HomeMy WebLinkAbout028-260-060,028-260-060 93-4029
RODRIGUEZ, FRANK
80 LOS VERJELES RD., BANGOR
ELE SER FOR EXIST SHOP / O C
028-260-060 94-0746P,E ,
RODRIGUEZ FRANK ----)
80 LOS VERJELES RD.-, BANGOR= '
MOBILEHOME UTILITIES
ELEC C 3 Gt) l ,(� •/3
GAS 4P W
COMPACTION TEST- REQ
SUPPORT `STRUCT' REQ, '•'. -iUD
028-260-060 9470747MHI
RODRIGUEZ, FRANK.
80LOS VERJEIES RD.,.', BANGOR
CONT: MOBILE HOME CE=R
MOBILEHOME INSTALLATION
G
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,028-260-060 93-4029
RODRIGUEZ, FRANK
80 LOS VERJELES RD., BANGOR
ELE SER FOR EXIST SHOP / O C
028-260-060 94-0746P,E ,
RODRIGUEZ FRANK ----)
80 LOS VERJELES RD.-, BANGOR= '
MOBILEHOME UTILITIES
ELEC C 3 Gt) l ,(� •/3
GAS 4P W
COMPACTION TEST- REQ
SUPPORT `STRUCT' REQ, '•'. -iUD
028-260-060 9470747MHI
RODRIGUEZ, FRANK.
80LOS VERJEIES RD.,.', BANGOR
CONT: MOBILE HOME CE=R
MOBILEHOME INSTALLATION
G
RP_arn to: AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT % — 14 35 4
Building Division FOR RESIDENTIAL DEVELOPMENT
,&ktiun�26-8.1 of the Butte County Code requires this
acknowledgement be recorded prior to issuance of a building 94-0143541
. _ 14 4 I
4
permit. 1 Rec Fee 9.00
1 Check 9.00
The property described herein is adjacent to land or included Recorded I
within an area zoned for agricultural purposes, and residents Official Records I
of this property may be subject to inconveniences or ' County of I
discomfort arising from the use of agricultural chemicals, Butte I
including, but not limited to herbicides, pesticides, and i Candace J. GrubbB I
fertilizers; and from the pursuit of agricultural operations Recorder I
including, but not limited to cultivation, plowing, spraying, 12: 59pm 31 -Mar -94 I PUBL XX 2
pruning, and harvesting which occasionally generate dust,
smoke, noise, and odor. Butte County has established agricultural zones which have as a priority use for productive agricultural
purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from
normal, necessary farm operations.
All that real property situate in the County of Butte, State of California, described as follows:
Date: 3-7-94
L�/� SL/,.?'fcaA
,419 I -O6 P—tgU-'-Z
/z L, 2 /-,, 6-,r1, "/ . 9odAiyU'C
State of California )
County of Butte )
On 3-7-94 before me, Michelle A. Miller
personally appeared Frank Rodriquez and Elizabeth Y. Rodriquez
personally known to me (or proved to me on the basis of satisfactory 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
Signature Seal:
9 4- 14 3 5 4. .
g4
SCHEDULE C Order No. 1_152765
The land referred to herein is described as follows:
All that certain
( California real Property
�. described as y situate in
follows: the County of Butte,
I PARCEL I; State of
s Lot 60 and
the
Official.a Portion Of
Map therE. Lots 56 and
County of Butte °f• filed in 57 °f the Town of
J Page 77, more State of Cal in
office of Bangor, according to
particularly described asafch 21 the Recorder:
BEGINNING at 1901, in Book of the
�_- alongthe most follows: 7 of Maps, at
�
Lot'. the Westerl Southerly corner
60;--thence,ln�' line of said Lot °f said Lot
said Lot a direct 60, to the- 60r thence Nor
South 60 and line, North most Westerl Northwesterly
westerl the Northeasterl e.asterl Y corner
Southeasterl Y line y extension Y, along the North °f said
180.0 f Y aloe of the Bangor and Su thereof, to west line_.
seer thenceg the Northeas gar Loaf a P°int on the of ...__,_
Southwesterly in leaving terly line of county Road; thence
56, a strafing the Northeasterl Lots 57 and 56
from which point ght line to y line of saida distance of
distance of 60 a point -on the Lot 56,
feet thence Westerly
corner of South
56, a distance feet
Westerl said Lot line ofsaid Lot
60 feet to Y along the Souther160 bears WeSterly, a
PARCEL II; the Point Y line
Of beginning, of.said Lot
A right of way for
the SoutheasterlyPipeline, or ditch
Official .Ma °ne-half of over the.Northeasterl
Butte,..State filed f said Lot 56
.State of , Town of B Y 2.0 feet of
California, Marche2office of angor, according
1901' the Recorder g to the
' in Book 7 of l' Of the county of
;AP
NO
Ps, at page 77.
End OF®�
hT OMMEN-f
8
e'028-260-060' 94-0747MHI
RODRIGUEZ, FRANK i
80'LOS-VERJELES RD.
-BANGOR
CONT: MOBILE HOME CENTER
MOBILEHOME INSTALLATION
Wio 17 �wp
I
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
x f7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATION AND PERMITS-�?
ASSESSOR PARCEL NUMBER 028-260-060
UZONING
BUILDING PERMIT
OWNER
FRANK RODRIlr —
TELEPHONE
679-0318
SQ, FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
PO BOX 177 BANGOR CA 95914
CONTRACTOR'S NAME
MOBILE HOME CENTER
TELEPHONE
533-4403
CONTRACTOR'S MAILING ADDRESS
1740 FEATHER RIVER BLVD OROVILLE 95965
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 20,00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ 23.00
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
8
PERMIT FEE
$ 43.00
BANGOR,CA 95914
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Each gas water heater or vent
15.00
USE OF STRUCTURE
SF ❑ Duplex MX Mobilehome ❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G I W
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities O Installation 1,UOther ❑
Describe Work: MITT / / / 1✓� -� i�"'�
EnE
PERMIT FEE
$
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service ( 800V OR LESS I
200A OR LESS
23.00
Main Service ( 200A TO 10o0A )
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( a ACC. BLDS. )
3.50 FSD.T.
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one)
I am a licensed under provisions of Chapter 9, Division 3 of the Business and
Professions Code and my license is in full force aid effect
License No. )� /C7y S+ Classification — LJ -7
I, as the owner, or my employees with wages as their sole compensation, will do
the work, and the structure is not intended or offered for sale. (Sec 7044)
❑ I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
❑ 1 am exempt under Sec. Business and Professions Code
forthis reason
NEW CONST. MULTI -OUTLET
NON.RESID. ( BRANCH CIRCUITS )
@7.50
( POWER APPARATUS )
a SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES
@
20 1.00) BAL, 50
Ex. Occup.UT ED (RESID OR
(OUTLETS IRESID.) EA. )
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
WORKER'S COMPENSATION INSURANCE
1 declare under penalty of per'ury*�check one):
O� Is permit is for $10 0 (valuation) or less.
�:I have placed on file with the County of Butte Dept. of Development Services,
Building Division a Certificate of Workmen's Compensation Insurance ora
Certificate of Consent to Self -insure.
O 1 shall not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California.
Notice to Applicant: If after making this statement, should you become subject to the
Worker's Compensation provisions of the Labor Code, you must forthwith comply with
such provisions or this permit will be revoked.
PERMIT FEE
$
Contractor
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEE
$
Contractor
I certify that I have read this application and state that the above information is correct.
I agree to comply to all Butte County Ordinances and California State Laws relating to
building construction, and hereby authorize representatives of the County of Butte to
enter upon the above mentioned property for inspection purposes.
1 also agree to save, indemnify and keep harmless the County of Butte against all
liabilities, judgments, costs, and expenses which may in any way accrue against said
County in consequence of the granting df this permit.
X _ a/(..� -� , .,/ J�- Date
Signature of Applicant - O Owner ElContractorContractor ❑ Agent
An OSHA permit is required for excavations over 5"0" deep and demolition or
construction of structures over 3 stories in height.
Mobile Home Installation Fee $ 1100.00
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $
HA2.
D. FE
IMP
`
F100D�
V/
CDF
PAflCEL PO
�"� `^
HD
"
ISSUE
This permit is hereby issued under
the Butte County Code and/or
inthe
above for which fees have
11 q
By /�/
C
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
i�
Date / 1'
IDste)
Receipt No. 156667
WHITE-D.D.S.-B.O. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
. l i Y.. ..... .+= •;: ;'s.`..L,' -. n- '.f: 7
r3`'..1.
MOBILEHOME INSTALLATION ACCEPTANCE' `•,_
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE
r OROVILLE, CALIFORNIA 95965 — TELEPHONE: (916) 538-7541
PERMIT N0. - 74(
-
Address or loc
Owner's name
Owner's address
Insignia or hud number
Manufacturer's name(
Serial number of V.I.N.
ial
1
Year of manufacture
4-4 staIIation) (Date
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.
5138 White - Owner, Yellow - Installer, Pink - D.P.W.
G
COUNTY OF BUTTE - DEPARTMENT OF DEVELIQPMENT SERVICES - BUILDING DIVISION
b 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATION AND PERMIT 991- 0 7 V,
ASSESSOR PARCEL NUMBER
ZONING _
BUILDING PERMIT -
OWNER
FRANK RODRIGUEZ
TELEPHONE
679_—W18
SQ. FT. OCC. BUILDING VALU`Xr0N
OWNER'S MAILING ADDRESS
80 LOS VER JETES PO BOX 177 BANGOR 914
CONTRACTOR'S NAME
TINKNOWN
ONE
TELEPA
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation is
Filing Fee
$ 20.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ 23.00
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS 80 LOSVE J LES
PERMIT FEE
$ 23.00
PLUMBING PERMIT
Filing Fee 20.00
BANGOR, CA RX911 95914
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
LOT N0.. j
SUBDIVISION'S Nj".c'�- f
PARCEL -MAP_ _
Each gas water heater or vent
15.00
USE'UF'STRUCTURE
SF ❑ Duplex Mobilehome ❑ Other SPECIFY
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Ty Mobile Home Pb i 1X(
@ 60.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilitie s� Installation O Other ❑
Describe Work: MW 2 BDRM
PERMIT FEE
$ 80.00
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service ( 101 OR LESS )
200A OR LESS
23.00
Main Service ( 200A TO 1000A )
46.00
NEW CONST. DWELLING OCCUP.
OR ADONS. ( 6 ACC. OLDS. )
SO.
3.5C FT.
CONTRACTORS LICENSE LAW(
I declare under penalty of perjury (check one)
am a licensed under provisions of Chapter 9, Division 3 of the Business and
P fessions Code and my license is in full force and effect.
ense No. Classification
as the owner, or my employees with wages as their sole compensation, will do
he work, and the structure is not intended or offered for sale. (Sec 7044)
as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
,❑ I am exempt under Sec. Business and Professions Code
forthis reason
NEW CONST. MULTI -OUTLET
-NON-RESID. ( BRANCH CIRCUITS )
@7.50
POWER APPARATUS )
& SINGLE OUTLET CIR.
Ex. OCCU OUTLET OR FIXTURES
P• ( )
20 @ 1.00
BAL. Bo
Ex. Occu FIXED (RESID OR
p (OUTLETS IRESID.) EA. )
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00 20.00
Misc. Wiring
23.00
WORKER'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ This permit is for $100.00 (valuation) or less.
❑ 1 have placed on file with the County of Butte Dept. of Development Services,
uilding Division a Certificate of Workmen's Compensation Insurance or a
\,/,Certificate of Consent to Self -insure.
shall not employ any person in any manner so as to become subject to the Worker's
ompensation laws of California.
Notice to Applicant: If after making this statement, should you become subject to the
Worker's Compensation provisions of the Labor Code, you must forthwith comply with
such provisions or this permit will be revoked.
PERMIT FEE
S 40.00
Contractor
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
►.
Hood
Ho
6.50 -
Ventilation
PERMIT FEE
$
Contractor
I certify that I have read this application and state that the above information is correct.
I agree to comply to all Butte County Ordinances and California State Laws relating to
building construction, and hereby authorize representatives of the County of Butte to
enter upon the above mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against all
liabilities, judgments, costs, and expenses which may in any way accrue against said
County in consequence the granting of this permit.
X Date L .
Signature of Applicant - ❑ 0 "er ontractor ❑ Agent
An OSHA permit is re . d for excavations over 5"0" deep and demolition or
construction of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
OCC
CONST. TYPE
TOTAL FEE $ 143.00
HA2
0. FEES
I IMP
I FEOOD
I CDF ARCEL I PO
I HO 1,4UE
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
DIRECTO
By
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
LCWORKS
Date
!L /y
7 ry
(Date)
No. 156667
E
D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
:'r'vkr'r�R9is�t;',7vly �w�1`yvrf�"•.��, t�'K�7�y7�7J,.r.'^yy �'!�.a Sli �s.m�r ..., h�i.:.:vi:ea...'t+�l; I'�+' .. - `ty�� li..,i-. ..,.vrrvit�,_... c,�f`.-••...- r ..l^•r`.-.•r.-..,-.
•-000NTYOFBUTTE - DEPARTMENTOF, ' L•OPMENTSERVICES - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE (916) 538-7541
OWNER It
Proposed Building Use
PERMITAPPLrICAT!O,N DATA SHEET
Building Inspector
A. P
Date
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED BY
1. All items have been submitted . .... ...............:....................
2. Plot plans, 3/4 sets, signed by preparer of plans. . ..........................
3. Complete plans, 3/4 sets, signed by preparer of plans . ......................
4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . .............
5. Hazardous Material Form . ............................................
6. Energy Design Compliance and supporting documentation . ..................
7. Statement of Intent for Non -Heated and A/C Buildings . ......................
8. Engineered truss details and layout in duplicate (required prior to plan check). ....
9. Mobilehome data and manufacturer's installation instructions, 2 sets. ...........
10. Fees of $ ..........................................
11, -Impact fees as shown on attached schedule. ..... .. ~
12. California Department of Forestry plan approva ee . � iW A//� .....�i��4
. Flood elevation letter (100 year flood) by California Engineer... ............ .
14. Sanitation and plot plan approval 0 Health Department . ............
15. City of Chico plumbing permit. ..........................................
16. Plot plan and business license approval from City of Biggs/Gridley. .............
17. Planning approval for (A) Use: (B) Parking: . .........
1& Contact Land Development.about (A) Improvements (B) Drainage. ...........
19. Driveway permit (construction approval required prior to occupancy). .. ........ I! Z2 1
uest
20. Pre -inspection for required. o Build g Inspenction ctor (Date)
21. Contractor's license information. No., Name Style, Classification) .
22. Certificate of Workmans Compensation Insurance . ......................... .
. Owner -Builder Verification (Given to owner ,Mail to owner . ...........�' .
24. Recorded copy of Agricultural Acknowledgement Statement . ..................
25. Letter of signature authorization . ........................................
26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... .
27. Letter of intent on building use . .........................................
28. Mobilehome utility clearance . ...........................................
29. Documentation of legal access . ..................... :..................
30. Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning area and frontage requirements . ............... h
31., Existing violations/expired permits . ......................................
32. Plan checklist ......................................................
33.
34.
W en u issue the permit, process as follows: Mail
Telephones �5 gc10 --7-) and hold for pickup at Qj
Other
Parcel Creation
Acreage Applicant
Copy of Haz-Mat form sent Health Dept. Fire Dept. _
Copy of plans sent Health Dept. Fire Dept. Other
Mail to contractor.
_ office- Deliver with inspector.
Air Pollution Date
Date
The following data must be submitted p ' o t iMa: (Circle new item not checked above).
1. Index permit for above items No.
2. Additional items required:
Date
M
Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date
Contractor, designe o er, was advised of above r quired data by _ phone _ mail C nter by _ Date
Plans checked by Date3 z £' Plans approved by Date
Sets of plans on hold in File cabinet 'AP folder
Copy - Department of Public Works '
!N
_ II +IM
I'Inl Him Aund ial
' flouf flan Alu1wd�
TO: Building Departmont
FROM: Environmental Health
SUBJECT: Sanitation Clearance
OG r P,, AA 1 Z d (is' IO zrt,, /-X�
Owner / Location
Plan Approved for: Sewaoc Disposal v Water Supply: Public
Clearance for �-- bcdr6om liiobile home. 011ier
Hold final for:
Final clearance O.K. for:
NOTE
Environmental Health Specialist
8/92
AP#
Private Well
Dat
TO: Building Department �^
FROM: Encroachment Permit Section
RE: Driveway Clearance
owner location'V
Driveway permit
Z-zt-�(q-oG�
At #
�1 4V d 7 2 _ L has been issued for the above property.
si ature
341-iy
date
ROTE:—All PAaterials & Workmanship Shall Be in
Accordance with Recognized Good Practices and
of a quality prescribed for the Specified use in the
' ?vim Uniform Building, Plumbing & Mechanical Codes and
/FS the National Electrical Code.
APPROVED
Butte County This set of pians and specifications MUST be
+' Environmental He Ith
kept on the job at all times and it is unlawful to
t f– 9 ake any changes or alterations on same without
--------- --- writ permission from the Department of Public
Date Works, unty f Butte,.
---------- -----------
Signature nd�
-------------
/ BUILDING D XRT NT
�APPR
p L
fired for the
q permit will 13e �qo
installation of the mo lehome.
f a REVIEWED
BUTTE CO. FIRE DEPT.
t CALIF. DEPT. RESTRY
approved as submitted
— -`1
app; oved v, ith conditions
'
per attacAed shee3
? The attached Fire Saf
requirements must b .completed -- oats
as specified and a foVed Signature
by C.D.F
-,�AIuK
p L a s Vt- R .i r_= R�
cb ,
M f• -i.1– –rrt
DING
DE .
OVERHANGS SMALL BLU GC,.fv2 4',ti/
STRUCTURES At D EQUIPMAN MENTS
ALL t_EAR OF QQ cv 14.C( C
E FROM TR/ r SIDE AND
A SET BACK OF 57)3 Lt
Fl .FROM THE REAR l�E4T ZRLiNE ISdALI. B®
f=T. F�tON1 THE ROAD C
CLEAR OF STRUCTURES A EdL)IpMENT EYCEPT a o _ �66 6 �6
FORA 2 FT. EAVE OVERHANG � 0
• « 1
1
Z�— 2(c�-(oo
AP #
CDF FIRE SAFE REQUIREMENTS
PERMIT # N E
Under authority of PRC 4290, the following
by the Butte County Fire Department and
permit. These requirements are minimums
Butte County local regulations which equal
Field inspections will be made by the Butte
for compliance.
checked items are required
are made a part of this
and will be superseded by
or exceed these standards.
County Building Department
KI 1272.00 Maintenance of Defensible Space. To ensure continued
''\\ maintenance of properties in conformance with these
standards and measures and to assure continued avail-
ability, access and utilization of the defensible space
provided for in these standards, annual maintenance must
be provided for by the land owner.
Driveway Standards
[/lIq
1273.02
Surface. All driveway surfaces and structures (bridges,
1273.07
culverts and other appurtenant 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 Rad'..us.. . .......
[�]
1. No roadway shall have a horizontal inside radius of
curvature of less than 50 feet and additional sur-
face width of 4 feet shall be added to curves of 50-
100 feet radius; 2 feet to those from 100-200 feet.
[�1
2. The length of vertical curves in roadways exclusive
of gutters, ditches and drainage structures designed
to hold or divert water shall be not less than 100
feet.
[�]
1273.05
Turnarounds. If required, will have a minimum turning
radius of 40 feet from center of the road.
-/_
1Y.1
1273.06
Turnouts. S ha.' 1 I a minimum of 10 feet wide and 30
/
feet long with a mir ;.:.u,n 25 foot taper on each end.
1270.10
Width. All driveways shall provide a minimum 10 foot
11
traffic lane and unobstructed vertical clearance of 15
feet along its entire length.
Page 1 of 3
c;Lk- 2—G -- LE) Iq V -0 7 (4 16 u_Lz F491l/k
AP # PERMIT # NAM
Ki 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
[Y.l 1. Gate entrances shall be at least two feet wider than
the roadway it .serves .
1 2. The gates must be located at least 30 feet from the
roadway and shall open to allow a vehicle to stop
without obstructing traffic on that roadway.
[ ] 3. Where a one-way road with a single traffic lane
provides entrance, a 50 foot turning radius shall be
used.
Fuel Modification
1276.01 Setback for Structure Defensible Space.
[ 1. All parcels 1 acre and larger shall provide a mini-
mum 30 foot setback for buildings and accessory
buildings from all 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.
rN1 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
old—z�o�4c�
AP #
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 1096 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
�f
Signature
Page 3 of 3
GOLDEN
Ne/SHowcR
OPTIONAL
BATHER /
OPTXKAI USTTR BATH TO STALL SHOW@
OR TDB/SHOWER
APPROVED
Butte County
Environmental He Ith
Dat
--------- -
------
Signature_
WEST HOMES v�.•
ORO r -,T. � ` :�03
VILL
G Omw � m. EN
s>'
OPT. SLOW MUSS DOOR
6' --
OPT. Woo"
2'-0"
fJ.V
LL_
nre . ID ;L L L Lo O.
w/x
LLLLL_ _
_�L
------ ILLLLLLLL—LLLLLLLLL
BEDROOM �2 w--"
;LLUTILITYLLLLLLLKITCHEN LLLL
MASTER• �LLLLLLLLI LLL-L_L-LL
BATH" L I I I I _CELL DINING
rr —
`� I� l07;D.. ' oO BAT PAHTRY -
I I I g . ri' I NB
REiLR
--�
wARDR =
a ---- -- _ Ll l ARtEN MOAT ShUVES
N
N '
R:
MASTER BEDROOM
e.A ,•.4'' WAllr-IR i STUDY,.
LIVING
o WARDROBE IiF*
, • .
.;Y•" ----- ..
6', x -,f 3'- 4
GV561S-1 • 1419 SQ. FT.
Return f \I to: AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT
Building Division FOR RESIDENTIAL DEVELOPMENT
Sectio 6 8.1 of the Butte County Code requires this
acknowledgement be recorded prior to issuance of a building MAR'3 l 1994
permit.
' Ndi' COMPARED WITH
The property described herein is adjacent to land or included ORIGINAL DOCUMENT
within an area zoned for agricultural purposes, and residents
of this property may be subject to inconveniences or _ -_ —
discomfort arising from the use of agricultural chemicals,
including, but not limited to herbicides, pesticides, and 1 94-014354
fertilizers; and from the pursuit of agricultural operations
including, but not limited to cultivation, plowing, spraying,
pruning, and harvesting which occasionally generate dust,
smoke, noise, and odor. Butte County has established agricultural zones which have as a priority use for productive agricultural
purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from
normal, necessary farm operations.
All that real property situate in the County of Butte, State of California, described as follows:
Date: 3-7-94
PROPERTY
State of California )
County of Butte )
On 3-7-94 before me, Michelle A. Miller
z,eAr-V- k0J 21q U f'z Z.
--1^ L, -z A 3 cZ-k y 6Q cA K 1 y u Z?--
State
Z
personally appeared Frank Rodriquez and Elizabeth Y. Rodriquez
personally known to me (or proved to me on the basis of satisfactory 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 pers _ • -'I
(MICHELLE A
NOTARY PLIC-'
djd�d�-
/���Prind !UB
ice in
Signature L -C. Seat: • M co mx . 0
---
A.P. N �� ,� 2 o - G6�
The land referred
to herein is described as follows;
All that certain real
California described S ropert
�� Y situate in the Count
PARCEL 1: s follows' Y of Butte,
State of
9 I - 1S2�94 -
Order No. 1_152765
SCHEDULE C
Lot 60
the
Official portion of Lots
Count 1 MaP thereof 56 and 57 of .
9 77of Butte State of filed in the Town of B
pa e , more Californiae °ffice of angor, according to .
ParticularlyMarch 21, the Recorder�.of.the
BEGINNING at the. described as follows;1901.. in Book -Of- h
', -.-. ...
along the Westerly °lineoutherly corner Ps, at
60; -thence in of said Lot °f said Lot 60;
i said
Lot a direct line,- 60, to the thence Northwesterly
Southwesterly
the Northeasterl NOrth�asterl most Westerl terly
SOU thea Y line of Y extensi �'' alon Y corner of said
sterl on thereof, g the Northwest_line,..o£._..__..
180.0 feet; Y along the theand
Sugar Loaf to
South thence lea Count a Point on the
Westerl wing the Northline of Lots 57y Road; thence
56, from Y in a strai easterlyand 56
distance which point ght line to line of said Lot a distance of
Of 60 feet the southerly a Point
56, a distance thence Y corner of°n the South line 56,.
tance of Westerly aloe said Lot °f said Lot
60 feet to 9 the Souther160 bears Westerly, a
PARCEL II; the point Y line
Of beginning, Of said Lot
A right of way for
the Southeaster) Pipeline or
Official -Ma Y one-half of ditch, over
Butte
P.thereof, said Lot 56 the. Northeasterl
,.State of filed in the office, Town of Y 2.0 feet of
California, March 21
of the Recorder• according to the
1901, in Book 7 of of the Count
' AP No• - Maps, at Page-77.
age .77of
RESIDENTIAL
028-260-060 94-0746P,E
RODRIGUEZ, FRANK
80 LOS VERJELES RD., BANGOR
MOBILEHOME UTILITIES
Address I
i
GASCP
Meter By Date
ELECTRIC
Meter By , Dat
408 .FINAk-f
;��Signaturo
J
R
V=OK
0 = Not OK
-=NotReadyApplicable MOBILE HOMES
=Not Ready
Date/Initials MOB /[VIE UTILITIES Plans OK except #'a
ning R uirements-Setbacks-Easements
2. S pecial MH Support Sketch
Sewer;,Location-Test-Fell-C/0 Concrete
4. a ocation-Teat-Easement Needed (Sketch)
lectr ; Location learences-Grnd-/ /Amp -Concrete '
/" . or G
7 eti ClearanceA Disconn j
)
Date/I itials M-Mtf HOME INSTALLATION Plana OK exce t`#'s '
1; Zoning Requirements -Setbacks Easements 1
Fo gs; Size -Spacing -Marriage Line
Gas• HTest-Demand-Valve—Connector
1. Ie tricity; MH Teat -Crossovers -Breakers -Clearances
p/S.'Drain; MH Test -Fall -Flex Connector i
er; MH Test -Regulator -Connector 1
C—Z-1Nfft#T —and, Sewer Connected -C/0 to Grade -HD Aooroval
and
art. of Occ pant
MISCELLANEOUS
Date/Initial DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'a
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posta-Beams-Rftm. Connectors
Shthg: Rfg: Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
& Carports; Windows -Doors
7. Electric
8. Frmg; Sils-Anchors-Studs-Rftm-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10.- Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
Date/Initials POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distances-GFI
5. Elec.; Pool Lighting; 15 volts-GFI
8. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Mein in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Lyb �:•��i
• f
MISCELLANEOUS
Date/Initial DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'a
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posta-Beams-Rftm. Connectors
Shthg: Rfg: Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
& Carports; Windows -Doors
7. Electric
8. Frmg; Sils-Anchors-Studs-Rftm-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10.- Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
Date/Initials POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distances-GFI
5. Elec.; Pool Lighting; 15 volts-GFI
8. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Mein in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Lyb �:•��i
V=OK
O = Not OK
- = Not Applicable
= Not Ready
RESIDENTIAL (Single & Duplex)
Date/Initials UNDERFLOOR (Plans) OK except #'s
1. Zoning -Setbacks -Easements -Flood -Slope
2. Fig., Main; Soils-Elec. Grnd. / P' Ftg. Depth
3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Fig. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth
5. Stemwalls, Main; Steel -Bloc kouts-Wra pped
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 -Anchor -Regulator -Service Test
12. Electric; Underground
13. Plenums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
15. Access & Ventilation
16. Insulation
Date/Initials PLUMBING (Permit) OK except #'s
16. Water Htr.; Vent -Access -Combustion Air -Baffle
17. Water Pipe; Test & Anchor -Nail Protection
18. D.W.V.; Test -Fittings & Anchor -Nail Protection
19. Shower Pan; Test, First Floor -Tub Access
20. Test Tub & Shower, Second Floor -Tub Access
21. Gas Pipe; Size & Anchors
Date/initials ELECTRICAL (Permit) OK except #'s
22. Fixture & Transformer Clearance -Ins. Protection
23. Elec. Receptacles Spacing -Lights & Switches at Doors
24. Size Boxes & No. of Conductors -Stapled
25. Romex Installed Close to Edge of Studs & C.J.
26. Equip. Ground made up w/Meth. Fastners-Bond Gas & Water
27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI
28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga.
Cu or Al
29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al.
Insulated Neutral ❑ Yes ❑ No
30. Service -Riser Conductors & Ground -Main Disconnect
31. Equip. Clearances Panels -Motors -Mach. Equip.
32. Clothes Closet Light -Shower Light -Spa Light
33. Smoke Detector
Date/Initials MECHANICAL (Permit) OK except #•s
34. A.C. Ducts Insulation & Support
35. Vent Fan; Exhaust above insulation
36. Condensate Drain & Overflow; Size & Grade
37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet
38. Attic Access & Platform if Furnance in Attic
Date/Initials FRAMING (Plans) OK except #'s
39. Sils, Proper Material & Anchors
40. Wells Studs -Nailing, Spacing & Bracing -Plates -Sound
41. Bearing Wells over Girders & Floor Nailing
42. Draft Stop in Wells (rat proof)
43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub
44. Headers & Beam -Size & Bearing
Date/Initials FRAMING (Continued)
45. Hangers -Post Ceps-Anchors=Connectors
46. Ong. Joist-Rftr. ties-Purlin=roof Brac-Truss-Shthng.-Rfng.
47. Fireplace Ties or Type A Flue -Fireplace Throat clearance
48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
50. Garage Fire Protection Framing
51. Property Line Firewall & Openings
52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits
53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers
55. Siding -Nailing Veneer
56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
57. Glazing Area -Glass Protectlon-Skylights-Plastic
58. Shear Walls; Nailing -Bolts
59. Insulation -Walls -Ceilings
60. Infiltration -Wells -Windows -
1
Date/Initials FINAL (Pians) OK except #'a
61. Ext. Steps -Door & Sidelight Protection -Landings
62. Smoke Detector I- _
63. Furnace; Vents-Clearance-Comb'Air-Connector-
In Garage; Above Floor -Ducts -Mach. Protection
64. Bedroom Exiting
65. G.F.I. & Bath Fixtures & Tub Access -Spa
66. Elec. Trim & Subpanel; Breaker Sizes & Labels
67. Stairs & Rails
68. Fireplace or Stove; Clearances -Hearth
69. Elec. Outlets at Wood Panel; Int. & Ext.
70. Kit.Fixt. & Appliance; Grnd: Air Gap -Cooking Clearance
71. Elec. Outlets & Receptacles at Kit. Counter
72. Garage Fire Door; Swing -Landing -Closer
73. A.C. Duct in Garage -Damper i•,
74. Mr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.
I - In Garage; Above Floor -Mach. Protection
75. Plb., Elec. & Mech. Equip. Listed for Location
76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection
77. Insulation -Foam -Looked in Attic ❑ Yes
78. Guard Rails & Deck Construction -Post Caps
79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth
Clearance Looked under Floor L� Yes
80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No;
Planters ❑ Yes ❑ No
81. Stucco; Brown -Finish
82. A.C. Unit; Disconnect, Electrical, Plumbing
83. Vents Above Roof; Plbg: Appliance-Fireplace:Clearance to
Openings
84. Water Well; Disconnect, Electrical, Plumbing
85. Exterior Elec. Trim; G.F.I. Receptacle -Underground
86. Ventilation Throughout House
87. Glass Protection
88. Corrections from Previous Inspections
89. Gas Test -Meters Tagged; Gas -Electric
90. Water & Sewer Connected -C/O to Grade -HD Approval
91. Energy Compliance Certificate -Other Certificates
Comnwnts at Final:
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER 028-260-060
U ZONING
BUILDING PERMIT
OWNER
FRANK RODRIGUEZ
TELEPHONE
679-0318
SQ. FT. OCC. BUILDING VA A IQ
OWNER'S MAILING ADDRESS
PO BOX 177 BANGOR CA 95914
CONTRACTOR'S NAME
MOBILE HOME CENTER
TELEPHONE
533-4403
CONTRACTOR'S MAILING ADDRESS
1740 FEATHER RIVER BLVD OROVILLE 95965
Fireplace
CONSTRUCTION LENDER UNKNOWN
Total Valuation is
Filing Fee $ 20.00
LENDER'S MAILING ADDRESS
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE No.
Plan Checking Fee $ 23.00
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
PERMIT FEE $ 43.00
FIANGOR.ICA 95914
PLUMBING PERMIT Filing Fee 20.00
Each Trap 7.00
Solar or heat pump water heater 23.00
Water piping 15,00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Each gas water heater or vent 15.00
USE OF STRUCTURE
SFO Duplex Mobilehome ❑ Other
SPECIFY
Gas piping system 1 - 5 outlets 15.00
Building sewer 15.00
Mobile Home S G W 20'00
TYPE OF WORK
New ❑ Addition ❑ Remodel ElUtilities ❑ Installation RX Other 1:1Contractor
DescribeWork:
PERMIT FEE g
ELECTRICAL PERMIT Filing Fee 20.00
Main Service ( BOOV OR LESS I 23.00
200A OR LESS
Main Service ( 200A TO 1000A ) 46.00
NEW CONST. DWELLING OCCUP. So.
OR ADDNS. ( 8 ACC. BLOS. ) 3.50 FT.
NEW CONST. MULTI.OUTLET
-NON-RESOD. ( BRANCH CIRCUITS ) @7.50
CONTRACTORS LICENSE LAW(
I de fare under penalty of perjury (check one)
3WJ am a licensed under provisions of Chapter 9, Division 3 of the Business and
Professions Code a d y license is in full forceed effect.
License No. Q Classification L(
rLe� _ _
❑ I, as the owner, or my employees with wages as their sole co pensation, will do
the work, and the structure is not intended or offered for sale. (Sec 7044)
❑ I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
❑ 1 am exempt under Sec. Business and Professions Code
forthis reason
POWER APPARATUS )
B SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES ) BAD @ 1.000
Ex. Occup. FIXED APPLNS. OR
p- (OUTLETS (RESID.) EA. ) 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
WORKER'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ Is permit is for $100.00 (valuation) or less.
have placed on file with the County of Butte Dept. of Development Services,
Balding Division a Certificate of Workmen's Compensation Insurance or a
Certificate of Consent to Self -insure.
❑ I shall not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California.
Notice to Applicant: If after making this statement, should you become subject to the
Worker's Compensation provisions of the Labor Code, you must forthwith comply with
such provisions or this permit will be revoked.
PERMIT FEE $
Contractor
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Contractor
I certify that I have read this application and state that the above information is correct.
I agree to comply to all Butte County Ordinances and California State Laws relating to
building construction, and hereby authorize representatives of the County of Butte to
enter upon the above mentioned property for inspection purposes.
1 also agree to save, indemnify and keep harmless the County of Butte against all
liabilities, judgments, costs, and expenses which may in any way accrue against said
Cou co sequence of the granting f this permit.
X - Date
Si nature of Applicant ❑ Owner ontractor ❑ Agent
An OSHA permit is required for excavations over 5"0" deep and demolition or
construction of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 143.00
HA2.
�"
I D. FE
IMP
F1o0C]
V/
COF
""
PARCEL PD
O
HO
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
By A9 Date
PERMIT EXPIRES ON
15
5
(Dere
Receipt No. 156067
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
IN
COUNTY OR BUTTE
BUILDINGrDIVISION
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
W on
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.
Date - �-Insp
REV 10/92
III''.�p.V Yr{.l..w .... ,.-�Vs.h...h+' � ,. .•.-..i%^..+�'Sn-�'�. �•-Y..4.i:.f'ir..�`•.:.� n.... ..y+^-4,'irr��i�.ikYlir. �...,y�'.w..�7..-ry.r w+w.pir�'�'>.•y'1 /r.""`rbJ�•-rr'�`-., V..'*t'._r � ... s �-t ..r
CO,UNTYOF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION
- VYtCOUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE (916) 538-7541
t
PERMIT APPLICATION DATA SHEET
OWNER ,.•' o 0 A. P. No.
Proposed Building Use Building Inspector Date
At time of permit application, I was advised, the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED BY
1. All items have been submitted . ............... ..........................
2. Plot plans, 3/4 sets, signed by preparer of plans . ......................... .
3. Complete plans, 3/4 sets, signed by preparer of plans . ......................
4. Engineered plans and calcs, 344 sets, with wet signature on plans . .............
5. Hazardous Material Form. ...:........................................
6. Energy Design Compliance and supporting documentation . ..................
7. Statement of Intent for Non -Heated and A/C Buildings . ....................: .
8. Engineered truss details and layout in duplicate (required prior to plan check). ... .
9. Mobilehome data and manufacturer's installation instructions, 2 sets. ...........
Ja-'Fees of $ . ..........:................... ......... .
11. Impact fees as shown on attached scheduld:s�_00001_ 17..SftC_;W.........
�
12. California Department of Forestry plan approval/fees. ....................... .
13. Flood elevation letter (100 year flood) by California Engineer . ................. .
14. Sanitation and plot plan approval Health Department . ............
15. City of Chico plumbing permit . .........................................
16. Plot plan and business license approval from City of Biggs/Gridley. .............
17. Planning approval for (A) Use: (B) Parking:
18. Contact Land Development about (A) Improvements (B) Drainage. .......... .
19. Driveway permit (construction approval required prior to occupancy). .. .. .. .
eF-
20. Pre -inspection for required. Ire -Inspection ile� (Date)
contractor's license information. (No., Name Style, Classification) . ..............
Certificate of Workmans Compensation Insurance . ..........................
23. Owner -Builder Verification (Given to owner , Mail to owner )............
24. Recorded copy of Agricultural Acknowledgement Statement`. ......:........... .
25. Letter of signature authorization ................................. ........
26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... .
. Letter of intent on building use . .........................................
28. Mobilehome utility clearance . .................. .?.................... .
29. Documentation of legal access . ..................... :..................
30. Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning area and frontage requirements . ...............
31. Existing violations/expired permits . .......................................
32. Plan check list . ........................... ,l .......................
33. -�
34.
When you sue the pMr
it, r cess as follows: Mail to o er. Mail to contractor.
elephone and hold for pickup at ✓'(�- office. Deliver with inspector.
Other 1
Parcel Creation 10, 3,2,(
Acreage Applicant Date
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 _ mail Counter by Date
Contractor, designer, owner, was advised of above required data by_phone _mail ounter b Date
Plans checked by Date Plans approved by Date
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Works
OWNER
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DMSION
7 COUNTY CENTER DRIVE, OROVILLE CA 95965 - TELEPHONE (916) 538-7541
00/t l
PROPOSED BUILDING USE ¢}
/1. CHOOL DISTRICT FEES
(paid at District Office
.. ... ..... ......
SHERIFF FEES
(paid at Building Department)
Residential...... x =$
Unit amt.
Commercial (sgft) x 1 =$-
'samt.
3. URBAN AREA FEES
(paid at Building Department)
Residential (per unit) x =$
# units amt.
Commercial (per sq.ft) x =$
sq.ft. amt.
.4. RECREATION DISTRICT FEES
(paid at District Office) .........................
5. DRAINAGE DISTRICT FEES
(Contact Land Development Division) ..............
J� 6. SRA FIRE INSPECTION AND PLAN CHECK = $89.00......
(paid at Building Department)
7. OTHER
8. OTTER
A. P. #,,,2
DATE ---3 1,2 Aq/
REC. # DATE REC
�("z go C/ , /�'v
At time of permit application, I was advised the above fees are required to be.paid
prior to issuance of the permit.
APPLICANT DATE
1 U'. e
.,F• BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One Form Per Building)
School District 0 Ae 0 61/y H S Building Department No.
A.P. Number o2 �—;�o —0 fo 0 Jurisdiction City 0 County
Property Owner�/�/i/
Property Location/Address(/ C--(-
`L
Subdivison Lot No.
Residential Development 0 E
No. of Living MHI Addition
j
Units
Sq. Footage 14117
(Group R)
Commercial/Industrial Sq. Footage
New Addition
`(Including�Exterior;,
/ Roofed Areas) •y
Building Department R resentativ�— Date
(Floor Plans reviewed by School District Personnel)
•'`District Identification No. 940124
jos,. •. _ ' � ..
School District certifies that
(Applicant
&yve A 14-1
e
(Street Address)
(Phone Number)
(City,) ,° � (State) (Zip Code)
has complied'with the requirements of Resolution No. ID5- 40 "by payment of $ y� -
representing ���. square feet.
CA ov e ,
School'Disfkt,Rep
Paid by Check Number
Bank Number
Paid by Cash
Date
Remarks: C'%
1114
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
- J J _ a ! - _ - � _ _ l - _ � l _ _ _ a _ L _ � � _ _ _ _ _ a _ _ _ a _ _ a _ _ - _ - _ _ a _ _ a � _ _ _ _ L _ _ • _ • _ a _ _ _ _ a � _ _ _ L _ _ i _
White (applicant), Yellow (building department), Pink (school district) ? feeformmkl (4/92)
AP 4k d'ao `-6 Q
OWNER`Pvl����'��-
PERMIT ' #
M UTIL.CLEARANCE DATE �G
INS
�4
ELECTRIC
GAS
Support
Struc.
Compactio
Test -Req.
Service
Size
Other
Load
Type
Pipe
Size
Length
YES NO
YES NO
A
4t'k
VZ//
.�z
c"
A
4t'k
VP
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS
7 County Center Drive, Oroville, CA
PHONE: 538-7541
MOBILEHOME INSTALLATION SHEET
1. Owner's,Name: -2-4
2. Installer's Na.me: '-S i
3. is the site currently under permit? Yes No
(If yes, furnish permit humbor 23 Yc) a C OR
Is the site an existing site? Yes--'.. E— J-- • No F71
(if yes, furnish two 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? ----------------- ej-0 Amps
6. What is the mobilehome site service rating? ------------- – Amps
7. What is the mobilehome site circuit breaker rating? ----- 1 d Amps
8. Is there any other electric load to be served by the
mobilehome site service? ----------------------- Yes No
jz
(If yes, identify the load and size: AJ (Load) jftlc0_(Amps-)
9. What is the mobilehome site gas pipe size? -------------- -- (in.),
10. What is the type of gas service? -------------------- Natural LPG
11. What is the gas pipe length from meter or tank to the
mobilehome? --------------------------------------------- - 6.3 (ft.
12. What is the mobilehome gas demand? ---------------------- (BTU)
*(This information not required if pipe length less than 6 ft. on
natural gas or less than 50 ft. on LPG.)
9
BUTTE COUNTY
BUILDING DEPARTMENT
XP P Ft
I';:;!iIL1HOHE: SU1`11OKT DATA
j .-� If other than single"wide,
Mobilehome Mfr. 6;A,� �V s( furnish Setup Model wNo,._(�, /®i 6/ 3j'� Y'ear �'0f
Width,2 g (ft.) Box Length �(' (ft.) Tagalong or Expandod Size-'- �• ft: x. ft.
V,
On all mobilehomes manufactured after October 7, 1973, furnish manufacture'r's -installation
manual and structural setup sheets (if not on file with the County of Butte).
FOOTINGS (check one)1. Wood -pressure treated or foundation grade.2. Other (specify)
SUPPORTS (check one)rK 1. Concrete block.2. Other (specify)`
Pier Footing Sizes and Locations
SINGLE -WIDE MULTI -WIDE
.Line I
2` — —
Main beema — ___ •
_"•`-ice � � fnc
_ in —Be—am
— — — — — MaamsLine I
— — — — •
� ins 2
9-0
J ----------- ..._ ns
Tag or Triple
r Line i
W ne I Piers'
Size -Min ..-.------- ,k -----..
Spacing -Max. -----'-'- ,
From Ends -Max. -------
Line 2 Piers:
Size -Min .............
.. Spaeing-Mar.. ..•- � ,- •�,
From Ends -Max .------.
Size -Min .-_--__-----_
Location (From Front)
Line 4 Pier -g:
Size-Min-------------
Spacing-Max -----------
From
------------
Spacing-Max.--------
From Enda-Max........
Line 1 Own into :
Size -Min. ...... •...........
�
Each Side of Openings
With Width Over .....
Line J Piers:(Under Bearing Wall Only)
Size -Min. ................
"x
Spacing -Max. ............... ,
?Too EodsrMax..............
Piers : (Under Bearing Mails On
Size -Min...................
Spacing -Max................
From Ends -Max.--------.....
Line 5 Foo[ Loads:
- - --
Size -Min ............. J
Location (From Front)
elf
57 YA.
—VN v \J� lel
ICI Jbv--'�J-�asz
esz
co
oomz
170
------
11
C>
p
LJ
rL)
CARPET'
.!OTAL-
>
OD
nD
Sil?PIORr VIM.
m
Klorm SUE
CAPZTT FOR HU UPPOIF DUAU,'
•
2000 19 12* x 24'
4000 24' x 247 6000
367 x 2e 4Er. x
8wo 24*
OOVS $4 a S-3 CF fWA;
10.000 1 SCr 2C
GOLDEN WEK HOMES
--
91 N•Uau
998 OLD P' WILLE PD.
a -P 0. SLIPD '7 LOCATI&G.
r
m-51' 1
s I -j/ 1 Q/T
56151 -co OF I
17
SACRAMENTO. CA 95877
MODEL: NUMBER DATE
REVISED PAGE S1 -IEE:
.�''...c•*�.'."�.x.'.'j:d�;,da'�.,��rs,�`�,'�'''3?�i�Sw.�'.'s`Sti"�,j�E'.G•`: ».q,�.''r...:r,��.u.,,
2 I.q ,3 `�"i�=-. �'';i'r�iSRy,,,:r�:{`°d'yr„�t it°�w'?,".`. �'i��.?.'�""�:�fa'�r#•i�;:i:,r--,r°�'T` u�:,rvr'^^.: 4,�
028=260-060 93-4029
t + t RODRIGUEZ, FRANK'
80 LOS VERJELES RD., BANGOR
ELE SER FOR EXIST SHOP
r,
OFFICE COPY
Address
GAS
Meter 13 �--=
' ELECTRI ate
Meter By
Dat tt`
fi
OFFICE COPY
Address
GAS
Meter 13 �--=
' ELECTRI ate
Meter By
Dat tt`
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive- Oroville, Califorrla 95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATION AND PERMIT ' F
ASSESSOR PARCEL NUMBER
028-260-060
ZONING
If
BUILDING PERMIT
OWNER
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
PO BOX 177 BANGOR t
CONTRACTOR'S NAME r
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee $
20.00
LENDER'S MAILING ADDRESS
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS 80 LOS VERLMES RD
PERMIT FEE $
BANGOR 95914
PLUMBING PERMIT Filing Fee 20.00
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15,00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Each gas water heater or vent
15.00
USE OF STRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other SHOP
SPECIFY
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G I W
20.00
TYPE OF WORK
New ❑ Addition ❑ Remodel CIUtilities,@ Installation ❑ Other ❑
Describework: ELECTRIC SERVICE FOR SHOP IS EXISTING
PERMIT FEE $
Contractor
ELECTRICAL PERMIT Filing Fee 20.00
PRE—INSP. FOR AUTHORIZATION OF
Main Service ( 2GOA OR LESS 1
23.00 23. ff
Main Service ( 200A TO 1000A )
46.00
R�LM{♦yriry��j, �tT�
"-'�"""-"'�'�ON.
OR ADONSNEW ? ( DWELLING &ACCBLS. I
o.
3.50 FT.
CONTRACTORS LICENSE LAW(
I declare under penalty of perjury (check one)
❑ I am a licensed under provisions of Chapter 9, Division 3 of the Business and
Professions Code and my license is in full force and effect.
License No. Classification
rft% as the owner, or my employees with wages as their sole compensation, will do
the work, and the structure is not intended or offered for sale. (Sec 7044)
❑ 1, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
❑ I am exempt under Sec. Business and Professions Code
forthis reason
NEW CONST. MULTI -OUTLET
-NON-RESID. ( BRANCH CIRCUITS I
@7.50
POWER APPARATUS )
& SINGLE OUTLET CIO.
EX. OCCU OUTLET OR FIXTURES
P• ( I
20 @ 1.00
BAL. @ .50
Ex. Occup.ED OR
(OUUTT LETS (RESIDRESID.1 EA. I
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PREINSP.
23.00
WORKER'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ This permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Dept. of Development Services,
Building Division a Certificate of Workmen's Compensation Insurance or a
certificate of Consent to Self -insure.
lki I shall not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California.
Notice to Applicant: If after making this statement, should you become subject to the
Worker's Compensation provisions of the Labor Code, you must forthwith comply with
such provisions or this permit will be revoked.
PERMIT FEE $
Contractor
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEE $
Contractor
I certify that I have read this application and state that the above information is correct.
I agree to comply to all Butte County Ordinances and California State Laws relating to
building construction, and hereby authorize representatives of the County of Butte to
enter upon the above mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against all
liabilities, judgments, costs, and expenses which may in any way accrue against said
County in consequence of the gra g off this permitt..,
X'. "�fYl dI�C`f`/ / !, l 17 L1 "1 Date �(rA
-Sig"nature-of Applicant wrier CIContractor gent
, • .11indicated
An OSHA permit is regdired for excavations pye 5"0" deep and demolition or
construction of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 66.00
HAZ.
D. FEES
IMP
FLOOD
COF
PARCEL PD
HO
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS r
By 4,4Af Date
J �/ q�✓
PERMIT EXPIRES ON x
I (Date)
Receipt No. 154056
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
✓ COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, CalVornia 95965 - Telephone (916) 538-754 PERMIT NO.
APPLICATION AND -PERMIT �3 _� a 9
ASSESSOR PARCEL NUMBER
028-260-060
ZONING
BUILDING PERMIT
OWNER
FRANK RODRIGUEZ
TELEPHONE
679-0318
SQ. FT. OCC. BUILDING VALUATI N
-
OWNERS MAILING ADDRESS
PO 'BOX 177 BANC-OR 95914
CONTRACTOR'S NAME
OWNER
TELEPHONE
CONTRACTOfl S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation is
Filing Fee $
20.00
LENDEMS 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 80 LOS VFRJELES RD
PERMIT FEE $
PLUMBING PERMIT
Filing Fee 20.00
BANGOR 95914
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Each gas water heater or vent
15.00
USE OF STRUCTURE
SFO Duplex O Mobilehome O Other SHOP
SPECIFY
Gas piping system 1 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
/�
` 20'CC
TYPE OF WORK
New O Addition ❑ Remodel 1:1Utilities 11 Installation O Other O
Describework: ELECTRIC SERVICE FOR SHOP IS EXISTING
PERMIT FEE g
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
PRE—INSP. FOR AUTHORIZATION OF
Main Service ( e,,v OR LESS
200AORLESS )
23.00 23.00
Main Service ( 200A TO t000A )
46.00
RECONNECTION.
OR ADONS.T ( D & ACCGBLDS. )
3.50 FT.
CONTRACTORS LICENSE LAW(
► declare under penalty of perjury (check one)
O I am a licensed under provisions of Chapter 9, Division 3 of the Business and
Professions Code and my license is in full force and effect.
License No. Classification
OKI, as the owner, or my employees with wages as their sole compensation, will do
the work, and the structure is not intended or offered for sale. (Sec 7044)
O I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
O 1 am exempt under Sec. Business and Professions Code
forthis reason
NEW CONST. MULTI -OUTLET
NON-RESID. ( BRANCH CIRCUITS )
@7.50
POWERAPPARATUS )
& SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES )
BAL. @ x.0600
Ex. Occup' (OFIXED APPLNS. OR
UTLETS IRESID.1 EA. I
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PREINSP.
23.00
WORKER'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
O This permit is for $100.00 (valuation) or less.
O I have placed on file with the County of Butte Dept. of Development Services,
Building Division a Certificate of Workmen's Compensation Insurance or a
al'sertificate of Consent to Self -insure.
hall not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California.
Notice to Applicant: If after making this statement, should you become subject to the
Worker's Compensation provisions of the Labor Code, you must forthwith comply with
such provisions or this permit will be revoked.
PERMIT FEE $
Contractor
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEE $
Contractor
I certify that I have read this application and state that the above information is correct.
I agree to comply to all Butte County Ordinances and California State Laws relating to
building construction, and hereby authorize representatives of the County of Butte to
enter upon the above mentioned property for inspection purposes.
1 also agree to save, indemnify and keep harmless the County of Butte against all
liabilities, judgments, costs, and expenses which may in any way accrue against said
the gra g of this permit.
' ` Date �- �(�
—Signature er El ctor gent
"permitIred for excav ions 5"0" deep and demolition or
construction of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
DCC
CONST. TYPE
I
TOTAL FEE $
66.00
HAZ.
1 D. FEES
I IMP
I FLOOD
CDF
PARCEL I PD
I HD
ISSUE
This permit is hereby issued under the applicable
of the Butte County Code and/or Resolutions
indicated above for which fees have been
OR OF PUBLIC WORKS
DIRECAX!T
By
?
PERMIT EXPIRES ON J
ID.W
provisions
to do work
paid.
Date ®�
�✓
9J
Receipt No. 154056
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
M \
COUNTYOF BUTTE - DEPARTMENTOEDFE'LOPMENTSERVICES =BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFPRNIA95965 - TELEPHONE (916) 538-7541
PERMIT APPLICATION DATA SHEET �`
OWNER �/T/I/� A. P. No. d Zg Z 60- v0
Proposed Building Use -Building Inspector Date Z/ 8
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED BY
1.
2.
3.
.4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
-34.
All items have been submitted.
Plot plans, 3/4 sets, signed by preparer of plans . ..........................
Complete plans, 3/4 sets, signed by preparer of plans . ......................
Engineered plans and calcs, 3/4 sets, with wet signature on plans . .............
Hazardous Material Form . .......................................... .
Energy Design Compliance and supporting documentation . ..................
Statement of Intent for Non -Heated and A/C Buildings . ......................
Engineered truss details and layout in duplicate (required prior to plan check). ....
Mobilehome data and manufacturer's installation instructions, 2 sets. ...........
Feesof $.........................................
Impact fees as shown on attached schedule. ..........
California Department of Forestry plan approval/fees.........................
Flood elevation letter (100 year flood) by California Engineer ...................
Sanitation and plot plan approval Health Department . ............
City of Chico plumbing permit . .........................................
Plot plan and business license approval from City of Biggs/Gridley. .............
Planning approval for (A) Use: (B) Parking: . .........
Contact Land Development about (A) Improvements (B) Drainage. ...........
Driveway permit (construction approval required prior to occupancy)
4
P�4°ppex'°" rtoBuilPre-inspection for /�t required. . . ngInapedo
(Date)
Contractor's license information. (No., Name Style, Classification) . ..............
Certificate of Workmans Compensation Insurance . ..........................
Owner -Builder Verification (Given to owner , Mail to owner )............
Recorded copy of Agricultural Acknowledgement Statement . ..................
Letter of signature authorization . ........................................
Copy of recorded deed of parcel creation and 60 right of way to a public road. .... .
Letter of intent on building use . ..........................................
Mobilehome utility clearance. ......................................... .
Documentation of legal access. ..................
Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning area and frontage requirements . ...............
Existing violations/expired permits . ......................................
Plan check list . .....................................................
When u issue the permit, process as follows: Mail to owner. Mail to contractor.
Telephone /19•n318 and hold for pickup at ZDJ�/, office. Deliver with inspector.
Other
Parcel Creation �i� ��� �7
Acreage Applicant � jL �'/1 AjW;;9te
Copy of Haz-Mat form sent Health Dept. Fire Dept. 6 Air Pollution Date `1
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 _ mail Counter by _ Date
Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date
Plans checked°by - Date Plans approved by Date
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Works
/ F
COUNTY OF BUTTE - Deoar.tmedt of Public Works
7 County Center Drive; Orovilie, CA 95965 Phone: 916-5J8_i54I
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing
your signature.
Please complete and return this information at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit
will be issued until this verification is received.
1. I personally plan to provide the major labor and materials for construction of
the proposed property improvement (yes or no) 4jes
2. I.(have/have not) signed an application for a building permit
for the proposed wo k.
3. I have contracted with the following person (firm) to provide the proposed
construction:
Name'
Address City
Phone Contractors License No.
4. I plan to provide portions of this work, but I have hired the following person
to coordinate, supervise, and provide the major work:
Name
Address City
Phone Contractors License No.
5. I will provide some of the work but I have contracted (hired) the following
persons to provide the work indicated:
Name Address Phone Type of Work
Signed:
Property Owner,
Social Security
Date /d
r
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and
19832 of the California Health and Safety Code.
This verification must be completed and returned toour office before we are per-
mitted to issue the permit.
OWNER:
LOCATI
PRF -INSPECTION
CONTRACTOR:
DATE
A.P.
ZONING j
PRE -INSPECTION FOR: �` � TU/L �Sl/l0 ��2/V . �O/- %S 4A-)
le Gl i/cam
DATE TO INSPECTOR
-------------------.---- ---------------------------------------------------------
PERMIT HISTORY: NONE AS FOLLOWS:
TYPE OF OCCUPANCY
FIELD - INFORMATION
BUILDING USAGE:
TENNANT : 'f
D /Wl-
OCCUPIED 0 HAS ELECTRIC FD HAS GAS HAS SANITATION FACILITIES
0 HEATED -COOLED PERSON CONTACTED
OTHER COMMENTS: /��S' � ( v _L2C, LS OA 44�
ACTION RECOMMENDED:
ISSUE Q HOLD FOR
OTHER:
i