mobilehome be located at least 5 ft. away septic tank and leach fields and
clear of all setbacks and easements? Yes / /' No
( If no, clarify )
5. What is the mobilehome electrical rating? ----------------------- Amps
6. What is the mobilehome site service rating? --------------------- ! Amps
7. What is the mobilehome site circuit breaker rating? ------------- Amps
8. Is there any other electric load to be served by the mobilehome
site service? --------------------------------------------------- Yes / / No =T--�—
(This information not required if pipe length less than 6 ft. on natural gas
or less than 50 ft. on LPG.)
(If yes, identify
the load and size:
(Load) (Amps)
9.
What
is the
mobilehome
site gas pipe size? ----------------------
(in.)
10.
What
is the
type of gas
service? -----------------------------
Natural / / LPG //7/
11.
What
is the
gas pipe length
from meter or tank to
the mobilehome? /� (ft.)
)
`^
12.
What
is the
mobilehome
gas demand? ------------------------------
_
j %V 00 (BTU)
(This information not required if pipe length less than 6 ft. on natural gas
or less than 50 ft. on LPG.)
1
• PERMIT N0.
u
389`2-76B'
PERMIT EXPIRES
OWNER H. B. Daugherty
CONTR. owner
LOCATION (A.P. 26-07-5
2371 Bohemia Ave., Palermo .
Temp. Power Pole
Called PG&E _
Temp. Elec. rv..
Called &E _
Temp./—
Ca
emp. G Serv. _
Ca ed PG&E
;(INALED— �� -
(Date
( i nature) /
inal
FIRE SPRINKLE
Framing _
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont'd)
PLUMBING
Setback ` ��
Firewall
Soil Piping
Forms
Parapets
1st Floor ,
Main Bldg.
Restroom Finish
2nd Floor ,
Footings
Windows
3rd Floor
Stemwall
Siding
To out
Slab
Roof Sheathing
Water Piping
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Stemwall
Garage Vents
Insulation
Water Htr.
Heaters !
Slab
Carport
Footin s
handicar pehysic y
Conformance of ex.
structure
Appliances
Gas Piping & iTest
Temp. Gas
Slab
Final /
Sanitation
Patio
FIREPLA
Final
Footings
Footing
ELECTRICAL
inal
FIRE SPRINKLE
Framing _
'Test
Water Htr.
Stucco
Final Y
Subpanels
Mesh
HANICAL
Grd. Fault Prot.
Scratch
Heating
Service
Brown
Cooling
Temp Pole
Finish
Ducts
Under round
Interior Lath
Ventilation
Permanent
Door Closer
Final
Final
DATE
REMARKS OR CORRECTIONS
r
(NOTE: An entry must be made on this form each time you visit the job site.)
i COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive —'.,Uroyille, California 95965
k., r Telephone: 5. 4-4541
APPLICATION AND PERMIT
auururlce represenia0ves of the County of Butte to enter upon the
above-mentio d property for inspection purposes.
X �u Date
Signature of Perm- eee or Agent
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR 09'PJBLIC WORKS
Date ?JL
ilding permit expires Date
BUILDING
Owner puC rT
t
SQ. FT. OCC. I BUILDING VALUATION
00 MdAll,%61
Mailing Address O. ►J k 7 Z
Telephone No.
Fireplace
Contractor
Total Valuation
Mailing Address W11 ti 2—✓
Permit Fee U d v
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee $
Building AddressPLUMBING
�e'"� Ape—PERMIT
No. @ FEE
FILING FEE $3.00
t/t LL P 4
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No.ti
Zoning &Planning
Gas piping system 1 - 5 outlets 1.w
Each additional outlet .30
F
) Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking Parcel
Declaration
Parcel Ma P
60' R/W
Improvements
P
Lawn sprinkler system 2.00
//Plans
BI.PI"ans ec Parcel Approval Plan pprovol
NEW ADDITION ❑ UTILITIES ❑ OTHERELECTRICAL
Permit Fee $
$
No. @ FEE
PERMIT FILING FEE $3.00
ASS .oLCr !.�%N 1-218X N ®
6001 OR LESS
L'
Main service 100 AMP OR LESS 5.00
Main service EA. ADD'L 100 AMP 2.50
Main service VER 600V
10 0 AMP OR LESS 25.00
Single Family ❑ Duplex ❑ Mobil Home ® Others ❑
Main service/ EA. ADD•L 100 AMP 1.00
NEW CONSTDWELI
OR ADDNS. \ ACCLBLNG DGOCCUP. &) 22sgft
NEW CONSTR. MULTI -OUTLET
NON-RESID, BRANCH CIRCUITS) 2.50ea
NEW CONSTR. (POWER APPARATUS &
NON-RESID. SINGLE OUTLET CIR.
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
Ex. Occup(OUTLETS OR FIXTURES)@L@@25C1
BA
Ex. Occu FIXED APPLNS. OR
P• OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
X am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑ I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
TOTAL PERMIT FEE
$ 1
(o
auururlce represenia0ves of the County of Butte to enter upon the
above-mentio d property for inspection purposes.
X �u Date
Signature of Perm- eee or Agent
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR 09'PJBLIC WORKS
Date ?JL
ilding permit expires Date
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