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028-130-023
A.P. 28-13-23 DAVE SAREY f' c N!. L r6-15-1-6 W/S of Drobish Rd., 800'--N. of LaPorte Rd., Bangor Permit 1.878-74P, E �Util, for MH) 281--!1.3-23 _.. NEW OWNER -1 ,CHARLE S_WOOD I / va l� W/S Drobish Rd, app 800' N of La Porte Rd., Bangor Permit x#5931-77MHI (existing site) Issued 28-13-23 4056-90P;E WILLIAMS, Gary ,19 Woodvine Rd, Bangor Contr: Lawson Rankin QD (elec & plbg/MH) ^ -1 �>3ua=lzdi z - - z RESIDENTIAL SFD-Mobile Home RET EX MH, EX SITE, PERM FND 19 WOODVINE LN SONG, JEAN S & KAT}Y K F 4,Ai- 6 t 2-4p ��� ��n�l W BUTTE COUNTY AREA DEPARTMENT OF DEVELOPMENT SERVICES 1 INSPECTION CARD MUST BE ON JOB SITE 24 Hour Inspection Line (IVR) : (530) 538-4365 Office: (530) 538-7541 Fax: (530) 538-2140 Website for Online Permits/Renewal Pavments: www.buttecountv.net/dds Permit No: B08-1201 Issued: 06/23/2008 Address: 19 WOODVINE LN Area: BANGOR Owner: SONG, JEAN S & KATHY K Applicant: GERALD GLEN DOREMUS Permit Type: SFD-Mobile Home RET APN: 028-130-023 Description: EX MH, EX SITE, PERM FND Flood Zone: None SRA Area: Yes Front: Ultimate R/W from CL: Rear: SRA: Side: AG: Other: Total Setback from Centerline of Road:+ 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 Shearwall/B.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 Finals Building Final 802 d Electrical Final 803 Mechanical Final 809 Plumbing Final 813 Pool Final 802 Mobile Home Final 802 Inspection Type I IVR 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: t Date of Manufacture: la Z-7 Model Name/Number: Serial Numbers: Length x Width: Insignia: Public Works Final 538-7681 Fire Department/CDF 538-6226 Env. Health Final 538-7281 Sewer District Final "PROJECT FINAL 801 -rrolect t final is a Uertlticate of Uccupancy for (Kesitrential Unly) PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE. IF WORK HAS COMMENCED, YOU MAY PAY FOR A 1 YEAR RENEWAL 30 DAYS PRIOR TO EXPIRATION Inspector Copy M �V T tF BUTTE COUNTY `1 °0 DEPARTMENT OF DEVELOPMENT SERVICES • 'BUILDING PERMIT • • 24 HOUR INSPECTION (IVR): (530) 538-4365 C�i11�1 OFFICE: (530) 538-7541 FAX#: (530) 538-2140 ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds PROJECT_ INFORMATION _ Site Address: 19 WOODVINE LN Owner: Permit NO: B08-1201 APN: 028-130-023 SONG, JEAN S & KATHY K Permit type: RESIDENTIAL P O BOX 175 - Issued Date: 06/23/2008 By KCG Subtype: SFD-Mobile Home RET BANGOR, CA 95914 Expiration Date: 06/23/2009 Description: EX MH, EX SITE, PERM FND Occupancy: Zoning: A5 Contractor Applicant: Square Footage: GERALD GLEN DOREMUS GERALD GLEN DOREMUS Building Garage Remdl/Addn PO BOX 4121 PO BOX 4121 CHICO, CA 95927 CHICO, CA 95927 Other Porch/Patio Total (530)895-1774 (530)895-1774 FEE INFORMATION DBF MH Plan Check $241.16 DBMSC Mobile Home Permit Fee. $361.74 LICENSED CONTRACTOR'SDECLARATION Contractor (Name) State Contractors License No. / Class / Expires GERALD GLEN DOREMUS 445103 / C47 108/31/2009 I HEREBY �kFFfR%%NE ER PENALTY OF PERJURY that I afn licensed under provisions of Chapter (cemman ng with Se ion 7000) of Division 3 of the Busines and Professions Code, and my license §in full f rce and effe 06/23/2008 Date i�VORKERS' 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 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: Policy Number: Exp. Date: (Thi action need not be completed if the permit rs oror onellars ($100) or less.) I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any manner so as to became subject to the Workers' Compensation Laws of California, and agree that if I should become subject to the workers' cgrQQen§atiokprovisions of Section 3700 of the Labor Code, I shall forthwith comply with those .X Signature Date WARNING: F LUR TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL UBJ CT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED HOU AND 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) Lender's Address City State Zip Balance Due: . $0.00 Receipt No: B7774 _] . 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 Contractors 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 Professions 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.). ❑ I AM EXEMPT under Section B. 8 P.C. for this LX 06/23/2008 Owner's Signature Date I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and Slate 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 here certify that I am the pro 'Barty owner or am authorized to act on rop y owners behalf.�/ ,�,�(JV iAA// /U6/23/2008 Owner Contractor QV []Agent for Owner ElAgent for Contractor FILE COPY BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION* OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.nWdds PLEASE PRINT CLEARLY PERMIT NO. �• i20 BIN # (TN SILL "When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. APPLICANT INFORMATION OWNER INFORMATION Last Name So First Name ✓ Mailing Address cz/ O0 L11 w -e— r t l CityStateC,A Stat Zip9 Zip Phone Fax -7Z`/ �5 7 Fax E-mail Lic. # APPLICANT INFORMATION CONTRACTOR Name Jow Address Zip City C 0 Stat Zip9 Phone 201L Fax -7Z`/ �5 7 E-mail Lic. # Class C_ -7 APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Fax E mail State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail �C�l\T LICANT SIGNATURE X WORKER'S COMPENSATION Policy Number Carrier Nhiring anyone other'than licensed 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: ix !l9 M ai9!eefl Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning Flood Zone SRA I Yes I No Occ. Type Const. STATE OF CALIFORNIA - DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT REGISTRATION CARD Manufactured Home Decal No: LAS1351 Manufacturer ID/Name FLEETWOOD Trade Name BROADMORE I Model DOM 00/00/77 DFS 11/18/77 RY Exp. Date Serial Number Label/Insignia Number Weight Length Width ( SPC SCC Exempt Use Type CAFL1A711200572 CAL032945 66' 12' i 04 SFD LPT � I Issued Total Fees Paid Jan 4, 1999 $111.00 Addressee JEAN S SONG 19 WOODVINE LANE BANGOR, CA 95914 Registered Owner(s) JEAN S SONG KATHY K SONG JTRS 19 WOODVINE LANE z. BANGOR, CA 95914 Situs Address 19 WOODVINE LN BANGOR, CA 95914 0 e a g1rJZ`I� COUNTY k 23 2008 yEVELOPMENT SERVICES IMPORTANT THE OWNER INFORMATION SHOWN ABOVE MAY NOT REFLECT ALL LIENS RECORDED WITH THE DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT AGAINST THE DESCRIBED UNIT. THE CURRENT TITLE STATUS OF THE UNIT MAY BE CONFIRMED THROUGH THE DEPARTMENT. COA ;' •. •.:, 2 3.2008 ; VELOPMENT SERVICES Record at the Request of Wd ,Valley flus dl Escrow Company I Order No, Y3Escrow No. 164214PE-3 (3 Loan No. WHEN RECORDED MAIL TO: ' JEAN S. SONG KATHY K SONG 19 WOODVINE BANGOR, CA. 95914 98-007.3721 Rec Fee 8.'00 I DOC 55.55 Recorded i IHF 2.00 Official Records 1 Check 65.55 County of ) Butte ) Candace J. Grubbs I Recorder I 9:00am 27 -Feb -98 I MVTC FM 2 i SPACE ABOVE THIS UNE FOR RECORDERS USE MAIL TAX STATEMENTS TO: DOCUMENTARY TRANSFER TAX $55.55 ii Com an the cmWerallm or value of pwtj.cmveyeE OR . SAME AS ABOVE _ Cmpoled an the comMermtial or value lase lane or wwxtrentea mgmhg at thle a UK ORO—C Tha rmrfarminnad rrantnr daelarac Sanawre d Deaelent or Agent de*n tthg telt - Flom Nemo E GRANT DEED 028-130-023-000 FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, GARY L WILLIAMS, AN UNMARRIED MAN AND PATRICIA ANN WILLIAMS, AN UNMARRIED WOMAN hereby GRANT(S) to JEAN & SONG,' AN UMARRIED WW AN AND KATHY K SONG, AN MOWMED WaW, AS JOINT TENANM f i the real property In the, UNINCORPORATED AREA ; County of BUTTE State of California, described as SEE ATTACHED LEGAL DESCRIPTION Dated Fahmary 5.9, 1998 ) STATE.OF =FORMA }s COUNTY OF BU` rE , } On FERRLIAAY ? 19SA before me, PFNNY C_ FNGI ANQ NOTAFIY P to I . Personally armed r^-ewyl WI IIAUC_ Nn GARY FF WI 11 NC personally known to me (or proved to me on the basis of satisfactory evidence) to be the Pensen(3) whaee name(a) Were M19=11Ded to the wilt Instrument and acknowledged' to me that he/sh0they executed the same In hM mAhelr aulhartted tnpacity(les),, and that by hls m/thelrsknetum(s) on the h strumwd the pmm(9) or the ently upon beAeM P m(s) acted execut Irotrutrye�y WITNESS Rry/hww ow of w aeeL ' / / / r N1 V WN t PENNY C. ENGtANO C0mmh3bn/Io79)22MfrCPSI ' Not Pubac e Butte County. Ccaomn ,. MyComnlsYunEYP DEC. 3, 1999 • Xi2 Foundation System Installation Instructions for California for Ground & Concrete Systems HUD Wind Zone 1, 15 PSF Wind Load Seismic 4 By Tie Down Engineering Xi2 Ground System -120 BUTT E COUNTY BUILDING DIVISION APPROVED AV-WONHW-093 Xi2 Concrete System Engineer Approval State Approval MANUFACTURED HOMEIMOBILE HOME FOUNDATION SYSTEM HEALTH AND SAFETY CODE, SECTION 18431 APPROVED SUBJECT TO CORRECTIONS NOTED APPROVAL DOES NOT AUTHORIZE OR APPROVE ANY OMISSIONS OR DEVIATION FROM REQUIREMENTS OF APPLICABL$ STATE LAWS AND REGULA71ONS BMW of CoNfomfi swatma "oofox tad Coamuft Do"f P=d 1SY aF�.��ANDSTA>ARDif t- 14C IWAlll>t. AR Tf1bPlanAFgo►a Baha 00PY Page 1 of 8 0 rO 0 0 0 0 Xi2 FoundationSystem Installation Instructions for California for Ground & 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 13`36 :3 Sub Section A and 97 UBC Seismic Requirements, CBC 2001 addition. • Maximum vertical projection at sidewall is 9'. Higher walls`Amf.- e,,Os-ed 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 shear walls, marriage line ridge beam support:posts)and rim plates. The longitudinal component of the Xi2 system replaces end frame ties. Check manufacturers set-up requirements. • Maximum pier height is 48" pier. *Except for single' sections 36". r r • 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. * Xi2 components exceed HUD code 3280.306g "Anchoring equipment exposed to .weathering 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 8 121=F-t- S�r�1oj 0 0 LD 0 0 0 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Installation of Xi2 Ground Systems Identify the number of systems to be used on the home using the chart provided. Identify the location where the systems will be installed. Clear all organic matter and debris from the pad site. Place U -bolts through holes in pan provided. Place pad centered under beam with the lateral strut bracket towards the inside of the home. Press or drive pan into ground until level and flush with prepared surface. Build pier according to State, Local or Home Manufacturers guidelines. (Figure 1) Attach the end of the smaller tube to the inside of pan using U -bolt & nuts provided 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) 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) Figure 1 rnd °fN o�1 e 1-314" Tube Lateral Struts 1-112" Tube 4-#12x1" Tek Screws M U -Bolt & mounting Bracket J -Boit Nut & Washer Strut (flag end) 1-0eam Figure 2 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. �an>ta GA, 30336 TIE (404) 349-0401 DOWN ___._. ENGINEERING J Xi2 Ground Parts Detail X12 Ground Xi2 Ground Lateral System �✓' y5tem �" Part Number 59306 Includes: 5' Strut ad & hardware kit (#59329-1 includes all nuts and bolts). Longitudinal Hardware Kits ;. Part Number 59331 Includes: 2 I-beam brackets & 2 U -bolts with all nuts and bolts. ^vM Lateral and Longitudinal Combination, Longitudinal Strut Part Number 59333 & Hardware Kit Includes: 5' Strut, Pad, Longitudinal Strut (#59329), Lateral and Longitudinal Hardware`kit Kit with all nuts and bolts.- 0 0 _. . Struts for Longitudinal Systems Part Strut Pier Height ® ® o 0 No. Length Up To: a>Y� a;IIS 59330-44 44" 4 Blocks or 32" Ground Longitudinal 59330-65 65" 6 Blocks or 48" Hardware Kit Ground Longitudinal Strut Xi2 Stabilization Pier Placement for Ground or Concrete Xi2 Pier Placement Single Section Home Double Section Home 0 -80' (76' Box) 4 Xi2 Systems 0 -62' 3 Xi2 Systems' 63'- 80' 4 Xi2 Systems "2 Xi2 systems can be placed at either end of the home. i Triple Section Home 0 -62' 4 Xi2 Systems 631-80. 5 Xi2 Systems Page 4 of 8 TIE DOWN- ENGINEERING - a • Installation of Xi2 Concrete 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. 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, tighten wedge/anchor bolt, securing bracket to the concrete. 5. Attach the end of the smaller tube to the bracket mounted on the pad, using the A 7 $ grade 5,1 /2" x 2-1/2" bolt/nut provided. 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 1 next page) 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 Install frame bracket clamps on I-beam on the inside of block/pier, Insert strut in frame bracket clamp and attach with nut & bolt. Attach opposite end to concrete bracket. Pull the frame bracket clamp with fastened strut outward.to remove any slack. 11. Tighten all nuts and bolts on system. 0 0 LO 0 0 0 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 (Includes2 sets per kit: I-beam bracket, nuts, bolts and washers) Lateral and Longitudinal Combination Part #59332 Includes: 5' Strut, Longitudinal Strut (#59364), Lateral and Long itudinal. Hardware Kit with all nuts and bolts. Figure 1 Lone ki Nut & Washer Beam Clamp Bracket Xi2 Installation Placement BeG Longitudinal Strut i Xi2 Concrete 6I zom Concrete Longitudinal Hardware Kit 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 Page 7 of 8 TIE DOWN ENGINEERING r m 0 0 0 0 Hardware Breakdown #59331 Longitudinal Hardware for 59306 2 #59329-1 Hardware for 59306 Lateral System 1 84533Z U -Bolt 1/2--13-x 2.63x 2.19 thread ; 59272-2 1-3/4 zinc 4 10556 Tek Screw #12 x 1" 1 10631 Z 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 3 Beam Clamp Top Flange r Full Thread 10 10646Y Hex Nut 1/2-13 grade 5 zinc 2 10801 Carriage Bolt 1/2-12 x 2-1/2 Grade 5 zinc 6 10646Y Grade 5 2 84533Z U -Bolt 1/2-13 x 2.63 x 2.19 thread 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 full thread 5 10646Y Hex Nut 1/2-13 Grade 5 zinc 1 10801 Carriage Bolt 1/2-12 x 2-1/ 2 Grade 5 zinc 1 84533Z U -Bolt 1/2-13 x 2.63 x 2.19 Thread 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 Beam Clamp Top Flange r 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 2 59272-2 Beam Clamp Top Flange r Full Thread zinc 12 10646Y Hex Nut 1/2-13 Grade5 zinc 4 10801 Carriage Bolt 1/2-13 x 2-1/2 Grade 5 zinc 6 10646Y Grade 5 zinc #59364 Hardware for 59332 Lateral and Longitudinal combination 1 59264 3 Way Concrete Bracket M 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 r 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 . , / CTIE °DOWN' ENGINEERING 0 0 0 o. i PERMIT NO. 5931-77MHI (existing site) PERMIT EXPIRES OWNER CHARLES WOOD CONTR. owner LOCAT N (A.P. 28- 3-2 W/S app 800' N of Laporte Rd. Ban or j r f k 7--Zq-11 (Tv,te Temp. Power Pole_ Called PG&E Temp. Elec. Serv._ Called PG&E Temp. Gas Serv. Called PG&E JOB FINALED (Date) (Signature) Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES ------------------ Elec_ Service Elec. Pedestal Water Piping Sewer Gas Piping MOBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping l Drainage Gas Piping DATE/SREMARKS OR CORRECTIONS &Vc-/C OJU Q /Do (NOTE: An entry must be made on this form each time you visit the job site.) 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 c-- Sewer Garage Fdn. Vents _ i' Fixtures Footings Stemwa l l Garage Vents Insulation Water Htr. Heaters Slab Carport Po Footings Prov. for physically handica ed Conformance of ex. structure Appliances Gas Piping 8 Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footino ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Gird. Fault Prot. Scratch Heating Service I Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES ------------------ Elec_ Service Elec. Pedestal Water Piping Sewer Gas Piping MOBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping l Drainage Gas Piping DATE/SREMARKS OR CORRECTIONS &Vc-/C OJU Q /Do (NOTE: An entry must be made on this form each time you visit the job site.) MOBILEHOME INSTALLATION INSPECTION CHECK LIST 1. Is the mobilehome located with hirequired separation from lot lines and buildings and generally conform to plot plan? Yes_ No 2. Does the mobilehome have.required clearances above ground? (Sec.5085) Yes` No_ 3. Are footings and supports properly sized, spaced, and braced as ped approved plans? (Note possible variation at spring shackles.) (Sec. 82 & 5083) Yes_ No 4. Is the mobil home level? (Sec. 5088) Yes_ No 5. If more 'ngle unit, are crossover connections properly installed? (Sec. 5088) Yes N 6. Water A. Is flex' e connector of adequate size and properly installed (1/2" ID md:n.)? (Sec. 5566) Yes_ No B. Test - Does water piping withstand working pressure or 50 lbs. air test? Yes_ No C. Backflow - If coach is not Sta California approved, does station have backflow device and pressure -relief valve? Ye N 7. Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? YesL/No_ B. Does it have minimum" per foot slope and is it properly supported? Yes_ <o C. Are any leaks detected in drainage system after runn g 3 -gallons of water through each fixture including washing machine standpipe? Yes No_ D. If cos not State of California approved, does station have required trap and vent? Yes N 8. Gas Piping and Gas Vents A. Connector - Is mobilehome nnected to the gas supply -with an approved 3/4" minimum mobilehome connector not a than 6 ft, long? N te: All piping is to be at least as large as the mobile e g s e inlet with ou eductions other than the mobilehome connector. Yes_ B. Test OK as per foillowin 1. Open all appliance c 2. Shut off appliance bu procedure? s_ No nector v ves. pilot valves. 3. Air test with manome er 10"-14" water column, or test with slope gauge (minimum 6oz.-makimum 8 oz ca ted in tenth pound increments. Test for 10 min, without drop, ` 4. Conne � ga meter to mobileh a with connector, turn on gas, test connections with soapy w er. C. Are all appliance vents properly installed? Yes_ No. 9. Electrical A. Is service large enough to provide adequate amperage -to mobilehome (must equal rating of mobilehome with a minimum of am nd other facilities on lot, i.e., water pumps, garage, cabana, etc.? Ye No, f B. Is there proper clearances panels? Yes <N_ C. Is power supply cord,or feeder assembly properly fused? Yes_ 50_ D. Is continuity test satisfactory as per the following procedure? Yes No 1. De -energize electrical wiring system of the mobilehome at the pedestal. 2. Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected. 3. Switch all breakers and switches in the mobilehome to the "on" position. 4. Connect one lead of a test instrument to the mobilehome grounding conductor and apply the other lead to each mobilehome supply conductor, including neutral. 5. All non-current, carrying metal parts of the mobilehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. 6. Upon completion of the above procedure, the power supply cord or feeder assembly conductors shall be connected to the site service equipment. A further continuity test shall then be made between the grounding electrode and the chassis of the mobilehome. Upon satisfactory completion of 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 -- L Manufacturer and/or Namestyle ctt �>"—cJM Do Length_ Width Vehicle Serial No. State Identification No. Additional Information or Comments: COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS • 7 County Center Drive — UroviIIe, California 95965 7. Telephone: 534-4541 APPLICATION AND PERMIT X Date Signature of Permitee or Agent Receipt No. 1ZQ -7 25�3 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant ine tsutte county Code and/or resolutions to do work indicated above for which fees have been paid. . DIRECTOR OF PUBLIC WORKS BY wilding permit expires Date BUILDING Owner(1 6-s. SQ. FT. OCC. BUILDING VALUATION Mailing Address Bo V Telephone No. Fireplace Contractor �� (r Total Valuation Mailing Address Permit Fee Plan Checking Fee&/or Penalty Telephone No. Permit Fee Building Address to PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. ,p '— I — Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F -S84, ion Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA ParkinPlans eclaration Parcel Map 60' R/W I Improveme is Lawn sprinkler system 2.00 131d2. P s Recd Parcel val Pla Approval Permit Fee $ NEWADDITION ❑ ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 1 y� AA. 14 , lS ` • l S S Main service 8011 OR LESan 100 AMP OR LESS 5.00 Main service EA. ADD -L 100 AMP 2,50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service R 600V 1100EAMP OR LESS 25.00 Main service EA. ADO'L 100 AMP 1.00 NEW CONST OR ADDNS. ( ACCLBLDGOCCUP. &) 20sgft NEW CONSTR. MULTI.OUTLET N0N•RESI D. (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: BAL�20501 Ex. Occup(OUTLETS OR FIXTURES)@ Ex. Occup. (OUTLETS ((RESID.)REA) 2,00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 Ee'l am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned nronerty fnr insnootinn —im—no TOTAL PERMIT FEE $� This permit is hereby issued under the applicable provisions of X Date Signature of Permitee or Agent Receipt No. 1ZQ -7 25�3 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant ine tsutte county Code and/or resolutions to do work indicated above for which fees have been paid. . DIRECTOR OF PUBLIC WORKS BY wilding permit expires Date This set of plans and specifications MUST be kept on the iob at all times and it is unlawful to m06 anv ch. noes or oltere-04 ins on same without written permission from the Department of Pubk- Works, County of Butte. a U 0,W,6 LI's � NOTE:—All Materials & Workmanship Shall go id Accordance with Recognized Good Practices and of a quality prescribed for the-Specaified use lin the Uniform Building, Plumbing & Mechanical Codos and the National Electrical Code. s • a p i Thee , Setback shagle 5 ft, from the side property line-and.,SO ft. ,from the centerline of the road, permitting a maxi- mum of a 2 ft. eave overhang but entirely out of all easements. i -7 BUTTE BUTTE COUNTY BUILDING DEP,ARTMENTj APPROVED f MOBILEHOME SUPPORT DATA If 'other than single wide, Mobilehome Mfr. furnish Setup Model No. Year Width(ft.) Box Length (ft.) - Tagalong or Expando Size ft. x 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. rSingle ft.)(in;) I (in.) (in.) Cente support Centers por loca'ons* footing izes (in (ft.)(in\) I (}/n.) (in.) ootings (check one) 1. Wood either pressure treated r —� foundation gra e. 0 2. Other (specify) Supports (check one) ED" <'Concrete block. Fl2. Other (specify) Tagalong or Expando, show support details. (ft.) I (in::) (in.) (in.) F (ft.)(in.) t BUTTE COUNTY BUILDING DEPARTMENT APPROVED *if canter piers are other than drawn above,, � �`��"z- draw in—locations, spacing, and dimensions., �.C� (ft.)(in.) x,301-- Typical Support (in.) (in.): Footing Size x (f .)(in.) (in.) (in ) �! -- Max. Pier Spacing Max. Overhang (ft.) I (in::) (in.) (in.) F (ft.)(in.) t BUTTE COUNTY BUILDING DEPARTMENT APPROVED *if canter piers are other than drawn above,, � �`��"z- draw in—locations, spacing, and dimensions., �.C� BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name: 2. Installer's name: /�}►/ 3. Is the site currently under permit? Yes / / 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 / / No (If no, clarify ) ( ) 5. What is the mobilehome electrical rating? ---`=----- �n Amps 6. What is the mobilehome site service rating?- y----- 0 Amps ating?j�-,A4,j#-A-1--/-0-0BakerAmps 7. What is the mobilehome site circuit br 8. Is there any other electric load to be served by the mobilehome siteservice? --------------------------------------------------- Yes /!i/ No (If yes, identify the load and sizeij Iq p Pjjdfoad) (Amps) 9. What is the mobilehome site gas pipe size? ---------------------- (in.) 10. What is the type of gas service? -------------a-------------=- Natural 11. What is the gas pipe length from meter or tank to the mobilehome? 12. .What is the mobilehome gas demand? --------- tL -ke -- ------ (BTU) (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft -.'on LPG.) tt r `PERMIT NO. i P E f M LH UTIL.. -;PERMIT NO. 1878-74P,E PERMIT EXPIRES -7S OWNER OWNER Dave Sarey CONTR. Owner k OCATLON A.P. W Rd., 800 ofLaPorte Rd. i k Temp. Power Pole Called PG&E Temp. Elea, Serv. Called PG&E Temp. Gas Serv. Called PG&E j' JOB FINALED (Date) (Signature) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING I BUILDING (Cont'd) I PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Sidinci To out Slab Roof Sheathing Water Piping— Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. Stemwall Slab Prov. for physically handicapped Heaters Appliances Carport Footings Conformance of ex. structure Gas Piping & Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent -- 7 Door Closer Final Final DATE REMARKS OR CORRECTIONS jigr _ COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WO K 7 County Center Drive 7 Oroville, California 95965 Tel epoone:' 53%-4541 APPLICATION AND PERMIT nature of Permitee or AgZ/c-;t /^7 / L/ �BY Dat i�Receipt No. i White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Iding permit expires Date ............................................ BUILDING Owner SQ. FT. OCC. BUILDING VALUATION �-- Mailing Addressfie r Telep ne No. Fireplace Contractor m Total Valuation Mai I ing Address Permit Fee Plan Checking Fee &/or Penalty Telephone Na. Permit Fee $ $ Building AddressS �© PLUMBING No. @ FEE PERMIT FILING FEE $2.00 peon 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 —!, g Gas piping system 1 - 5 outlets 1.50 14 Each additional outlet .30 Fe S t on FireDept. FireZone Use Permit Building sewer 5.00 Q EQA Parking Plans arcel eclaration Parcel Ma P 60' R/W Im rove ents P Lawn sprinkler system 2.00 Bldg. P Rec'd Parcel fppr Pla ppro,GI Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 on Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Single Family ❑ Duplex ❑ Mobil Homelz Others ❑ Range, Cook -top or Oven 1.00 11 SAO ice., c /4 S Q C 6 f P� Water Heater or Space Heater 1.00 fight fixtures ba 2 Receps., switches & fix outlets Z 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: Hood, Ex. FanorF.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring 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. Elhave placed on file with the County of Butte a certificate of 'workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned pro ty f i pection purposes. X t _ natPS �%� �y TOTAL PERMIT FEE $ _ This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF�UBLIC WORKS nature of Permitee or AgZ/c-;t /^7 / L/ �BY Dat i�Receipt No. i White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Iding permit expires Date ............................................ suk CO s39; 96R - G G(57 a rte; 43 G - r 1 I' .1 The�bahalqe 5 ft. from-� the gide property�ine50 -ft. from the centerfirie of he rpermitting maxarnt�:r�a a overhang: ' All utility'; connections .shall be lcated with n 4 ft. outside•the rear -r tbRd sectio•, of the mobile home on .the left goad) side of the .mobi le i Septic syste rri anscLIOGAIWT�,, jtub_QL4t_,to be . as per utte Cou , ty, . Health' Dept. Re- quirements ' P+"N�`T}�+`,%•`r`Y�s"v-K-�j.,�^�,o�',� :�•}+-�,.rr+ i�'�'�'�"4'�.lfs+.��„ai^*�"�rr,• °E:- • '-r...iY`�"':tiF'.'.'"'"'f�'"`4i's4�...tv.^`.....�7y«.�,,.h./ti”jw'..(-�cvi..,n.,r,�.�;,,,,,r,pw..n.r.4,�...+:�++'r'�� .. ^ '` .. � COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroviller California 95965 - Telephone: 916/538-7541 ,/APPLICATION AND PERMIT PERMIT NO. ASSE550• ARCEL NUMBER 028-130-023 ZONING A5 BUILDING PERMIT OWNER Rity-mikki=2 GARY WILLIAMS TELEPHONE S0. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS P.Q. BOX 2024 ORQVILLE 95965 CONTRACTOR'S NAME LAWSON RMIN TELEPHONE 532-1030 CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN r Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee k $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 19 WOODVINE ROAD, BANGOR Permit tee $ PLUMBING PERMIT Filing Fee 10.00 t Each Trap 2.00 ' I Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME 1 PARCEL MAP Water piping 5.00 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex[] Mobilehomel>_� Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G JW 10.00e TYPE OF WORK i New ❑ Addition ❑ Remodel ❑ Utilities ® Installation❑ Other ❑ Describe work: NEW ELECTRICAL LINE & PLUMB (WATER LINE) Permit Fee $ 15.00 Contractor ELECTRICAL PERMIT Filing Fee 110.00 Main service 100 AMP ORV OR LESS10.00 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 and Professions Code and my license IS In full force and effect. License No._ f2'p / / V `?. Classification G License " ❑ I, as the owner, or my, employees with wages as their sole compen- sation, will do the workand 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 OCCUP.tk A New 2/z2sgft CONSODNSTR.� ULTBI.OUTLET NON.RESID BRANCH CIRC ITS 2.50 ea (POWER APPARATUS e) SINGLE OUTLET CIR. Ex. OCCUp( OUTLETS OR FIXTURES 1.20@50t 2ALO30 Ex. Occup. our ETS ((RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 15 . PRE INSPECTION 15. 1 Permit Fee $ . WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. LJ 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 Filing Fee 10.00 Heating Coolin g 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 liabilities, judgments, costs, and expenses which may in any way accrue a ainst S,/aid County in consequenceof the granting of this permit. c.� ��� !�/�7/91) >^�''1 �� L�ZrSs,.._ v Date Signature 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 in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 55.00. HAZ CUA PARK SCHL FLD PAR JP0JHDJ Issu ' This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC B y , . .'�. PER IT'EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date /A //—,a 7 66 - %/ Receipt No. 84526 WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovil!e, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 028-130-023 ZONING A5 BUILDING PERMt OWNER gaxyxxiiiiama GARY WILLIAMS TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS PA B 4 OR VILLE 95965 CONTRACTOR'SNAM LAWSON RANKIN TELEPHONE 532-1030 CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 19 WOODVINE ROAD BANGOR Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 5,00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex[] Mobilehome5' Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home is G W 0.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities© Installation❑ Other ❑ Describe work: NEW ELECTRICAL LINE & PLUMB (WATER LINE) Permit Fee $ 15.00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 1000V OR 0 AMP ORLESS10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): R__'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.SINGLE License No. & 09 /7:!zV Classification 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 OCCUP.& OR ADDNS. ACC. BLDGS. , 2/z ¢sq ft NEW CONSTRESID, RANCH TLET NO N•R ESID BRANCH CIRC ITS CIRCUITS) 2,50 ea POWER APPARATUS &) OUTLET CIR. Ex. OCcup(OUTLETS OR FIXTURES 520@509 Ex. Occup. OUED P TLETS (RESID.)LNS REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 15.00 PRE INSPECTION 15.01 15.00 Permit Fee $ 40,00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): F-1 The permit is for $100.00 (valuation) or less. /I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling g 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 agre to save, indemnify and keep harmless the County of Butte against all liabi ' es, judgments, costs, and expens � which may in any way accrueIVS agains id County in conseque of the ting of this permit. %ate % aj 5 gnarOre 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 in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE AL AL E TOTFE$ 5.0 5 5 HAz CUA PARK EE PAR JP0JH0J This permit is Hereby issued under sions of the Butte County Code and/or work indicated above for which fees ORRECTOR OF PUBLIC By, , PER&T EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date // Z festa jl—� /� �/ Receipt No. 84526 WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT Vl�.�.. '.�.� r''��i't�f"wi'i7Y� �%/'.'�!r'v�i1 sK.%i�1� "."�F •%tlpi"4' .. r.'-r•r�.w«ciy, ,,r:t, -. .. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION . 7 couriTv cENTER DRIVE - PERMIT APPLICATIONiIDATA SHEETNE. 9,6.538-�54, Permit No. OWNER ('aAAA (.yIQQ..eCAM A. P. No. OZS-- (3U- 023 Proposed Building Use rn N - Building Inspector %W Date 2-7-90 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, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ............... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13. School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of -Plot for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. 'Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) �0. 21. LO -22. Pre -Inspection for �-i gh6 required Pre-inspec. requestt�o Building Inspector/ Contractor's license information (No., Name Style, Classifications ... Certificate of Workmans Compensation Insurance ..................- �� (Date 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 26. 27. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone 632- 1030 and hold for pickup at j00 office. Deliver w/inspector. Other AppIicat ' .Date �� / 7 %D Copy of Haz-Mat form sent Health Dept. Fire Dept. -Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By. The following data must be submitted prior to permit issuance: (Circle new item not checked above), 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone_lnail-counter by ..date Contractor, designer, owner, was advised of above required data by -phone -mal l -counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy -DPW COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT —ASSESS PARCEL NUMBER ZONING _ : _:BUILDING. -PERMIT----_----- ----- •--- OWNER TELEPHONE SOS FT. OCC, BUILDING VALUATION G WiEg_uavlvm OWNER'„S MAILIIADDRESS .0A. aely CONTRACTOR'S MAILING AODRF-55 Fireplace CONSTRUCTION LENDER UNKNOWN C Total Valuation J C Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 19 womuuUg e ronA —r Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 5 .601 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 I S I G JW O.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities [j3' Installation❑/� Other ❑ Describe work: nwa 2� Gi�Q, (I/V1.Q 1- PULM&b fW -- Permit Fee $ 1510 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6100V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADO -1- 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ 1 am licensed under .provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification ❑ 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 CONST. ( DWELLING OCCUPM OR ADONS. ACC, BLOGS. 1/z¢sgft NEW CONSTR. ULTI.OUTLET 12.50 ea NON-RESID BRANCH CIRC ITS POWER APPARATUS o- (SINGLE OUTLET OR. Ex. Occup(OUTLETS OR FIXTURES .0e50t AL@ 30c FIXED APPLNS. OR Ex. Occup- OUTLETS IRESIO.I EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Q( UNO i? lfyln S• ) S Permit Fee S Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 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 Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE Butte to enter upon the above-mentioned property for Inspection purposes. TOTAL FEE $ r . aU 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 HAz CUA PARK SCHL FLD PAR Po Ho IssuE against said County in consequence of the granting of this permit. Th;s permit is nereby issued under the applicable provi- X Date sions of the Butte County Code and/or resolutions to do Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ work indicated above for which fees have been paid. An OSHA permit is required for excavations over 5'0” deep and demolition or construct- DIRECTOR OF PUBLIC WORKS ion of structures over 3 stories in height. Receipt No. g¢SZ% By o:.1• `4SPtC-O-. !OLDENPOD.APPLICANT PERMIT EXPIRES Date_ Date I OWNER: PRE -INSPECTION y " ' DATE I- 2-7 90. LOCATION• tdomjUvy FAfficiar A.P. # 623 CONTRACTOR: ( um VcWICLm ZONING PRE -INSPECTION Or / I &LrtI LI 1 ILS ..Il _' -b L �__ , :JLL�� TYPE OF OCCUPANCY FIELD - INFORMATION BUILDING USAGE: TENNANT: i O�TED-COOLED �_HAS ELECTRIC S GAS NITATION FACILITIES PERSON CONTACTED OTHER COMMENTS: ACTIO ECOMMENDED: ISSUE HOLD FOR OTHER: �.4. Dol I OoI Biu oS' s ni�a Me