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HomeMy WebLinkAbout028-110-035v 1 28-11- "'e4�t35 SHI �Y & ERIC ADAMS + E/S Plea•sgnt Grove Ln, 1600'N Laporte Rd, lot 2 , -ta g�or V( ,. Permit��224-85P, (:. til, MH) ��� ELEC o?06 w • '(�j•l GAS ;V SUPPORT STRUCTURE COMPACTION TEST REQ__Af O 1 - - --- 2 8 - ]-fig i Contr; R.tavern, Paradise I Permit 22'97-85MHI r/ _- Is ed / S - d Ft �� $. _ .28-11-35 Permif#233-8 B(new stairs &landings/MH) B07-1484 028-110-035.. RESIDENTIAL SFD-Mobile Home RET •' EX MH, EX SITE, PERM FND ¢ 1676 PLEASANT GROVE LN ADAMS SHIRLEY A. PO ha] 7-12-07 ' 4 1 � 1 O BUTTE COUNTY AREA DEPARTMENT OF DEVELOPMENT SERVICES 1 INSPECTION CARD MUST BE ON JOB SITE 24 Hour Inspection Line: (530) 538-7636 (Oroville) (530) 891-2834 (Chico) Office: (530) 538-7541 Fax: (530) 538-2140 Website: www.buttecounty.net/dds Permit No: B07-1484 Issued: 07/10/2007 Address: 1676 PLEASANT GROVEArea: BANGOR Owner: ADAMS SHIRLEY A. APN: 028-110-035 Applicant: SIERRA MOBILE SERVIMap Page: Permit Type: SFD-Mobile Home RET SJR D — 9 Description: EX MH, EX SITE, PERM FND Flood Zone: None SRA Area: Yes SETBACKS Front Setback: Side Setback: Rear Setback: Other Setback: inimum Setback From Centerline of Street: ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING Inspection Type IVR INSP DATE Setbacks 132 Foundations / Footings 111 Pier/Column Footings 122 Grade Beams 114 Eufer Ground 216 Forms/Steel/Holdowns 122 Do Not Pour Concrete Until Above are Signed Pre -Slab 124 Gas Test House 404 Gas Test Yard 404 Masonry Grout 120 Masonry Bond Beam 119 Underfloor Framing 149 Underfloor Ducts 319 Shear Transfer 136 Under Floor Plumbing 412 Under Slab Plumbing 411 Gas Piping 403 Do Not Install Floor Sheathing or Slab Until Above Signed Holdowns/Straps 122 Shearwall/B.W.P.-Interior 135 ShearwallB.W.P.-Exterior 135 Roof Nail/Drag Trusses 129 Do Not Install Siding/Stucco or Roofing Until Above Signed Rough Framing 128 Rough Plumbing 406 Rough Mechanical 316 Rough Electrical 208 Gas Piping 403 Shower Pan/Tub Test 408 Fire Sprinkler Test 702 Fire Sprinkler Final 702 Building Final 802 Electrical Final 803 Mechanical Final 809 Plumbing Final 813 Pool Final 802 Mobile Home Final 802 Inspection Type NR I INSP DATE Do Not Insulate Until Above Signed Wall Insulation 117 Ceiling Insulation 118 Do Not Cover Until Above Signed T -Bar Ceiling / RC 145 Stucco Lath 142 Stucco Scratch 143 Stucco Brown 144 Swimming Pools Setbacks 132 Pool Plumbing Test 504 Gas Test 404 Pre-Gunute 506 Pool ElecBonding/Light Nitch 502 Pool Fencing/Alarms/Barriers 503 Pre -Plaster 507 Manufactured Homes Setbacks 132 Blocking/Underpining 612 Tiedown/Foundation System 611 Site Utilities/Trench Insp. 137 Gas Test Yard 404 Manometer Test 605 Continuity Test 602 Skirting/Steps/Landings 610 Coach Info Manufactures Name: Date of Manufacture: Model Name/Number: Serial Numbers: Length x Width: Insignia: Z 1 Public Works Fina 538-7681 Fire Department/CDF 538-6837 cxt 169 Env. Health Final 538-7281 Sewer District Final "PROJECT FINAL 801 -1 -rrolect rural Is a Uernficate of Occupancy for (Residential Only) PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE. IF WORK HAS COMMENCED, YOU MAY PAY FOR A i YEAR RENEWAL 30 DAYS PRIOR TO EXPIRATION Inspector Copy I BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530).538-2140 WEBSITE: www.buttecounty.net\dds ; FEE INFORMATION DBF MH Plan Check $233.56 DBMSC Mobile Home Permit Fee. $350.34 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires SIERRANOBILE SERVICE & S 470386 / C47 ' B / 03/31/2009 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Se 000) of Division 3 of the Business and Professions Code, and my license is in full force and effect!/ X Q 07/10/2007 Contractors Signature Date WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I—IJ-HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by �/ Section 3700 of 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. State Fund Policy Number. 046-0004267 Exp. Date:01/01/2008 (This section need not be competed if the permit is for one hundred dollars ($100) or ess. aI 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 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� 07/10/2007 Signature Date ' WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. : , CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lenders Address City State Zip Balance Due: $0.00 Receipt No: B3813 OWNER / BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF. PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code] or that he or 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]; Please check one of the following: 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 Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). ❑I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). DI AM EXEMPT under Section B. 8 P.C. for this Owners Signature 07/10/2007 Date I hereby certify that I have read this application and stale that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the property owner or am authorizo to act on th roperty owners behalf. /( E t D 07/10/2007 ❑ Owner ontractor OR: E]Agent for Owner. DAgent for Contractc FILE COPY PROJECT INFORMATION Site Address: 1676 PLEASANT GROVE LN Owner: 'Permit No: B07-1484 APN: 028-110-035 ADAMS SHIRLEY A. Permit type: RESIDENTIAL 1676 PLEASANT GROVE Issued Date: 07/10/2007 By KCG Subtype: SFD-Mobile Home RET BANGOR, CA 95914 Expiration Date: 07/09/2008 Description: EX MH, EX SITE, PERM FND Occupancy: - Zoning: A5 0( Contractor Applicant: Square Footage: SIERRA MOBILE SERVICE & SUPPLY SIERRA MOBILE SERVICE & Building Garage Remdl/Addn 466 CIRCLE DRIVE 466 CIRCLE DRIVE OROVILLE, CA 95966 OROVILLE, CA 95966 Other Porch/Patio Total (530) 534-0599 ! (530) 534-0599 FEE INFORMATION DBF MH Plan Check $233.56 DBMSC Mobile Home Permit Fee. $350.34 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires SIERRANOBILE SERVICE & S 470386 / C47 ' B / 03/31/2009 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Se 000) of Division 3 of the Business and Professions Code, and my license is in full force and effect!/ X Q 07/10/2007 Contractors Signature Date WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I—IJ-HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by �/ Section 3700 of 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. State Fund Policy Number. 046-0004267 Exp. Date:01/01/2008 (This section need not be competed if the permit is for one hundred dollars ($100) or ess. aI 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 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� 07/10/2007 Signature Date ' WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. : , CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lenders Address City State Zip Balance Due: $0.00 Receipt No: B3813 OWNER / BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF. PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code] or that he or 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]; Please check one of the following: 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 Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). ❑I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). DI AM EXEMPT under Section B. 8 P.C. for this Owners Signature 07/10/2007 Date I hereby certify that I have read this application and stale that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the property owner or am authorizo to act on th roperty owners behalf. /( E t D 07/10/2007 ❑ Owner ontractor OR: E]Agent for Owner. DAgent for Contractc FILE COPY guTTF BUTTE COUNTY PERMIT 0 o DEPART&IE•NT OF DEVELOPMiENT SERVICES ° BUILDING PERMIT APPLICATION NO. ° AND SUBMITTAL REQUIREMENTS �"N� ° 24 DOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 B OFFICE #: (530) 538-7541 A TEL' WILL BE REQUIRED AT TIME OF APPLICATION BIN # **PLEASE PRINT CLEARLY** Ole iv_R Last Name ,I PAMs First Name Address p 76 City lj#V& 64 i State e14 JP Phone r Fax i E-mail APPLICANT SIGNATURE X For office use only: CONTRACTOR Name ��� , • . - Address 4/661„ City i i State Zip YS -f E Phone 5--741 0,5”? Fax E-mail .1 L ic. # Class APPLICANT SIGNATURE X For office use only: ARCHITECT -"ENGINEER Name Flood Zone: Address Address City i State Zip Phone _-F-ax ZiP%SE6 E-mail 93 q 0,5- I State License Number APPLICANT SIGNATURE X For office use only: APPLICANT NAME Name Flood Zone: Property Address /67G Address Yes No City L� Subdivision Name Stale C ZiP%SE6 Phone 93 q 0,5- DateApproved: Fax E-mail APPLICANT SIGNATURE X For office use only: Zoning AP# dig Flood Zone: Property Address /67G SRA Yes No Occ. Type Const. Subdivision Name Hap Book Page Lot # Planner DateApproved: V Y LI\ I -ter\ OUDIVI .l I ,vL KtQUlKEMENTS Description or Scope of Work: Sq. Footage " ❑ Structure Built without 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. Received by: . 6 LOCATION AP# dig ilU b3S Property Address /67G fA45NS%tNt G�Po✓� City e�NGv� Cross Street Date: 1�' b- Other 2! " `� Total WORKER'S COMPENSATION Policy Number Y7 S 7 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 Description or Scope of Work: Sq. Footage " ❑ Structure Built without 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. Received by: . 6 Amount - Bldg SRA Receipt . Sheriff -MIP Date: 1�' b- Other 2! " `� Total I XW Foundation System Installation Instructions for California for Ground & Concrete Systems HUD Wind Zone I, 15 PSF Wind Load Seismic 4 By Tie Down Engineering Xi2 Concrete System W -[*A BUTTE COUNTY BUILDING ®B WON APPROVED 0* 110- 03� �- ��-07 ma `4 ' Engineer Approval State Approval MANUFACTURED HOMElMOE1LE HOME FOUNDATION SYSTEM HEALTH AND SAFETY CODE, SECTION 18551 APPROVED SUBJECT TO CORRECTIONS NOTED APPROVAL DABS NOT AUTHORIZE OR APPROVE ANY OMISSIONS OR DEVIATION FROM REQUIREMENTS OF APPLICABLE STATE LAWS AND REOULATIONS Suft of Celifomit DV&Mw t OfFlaning =4 Canum tq Davdapd OF COPES AND STANDARDS DATE u Alcoa PLsAffwv&Egi= - Page 1 of 8 0 LD 0 0 0 t• Xi2 Foundation System Installation Instructions for California A,... for Ground B Concrete .Systems, HUD Wind Zone 1, 15 PSF Wind Load Seismic 4 By Tie. Down Engineering REQUIREMENTS • These plans and specifications meet the requirements of Title 25 Section 1336.3 Sub Section A and 97 UBC Seismic Requirements, CBC 2001 addition. • Maximum vertical projection at sidewall is 9'. Higher walls may be used when the design loads are adjusted accordingly and approved by HUD. • Main rail spacing must be 75.5" - 99.5" * Except single sections 95" minimum • Additional vertical anchor ties that are unique to a home's design may be required by the home manufacturer. These locations may include shea'L ll%vmarriage�lineridge beam support posts, and rim plates. The longitudinal component of the Xi2 system-replaces,endframe ties. Check manufacturers set-up requirements. • Maximum pier height is 48" pier. *Except for single sections 36". • Steel piers must be fastened to the I-beam with clamps provided with steel pier. • Systems must be placed as evenly as possible, no more than 10' from end of home. • Designed for 7:12 roof slope. *Except single sections, (20° - 4.37 in. 12" pitch). Additional Requirements for Concrete Systems • Poured concrete must be 2,500 PSI minimum at 28 days. • Square concrete pads minimum is 18" wide by 12" deep. Round concrete pads minimum is 18" wide by 14" deep. Strip footings minimum is 18" wide by 14' long by 6" deep. �� A 11i �,, * Xi2 components exceed HUD code 3280.306g "Anchoring equipment'exposed to weathring shall have a resistance to weather deterioration at least equivalent to that provided by a coating of zinc on steel of not less than 0.30 ounces per square foot of surface coating...." Page 2 of 8 0 LD 0 0 0 Installation of Xi.2 Ground Systems 1. Identify the number of systems to be used on the home using the chart provided. 2. Identify the location where the systems will be installed. 3. Clear all organic matter and debris from the pad site. 4. Place U -bolts through holes in pan provided. 5. Place pad centered under beam with the lateral strut bracket towards the inside of the home. 6. Press or drive pan into ground until level and flush with prepared surface. 7. Build pier according to State, Local or Home Manufacturers guidelines.(Figure 1) 8. Attach the end of the smaller tube to the inside of pan using U -bolt & nuts provided 9. Attach the flag end of the larger tube to the opposite I-beam using the "J" bolt over the top of the I-beam with the nut & washer provided. (Figure 2) 10. Install a minimum of four (#12 x 1" tek screws) self -tapping screws into the holes provided in the lateral strut so that the two tubes are connected together. (Figure 1) J -Bolt Nut & Washer 1-3/4" TubeCs A,1 Lateral Struts Strut (flag end) 00 1-1/20 Tube 4-#12x1" Tek Screws 1-13eam Figure 2 U -Bolt & mounting Figure 1 Bracket end 01P Nome 11. Install frame bracket clamps to I-beam on in side of block/pier. Do not tighten nuts at this time. 12. Attach longitudinal strut to U -bolt in pan using nuts provided. 13. Insert strut in the frame bracket clamp, attach with nut and bolt. Do not tighten at this time. 14. Pull the frame bracket clamp with the fastened strut outward to remove any slack. 15. Tighten all nuts and bolts on the struts and beam clamps. &_717; It Y-.-- 2.. Pana I of R r�E DOWN= ENGINEERING Xi2 Ground Parts Detail Xi2 Ground Lateral System Part Number 59306 Includes: 5' Strut, pad & hardware kit (#59329-1 includes all nuts and bolts). Longitudinal Hardware Kit Part Number 59331 Includes: 2 I-beam brackets & 2 U -bolts with all nuts and bolts. Lateral and Longitudinal Combination Part Number 59333 Includes: 5' Strut, Pad, Longitudinal Strut (#59329); Lateral and Longitudinal Hardware Kit with all nuts and bolts. Struts for Longitudinal Systems P rt St t P'ier H i ht Xi2 Ground Longitudinal Strut & Hardware Kit a No. ru Length eig Up To: 2,11 � ���� Ground Longitudinal Strut 59330-44 44" 4 Blocks or 32" Ground Longitudinal 59330-65 65" 6 Blocks or 48" Hard ware Kit Xi2 Stabilization Pier Placement for Ground .or Concrete Single Section Home 0 -80' (76' Box) 4 Xi2 Systems &� Xi2 Pier Placement Double Section Home 0 -62' 3 Xi2 Systems" 63' - 80' 4 Xi2 Systems *2 Xi2 systems can be placed at either end of the home. Triple- Section Home 0 -62' 4 Xi2 Systems 63' - 80' 5 Xi2 Systems r it ` 2. t r lt / v'✓ Page 4 of 8 m 0 0 0 Installation of Xi2 Concrete Systems 1. Identity the number of systems to be used on the home using the chart provided. 2. Identify the location where the systems will be installed. 3. Build pier according to State, Local or Home Manufacturers guidelines. 4. Drill two 3/8"x 3" deep holes in the concrete using holes in galvanized bracket as; a guide. Attach bracket to concrete pad using 3/8"x3-1/2" wedge anchors provided. Place nut & washer on anchor, leave enough room for 1 to 2 threads showing on top of bolt. Using a hammer, tap the wedge bolts into hole through bracket, leaving nut & washer flush with bracket. Using a 9/16" socket wrench, -m tighten wedge/anchor bolt, securing bracket to the concrete.��q�o�`� 5. Attach the end of the smaller tube to the bracket mounted on the pad, using the rade 5,1/2" x 2-1/2" bolt/nut provided. 6. Attach the flag end of the larger tube to the opposite I-beam using the "J" bolt over�� the top of the I-beam with the nut & washer provided. (Figure t next page) 7. Install a minimum of four (#12 x 1" tek screws) self -tapping screws into the holes provided in the lateral strut so that the two tubes are connected together 8. Install frame bracket clamps on I-beam on the inside of block/pier. 9. Insert strut in frame bracket clamp and attach with nut &bolt. Attach opposite en ete brack t. 10. Pull the frame bracket clamp with fastened strut outward to remove any slacN � 11. Tighten all nuts and bolts on system..° li y_ z L 1 Page 5 of 8 J� T/E�f �DOWN>x ENGINEERING 0 LD 0 0 O Xi2 Lateral Concrete Systems Part#59307 Includes: 5' Strut, Bracket, & Hardware Kit #59315-1 with all nuts and bolt. Longitudinal Struts for "Concrete Systems" Part No. Length Pier Height #59013 44" up to 4 Blocks #59015. 65" up to 6 Blocks Longitudinal Hardware Kit Part#59263 (Includes 2 sets per kit: I-beam bracket, nuts, bolts and washers) Lateral and Longitudinal Combination Part#59332 Includes:�5' Strut, Longitudinal Strut (#59364), Lateral and Longitudinal Hardware Kit with all nuts and bolts. Figure 1 Lone J Nut & Washer Beam Clamp Bracket Xi2 Installation Placement Beam Longitudinal Strut E„d o f Name Lt l X35' Page 6 of 8 1 IM m 0 �i 0 I I � 0 0 40� Concrete Longitudinal Hardware Kit Lt l X35' Page 6 of 8 1 IM m 0 �i 0 I I � 0 0 1 'S Lt l X35' Page 6 of 8 1 IM m 0 �i 0 I I � 0 0 Offset Placement Diagrams represent examples of double and triple section offsets. Total size is determined by the length of unit plus offset. Xi2 Stabilization Pier Placement for Ground or Concrete Single Section Home 0 -80' (76' Box) 4 Xi2 Systems Xi2 Pier Placement Double Section Home 0 -62' 3 Xi2 Systems' 63' - 80' 4 Xi2 Systems *2 Xi2 systems can be placed at either end of the home. Triple Section Home 0 -62' 4 Xi2 Systems 63' - 80' 5 Xi2 Systems axii-> ", Page 7 of 8 TIE DOWN, ENGINEERING {" � sr Hardware Breakdown #59329-1 Hardware for 59306 Lateral System 1 84533Z U -Bolt 1/2-13 x 2.63 x 2.19 thread Beam Clamp Base 1-3/4 zinc 4 10556 Tek Screw #12 x 1" 1 10631Z J Bolt 1/2 x 5-1/2 grade 5 zinc 2 10640 Push Nut 1/2 1 12107 Flat Washer 1 x2" SS 1 10646Y Hex Nut 1/2-13 grade 5 zinc 2 10519 Hex Nut 1/2" w/ Serr flange #59331 Longitudinal Hardware for 59306 2 59272-1 Beam Clamp Base 4 59272-2 Beam Clamp Top Flange 8 10926 Carriage Bolt 1/2-12 x 1-1/4 Carriage Bolt 1/2-12 x 1-1/4 4 10801 Full Thread 10 10646Y Hex Nut 1/2-13 grade 5 zinc 2 10801 Carriage Bolt 1/2-12 x 2-1/2 1 84533Z U -Bolt 1/2-13 x 2.63 x 2.19 Thread Grade 5 2 84533Z U -Bolt 1/2-13 x 2.63 x 2.19 thread 2 10519 Hex Nut 1/2" w/Serr Flange 1-3/4 zinc 4 10640 Push Nut 1/2 4 10519 Hex Nut 1/2" w/ Serr flange # 59329 Hardware for 59333 Lateral and Longitudinal combination 1 59329-1 Hardware Kit 1 59272-1 Beam Clamp Base 2 59272-2 Beam Clamp Top Flange 4 10926 Carriage Bolt 1/2-12 x 1-1/4 4 10801 full thread 5 10646Y Hex Nut 1/2-13 Grade 5 zinc 1 10801 Carriage Bolt 1/2-12 x 2-1/2 2 10801 Grade 5 zinc 1 84533Z U -Bolt 1/2-13 x 2.63 x 2.19 Thread 6 10646Y 1-3/4 zinc 2 10640 Push Nut 1/2 2 10519 Hex Nut 1/2" w/Serr Flange #59315-1 Hardware for Lateral System 1 10631Z J Bolt 1/2 x 5-1/2 Grade 5 zinc 1 12107 Flat Washer 1/2" SS 4 10556 Tek Screw #12 x 1" 2 10646Y Hex Nut 1/2x-13 Grade 5 zinc 1 10826 Carriage Bolt 1/2-12 x 3 4 10801 Grade 5 zinc #59027 Hardware Kit for 59307 Lateral System 2 59264 3 Way Concrete Bracket 4 10530 Wedge Anchor 3/8 x 3.50 1 59315-1 Hardware Kit #59263 Longitudinal Hardware for 59307 2 59272-1 Beam Clamp Base 4 59272-2 Beam Clamp Top Flange 8 10926 Carriage Bolt 1/2-13 x 1-1/4 1 59315-1 Full Thread zinc . 12 10646Y Hex Nut 1/2-13 Grade 5 zinc 4 10801 Carriage Bolt 1/2-13 x 2-1/2 4 10926 Grade 5 zinc #59364 Hardware for 59332 Lateral and Longitudinal combination 1 59264 3 Way Concrete Bracket 2 10530 Wedge Anchor 3/8 x 3.50 1 59315-1 Lateral Hardware Kit 1 59272-1 Beam Clamp Base 2 59272-2 Beam Clamp Top Flange 4 10926 Carriage Bolt 1/2-13 x 1-1/4 Full Thread zinc 2 10801 Carriage Bolt 1/2-13 x 2-1/2 Grade 5 zinc 6 10646Y Hex Nut 1/2-13 Grade 5 zinc Page 8 of 8 t TIE, DOWN" ENGINEERING a -o? n 0 L 0 0 0 Prco�EP:Tr P, LEI A, RoAN.S (06� IG7,LPLEASANT Cr (QooE bRuUo� CA 9s9iy D 8' 110 n3S �. _. XD x.'09-' '00, 1E. i -? i i i D I AL_LIIEY TITLE TLE DROO I LLE 5340'709 NO. 049 001 6TATE OF CiUFn»bi�,1 1aU511��a$. T(eANSi'Gr�TAT10N AND i4009iNG AGENCY ARNOLD SehWAR2ENEGCiER. Gover _._ DEPARTMENT OF HOUSING ANP COMMUNITY DEVELOPMENT ®iviHloA �4 Cvdas an 5oru arae ` � s a - n 'Title sure#li Due Pri.atca : 07/N/20(17 LA J2656 Uie Code: SM � ar�t►ta.ct rer . 900:0 BAY3i-'iORE FUNIS CALIF INC Original Price oC1e: ANA , I radetlame: BA'YS'IKOR.F T10'IV L.S Rating Year: model: 9907 Tax Type: r PT lvi�.nufscnlT�c� t Yci: ()8!19;=185 Last ILT Atmo t: RegiAratiop E.xp: Date ILT fee T id: First Sold On.: 09/20'1:x; ILT Exemption NONE. Se'^i�it ?Wur11 r HL!b Label i In8ictii Length Width WAC10314A 3) 2171 SCS' 12 St�AOs.:+5i3 312172 g?' 12' 9I F.003 �, C 3.12173 10' R6�1SC�.7sC1 �ti!1?Oi: rY'!1RLEY A ADAMS n0 83i 3i2 &ANGOR.CA 95914 LQasi Tiae qty: U711.Sr 06 �A9 12eS C€tru: 07115/1996 - Sule!Trwisr2r Ir;9o: Pricc S48,3145.00 Tru,)6fC1Tei1 cn 09/20i I +SS ' Sitas Addt•css; 1 1/2 IMI BANGOR 10N PLENASA GROV" Rn RANCOR, CA 9591.4 Situs Cu'ur.:y; BUTTE. Legal OWner:. 'ES i I'_.R.N S..( NRISE MTG 865 SUNRISE 1B1. S1 I) I RA.NCff0 COX00VA, Cit `35742 List :1'icls �:i,te: (17/1 ii 1996 LWI) fill- 05/22-A.996 16:%00 * * Et� ,D OF TITLE SEARCH. ori* BUTTE COUNTY JUL 10 2007 DEVELOPMENT SERVICES 1`0 RECORDING. REQUESTED BY: When Recorded Msl ocument and Tax Statement To: Shirley A. Adams P.O. Box 352, Bangor, Ca. 95914 I Escrow No. 1 -55371 -VL Title Order Nu. APN: 028 110 035. 96=12097 7 6 �0 120971 Rec Fee I DOC Recorded I Check Official Records County of Butte Candace J. Grubbs Recorder 8:00am 2 -Apr -96 F N T C 6. 00 20.35 26.35 MD 1 QUITCLAIM DEED The undersigned giantor(s) declare(.' Documentary transfer tax Is $ 10. �� City tax $ ( 7< I computed on full value of property conveyed, or l I computed on full value less value of liens or encumbrances remaining of time of sale, ( X I Unincorporated Area City of FOR A VALUABLE CONSIDERATION, receipt of which Is hereby acknowledged, ERIC ADAMS, a single man hereby remises, releases and quitclaims to SIURLEY A.'AD«MS, an unmarried woman th& following described real property in the City of County of Butte State of California: Parcel::, as shown on'that`certain Parcel Map of Lot 57, as shown on that certain niap entitled, Bangcr Tract Unit No. 1", filed in the office"of the County Recorder of Butte County, California, on December 17, ?984, of Maps, page 43. Book 98 DATED: March fi, lqi _ STATE OF CALIFORNIA Eric Adams COUNTY OF Butte ON March 26. 1996 _ before me, Barbara A. Woodward personally appeared **Fri r Arfamc** personally 'know.n to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whoee , name(s) is/are subscribed to the within instrument. and acknowledged to ma that he/she/they executed the same in his/her/their authorized capacity(ies), and that' by his/her/their signature(s) on the instrument the' person(s), or, the entity upon behalf of which the persons) acted, -executed the instrument. wonow�u z • s"a0ARY �no=X.C4F01051 OM �Y Corrrrt E�plrej ex. ry Z 1797 RtJj-j,k C011iy7Y Witness my hand and official seal. .9UL I U-200% M VEI.oPNL,,ivT Signature SERVICES MAIL TAX STATEMENT AS DIRECTED ABOVE FD -213F (Rev. 4(94) QUITCLAIM DEED 1 'OF DOCUMENT .., � r . ;, � .. r` .. s ,ar .. . , SIERRA MOBILE SERVICE EXPLANATION SIERRA FOUNDATION 70386 NO 4530 466 CIRC AMOUNT 90-2267/12113827 19962 E DRLIC 534-0599 OROVILLE, CA 95966 PAY OFOUNT j 7 H16B DATE i ' TO THE ORDER OF GROSS INC. TAX SOC. SEC. ST. TAX ME DOLLARS s"ty ommb, me,. CHECK )F0090 B4 O90 84 / TAX I TAX � NUMBER 1 DESCRIPTION � US BANK y� 1101996 2118 1: 12 11 2267r,: nm i AUTHORIZED SIGNATURE 1 5 340 14039 2 5n' PERMIT NO. 233-86B ` PERMIT EXPIRES OWNER SHIRLEY & ERIC DAMS, CONTR. owner ASSESSOR PARCEL 28-11-35 LOCATION E/S Pleasant Groue Ln, 1600' N Laport( Rd, Bangor i Temp. Power Pole ` Called F- 1 I Temp. Elec. S i Called Pf , I Temp. Gas Se Called PC- JOB C JOB FINALEI c , f Signature � _ I � f J=OK. _ O Not OK -Not Applicable MOBILEHOMES = Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Date DEC , COVERS, CARPORTS, ETC. (Plans) OK except #'s ning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 4< F rings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/0 -Concrete Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4; wn.; osts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 6. Gas; Locatiorr-Test-Wrap: / /"L"ft./ /"Nat.or/ /"L" ft./ /"LPG 5.,ns-Connections-Splice-Decal-Enclosures 6. or s; indows-Doors 7. Utility Clearance 7-Elu — onE� Card -BI Card -BI Date Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Card -BI Card -BI Date Date - Card -BI Date Date Card -BI Date OLS (Plans) OK except #'s 1. Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men-Linino 4. Electricity; MH Test -Crossovers -Breakers -Clearances 4. Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/O to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B-1 Date Card -BI Date Card -BI Date Card -BI Date ME J OK - 0 = Not OK ` = Not Applicable aF = Not Ready RESIDENTIAL (Single and Duplex) Date UNDERFLOOR Plans OK except hi's Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Fig., Main; Soils-Steel-Elec. Grnd.- / . /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Fig. 'Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., 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 Ftg.-Steel 54. Glazing Area -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 -61 Date Card -BI Date Card -BI Date Date FINAL (Plans) OK except N's 56. Ext. Steps -Door & Sidelight Protection -Landings Card -61 Date Date Card -BI Date PLUMBING (Permit) OK except q'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. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting _ 17. Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. _Shower 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 Card -61 Date Card -BI Date Date Card -BI Date 64. Elec. Outlets at Wood Panel; Int. & Ext. 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except N'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. Elec. Receptacles Spacing -Lights &Switches at Doors _ 22. Size Boxes & No. of Conductors -Stapled 70. Plb., Elec. & Mech. Equip. Listed for Location 71. Elec. Receptacles in Garage; (G. F.I.)-Romex Protec. 23• Romex Installed Close to Edge of Studs & C.J. _ - - 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. Insulation -Foam -Looked in Attic El Yes 73. Guard Rails & Deck Construction -Post Caps 25. 26, 2 Appliance Circuits in Kitchen &Conductor Size Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes _28. 27 _ Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated_ Neutral _,Yes DNo - Service -Riser Conductors & Ground -Main Disconnect _ 75. Following instld.: Drive ❑ Yes []No; Walks E] Yes ❑ No; Planters ❑Yes ONO 76. Stucco; Brown -Finish 29. Equip. Clearances; Pane ls=Motors-Mech. Equip. 77, A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet Card B-1 Card B -I 30. Clothes Closet Light -Shower Light _ - -- - --- -- - _-_ Date _ Card -BI Date Date Card -BI Date 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 81. ventilation throughout House 82. Glass Protection Date MECHANICAL (Permit) OK except q's 83. _ Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric _ Card -BI Card -BI 31. 32. 33. 34. 35. A.C. Ducts: In_sulation & Support - - - - Vent Fan; Exhaust above Insulation-,--- __ - Condensate Drain & Overflow; Size & Grade Furnace -Vent Access -Comb. Air -Return Air Vent -11_5V outlet Attic Access & Platform if Furnace in Attic _ Date Card -BI Date - Date Card -BI Date 85. Water & Sewer Connected -C/O to Grade -HD Approval 86. Energy Compliance Certificate -Other Certificates - Card -BI Date Card -BI Date Card -BI tate Card -BI Date Card -BI Date Card -BI Date Date FRAMING(Plans) OK except N's Comments at Final: 36. 37. 38. 39. 40. Sills; Proper Material & Anchors _ Walls: Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls over Girders &_F_loor Nailing Draft Stop in Walls (rat proof) Fire Stops: Furred Ceilings -Stairs -Chases -Tub 41. 42. 43. 44. 45. 46. 47. Header & Beam -Size & Bearing Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. Fireplace Ties or Type A Flue -Fireplace Throat - - - - -- . --- - -- Attic Access: Size &Romex Protection -Draft Stop -Ins. Baffles Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimen-sions Garage Fire Protection Framing - - - --- ---- - -- -- (NOTE: Anentrymust be made each time youvisit jobsite) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS A PERMIT NO. • 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 `�t�� APPLICATION AND PERMIT A 45, ASSE O PARCEL NUMBEg -.- ZONING BUILDI G PERMIT ow p n°V, �- ✓'� owl TE PHONE SO. FT. OCC. BUILDING VA ATION offl I o4 ov �j OWPR'SMAILIJU ODRESS CON TOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONST UCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10,00 LE R'S MAILING ADDRESS Permit Fee $ toe M ARCHIT CT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDIN A ESS J`'q"6 r Permit fee $ .1033 PERMIT FiIingFee 10.00 to -PLUMBING Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home Is G W O.00ea TYPE OF WORK NewPr Addition El Rem I❑ Utilities In tallatio p Other E] De cribe work: r 4Q / De�cribe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business/POWER and Professions Code and my license is in full force and effect. 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- ontract- ors.(Sec. 7044) ors. ❑ 1 am exempt under Sec. , Business and Professions Code for this reason NEW CONST. / DWELLING OCCUR.&) yx2sgft OR ADDNS. 1 ACC. BLDGS. NEW CONSTR. MULTI -OUTLET 2,50 ea NON-RESID BRANCH CIRC ITS APPARATUS &) (SINGLE OUTLET CIR. EX. Occup(OUTLETS OR FIXTURES 2AL@30 eLe FIXED APP LHS. OR EX. Occup. OUTLETS (RESID.) EA. 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject l� to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 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 Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilitie judgments, costs, and expenses which may in any way accrue against sai my in consequence of the granting of this permit. %� ate — Signa re of Applicant Owner Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or Construct- ion of structures over 3 stories iin�height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ \ OCCUP. CONST.TTPE FLOOD L11 ARCEL D ND su This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIREC OF PUBLIC By ` PERMff EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. C2D V Y l WHITE-D.P.W.. TELLOW-ASSESSOR, PINI( -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMEN_TT OF PUBLIC WORKS - BUILDING�DJVISION 7 COUNTY CENTER DRIVE - OROVIL�,'OALIFOReNIA 95965 - TELEPHONE: 916/54-4541 PERMIT APPLICATION DATA SHEET } -- c �1 Permit No. �y OWNER SLI v if, C- y' r 112 A. P. No. Proposed Building Use f[H Permit Fee Based Upon: Complete Contract Price DPW Valration Other (Explain Building Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or Issuance: DATE RECEIVED APPROVED 1. All items have been submitted. . . . . . . . . . . . 2. Plot plans in duplicate/triplicate. . . . . . . . . . . 3. Complete plans in duplicate/triplicate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. CUSD "Fees Paid" Stamp on Floor Plan . . . . . . . . 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . Letter of signature authoriza ' n. 10. Sanitation approval from. u I'. Health Dept. 4-- S4 --Z 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. :11-1.1 . 13. Contractor's License Information (no., name style, clapsif.) 14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ ) 15. Improvements may be required. . . . . . . . . . . . 16. Mobi lehome Installation Data. . . . . . . . . . 17. Pre -Inspection for Required- BuildingPre-Insp request to (Dote) p q Building Inspector 18. RecoOther �� �i'ur onstruction approvals required prior to occupancy) 19. Other When you issue the permit, process as follows: X Mail to owner. Mail to contractor. Telephone and hold for ickup at office. Deliver w/inspector. copy of plans sent Health wept., I- Ire wept., Utner gate During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone By Plans checked by. Plans approved by Other Copy—DPW ri Date Date -P- Mail Other Date E To: Building Department From: 4.:nvironmental Health Subjeclt: Sanitation Clearance -a� t r J- � Owner. Plan Approved for: Hold final for: f Location AP# Sewage disposal water supply water supply Final clearance O.K. for: water supply Clearance for bedroom mobile home. Other �-- NOTE an COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-534-4541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materiaJs for construction of the proposed property improvement (yes or no) _'2. I (have/have not) signed an app ication for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed: Property Owner _ Zz, ZI, Social Security umber _ v Date / —2 —"p( NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. This set of plans and specifications MUST be kept on the job at all times and it is unlawful to make dnv changes or alterations on same without written permission from the Dencirtment of Public Works, Coun of Rtitfa TE-,--All. Materi Is. A Workmanship- Shall Be. t , Accordcince with Reco.gnized Good Practices ark . U ility connections shall be, within' of a quality prescribed for .the Specified use in tht a ft. of the mobile"home, either Uniform Building, Plumbing -a. Mechanical Codes and directly'behind or within thea -teat the National Electrical 'Cod®: . half of the roadside (left)•of the mobilehome. 00.SQ. FT. MINIMUj � cJ �� z., L c� G✓` R MOBILES A permit will required for the f `✓ 1_; ,� r installatio f the _ I +r.. -? - , ` mo it g: 1 no e __7T0` A setback'of'5 ft. from the prpper_t�i-linesand a setback _ - - hof 50ft. from the road cerlineshall be ar of s ct�es or = . uipment exc "for a 2 ft. eave overhar VN z I Yl!AUOQ 31 zU6 - iIlGjlUr 1-'MTq/Aq:3(] V ocl, rl q A VARIES 3(," 212 ofDv�� 3' M) A ° y z �> i/ AIJfAI EIGHT 4L ° --I � v • °Z 8 'U � rn NIAX. ti 6- C D W Z Ul O -a 2q Ln 3 �I X W �oN II rn � o � � N • rl> m � I I I n 3 2-E: � iE c 212 ofDv�� 3' M) A ° y z �> i/ AIJfAI EIGHT 4L ° --I � v • °Z 8 'U � rn NIAX. ti 6- C D W Z Ul O -a 2q Ln W �oN II O � N -1 rl> m I I I s 2-E: In I C> A II I II 30" MIN. STAIR . rn W I DT4 rn 7q 41v c , y S � � 1 'r PERMIT NO. PERMIT EXPIRES OWNER SHIRLEY & ERIC ADAMS CONTR.. owner ASSESSOR PARCEL E/S Pleasant Grove Ln, 1600' 1 LOCATION Laporte Rd, Bangor lot 2 28-1-28port i OFFICE COPY Address PlPti .—/T G, uL,-- GAS Metery 1�Ti Date i ELECTRI Meter By Date I Temp. Power Pole Called PG&E Temp. Elec. Service Called PI Temp. Gas Se Called PC JOB FINALE[ Signature V = 'OK' 0 Not OK = Not Applicable MOBILEHOMES = Not Ready MISCELLANEOUS Date MOB!TOME UTILITIES (Plans) OK except N's Zoning Requirements—Setbacks—Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except H's 1. Zoning Requirements—Setbacks—.Easements oils; Special MH Support—Sketch 2. Footings; Size—Depth—Spacing—Connectors SO vtier; Location—Test—Fall-C/0—Concrete 3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails W ter, Location—Test—Easement Needed (Sketch) 4. Wood Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.—Rfg.—Bracing ectricity; Location—Clearances—Grnd.—/ / Amp—Concrete 5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures te"4a's; LocatiorrTest—Wrap:/ /"L"ft./ /"Nat.or/ /"L',ft.r _/"LPG 6. Carports; Windows—Doors Utility Clearance 2pli !!2- ;2" 7. Elec. d, Card -BI Date ——V;;__Card-BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBI HOME INSTALLATION (Plans) OK except q's Card -BI Date Date Card -BI Date POOLS (Plans) OK except N's Z ing Requirements—Setbacks—Easements 1. Setbacks—Easements . F ' gs; Size—Spacing—Marriage Line 2. Soils; Compaction—Structure Stability 3 Gas; H Test—Demand—Valve—Connector 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining 4 les ity; MH Test—Crossovers—Breakers—Clearances 4. Elec.; Receptacles and Lighting; Distances—GFI 5 r H Test—Fall—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI 6. W ; MH Test—Regulator—Connector 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed 7 r and Sewer Connected—C/O to Grade—HD Approval 7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater . G and Electricity Tagged 6. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghig. Boxes—Enclosures—Panel boards—Ins. to Main in Conduit 914*�Exits; Insp.—Sketch 10 ert. of Occupancy g. Health Department Approval 10. Plumb; Cir. Test—Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date OK =+Not OK• _ Not Applicable RESIDENTIAL (Single and Duplex) Not Ready Date UNDERFLOOR Plans OK exce t#'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 5.Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 51. 52. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -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. 12. Electric; Underground 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 N's 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date Date Card -BI Date PLUMBING (Permit) OK except q'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. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth Card -BI Date Card -BI Date 64. 65. Elec. Outlets at Wood Panel; Int. & Ext. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Date Card -BI Date ELECTRICAL Permit OK except N's 66. Elec. Outlets & Receptacles at Kit. Counter 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. Elec. Receptacles Spacing -Lights &Switches at Doors 22. Size Boxes & No. of Conductors -Stapled 70. Plb., Elec. & Mech. Equip. Listed for Location 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 23. Romex Installed Close to Edge of Studs & C.J. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas &Water 72. Insulation -Foam -Looked in Attic ❑Yes 25. 2 Appliance Circuits in Kitchen &Conductor Size 73. Guard Rails &Deck Construction -Post Caps 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or 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 El No 75. Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑Yes ED 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 -I Card B -I Date Date Card -BI Date Date Card -BI Date MECHANICAL (Permit) OK except N's 31. A.C. Ducts; Insulation & Support 81. 82. Ventilation throughout House Glass Protection 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 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 Card -BI Date Card -BI Date Date Card -BI Date Comments at Final: Card -BI Date Card -BI Date Date FRAMING Plans OK except q's 36. Sills; Proper Material & Anchors 37. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound 38. 39. 40. Bearing Walls over Girders & Floor Nailing Draft Stop in Walls (rat proof) Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. Header & Beam -Size & Bearing 42. Hangers -Post Caps -Anchors -Connectors 43. 44. Cing. Joist-Rflr. Ties-Purlin-Roof Brac.-Truss-Sh_thng_.-Rfn_g_._ _ 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 job site) a 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 _ A 4-1 c 1--7 t!C OWNER PERMIT NO. 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. Date ar 3 e I MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY'CENTER DRIVE OROVILLE, CALIFORNIA — 534-4541 l PERMIT NO. `� K> Address or location of mobilehome/ �jt'c���,, ;`' C -- Owner's Owner's name �= A Owner's address �� a c ,Insignia or hud number Manufacturer's name ,Serial number of V.I.N. N t) d, ) — S Year of manufacture / j SCS \ h ( �'- r,C % ? - A6 (Official Approving Installation) (Date) IF TH MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION =ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE 'MOBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM. "513B White - Owner, Yellow - Installer, Pink - D.P.W. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. / d(/ ASSE�S�R-PA CEL NUMBE !!//may// ZONING BUILDING PERMIT OWN r q- Iflr TELEPHONE 6T7 - 2 6z3 SQ. FT. OCC. BUILDING VALUATION OW 'SAILING ADDRESS yr COACTO 'S AME TELEPHONE CON RACT OR'S AIL G ADDRESS IC?r0 Y , Fireplace CONSTR C ION LENDER UNKN�wr• Total Valuation Is Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ /Slap Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING D REssPermit 0 fee $ PLUMBING PERMIT Filing Fee 10.00 PO �fC'61 )­61Each Trap 2.00 G n 0 ® Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME RCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome Other SPECIFY' Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00 ea TYPE OF WORK �, / New ❑ Addition ❑ mode Utilities' [:1 Instal lationP Other ❑ Describe work: r a aY Jr _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 �1 v` I Main service e00V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACT RS LICENSE LAW I declare nder penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. �_ License No. '3'l 1�-7r� Classification `F `1 ❑ 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 CONST. DWELLING CCCUP.N 2�, OR ACDNS. ACC, SLOGS. 2�$gft NEW CONSTR. ULTI-OUTLET NON-RESID BRANCH CIRCUITS) 12.50 ea POWER APPARATUS &) SINGLE OUTLET CIR. ) EX. Occup(OUTLETS OR FIXTURES 20®SOt eAL93o FIXED A Ex. Occup. OUTLETS PLNS (RESID,)REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. byirin g 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. E9,_I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 10.00 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 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 saLid Cou9,tyyyin'co//nsequen a of the granting of this permit. X U`,�` `"� o'er. V�� Date S — Z- $S i Signature of Applicant — Owner ❑ Contractor 9� Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories Mobile Home Installation Fee $ S Energy Inspection Fee $ r TOTAL PERMIT FEE $ , occu P. CONST.TYPEJ FLOODJPARCFLJ PD I NO I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which PUBLIC DI=:Rd By. PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date �- ,in`height. ReceiptNo. I �rly� �-f WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT J' COUNTY OF., BUTTE - DEPARTMENT".OFn PUBLIC WORKS '' - PERMIT Nq. /, 7 County Center Drive Oroville, California 95965 - Telephone 916/534-45 _ APPLICATION AND PERRIT ' ASSESSOR.kARCEL NU E ZONING BUILp,NG PERMIT OWNER TELEPHONEi .. SO. FT. OCC, BUILDING VALUATION O R'S MA ING AD RESS - f © 4 CONTRACT S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER - UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER ' LICENSE NO. Plan Checking Fee $ -fob Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING AD RESS s PLUMBING PERMIT FilingFee 10.00 Each Trap 2.00 Solar Water Heater 20.00 r-' Water piping 5.00 LOT NO. SUBDI VISION NAM PARCEL MAP ! Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF ❑ Duplex ❑ Mobi lehome E' Other SPECIFY Building sewer 5.00 Mobile Home W 110-00e4 TYPE OF WORK / New ❑ Addition ElRemodel ❑ Utilities R Instal latiori❑ Other ❑ Describe work: Permit Fee $ t Contractor, ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 , Main service EA. ADD•L 100 AMP 2.50 NEW LING O OR ADDNST ACCLBLDGS.CCUP.&) 21/20sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the BUS Ines8 and Professions Code and my license is in full force and effect. 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 CONSTR. U TI.OUTLET 2,50 ea NON.RESID BRANCH CIRC ITS NEW CONSTR. POWER APPARATUS &\ NON.RESID. ( SINGLE OUTLET CIR. / Ex, OCCUp(OUTLETS OR FIXTURES 6AL®30 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID,) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 fir; Misc. Wiring 15.00 Permit Fee $ 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. 1 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. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabi ities, judgments, costs, and expenses which may in any way accrueKI against Cou ty in consequence of the granting of this permit. Date /::S22E � nature of A g pp ant — Owne Contractor ❑ Agent ❑ An OSHA per is required for excavations over 5'0" deep and demolition or construct- ion of structures Cries in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP TYPE OF CONST. PARCE PD D Issu This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECT OF PUBLIC By PE, IT EXPIRES Date the applicable provi- resolutions to do fees have been aid. p WORKS _ Date��Z�j��J _ a ��over �3,�,s Receipt No. D_ WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT Return to DPW' AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT . j OFFIC:A;. FOR RESIDENTIAL DEVELOPMENT Pages Section 26-8.1 of the Butte County Code requires this acknowledgement I P be recorded prior to issuance of a building_permit. Jit �UJ i u� The property described herein is adjacent to land or included 11�;tk - .{.t within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort arising 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 agricultural 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 disconform from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: Parcel 2, as shown on Parcel Map of Lot 57 of "Bangor Tract Unit No. 111, which map was filed in the office of the Recorder of the County of Butte, State of California, December 17, 1984 in Book 98 of Parcel Maps, at page 43. Date: January 30, 1985 PROPS TY OWNERS: Shirle A. Adams State of California ) . On this the - 30th day'of January , 19 85, before SS. me, the undersigned Notary Public, personally appeared County of Butte ) Shirley A. Adams XXII LO / Personally known to me. f/ Proved to me on the basis ln-}.` OFFICIAL SEAL of satisfactory evidence. SHELLIEY SHELDON to be the ! c, NOTARY PUBLIC -CALIFORNIA person(s) Whose hame(s) is subscribed to — Principal Office in BUTTE County the within instrument and acknowledged that she ! My Commission Expires Sept. 30, 1988 executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Present A. P. No. (90 A) _ _ r Notary Public This set of plans and specifics ions MUST be kept on the job at all times and it is unlawful to make any changes -or alterations on snore withoui written permission frgm the Department of Publ`ec Works, County of Butte. NOTE—All. Materials. I Workmanship Shoff Be �ltiiifiy conraect9ons Accordance with Recognized Good Practices . and . shell be within of a quality prescribed for the Specified use in the a.ft. of the mobile -'home, eitho- Uniform Building, Plumbing. «. Mechanical Codes and directly behind or within the reg the National Electrical Code. . half of the' roadside (left) of the rriobilehome. -. � ,�.�. 4:' �_J ,�✓ c 500 SQ. FT. MINIM U°� c. c EOR MOBILES ; V � � -� A permit will be required for tits installation of the mo_bilehom setback o� 5 ft. -from the " prQpertylines-a�nd a setbac v t+ of 50ft. from the r2ar cen rli�re-shall be of -�.- stryctures oyKipment excc , -'"-- —'"—for a 2 ft. eave overhan�' Jam: �-- — IZZ zVN BUTTE COUNTY BUILDING DEPARTMEN i APPROVED 1. Owner's name: Installer's name: \ lA Is the site currently under permit? Yes /- No ( If yes, furnish permit number z 4- - gs_ ) OR Is the site an existing site? Yes / / No / ,7r (If yes, furnish two (2) plot plans.) 0 BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 2. 3. 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 / C4- No (If no, clarify 1 S. What is the mobilehome electrical rating? ----------------------- 6. What is the mobilehome site service rating? --------------------- 7.. What is the mobilehome site circuit breaker rating? ------------- 8. Is there any other electric load to,be*served by the mobilehome siteservice? --------------------------------------------------- (If yes, identify the load and size: t—`� � (Load) 9. What is the mobilehome site gas pipe size? ---------------------- I 2 Amps 2 o a Amps Z o o Amps Yes L_tt- No = 2_0 (Amps) c--- . (in.) 10. What is the type of gas service? ----------------------------- Natural I% LPG 11. What is the gas pipe length from meter or tank to the mobilehome? ;-dam- (ft.) 12. What is the mobilehome gas demand? -------------------------- ld.?C �S (BTU) (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) BUTTE COUNTY SUILDiNG DEPARTMEN, APPROVED �� MOBILEHOME SUPPORT DATA If other than single wide Mobilehome Mfr. furbish Setup Model No. �03 %s , Year )4idt(ft.) Box Length to (ft.) Tagalong or Expando Size /10 ft. x ell ft. (SHOW SUPPORT DETAILS BELOW) On all mobilehomes manufactured after October 7, 197:3; furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of Butte). All center supports measured from f mobilehome unless otherwise specified. Footings (check one.) Lr 0 11A x d (ft.)(in.) (in.) (in.) ei, 5 o " -- Max. Pier Spacing (ft.)(in.) Max. Overhang (ft.) (in.) (in.) (in.) Z (ft.)(in.) 4% 30i *If center piers are other'fhari 'drawn above, draw in -locations. spacing, and dimensions. Single t� 1'. Wood either pressure treated or ._. foundation grade. (ft.) (in.) (in.) (in.) X 2. Other; (specify) Center support locations* Center support footing sizes Supports.(check one) • (in.) Concrete block. rr L 6x-� �M / VON 3�K3o •2: Other. (specify) (ft.)(in.) (in.) (in.) E ---tagalong or Expando,' 3q re JQ y Xao show support details. (in.) (in.) t Lx 10 -- Typical Support (in. (in.) Footing Size Lr 0 11A x d (ft.)(in.) (in.) (in.) ei, 5 o " -- Max. Pier Spacing (ft.)(in.) Max. Overhang (ft.) (in.) (in.) (in.) Z (ft.)(in.) 4% 30i *If center piers are other'fhari 'drawn above, draw in -locations. spacing, and dimensions. AP # I-/— FS Pear-"+" OWNER _ 5I ,rle-e Acta, rt PERMIT -X q MH UTIL.CLEARANCE DATE S INSPECTOR ELECTRIC GAS Support Struc. Compaction Test Re . Service Size Other Load Type Pipe Size Length YES NO YES NO zoo wc-(/ ,2o a .gyp y AP (r., y ss