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028-230-019
C 028-230-019 PERMIT#97-0504 ROMINGER, Todd 790 Los Verjele Rd., Bangor Cont: Todd Hemsta Mobilehome Utilitie ELECTRICJREQ? ¢ ftiGAS LINECOMPACTIOQ ? Y% d ASUPPORT SREQ? /76 028-230PERMIT#9 -0740 ROMINGE790 LbsRd., Ba orCont: Iomes In .Mobilehllatio r 200' 88 y�1, aid 1;,00T ad 0006 Qd'lez 08"' �sA ConV2 re gc g 180' %0'� dice PecOio$,>� ot 160' }40�. 20' This se of plans and specftaUms NMI* lKept� oxo. heIob at all times and it is unl.avnd to .:,��y changes or elterations a,- on $ne without :- pe rmission rmissionfrom the Department of public Wnrks. County of Butte. ALL STRUCTURES AND EQUIPMENT INCLUDING OVERHANGS SHALL BE CLEAR OF ALL EASEMENTS. A SET BACK OF 3 D FT. FROM THE -SIDE AND .?D FT. FROWT_ HE REAR PROPERTY-L-INES-AND FT, FRO l THE ROAD CENTERLINE SHALE BE CLEAR OF STRUCTURES AND EQUIPMENT EXCEPT FOR A 2 FT. EAVE OVERHANG. _ B gPpR ov 0?heaj n�, •� hNea�th �o 20' 40' 60' 80' C A�C. 'REV: ErNEu. B`( BU-ri-fr CO- FfR ,D-pT. CALIF. DEP'i . of FOPESTRY approved as mbmittad approved with conci'ions r - s,,, i ttaclI ad, sheet. 7tF J�. 0 �!� 100' 120' 140' 160 CDF FIRE SAFE REQUIREMENTS AP# PERMIT NAME Under authority of PRC 4290, the following checked items are required by the Butte County Fire Department and are made a part of this permit. These requirements are minimums and will be superseded by Butte County local regulations which equal or exceed these standards. Field inspections will be made by the Butte County Building Department for compliance. J] 1.272.00 Maintenance of Defensible Space. To ensure continued maintenance of properties in conformance with these standards and measures and to assure continued avail- ability, access and utilization of the defensible space provided for in these standards, annual maintenance must be provide for by the land owner. Driveway Standards [� 1273.02 Surface. All driveway surfaces and structures (bridges, 1273.07 culverts and other appurte-nant structures which supple- ment the roadway bed or shoulders) shall provide unob- structed access to conventional drive vehicles, includ- ing sedans and fire apparatus weighing up to 40,000 pounds. [ 1273.03 Grade. Not to exceed 16 percent unless paved. 1273.04 Driveway Radius 1. No roadway shall have a horizontal inside radius of I curvature of less than 50 feet and additional sur- face width of 4 feet shall be added to curves of 50- 100 feet radius; 2 feet to those from 100-200 feet. I�] 2. The length of vertical.curves in roadways exclusive II of gutters, ditches and drainage structures designed to hold or divert water shall be not less than 100 feet. [`�3,• 1273.05 Turnarounds. If required, will have a minimum turning radius of 40 feet from the center of the road. 1273.05 Turnouts. Shall be a minimum of 10 feet wide and 30 feet long with a minimum 25 foot taper on each.end. ,] 1270.10 Width. All driveways shall provide a minimum 10 foot traffic lane and unobstructed vertical clearance of 15 feet along its entire length. Page 1 of -3•. ? 7 , os -6 /may„ / 4 __ryD.0 AP # PERMIT # NAME Q�] 1273.10 Turnouts. Driveways exceeding 150 feet in length, but \\ less than 800 feet in length, shall provide a turnout near the midpoint of the driveway. Where a driveway exceeds 800 feet, turnouts shall be provided no more than 400 feet apart. [�] 1273.10 Turnaround. A turnaround shall be provided at all building sites on driveways over 300 feet in length and shall be within 50 feet of the building. 1273.11 Gates [�J 1. Gate entrances shall be at least two feet wider than the roadway it serves. [ 2.- The gates must be located at least 30 feet from the roadway and shall open to allow a vehicle to stop without obstructing traffic on that roadway. ( J 3. Where a one-way road with a single traffic lane provides entrance, a 50 foot turning radius shall be used. Fuel Modification 1276.01 Setback for Structure Defensible Space. [ 1. All parcels 1 acre and larger shall provide a mini- mum 30 foot setback for buildings and accessory buildings from ul] property lines and/or the center of the road. 2. For parcels less than 1 acre, local jurisdiction shall provide for the same practical effect. See Other Requirements below. (�y 1276.02 Disposal of Vegetation and Fuels. Disposal, including chipping, burying, burning or removal to a landfill site approved by the local jurisdiction, of flammable -vegetation and fuels caused by site development and construction, road and driveway construction and fuel modification. shall be completed prior to completion of road construction �r fi:ial inspection of a building permit. Page 2 of 3 AP # 9? a�vC/ PERMIT # Other Requirements [ ] If Building Setback is 15 to 30 Feet: - Class A or B roof - Enclosed eaves NAME [ ] If Building Setback is Less Than 15 Feet Choose any 3 of the following: Metal or no doors on side toward property line with insuffi- cient setback Class A or B roof with enclosed eaves Interior automatic sprinkler system per NFPA 13D Glass area not to exceed 10W of wall area toward property line with insufficient setback - Siding from the following list: Stucco - 3 coat Hardi-Board or Plank Masonry Masonry veneer Metal Other Butte County Fire Department approved materials Date Page 3 of 3 ture 20D'.to oa �a�•tp�t NOTE -All )ZA_'aterlai. & Workmanship Shall Be iri. . t Accordance with eca^.Gd`s1.zed CytiZ :'�,.:f Fs "• $ i�. �a es a off' e�� of a wally Fri urnec3. for tl'a0 &eciti:a„r: +g ®p in fi e Z1nif Am Fufld�;, Plumbing & Mechauica: ” se anb o� �, "cam Codes tha National Rkmtriml Co" IUU'...... .. _... p 80 C,�`�D 40' 20' ate 5e oe �tnp�eted �t be d ava, eons voo appI0,je speC�f�� w �1 b,G� 150 20' 40' 60' 80' 100' 120' 140' 160 LAND DEVELOPMENT BUILDING /,f ON MENTAL HEALTH: PERMIT CLEARANCE Building PermiiNo. L65 OWNERS A.P. NAME: NUMBER: DAY — PRINT LAST NAME FIRST COUNTY ZONING n A S Z SB DESIGNATION: FLOOD ZONE: FLOOD MAP: r APPROVED: CONDITIONALLY APPROVED: RESOLVE PROBLEMS PRIOR TO APPROVAL: PARCEL CREATION BY DEEDS -OR MAP Los VEieJ F`CS �'c. DEED INFORMATION: Ac DATE OF CREATION:5hL115- DEED REFERENCE: �/ 11J C�17S ✓�S3 LEGAL ACCESS PROVIDED: YES NO LEGAL ACCESS REQUIRED: YES NO COMPLIES WITH COUNTY STANDARDS.FOR.DEED CREATION: YES NO COMMENTS/CONDITIONS: t,Od /55V60 q / 5EZ9S Z c) S 3 OR 3 & I �AIO CoAJair10k5) MAP INFORMATION: DATE OF -RECORDING LOT BOOK PAGE COMPLIANCE WITH OLD SUBDIVISION LOT ORDINANCE REQUIRED? (MAP RECORDED PRIOR TO BOOK 17 OF MAPS AT PAGE 23): YES NO . IF YES, MARK APPROPRIATE ITEM(S) BELOW: A. Construct road to B. Meet parcel size required by zone. C. Meet current E.H.D. requirements. CHECK SPECIAL CONDITIONS WHICH APPLY TO MAP: ALL FEES TO BE PAID TO THE BU/LD/NG DIVISION UNLESS OTHERWISE NOTED. 1. Maintain a 50 ft. building setback from centerline of road. _ 2. Maintain a ft.building setback from right-of-way/centerline of 3. Comply with Zoning code for building setback from road. _ 4. Maintain a 100 ft. leachfield setback from all existing wells. 5. Maintain a ft. leachfield setback from _ 6. Pay water tender fees in the amount of $ to Battalion Number of the Butte County Fire Department. X7. Meet the Fire Safe Regulations of Butte County and P.R.C. 4290. _ 8. Connect to a public water supply. _ 9. Connect to a public sewer system. _ 10. Automatic fire suppression sprinkler systems shall be installed in all residential structures in accordance with the National Fire Protection Association Standard for the installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet Fire Department specifications, serves the parcel. _ 11. Pay T.D.D. (Thermalito Drainage District) fee in the amount of $ 12. Meet the requirements of the Department of Fish and Game for the preservation of oak trees. (See phone number below) y 'A 4 _ 13. Obtain approval from the Department of Fish and Game for vegetation removal. Contact Fish & Game at 916-355-7010. _ 14. A traffic mitigation fee for each new or additional living unit shall be paid. Pay the amount of $ as stated in the Oroville Area Traffic Mitigation Fee Agreement. Payment to be made to the Planning Division. _ 15. All new residential buildings shall be constructed to comply with the requirements of the Uniform Building Code for seismic safety: Mobile homes shall be constructed on a permanent foundation system which complies with the Seismic Zone 3 requirements of the Uniform Building Code. 16. Deer Mitigation fees are to be paid, if such fees have been adopted by the Butte County Board of Supervisors. X 17. Pay school impact mitigation fees. X 18. A development impact fee for sheriff facilities shall be paid pursuant to the provisions of Chapter 3, Article II of the Butte County Code. _ 19. Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988 as amended. 20. If any cultural resources are"'encountered during ground disturbing activities, all work shall cease in the area of the find pending examination of the site by a professional archaeologist. This person would then be able to assess the site significance and suggest appropriate mitigation measures. 21. 22. 23 24. 25 26 311118 30I11Nf100 66t L t 8VW a3n13a3H LD 7/96 CAWP51 \FORMS.K\BLDGPERM.CLR MASTER BEDROOM KITCHEN — DINING n.. "Ex 12'51-F—AR UALL REQ AIVING ROOM ism BEDROOM `3 Oen - .- - 3 BEDROOM MODEL" .636— 24Appfzbvx 52' 1198 SQ.FT. Buttes c6urstw -361 %EAR WALL REQ 36' SWEAR WALL REQ d c .e 30 Ctiapi®n f z- HOME BUILDERS CO. 97-010044; Rec Fee 9.00 And when recorded mail to: I COP 2.50 Building Division Recorded I Cash 11.50 #7 County Center Drive Official Records I Orovilie, Ca. 95965 County of I Butte I Candace J. Grubbs I Recorder I 2:31pm 19—Mar-97 I PUBL XX 2 AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code requires this acknowledgment to be recorded prior to issuance of a building permit. The propem described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to .inconveniences or discomfort from the use of agricultural chemicals. including. but not limited to herbicides. pesticides, and fertilizers: and from the pursuit of agricultural operations including, but not limited to cultivation. plowing, spraying, pruning, and harvesting which occasionally generate dust. smoke. noise. and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal. necessary farm operations. All, that real property situate in the Count,- of Butte. State of California. described as follows: 5'x� . a�7� '4&zo - Date: g_ l k— 97 PROPERTY OWNERS: State of County of CARR/z ) On yy) before me, personally appeared Al +� �e/L personally known to me (or proved to me on the basis of Vatisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me 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 person(s) acted, executed the instrument. WITNESS my hand and official seal. OFFICIAL SEAL 1 C -m q, DOTTY Dr088!tJS ��h<Nic - State o' Nevada Ciarx."` CountSignature Seal: 'hiy Comm. Expires July. 03, 1997 88-31560 3 EXHIBIT "A" PARCEL ONE: AP 028-23-0-016-0 All that portion of the West half of the Northeast quarter and the Northwest quarter of the Northwest quarter of the Southeast quarter of Section 35, Township 18 North, Range 5 East, M.D.B. & M., lying Southerly and Westerly of the .Los Verjeles Road as the same existed on July 1, 1988. Excepting therefrom the land described in the deed from James H. Hedge and his wife' to Francis William Cain dated April 20, 1915 and recorded May 8, 1915 in Book 150 of Deeds at page 353 records of Butte County, California. PARCEL TWO: AP 028-23-0-019-0 Commencing at a point in the North and •South half section line of Section 35, Towgswp 18 North, Range 5, East, M.D.R. & M., distant thereon 2641.47 feet, South 00 15' West frogi the quarter section corner in the North,boundary of said Section 35.; thence South 00 15' West on said half section line, 2522.37 feet, more or less to the quarter i section corner in South boundary of said Section 35; thence East on Township line, 1060.13 feet to a point; thence North 00° 151 East, para%el to West boundary 'of said half section line, 1753.30 feet to a post; thence North 48 03' East, parallel to North boundary thereof, 628.42 feet to an Iron stake in the Rangor and Sugar Loaf- County RF�d; thence along the center line of said County Road on following courses: North 39 24' West, 1.82.70 feet; thence North 1Q° OS' West, 780.50 feet to an iron stake; thence North 36 57' West, 376,50 flet; thence North 4A° 511 west, 21.48 feet; thence leaving said County Road, South 48 03' West, 1239.15 feet to the place of beginning. END OF DOCUMENT COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES- BUILDING DIVISIO( 7 County Center Drive - Oroville;�California 95965 - Telephone (916) 538-7541 PERMIT N (Rev. 12'/96) APPLICATION AND PERMIT q1 _n,�570< ASSESSOR PARCEL NUMBER — ZONING BUILDINGPERMIT 0 OWNER TODD ROMINGER TELEPHONE SO, FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS PO BOX 1 BANGOR 95914 CONTRACTOR'S NAME TODD HEMSTALK TELEPHONE CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER - LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE No. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 23.00 BUILDING ADDRESS 790 LOS VER ELES RD Energy Plan Checking Fee $ BANGOR $ PERMIT FEE $ LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 1 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome IX Other SPECIFY Each Trap 1 7.00 Solar or heat'pump water heater 23.00 Water piping 15.00 Each as water heater or vent 1 5.00 TYPE OFWORKGas New ❑ Addition ❑ Remodel ❑ Utilities FJ Installation 11 Other ❑ Describe Work: 71 2 BEDROOM piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home 920.00 PERMIT FEE 4 ELECTRICAL PERMIT Filing Fee 20.00 Main Service 2oonoa�ss 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9commencin with Section 7000 of Division 3 of the Business and Professions Code, 9(commencing ) and my license is in full f and effect.POWER License Class Llc. No. ��� �� OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have a will maintain a certificate of consent to self -insure for workers' coT,peehsation, as provided for by section 3700 of the Labor Code, for the ,pdrformance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' 9mpgnsation insur�pce carrier and policy number are: Carrier ,;P10 Main Service 200A TO 1000A 46.00NEW CONST. DWELLING OCCUP. SO OR ADONS. ( & ACC. BLDS. 3.5¢FT, NEW CONST. MULTI -OUTLET NON-RESID. ANC C C @7.50 APPA S 8 SINGLE OUTLET CIR. EX. Occup. OUTLET OR FIXTURES BAIL @'.550 Ex. Occup. ouT�is AEES o.)0E 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE 3 MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall o w ly with those provisions. ___,�Date Signa - ❑ Owner C� onractor ❑ AgAn OSHA permit is required for excavations over 5'0" dee and demolition or construction��3 of structures over 3 stories in Peight. �i �,S Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEC $16b. 00/ HAZ. � p, E IMP 0 PARC PD AQP v S Th*mitis issued under the applicable provisions ofCode and/or Resolutions to do work i whish fees have been. paid. By Datte' PERMIT EXPIRES ON 3 /� Date Receipt No. %% 9.00 WHITE-D.D.S.-B.D. CANA -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT . 71-- -\: + ..� ..,r! + '`!4'�✓M'�"1 �-�f "W1jr,J .--�••+rte ^^�d:'�th'-i° ri. ..•i 4., ��frT'•d... : y. .. + . - �,r - COUNTY OF BUTTE DEPARTMENT OF DEVMOPMENT SERVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILL0, CZFORTQa 95.965 -TELEPHONE (916) 538-7541 .PERMIT APPLICATION DATA SHEET OWNER: / p Ao/mi'rioev- ASSESSOR PARCEL Proposed Building Use: Building Inspect9r :'"° Date: At time of permit application, I was advised the following data must be submitted prior to permit p cessing and/or issuance: Date Received By ❑ 1 -All items have been submitted.------------------------------------------------------------------------------------- N 'lot plans, sets, signed by the preparer of plans.------------------------------------------------------------�4:2a:> ❑ 3. Complete plans, 3/4 sets, signed by the preparer of plans. ----------------------------------------------------- 114. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. -------- 05. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------ 116. Energy Design Compliance and supporting documentation. ---------------------------------------------------- ❑ 7. Statement of Intent for Non -Heated and A/C Buildings.--------------------------------------------------------- ❑ 8. Hazardous Material Form. ------------------------------------------------------------------------------------------ ❑9. Manufactured Home data and installation instructions including Tie Down Specifications. ------------------ Feesof $ R9, 0 0-------------------------------------------------------------------------------------� C��L ❑ ) J J. Impact fees as shown on the attached schedule. ------------------- rr-----------------------------------,-------/--- t2, California Department of Forestry ��- plan approval/fees. ----- /--J��----/---1--! — 41 El 1,2r. Flood elevation certificate. ---------------------------------------------------------------------------------------- 4. Sanitation and plot plan approval QVDv 2Health Department. Ell 5. City of Chico plumbing permit. --------------------------------------- ❑ 16. Plot plan and business license approval from the City of Biggs. --- ❑ 17. Planning approval for (A) Use: (B) Parking: A ❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ----------------- i6915—Encroachment Permit for driveway (construction approval prior to occupancy) - --------------------- A E120. Pre -inspection for required. Request to Building Inspector on 41+ ❑21. Contractor's license information. (Number, Name Style, Classification). ----------------------------- workers' Compensation carkerand policy number. ------------------------------------------------------- E323. Owner-Builder ----_---------------------------------------------- ❑23.Owner-Builder Verification (Given to owner ❑, Mailed to owner 0) - -------------- ---------------- E124. Letter of signature authorization. ------------------------------ Recorded copy of Agricultural Acknowledgment Statement. ❑26. Letter of intent on building use. -------------------------------- ❑27. Manufactured Home utility clearance. ------------------------- x 1. ❑28. Existing violations and/or expired permits. ------------------- 029. 0433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D ❑30. Other: (Date) ------- 3-19-9? --------------- a i When you issuethe �rss as follows ❑Mail to owner, ❑M ' ctor. •❑ Telephone and hold for pickup at office. liver with inspector. Applican. Date: Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution Date:' By: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other` Date: _ _By-,� 1. Index permit application for the above items numbered: Plan Cheek List 2. Additional items required: Contractor, designer, owner, was advised of the above required data by ❑ phon , ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required dais by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Plans reviewed by: Date: Plans approved by: Date: Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: rte. Yellow Copy - Department of Development Services, Building Division. E.H..HUSEW Plot Plan Attached G"y~ Floor Plan Attached Sent to B.D./�C� TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner J Location 8A'NGdA AP# Plan Approved for: • Sewage Disposal (/ Water Supply: Public Private Well Clearance for dwelling. Other 1"1-4 yASILC Hold final Final cle NOTE: r: ce C.K. for: rz Environmental Health SlAecialist 8/96 Date COUNTY OF BUTTE- DEPARTMENTOF DEVELOPMENT SERVICES- BUILDING DIVISION 7 County Center Drive - Oroville, Califctnja 95965 - Telephone (916) 538-7541 PERMIT NO. (Rev.12/96) APPLICATION AND PERMIT. ASSESSOR PARCEL NUMBER ZONING ., BUILDING PERMIT-`-"'""- py E TELEPHONE Sp, Fr, OCC. BUILDING VALUATION MAniNG ADORES a o ✓� 9S"9 COMRACroR' mTELEPHONE el 0-.,, ' CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS - Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ (� Q BUILDINGADDRESs - ` / Q ©S may`, - � C"J/ Energy Plan Checking Fee $ /tJ$ ►'t O 1r PERMIT FEE i IDT NO. SUBDIVISIONS NAME VRCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome/1P Other SPECIFY Each Trap . 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities Installation ❑ Other ❑ Describe Work: Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home @20.00 0,00 PERMIT FEE $ 6,001 ELECTRICAL PERMIT Fee 20:00 RLEFiling Main Service 200A OR LESS 23.00, LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors license Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, 1 shall forthwith comply with those provisions. X _ Date Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories In height. Main Service 200A TO I000A 46.00 NEW CONST. DWELLING OCCUP. SO OR ADONS. ( 8 ACC. S.3.5¢FT. LmµgajpT MULTI.OUTLET @7.50 POWER APPARATUS 8 SINGLE 011flET CIR. Ex. Occup. OUTLET OR F0ffURES BAZL @' 0O L @ .SO Ex. Occup. GFIxuTLEeDrsA aFsiDOFR. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 070, 00 Misc. Wiring 23.00 PERMIT FEE _ (�(� MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ :HAIZ.C..EES FIMP FLOOD COF PARCEL PD HD ISSUE This permit is hereby issued under the of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON applicable provisions Resolutions to do work been paid. Date Dare ReceiptNo. WHITE-D.D.S.-B.D. CA AR -ASS SOR PINK -INSPECTOR GOLDENROD -APPLICANT RESIDENTIAL J 1. 028-230-019 PERMIT#97-0504 ROMINGER, Todd 790.Los Verjeles Rd., Bangor Cont: Todd Hemstalk M Mobilehome Utilities l 7 `Y.0 i �i i i - Y OFFICE COPY Address�C z eter By Date °2 .7 ?, ELECTRIC Meter By '•^X Date JOB FINALED (Date) Signature 'v I V=OK h 0 = Not OK Not •=Not Ready MOBILE HOMES 4 t• t i t MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Connectors Shthg: Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sils-AnchorsStuds-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing Date ' Card B-1 Date Card B-1 11. Ext.; Steps -Doors -Landings Date Card B- Date Card B-1 Date MOBIL OME INSTALLATION(Plans) OK except #'s oni equirements- Setbacks Easements Date Card B-1 Date Card B-1 s; Size -Spacing -Marriage Line J Date Card B-1 Date Card B-1 Ae*tas; est-Demanda/aNe-Connector Date POOLS (Plans) OK except #'s ec ' 'ty; MH Test -Crossovers -Breakers -Clearances } , 1. Setbacks -Easements rat Test -Fall -Flex Connector ` F 9%M� i � 2. Soils; Compaction -Structure Stability r and Sewer Connected -C/O to Grade -HD and Electricity Tagged owns -Type -Installation Cert. ; Insp.-Sketch of Occupancy Date'/ / Card B-1 // kA_ W ��- 35 (,, r3-7 Date Card B-1 Date Card B-1 6797_ ( _3�, -1/'� 5 t, 34--2 C��„�, Y� t:. i. �• 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance--GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5Circulating Equip. -Pool �qh Cq• _ Boxes-Enclosures-Panelboards-Ins. to Main in Conduit 9. Health Department p Approval 10. Plumb.; Cir. TestWater Supply Test J Date Card B-1 Date Card B-1 Date Card B-1 Date Card 8-1 a V = No OK RESIDENTIAL (Single & Duplex) N to 1' bl App ica e Not Ready Date 46. UNDERFLOOR (Plans) OK except #'s 1. Zoning-Setbacks-Easments-Flood-Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ P' Ftg. Depth 3. Ftg. Garage; Soils-Steel-Elec. Grnd/ P Ftg. Depth 4. Ftg. Porches & Decks; Soils -Steel-/ P Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF. Gas Pipe; Size Anchors - Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card E-1 Date 63. PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 70. Fireplace or Stove, Clearance -Hearth Date 71. Card B-1 Date Card B-1 Date 72. Card B-1 Date Card B-1 Date 73. ELECTRICAL (Permit) OK except #'s 23. Fixture & Transformer Clearance -Ins. Protection 24. Elec. Receptacles Spacing -Lights & Switches at Doors 25. Size Boxes & No. of Conductors Stapled 26. Romex Installed Close to Edge of Studs & C.J. 27. Equip. Ground made up w/Mech Fastners-Bond Gas & Water 28. 2 Appliance Circuts in Kitchen & Conductor Size GFI 29. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or Al 30. Ran !e Circ. / / ga Cu or AI -Oven Circ. / / ga Cu or Al Insulated Neutral 0 Yes 0 No 31. Service -Riser Conductors & Ground -Main Disconect 32. Equip. Clearances Panels-Motors-Mech. Epuip. 33. Clothes Closet Light -Shower Light -Spa Light 34. Smoke Detector 86. Water Well, Disconnect, Electrical, Plumbing Date 87. Card B-1 Date Card B-1 Date 88. Card B-1 Date Card B-1 Date 89. MECHANICAL (Permit) OK except #'s 35. A.C. Ducts Insulation & Support 36. Vent Fan, Exhaust above insulation 37. Condensate Drain & Overflow, Size & Grade 38. Furnance-Vent Access -Comb. Air -Return Air Vent 115 outlet 39. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except #'s 40. Sits Proper Materials & Anchors 41. Walls Studs -Nailing Spacing & Braces -Plates -Sound 42. Bearing Walls over Girders & Floor Nailing 43. Draft Stop in Walls (rat proof) 44. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 45. Headers & Beams -Size & Bearing Date 46. FRAMING (Continued) Hangers -Post Caps -Anchors -Connectors 47. Cling. Joist-Rftr. Ties-Purlin-roff Brac.-Truss-ShGng.-Ring. 48. Fireplace Ties or Type A Flue -Fireplace Throat clearance 49. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 50. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 51. Garage Fire Protection Framing 52. Property Line Firewall & Openings 53. Ext. Doors -One 3 -Check Garage 3rd Story, 2 Exits 54. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 55. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 56. Siding -Nailing Veneer 57. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 58. Glazing Area -Glass Protection -Skylights -Plastic 59. Shear Walls; Nailing -Bolts 60. Brace Wall Panels 61. Insulation -Walls -Ceilings 62. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 63. Ext Steps -Door & Sidelight Protection -Landings 64. Smoke Detector 65. Furnace; Vents -Clearance -Comb, Air-Conector- n Garage; Above Floor-Ducts-Mech. Protection 66. Bedroom Exiting 67. G.F.I. & Bath Fixtures & Tub Access -Spa 68. Elec. Trim & Subpanel, Breaker Sizes & Labels 69. Stairs & Rails 70. Fireplace or Stove, Clearance -Hearth 71. Elec. Outlets at Wood Panel, Int. & Ext. 72. Kit. Fixt. & Appliance; Ground. -Air Gap -Cooking Clearance 73. Elec. Outlets & Recepticales at Kit. Counter 74. Garage Fire Door; Swing -Landing -Closure 75. A.C. Duct in Garage -Damper 76. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. In Garage; Above Floor-Mech. Protection 77. Plb., Elec. & Mech. Equip. Listed for Location 78. Elec. Receptacles in Garage (G.F.I.)-Romex Protection 79. Insulation -Foam -Looked in Attic 80. Guard rails & Deck Construction -Post Caps 81. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 82. Following Instld./Drlve 0 Yes 0 No/Walks 0 Yes 0 No/Planters 0 Yes 0 No 83. Stucco Brown -Finish 84. A.C. Unit Disconnect, Electrical -Plumbing 85. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 86. Water Well, Disconnect, Electrical, Plumbing 87. Exterior Elec. Trim, G.F.I. Receptacle -Underground 88. Ventilation Throught House 89. Glass Protection 90. Corrections from Previous Inspections 91. Gas Test -Meters Tagged, Gas -Electric 92. Water & Sewer Connected -C/O to Grade -HD Approval 93. Energy Compliance Certificate -Other Certificates Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: Nates on Installation _ �.. `ter;. 7 % F. V-, • 6oll Descriptlon M'6 t.. Class Test Value 1. Sound hard rock. MA Deme ..r cttt"t n, coarse`Ver r and lop clays ., coraL 3• Medium dense coarse sands;, sandy gravels, 350 to 550 very sdfi'Silts and clays. in. lbs. 4. 5. •. - -".'•. -,-:.: _ :-:�.r,.��;,.:...:,. ^•''ytom. Frame Tie-wl�h=Buck[e I.Install strap by pushin the end between the inside of theframe "I" beam and the floor, 2. Position the buckle at upper end Of the "I" beam frame. Wrapp the end of the strap_ around' the "I" beam. Thread the end of the strap thru the slot'in the buokle as shown. Push the end of strap in-between -I- beam and floor. 3. Pull the strap, making certain the buckle stays rn position. Thread loose end of strap thru slotted tensioning bolt attached to ten- sioning head of anchor. Tighten Slotted tensioning bolt a minimum of 3 full turns until all slack in strap is removed. (Anchor must be properly installed into ground �befarproceeding with r P•) Recommended Anchors Model # Stk # Description M>Z 59110 cross drive rods anchor MM518 59090 30" f S ' rrnd, Z-4" helix M=14 . 59095. 30"x' 314" nod, 2-4" helix (and those listed below) M M5/8 59080 48" x SB" rod, 14" helix M12H3/4 59085 48" It 3/4" rod, 1-6" l,:lix Loose to medium dense sands, firm to 200 to 350 stiff clays and ailts. alluvial fill. In. lbs MI2H5/8 59080 48" x 5/8" rod, 1-6" helix *Below these vatue� a prgfesriolml arg&teerrhould be eonsuUed MMA 5908s 48" x 3/4" rod, 1-6" helix Concrete Slab Tensioning devIees for use in concrete time of concrete reinforcement, size and thl knas of concrete, irunne'r. etc. shall be ze and depth of bolt hole, type ed (same as anchors) and specifications kind o. as to PSI and cure Minimum distance at which tensionlag device can be installed from edge of end of slab, pad uoner, etc shaShield ll be If permissible. Installer/Contractor Certification I cett'fY that I have installed the T1B DOWN BNQINL that no modifications have been made to the anchoring system or building structure �r TES ��t Installation instructions and company Name: contmctoes U Date: 2tee Signature: Page 4 of 8 COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 1469 Humboldt Road, Chico, CA - (916).891-2751 7 County Center Drive, Oroville, CA - (916)'538.-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE OWNER V PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. y .k 1 Date Inspector 1A 54P u REV 10/92 MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES BUILDING DIVISION --7 COUNTY CENTER DRIVE OROVILLE, CA 95965 --PHONE (916) 538-7541 APN: PERMIT NO.: 9-7 Owners: �G' Name: t� U /"I/, it/ P Owners: // Address: %�f' (� L� h f A iL� G �./ Mobilehome CIAO � 1 Year of �+ / / 57 Manufacturer L {I//':+'9 ; v r' Manufacture: Serial number Insignia or '7 CL or V.I.N. C q9 7 — 3 -$/s 5 _! �. �+ " Z HUD number: 3 C_ ! 3 Official approving installation: Date: rc 669-r2n�Q % If the .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 -Bldg., Gold -Assessor .�, � �.;{S s•'i+., Yu�....n. ..� :. ).._— ✓� .�i. .. _Y:.'tr.G rn.. _�.. s;� , .✓f_i.�t " i..,el.� .-n v. ...k .. .. _ _ ......... iii•1.... — _c .... .. r.. ... a ..... COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION .7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT ��`�1� ASSESSOR PARCEL NUMBER 028-230-019 ZONING As BUILDING PERMIT OWNER LES ROMINGER T 679N2507 HOE SQ. FT. OCC. BUILDING VALU TION OWNERS MAILING ADDRESS PO BOX 1 BANGOR, 95914 CONTRACTOR'S NAME INTEGRITY HOMES, 8INC. TELEPHONE CONTRACTOR'S MAILING . , ADDREY740 FEATHER RIVER BLVDOROVILLE l CONSTRUCTION LENDER - - LENDER'S MAIUNG ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER UCENSE NO. Filing Fee $ 20.QO Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 9-1 nn BUILDING ADDRESS 790 LOS VERJELES RD. Energy Plan Checking Fee $ BANGOR, CA 95914 PERMIT FEE $ LOT NO. SUBDNIS IONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehomeb Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation IN Other ❑ Describe Work: M/H/ INSTALLATION��'�� S`�� Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service OOOY OR LESS 2D DA OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is 1 II force and effect. 1� �7 N Q License Class Zf � Lic. No. / i/ / � 5 (J OWNER -BUILDER ECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO IDOOA 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( s Acc. BLDs. 3.5¢so FT* NEW CONST. NON -RES D. uLT CUTLET 97.50 POWER APPARATUS 8 SINGLE OUTLET CIR. Ex. Occup. OUTLET ORFDLTURES 00 BAL°':50 Ex. Occup. ouTrs AESID.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE i WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. t>D 1 have and will maintain workers' compensation insurance, as required by Section 0 /► 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' c mpensation insurance carrier and policy number are: Carrier C0.f a Policy Number s — (The above sections need not be completed if the permit is forwork of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forth 'th comply with those provisi ` X _ Date Sig atu of Applicant - OwnerContractor ❑ Agent An OSHA permit is required for excava Ions over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ 100.00 , Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ 143.00 HAZ. D. FEES IMP I FLOOD I CDF PARCEL I PID HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which ees have By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date// �Trahq Date Receipt No. 218847- WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT .� '�x'�'Sr�i(0�?'�""'�„'.(('"�,�h'„"_',�""',��;",,�,�::rr•i��5''..,:,,;4�T � :�-ism'' --,��, ,"'.r:`:'..-"'.�.'.ti-,'�.r� "" ".'t-'"� _-•'- r -, � I♦ /11 1. Y' 9 COUNT_ Y OF UTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION "7iTN)wY�CENTERDRIVE OROVILLE C IFORNIA95965 TELEPHONE 9 6 ..PERMIT APPLICATION DATA SHEET 4�OWNER:�w n' n ASSESSOR PARCEL V D 0 3,0 Proposed Building Use: Building Inspector: Date: At time of permit application, I was advised the following data must be submitted prior to permtt processing d/or issuance: Date Received By ❑ 1. All items have been submitted -------------------------------------------------------------------------------------- 02. Plot plans, 3/4 sets, signed by the preparer of plans. --------------- Z -------------------------------------------- ❑ 3. Complete plans, 3/4 sets, signed by the preparer of plans. ----------------------------------------------------- 04. Engineered plans, 3/4 sets, with wet signature on plans. All engineering m�ist be shown on plans. -------- ❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------ t 06. Energy Design Compliance and supporting documentation. ---------------------------------------------------- ❑ 7. Statement of Intent for Non -Heated and A/C Buildings. --------------------------------------------------------- 08. Hazardous Material Form. ------------------------------------------------------------------------------------------ ❑9. Manufactured Home data and installation instructions including Tie Down Specifications ------------------- 0 10. Fees of $ ------------------------------------------------------------------------------------- 795 . Impact fees as shown on the attached schedule.----------------------------------------------------------------- TIS. California Department of Forestry plan approval/fees. --------------------------------------------------------- ❑ 13. Flood elevation certificate. ---------------------------------------------------------------------------------------- ❑ 14. Sanitation and plot plan approval Health Department. ------------------------------------------- 015 : City of Chico plumbing permit. ---------------- - : -- s -------:t ------------------------------------------------ 0 16. Plot plan and business license approval from the City of Biggs. ---------------------------------------------- + ❑ 17. Planning approval for (A) Use: (B) Parking: -------------------------- ❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ----------------------- ❑ 19. Encroachment Permit for driveway (construction approval prior to occupancy). ---------------------------- '020. --------------------------- `❑20. Pre -inspection for ) u�sp required Request to Building Inspector on (Date ' ❑21. Contractor's license information. (Number, Name Style, Classification). ------------------------------------- 0 22. ----------------------------------- ❑22. Workers' Compensation carrier and policy number. ----------------------------------------------------------- 023. Owner -Builder Verification (Given to owner ❑, Mailed to owner EI) - -------------------------------------- 024. Letter of signature authorization. -------------------------------------------------------------------------------- ❑25. Recorded copy of Agricultural Acknowledgment Statement. -------------------------------------------------- ❑26. Letter of intent on building use. --------- --------------------------------------------------------------------------- ❑27. Manufactured Home utility clearance. --------------------------------------------------------------------------- ❑28. Existing violations and/or expired permits.----------------------------------------------------------------------. ❑29. ❑433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ . --------------- 030. Other: ------- When you issueLthe ermit, process as follows ❑ Mail to owner, ❑ ail to co7toffice. ctor. Telephone S V and hold for pickup at m �' ❑ Deliver with inspector. Applicant: Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution,, Copy of plans sent ❑ Health Department; ❑ Fire Department, ❑ Other: 1. Index permit application for the above items numbered: 2. Additional items required: 3,. Contractor, designerowner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, desiser, owner, was advised of the above required data by ❑ phone, 13 mail, 13 Building Division counter, by Date: Contracto desiggner, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, d signer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Divi *on counter, by Date: Plans reviewed by: Date: Plans approved by: /f� Date: Q i Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: Yellow,Copy - Department of Development Services, Building Division. Date: Date:_ By: Date: By: ❑ Plan Check List .�T�yr�''.ir�m.'v3�`�-.�:^ �'��'��'"-• N7�%�'�rri"�'Y.},'ri'4��'iii'%i6'3ii"'�T�Ri�l�i`\'�7yi'tlYiYiiF�f�+'yi1w��.`#':'Y1rrSi.iix�''rt�a'°"'+r7`'�"s+"7.",�i�.. ..,._.. COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE CA 95965 TELEPHONE (916) 538-7541 SCHEDULE OF FEES DUE OWNER 40 i A.P. # PROPOSED BUILDING USE DATE Q REC # DATE REC 1. BUILDING PERMIT FEES -- Balance Due ................ $ . -- Additional Fees Due ............. $. -- Additional Fees Due ............ $ -- evised Plan Checking Fee ....... $ 2. SCHOOL DISTRICT FEES (paid at District Office) Y-__3,. SHERIFF FEES (paid at Building Division) esidential ........ x $360.00 = $ Units Commercial (sq.ft.)... x $0.03 = $ Sq.Ft. 4. URBAN AREA FEES (paid at Building Division) Residential (per unit) . x = $ #Units Amt. Commercial (sq.ft.) .. x =$ Sq. Ft. Amt. 5. RECREATION DISTRICT FEES (paid at District Office) 6. THERMALITO DRAINAGE DISTRICT FEES $425.00 (paid at Building Division) 7. SRA FRE INSPECTION AND PLAN CHECK $89.00 (paid at Building Division) 8. WATER TENDER FEES (Battalion # ) $200.00 (paid at Building Division) 9. CSA 87 TRAFFIC FEE $2500.00 (paid at Building Division) 10. OTHER At time of permit application, I was advised the above fees are required to be paid prior to issuance of the building permit. These fees may be changed during the plan checking process. ' Original -Owner Copy -Building Div DATE Q (Rev. 12/96) D �yLr0"t, R J COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION ..7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. ` (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMaER- �� ^��//� 7 ZONING BUILDINGPERMIT OWNER- fOjOjAAo %�Uer TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERS IU ADD SS a r / COM CTOR' NAME r e TELEPHONE 593 J9j CONTRACTORS MAILING 0 ESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Plan CheckingFee $ .00 BUILDING 2y ZU S V e,r' e— ),P—s Energy Plan Checking Fee $ (�,q PERMIT FEE $ LOT NO. SUBDNIS ION'S NAME PARCEL MAP PLUMBING PERMIT Filing Feel 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome X Other SPECIFY Each Trap _ Solar or heat um water heater _ 7.00 23.00 Water piping 15.00 Each qas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation X Other ❑ Describe Work: _rv� �—a Gas piping system 1- 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT I Filing Feel 20.00 Main Service EDDY OR LESS xooA OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencingwith Section 7000 of Division 3 of the Business and Professions Code, ) and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service TO ,000A 46.00so WEE200A NEW CONST. DWELLING OCCUP. OR ADONS. ( a A.C. e.CS SO 3.5¢FT: N� CONST. MMUJL 0CUI r 11T NON-RESID. @7,50 POWER APPARATUs 8 SINGLE OUTLET CSR. EX. OCCU OUTLET OR FDrruREs a20 @ I.00 Ex. Occup. ourEiFrs AES,6.) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE t 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 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.0 Heating Cooling Hood 6.50 Ventilation PERMIT FEE S Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X Date Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ /0C).00 Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ HAZ. D. FEES IMP FLOOD/ V/ CDF PARCEL I PD I HD I ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON the applicable proyjsigA- Resolutions to do work been paid. Date (Da te ReceiptNo. WHITE-D.D.S.-B.O. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 'V / BUTTE COUNTY'. SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) School District S Building Department No. «� a -o� q A.P. Number' Jurisdiction: City County Property Owner Property Location3 Subdivision Lot No. Residential Development Sq. Footage No of Living Mob a Home Addition (Group R) Units Installation Commercial/Industrial Building Department Rep6lentz Di t ict IdeAtification (Street Address) r (City) New Addition Sq. Footage (Including Exterior Roofed Areas) 1 /92 Date (Floor Plans reviewed by School District Personnel) .970126 J School District certifies 04z" rn (/ ,( \ } (Applica • t) ) has complied with the requirements of Resolution No. presentin / 1 ! square vN - Representative Paid by Check # V Remarks: (Phone Number) (State) (Zip Code) % by payment of $ YB 9 $ LL MITIGATION $ -we ,I" -/1-j— Date t& A n 1_ A A/ ... Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the imposition of the fees in any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.xis (2/97)dmm AP # -2n0'--Zs— 1 OWNER 40/yVa6f52— PERMIT MH UTIL. INSPECTC ELECTRIC GAS Support Struc. Compaction Test -eq. Service Other Pipe YES NO YES NO Size Load 'Twe Size Length A� p 01, ALL alrujiv unco AND, EQUIPMENT INCLUDING' OVERHANGS SHALL BE CLEAR OF ALL EASEWNTi� A GET BACK OF�FT. FROM THE SIDE ANO; 40 FT. FROM THE REAR PROPERTY LINES AW -1- S70 FT. FROM THE ROAD CENTERLINE SHALL BE 5WRR OF STRUCTURES AND EQUIPMENT EXCEPT FOR Ag M-EAVO- OVERHANG., -;0 9 -/- 7740. BME COUNTY BUILDING DEPARTMENT APPRgVED e'o&l '11Z2k7 i � 1. Owner's Name: 2. Assessor's Parcel Number: D�S — P30-0151 3. Installer's Name: &I.4 s, -Enc. 4. Is the site currently under permit? Yes[XJ No[ ] Permit No. 5. Is the site an existing site? , Yes [ ] No [ ] (If yes, furnish two plot plans). 6.. What is the electrical rating of the mobilehome7io6 Amperes. 7. What is the mobilehome site circuit breaker rating? a4G Amperes. 8. What is the electrical rating ofthe mobdehome-site? Amperes. 9. -is the main service. remote from the mobilehome site? Yes[ ] Nop(] If it is, what.is the rating? Amperes. 10. Is there any other electric Icad to .be served by the -mobilehome site electric service (i.e. well, garage etc.)? Yes[ ] No[ ] If yes, please identify the load and size: a) The mobile home site: Load- (,U 1 (( Amperes - b) The main service: Load- Amperes - 11. Type of gas service at mobilehome site: Natural[ J Propane[x] None[ ] 0 12. Size of gas . pipe at the mobilehome site from - -the meter 'or tank: 3 inches. 13. What is the gas pipe length from the meter or tank to the mobilehome? 00 (ft.). 14. . What is -the mobilehome gas demand? B.T.U.* *(This information is not required if the pipe length is less than 6 feet on natural gas or less than 50 feet on propane). THE OTHER SIDE OF THIS FORM MIDST BE COMPLETED IN ORDER TO PROCESS THIS PERMIT APPLICATION BUTTE CAUNTY BUILDING DEPARTMEN'i kppROVEQ May 1995 8.5 Mobilehome Manufacturer: A10 �•� Manufacture Year: 92 C��-% %' - If other than single wide, furnish Setup Model Number:_ ' Width: _2��_(ft.) Length:_f,� _(ft•) Tagalong or Expando Size (ft•) x _(ft ) October 7, 1973, furnish manufacturer's On all mobilehomes manufactured after installation manual and structural setup sheets. [X Other: FOOTIIJGS: Wood pressure treated or foundation gr ade ] SUPPORTS: Concrete block[X] Other: Provide Tie Down Specifications for all Mobilehomes: Pier Footings Sizes and Location MULTI -WIDE SINGLE WIDE ' 1 Line 1 _ Line 2 Lice 2 ........................................ ............... Lm 3 Main ................. ........................................ Line 2 Liao 2 _ - Line 1 . ...................................................... Main Beams Line 2 ...................................................................... Line• 1 ................................................ Tag or Triple ................................................ Line 1 Piers: Size minimum: x Spacing maximum: ` From ends -maximum: ` Line 2 Piers: Size minimum: Spacing maximum: ` From ends -maximum ` O ` Line 3 Roof Loads: Size minimum Location (from front): Line 5 Roof Loads: Size minimum: Location (from front): 1 Line 1 Openings Size minimum: Each side of openings with width over: Line 4 Piers: Size minimum: � x Spacing maximum:` From ends -maximum: ` �, OVER r 4043490401 TIEA.DOWN ENGIN - a� g' (-s , r VEERING?,, . 318 P01 JAN02 s..&iR.�sre3a=n� 'it�attr e n-7�.�r� 7 i z w F�13��,sssxam��nesa c�sa.t3SaEae�t��w` •`jsL.��IyM;ale. .. TIS' DOWN. IV � RIN6I En - ianee_red -T-1 Gown sstem Manufactured h y home tie down calculations and schedules Design Loads for single/double/triple wides 1 Wind 15 PSF Engineer Approval Soil Bearing 1000 PSF Te Down Straps 3150 # Working Load Seismic Zone 4 'Xie down straps meet federal specifications - Class B, Grade 1 strapping and be at least 1-11//44-,x .035, zincyplated. I `�,�S. P0�l l PP� g Earth Augers 2962 # Msted to 4750 # minimum) Cross Drives 1727 # (Calculated) Concrete Slab Anchors 1390 # (Calculated) Note: Maximum soil preturc is 1000 P.S-F. without a soils report General Notes I. The charts shown herein are for the required number of tie downs on the sides of the Manufactured.Home. 2. Tie downs are required at each chassis beam, each end,vf each tratispotfeble section of the Manufactured Homer and,6 be any Of the types shown heroin. 3. Combinations of the different types of tie downs can be used. 4. In the event an earth anger cannot be installed due to an obstruc- tion, use of cross drive anchors is permitted, provided 2 cross drive anchors are installed for each earth. auger that cannot be installed. S. For all tie down installations, the Manufactured Home chassis members are shown as "I" beams for illustration purposes only. Chassis beams can also be "C" shaped or RFC shaped. 6. End tie downs can be located within 18" of either side of chassis beam axis as shown. One end tie down required 1g " at each bears end 1 "".__ Chassis Beam 7. The sizes, types; lengths, ac. of materials shown herein are minimurn. Larger, longer, heavier materials supplied by Tie Dowty Engineering may be used at the same spacing and, locations shown. 8. Alternate devices may be substituted with engineers approvals. Page I of 8 No. 15,1 C1Yit Vxp 4-'t31�J7 State Approval EN�/iVA &0 TJ• 1rdC/ 1 APPROY E.t) SUS1ECT TO CORRECTIONS NOTED dI `ea wet oalAo►Ise er epprove any . arnlsdai dev;a l'Iwm r9quiffmMts a( applicable Stat* lows, stat* o/arllra C*Po►nneal o! Hovdnp and caq,*i,,,,ily D*rdopmem OlvisloN CODES ANO STANDARDS Y Doted e (tiy"Qfvy? SPA NO-_,.!!-r-,%S rhis Plan Approval This tie down system Meets the requirements of section 1336$, subsection (a) 77E DOWN ENGINEERING 5901 Wheaton Drive Atlanta- Georgia 30336 404.344.0000 Fax 404,-349-0401 ►' A043' 0401 71 E 'iH)t�l ENGINEERING ,s x, 318 ", ; , pr7 r� . �3 �ti ��'x�� ;1*�N �z3� `,(., �.,T- fpC�.J�O I fl'U `I •��I. 7.f. 1�cf0Sk�Y.o..��,j ny,Y . ., } .,.5 �' . 1'!'�°�`'fy"'�''+��•��'Y�+^hv!!*ti-J+: �"! ." 6 ., • 1 e{l�� �i�( "� r3r;�..�HTPz.,�-•i i� i.v^�'�f35`4 (f jiy'�.� -+�` T. January. 2, 1996 LISTING NUMBER: TIE -942609 Mr. Merrill Sutton Tie Down Engineering 6901 Wheaton Drive Atlanta, GA 30336 Dear Mr. Sutton: • Having completed the in-house audit of quality control, quality assurance Procedures, etc., Tri-State Testing Services in compliance. with the rules �anrd procurement, welding Department of Housing of California lists the following regulations of the . g products: MODEL NUMBER PART NUMBER • M12H5/8 M12H3/4 M1Z2S/8 M1223/4 MIT2 MIJ2 MICS2 - 69250 MRA 59292 MGRB ".BCS MBU BISB MS33 59080 59085 59090 59095 59115 59120 J59125 59250' 59110 69292 59145 69175 59140 59135 59149 E CRIPTION 5/8" X 58" DOUBLE HEAD ANCHOR W/6" AUGER 3/4" X 48" DOUBLE HEAp.ANCHOR W/6" AUGER 618"'hC 30 DQUBLF. HEAD ANCHOR W/2 -q ^ AUGERS 3/4" X 30 DOUBLE MEAD ANCHOR W/2-4 AUGERS 3/4" X 8" DOUBLE HEAD THREADED ROD PATIO ANCHOR 5/8" X 12" DOUBLE HEAD J -ROD SLAB ANCHOR PATIO ANCHOR W/EXPANSION BOLT . 3/4"'X 36" DOUBLE HEAO ANCHOR W/6" & 4".AUGER CROSS DRIVE ROCK ANCHOR 3/4" X 30" ROD: LATERAL STABILIZER PLATE GALVANIZED ROOF BRACKET CRIMPING SEAL FOR 1_1/4" STRAP GALVANIZED STRAP BUCKLE SLOTTED BOLT AND NUT 1-1/4" X 33' GALVANIZED STRAP 6756 BUCKLES Cove MEINAPHIs, TN Sal 33 1901-385-1199 FAY' 90 1-386-66 14 •� :w X4043490401 T.I E DOWN ENG I NEER-,I NG x' X318;' PO7' - U -- rnn r'y� .r . T•ie Down Engineering. .?. :3 Page 2 LISTING NUMBER: TIE -942609 January 2, 1996 MS35. 59150 1-1/4" X 35' GALVANIZED STRAP MS37 59155 1-1/4" X 37' GALVANIZED STRAP MS42 59160 .1-1/4" X 42' GALVANIZED STRAP MS60 59165 1-1/4" X 60' GALVANIZED STRAP Mssoo 59170 1-1/4" X 600 GALVANIZED STRAP MBU6 59137 1-1/4" X 6' FRAME TIE W/BUCKLE MBU7 59141 1-1/4" X 7' FRAME TIE W/BUCKLE MBU8 59142 1-1/4" X 8' FRAME TIE W'/BUCKLE MBU10 59138 1-1/4" X 10' FRAME TIE W/BUCKLE MBU12 59144 1-1/4" X 12' FRAME TIE W/BUCKLE M6U15 59143 1-1/4" X 15' FRAME TIE W/BUCKLE MLFT 59188 End Frame Tie (Approved 5-25-95) If you have any questions or if we may be of further help, please 'call us. Sincerely, ,TRI'TATI:LTESTING.SERVICES INC. William E. Jackson Manager TRI-STATE TESTING SERVICES, INC. a 59145 Rnof Bra ckA m. MIT2 Concrete Slab Anchor (pry) "O MU2 _ Concrete Slab .Anchor (Wet) TIE DOWN N . ENGINEERING Tie Down Anchoring. -System__ D D MLFT End Frame Tie M DU/59140 59292 Strap Buckle MRA Lateral Stabilizer Plate Rock Anchor ��' DOWN .,J� �� ' Long AnchorM13U7 13150/59155> ¢nrsiwcreTv TF-- s ^'iyx ,.-c._m-",:uY.., Max Length of 36' 54' 72' .Manf. Home Minumurri No. of 2 3 4 Side Tie Downs One tie down Is required at each end Max LengthKim of Mahf. Home FAR ntirnum Na.;� Ar e, Max length of Manf. Home Minumum No. of Side Tie Downs One tie down is j 32' 42'. 62' 1 62' 1 73'. 0="BWA 50 69' 6W Side Tie Downs (tee Note Below) . 4 u_ fired at each end of "I" beam_ : SINGLE wIDE Eveniv 5oaced 1 � � :� 2 length Varies 2 Side Tie Downs (5eo Nate Belowl Side ne.Downs (see Note Below) IN, I It 11- Evenly 5paeed I I ' T t t 2' length Varies 21 1 _ Evenly Spaced 1 21 Length Varies 2' Side tie dawns must be within 24" of the end of the chassis beam. End tie downs can be located within W' of the center line of each chassis bcam, one tie down 15 "uired for each and of "(" beam. Page 2 of 9 ALWAYS CHECK FOR_UNDERGROUND _UTIUTY LOCATIONS 'BEFp STARTING-INSTAL:LATION QFANYANCHORING SYSTEM Cross drive anchors are used where hard or rocky soil occurs. If the ground surface is other than rock or mini- mum 2" asphalt, encase the cross drive anchor with concrete as shown in fig. l • Drill 5B" diameter hole 5 -ill" deep In center of anchor location. Insert pilot stud into hole. Earth Anchor 1. Partially install anchor allowing 14" to 16" remaining above ground level using constant downward pressure to minimize soil disturbance. 12. Utilizing oversize hammer, vertically install stabilizer plate, nesting anchor rod in between formed channels on outside of stabilizer plate (between anchor and frame). 3. Fully install anchor until tension head rests against stabilizer plate. Cross Drive Anchor Concrete 12" square x 12" deep • Drill -two 3/4" diameter holes Into the rock at 450 fig angles, using the anchor head as a locating guide. • Place r6d throagt top'nnd cotiespo• adiag bottom web flange and into 450 hole. Drive rod Into rock. Rod must be driven into rock at least 80% of it's length to achieve tnlaimum allowable pullout resistance. Concrete Anchors MIJ2 • Concrete must be a 2500 PST minimum slabwith 4tnstanlled um thickness and 6/6 x 10/10 wire mesh MIG52 • After reviewing restrictions .. Concrete slab must allow 4750 lbs of vertical ten- listed to the left, dill A 5/8 in x 3 In.• h hole is the be l where the an - c or head is to be located. - sion on anchor without lifting. This assuines that the concrete weighs 150 lbs per cu. ft. • Place steel erasion sleeve over • Minimum distance from the anchor shaft to one edge 'and O bolt and place mto the drilled hole. Of the slab is 12 in. 5 ft. from any other edge. g • Place the washer onto the expan- sion bolt. MUT2 is designed to be installed into a concrete slab at the time it is'being • Thread nut onto expansion bolt and tighten until maucrmum expa It pouted. • Slab must be 8 in. minimum thickness at location sion of steel expansion sleeve has under any anchor to allow S in. embedment of'1" rod anchor. been achieved. MIT2 is designed to be insetted through a 3/4" hole MIT2 drilled or formed.into an existing ' Remove nut and washer and place anchor head over exposed bolt. concrete slab. - O • PIace washer and nut onto bolt to attach anchor head, tighten nut. Page 3 of 8 w 'i5 • . 7r �i + 170' WE Mallation 1—- 71 - :game Tie :w_ih-B_uc_kle_ IInstall strap by pushin the end between the inside of the frame "I- beam and the floor. 2. Position the buckle at upper end Of the "I" beam frame. Wrapp the end of the strap: around the "I" beam. Thread the end of the strap thou the slot'in the buckle as shown. Push the end of strap in-between 'I" beam and floor. 3. Pull the strap, tnaking certain the buckle stays in position. Thread loose end of strap thru slotted tensioning bolt attached to ten- sioningbead of anchor. Tighten Slotted tensioning bolt a minimum of 3 full turns until all slack in strap is removed. (Anchor must be propedy installed into ground before proceeding With . this step.) Recommended anchors RMEMMM 5011 Soil Description Class JI Test M 59110 , Cross drive rock anchor Value 30" ii 5/8"rod, 24" helix L Sound hard rock, MA (and those listed below) 2' = -Very Dense and/orcemented sands, 550 in. lbs coarse gravel/oobbles, preloaded silts, and up clays and coral. 3. Medium dense coarse sands, sandy gravels, 350 to 550 very stiff silts and clays. in. lbs. - :game Tie :w_ih-B_uc_kle_ IInstall strap by pushin the end between the inside of the frame "I- beam and the floor. 2. Position the buckle at upper end Of the "I" beam frame. Wrapp the end of the strap: around the "I" beam. Thread the end of the strap thou the slot'in the buckle as shown. Push the end of strap in-between 'I" beam and floor. 3. Pull the strap, tnaking certain the buckle stays in position. Thread loose end of strap thru slotted tensioning bolt attached to ten- sioningbead of anchor. Tighten Slotted tensioning bolt a minimum of 3 full turns until all slack in strap is removed. (Anchor must be propedy installed into ground before proceeding With . this step.) Recommended anchors Model # Stk # Description M 59110 , Cross drive rock anchor MM5/8 59090 ` 30" ii 5/8"rod, 24" helix MI223/4 59095. 30" x:3/4" rod, 2-4" helix (and those listed below) MI2F15/8 59080 48"x 5/8"nod,1-6" heiix MI2H3/4 59085 48" x 3/4" rod, 1-6" helix 4. Loose to medium dense sands, firm to 200 to 350 stiff clays and silts, alluvial fill. - in. lbs • I M12115/8 59080 48"x 5/8" rod; I-6" helix • 8"row these valaeA aPrrfu"orral enghwers/rould be eortaalLd. MUH3/4 S9085 48" x 3/4" rod, 1-6" helix 5. Concrete Slab Tensioning devices for use in concrete pad, runner, etc. shall be tested (same as anchors) and specifications as to PSI and cure time m concrete crri t which tension and thickness of concttte, size and depth of bolt hole, type and kind of shield if permissible. Miaitrtum distance at which tensioning device can be installed from edge of end of slab, pad, runner, etc. shall be specified . Installer/Contractor Certification I certify that I have installed the T>fi DOWN BNG1N1?ERINo anchoring system as per 116 DOWN's Installation instructions an that no modifications have been made to the anchoring system or building structure. d Company Name: Contractoes I.lcensc f1 Date LSignature: Page 4 of 8 Nil ,i't��w 4 n'40�43490401;; T� I E ,M]bAJ �ET1G I h�ER r... _ �a05 JAN - TJE--DOWN ENGINEERING INDEPENDENT TESTING RESULTS MODEL NO. bESCRip ITON OF TIw ULTI ATE ENGTR nMDATE' M12H VERTICAL PULL-OUT 1N MOIST SILTY CLAY. (S/8"&3/4") TEST PROBE TORQUE VALUE BETWEEN 6,133A'9/15/92 200-349 INCH POUNDS. (AVG.) MI22 VERTICAL PULL-OUT IN SILTY SAND AND GRAVEL. 5,7338 TEST PROBE TORQUE VALUE 550 INCH POUNDS 9/15/92 AND MOR' (AYG E .) M VERTICAL PULL-OUT IN LABORATORY FDaVREs 5,567"- 3/2/93 FOR SIMULATION. UNCONFIRMED ROC$ WAS NOT AVAILABLE- aC.V VERTICAL PULL-OUT 1N 2500 PSI CURED CONCRETE- TEST SWOPPED AT 5,200 POUNDS. 5,200„ 3/?4/94 MV2 VERTICAL PUlL-0UT W 2500 PSI CURED CONCRETE. TEST STOppED AT 5,200 -POUNDS. 5'200„ 3/30/94 MTI2 VERTICAL PULL-OUT IN.2,500.PS1 CURED' CONCRETE TES'r STOP PED A7 5,200 POUNDS 5,200A 3/30(94 4: ice -,t VERTICAL PULUOtTT �I SILI Y qAY::TEST PROBE 5,2.00"- (59250) TORQUE VALMBETWEEN.200440 iNCR POUNDS ld/6/93 ML 45 DEGREE PULL ON-SrABIIIM PLATE IN SILTY 6,067' 5/5/92 CLAY. TEST PROBE TORQUE VALUE BETWEEN 200-349 INCE; POUNDS. _ (AVG.) NOTE: -ALL 'ABOVE 'TESTS -WERE 'CONDUCTED 'BY 'PTEC ASSOCIATES, PRODUCT TESTING, ' INC; AND GALLET & ASSOCIATES. THE IND1VIDiTAL TEST PRODUCTIZESULTS WILL BE MADE AVAILABLE UPON REQUEST. PLEASE FORWp.RD XOIIR REQUEST FOR THIS =FORMA.TION TO: TIE DOWN ENGINEERING 5902 WHEATON DRIVE ATLANTA, GEORGIA 30336 Page 5 of 8 DEPARTMiI.=NT OF:HOUSING ANQ COMMUNITY DEVELOPMENT DMSION OF. CODES AND STANDARDS i8g0'CHIRb STREi;T, Suite 260 P.O• Box 1407 S4 C8 AMRNTO.CA _ 95812-1407 - =445=.947.1:`.FAX:.(91.6y _327-4712 TDD 800-735-2929 September 29, 1994 William Z Jackson, Manager Tri-State Testing Services, Inc. 6756 Buckles Cove Memphis, TN 38133 Dear Mr. Jackson: OCT 0 6 1gg¢ This is to confirm that the California Department of Housing and Community Development has approved your rums application to become an approved testing and listing agency for load bearing supports and structural components used with manufactured homes, mobilehomes and commercial coaches. This approval is for the listing and labelling of structural components used in the manufactured housing industry in accordance with the standard established by your firm. PIease note We Department may require design calculations and test data .be submitted to substantiate a design when the listed system or component does not appear to co y9ur-approved standard. We may also u PP conform to '.:. : � „r ;, .Y req est this infortuadon. for the purpose of routine mow 6- or complainE'uryestiPatiOn. iRbviiions to your approved standard as well a listed designs may be necessary in the future as a result of amendments to currant statutes and/or regulations. • I Thank you for choosing t to become an approved listing I you have any questions or nem to c and testing agency. If in the future I discnss.a particular issue, you may contact either myself at (9167.445-9471 or ? -Eke Rosen � I � at (9167 255-2501. II •Sincerely, .J-. •-------•.-..... •- --'....__. ____._ _.._.-•--••-.. i Chris L. Anderson Mobilehome Parks Program Manager ' , :i I cc:.. bike Rosenberg I s I Page 8 of 8 I j . i APR.-10'97(THU) 12:05 CHAMPION #0009 F-1 a 9 iw N_ mo 0o d. 6m IN V:!:!!g m o � c d0rnm���j g O�>Z9 Or Xi wxi M 0,3 OO��S O v 4 ti EEmrp dD , h mm'�'a�cr 'NN'�X�Or X v� xW Xd�X X T TEL:209-562-1463 2Y -A' TYP. BEAM SPACING TYP. BEAM SPACING — r-- -------------- — ----- 11 T all III.1 I, w1 I 1 I 1 I 1 i m 1 UP i A R 3Ui m x I a N I I 1 I r I R I ' D i 1 i 1 1 1 I 1 N I P. 001 4