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TEST REQ COMPACTION'TEST REQ
SUPPORT STRUCT REQ
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CULET,
LET, Ben
30 m tr. 1
0 Demetri 1, Bangor
MHI
028-330-036 05-0839
MCMILLAN, WILLIAM
30 DEMETRI PL, BANGOR
CONT: OWNER
U"PGRD TO 200 AMP
tc --'s —05
B07-2177 028-330-036
MISCELLANEOUS - Electrical
TRENCH FOR ELEC AND WATER FO]
30DEMETRJPP',-',-,'--.,,.
4A L'y40ANNAA FAMILY ' TRU§
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X36
BUILDING PERMIT NUMBER: B09-0736
Address or location of unit: 30 DEMETRI PL, BANGOR, CA 95914
Legal Description of Real Property: 028-330-036
SEE ATTACHED
(x) Mobilehome/Manufactured Home
() Commercial Coach
Has been affixed to the real property above by installation on a. foundation system
pursuant to Health and Safety Code Section 18551.
Owner's name: MCMILLIAN, WILLIAM
Owner's address: 3050 SAN LORENZO WY, CARMICHAEL CA 95608
INSIGNIA OR HUD NUMBER: RAD 1477822/23
SERIAL NUMBER OR V.I.N.: SAC033655CA A/B
MANUFACTURER'S NAME: CMH Manufacturing West, Inc.
YEAR: 2009
r-.
OFFICIAL APPROVING INSTALLATION:
DATE: 10/23/2009
PHONE: (530) 538-7541
H.C.D. 513
y
OWYA-Ni(4ev
S
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
OFFICE #: (530) 538-7541 FAX #: (530) 518-2140
A FEE WILL BE REQUIRED AT TIME OFAPPLICATION
Website: www.buttecounty.nd/dIds
"PLEASE PRINT CLEARLY"
---_6WNER INFORMATION
WOMB■
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E-mail
or.
Class
Fax
U
CONTRACTOR
Name
Address
City
State
Zip
Phone
Fax
E-mail
Lic. #
Class
APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
Address D
Address
State rA
City
Type Const.
State
Zip
Phone
Fax
E-mail
State License Number
APPLICANT INFORMATION
Name
t AQL4_—JjL
Address D
City iV
State rA
I Zip 901
Type Const.
07(b
E-mail
1 1 t Z OL�qv, C6 -
APPLICANT SIGNATURE
LI� c-�.
X
PERMIT
NO.
1 of11,1�
BIN #
PROJECT LOCATION
AP# 623' 330 -63L-000
Property Address —2
_,JIJ
1.
City r
J
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
DESCRIPTION OR SCOPE OF WORK:
r rem mofev
ow n k I I to W I ,
Sq FT- Living Garage Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
For office use only:
Zoning
Flood Zone
SRA I Yes I No
Occ.
Type Const.
i
NOTES
RESIDENTIAL
PERMIT NO. _ 028-330-036 05-0839.. .
MCMILLAN, WILLIAM
30 DEMETRI PL,•BANGOR I
CONT: OWNER I
UPGRD TO 200 AMP I
SPECIAL CONDITIONS
CHECKED
BY
SRA \
FLOOD CERTIFICATE REQ��
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
OFFICE COPY
Address �D �G ,wiz/ AG f
GAS Zj
Mete •By ate
ELECTRIC
Meter By Date
JOB FINALI
1 Signatu
i
J=OK
0 = Not OK
. = NotReadyable MOBILE HOMES
Date MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support Sketch
'3. Sewer; Location -Test -Fall -C/0 -Concrete
4. Water; Location -Test -Easement Needed (Sketch)
5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete
6. Gas; Location -Test-Wrap;-/ /" L'ft.
/ P Nat. or/ /" L "ft./ P LPG
7. Well Clearance & Disconnect '
8. Utility Clearance
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date MOBILE HOME INSTALLATION (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Size -Spacing -Marriage Line
3.
Gas; MH Test -Demand -Valve -Connector
4.
Electricity; MH Test -Crossovers -Breakers -Clearances
5.
Drain; MH Test -Fall -Flex Connector
6.
Water; MH Test -Regulator -Connector
7.
Water and Sewer Connected -C/0 to Grade -HD Approval
8.
Gas and Electricity Tagged
9.
Tie Downs -Type -Installation Cert.
10.
Exits; Insp.-Sketch
11.
Cert. of Occupancy
Date
Card B-1 Date
Card B-1
Date
Card B-1 Date
Card B-1
Date
PERMANENT END SYSTEM (ONLY)
Wood Awn.; Posts- Beams- Rftrs-Connectors
Shthg-Frg-Bracing
5.
1. Zoning Requirements -Setbacks -Easements
6.
Carports; Windows -Doors
2. Footings; Size -Spacing -Marriage Line
Electric
8.
3. Blocking
9.
Siding; Nailing -Veneer -Stucco -Mesh
4. Gas; MH Test -Demand -Valve
Roof; Shthg-Roofing
11.
5. Electricity; MH Test
12.
Braced Wall Panels
6. Water; MH Test
Date
7. Water and Sewer Connected
Date
Card B-1 Date Card B-1
8. Gas and Electricity Tagged
1.
Setbacks -Easements
9. Exits
Soils; Compaction -Structure Stability
3.
10. License Decals
4.
Elec.; Receptacles and Lighting, Distance-GFI
11. Verify #'s with Office
Elec.; Pool Lighting; 15 Volts-GFI
6.
Elec.; Enclosures; Conduit Entries -Terminals -Listed
7.
Date
Card B-1 Date
Card B-1
Date
Card B-1 Date
Card B-1
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1.
Zoning Requirements -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-Frg-Bracing
5.
Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6.
Carports; Windows -Doors
7.
Electric
8.
Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9.
Siding; Nailing -Veneer -Stucco -Mesh
10.
Roof; Shthg-Roofing
11.
Ext.; Steps -Doors -Landings
12.
Braced Wall Panels
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date 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, 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/5' Circulating Equip. -Pool Lghtg.
Boxes- Enclosures- Panelboards-Ins. to Main Conduit
9.
Health Department Approval
10.
Plumb.; Cir. Test -Water Supply Test
11.
Light Niche
12.
Enclosure; Fencing -Alarms
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
J=OK
0 = Not OK
- = Not Applicable
. = Not Ready
RESIDENTIAL (Single & Duplex)
Date UNDERFLOOR (Plans) OK except #'s
1.
Zoning -Setbacks -Easements -Flood -Slope
2.
Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
3.
Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
4.
Ftg., Porches & Decks; Soils -Steel-/ /" 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.
Plenums & Ducts; Clearance -Material -Support -Ins.
14.
Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
15.
Access & Ventilation
16.
Insulation
Date
FRAMING (Continued)
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PLUMBING (Permit) OK except #'s
49.
17.
Water Htr.; Vent -Access -Combustion Air Baffle
50.
18.
Water Pipe; Test & Anchor -Nail Protection
51.
19.
D.W.V.; Test Fittings & Anchor -Nail Protection
52.
20.
Shower Pan; Test, First Floor -Tub Access
53.
21.
Test Tub & Shower, Second Floor -Tub Access
54.
22.
Gas Pipe; Sixe & Anchors
55.
23.
Fire Sprinkler; Test
56.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
Date
Siding -Nailing Veneer
Card B-1 Date Card B-1
Date
Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) OK except #'s
60.
24.
Fixture & Transformer Clearance -Ins. Protection
61.
25.
Elec. Receptacles Spacing -Lights & Switches at Doors
62.
26.
Size Boxes & No. of Conductors Stapled
63.
27.
Romex Installed Close to Edge of Studs & C.J.
28.
Equip. Ground made up w/Mech Fasteners -Bond Gas & Water
29.
2 Appliance Circuits in Kitchen & Conductor Size GFI
FINAL (Plans) OK except #'s
30.
Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al
Ext. Steps -Door & Sidelight Protection -Landings
31.
Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or All
Insulated Neutral 0 Yes 0 No
Smoke Detector
32.
Service -Riser Conductors & Ground Main Disconnect
Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
33.
Equip. Clearances Panels-Motors-Mech. Equip.
Bedroom Exiting
34.
Clothes Closet Light -Shower Light -Spa Light
G.F.I. & Bath Fixtures & Tub Access -Spa
35.
Smoke Detector
Elec. Trim & Subpanel, Breaker Sizes & Labels
70.
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MECHANICAL (Permit) OK except #'s
73.
36.
A.C. Ducts Insulation & Support
74.
37.
Vent Fan, Exiaust above insulation
75.
38.
Condensate Drain & Overflow, Size & Grade
76.
39.
Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet
77.
40.
Attic Access & Platform if Furnace in Attic
Date
Plb.; Elec. & Mech. Equip. Listed for Location
Card B-1 Date Card B-1
Date
Elec. Receptacles in Garage (F.F.I.)-Romex Protection
Card B-1 Date Card B-1
Date
FRAMING (Permit) OK except #'s
41.
Sills Proper Materials & Anchors
42.
Walls Studs -Nailing Spacing & Braces -Plates -Sound
43.
Bearing Walls over Girders & Floor Nailing
_
44.
Draft Stop in Walls (rat proof)
45.
Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
46.
Headers & Beams -Size & Bearing
Date
FRAMING (Continued)
47. Hangers -Post Caps -Anchors -Connectors
48.
Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting.-Rtng.
49.
Fireplace Ties or Type A Flue -Fireplace Throat Clearance
50.
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
51.
Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
52.
Garage Fire Protection Framing -RC Channel
53.
Property Line Firewall & Openings
54.
Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
55.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
56.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
57.
Siding -Nailing Veneer
58.
Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
59. Glazing Area -Glass Protection -Skylights -Plastic
60.
Shear Walls; Nailing -Bolts
61.
Brace Interior/Exterior Wall Panels
62.
Insulation -Walls -Ceilings
63.
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
64.
Ext. Steps -Door & Sidelight Protection -Landings
65.
Smoke Detector
66.
Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
67.
Bedroom Exiting
68.
G.F.I. & Bath Fixtures & Tub Access -Spa
69.
Elec. Trim & Subpanel, Breaker Sizes & Labels
70.
Stairs & Rails
71.
Fireplace or Stove, Clearance -Hearth
72.
Elec. Outlets at Wood Panel, Int. & Ext.
73.
Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance
74.
Elec. Outlets & Receptacles at Kit. Counter
75.
Garage Fire Door; Swing -Landing -Closure
76.
A.C. Duct in Garage -Damper
77.
Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
78.
Plb.; Elec. & Mech. Equip. Listed for Location
79.
Elec. Receptacles in Garage (F.F.I.)-Romex Protection
80.
Insulation -Foam -Looked in Attic
81.
Guard Rails & Deck Construction -Post Caps
82.
Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor 0 Yes
_
83.
Following Instld./Drive O Yes O No/Walks O Yes 0 No/Planters O Yes 0 No
84.
Stucco Brown -Finish
85.
A.C. Unit Disconnect, Electrical -Plumbing
86.
Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
87.
Water Well, Disconnect, Electrical, Plumbing
88.
Exterior Elec. Trim, G.F.I. Receptacle -Underground
89. Ventilation Throughout House
90.
Glass Protection
91.
Corrections from Previous Inspections
92.
Gas Test -Meters Tagged, Gas -Electric
93.
Water & Sewer Connected -C/O to Grade -HD Approval
94.
Energy Compliance Certificate -Other Certificates
95.
Address Posted
96.
Fire Sprinkler
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Comments at Final:
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
PERMIT NO.
BP050839
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penally 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 : License Number:
Date: Contractor:
Issued Date: 04/01/2005 APN: 028-330-036-000
Site Address: 30 DEMETRI PL BAN
Map Index:
Description: REPLACE EX METER UP GRADE TO 200
OWNER -BUILDER DECLARATION
1 hereby affirm under penally of perjury that I am exempt from the
AMP
Contractors' Slate License Law for -the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, Improve, demolish, or repair any structure, prior
WILLIAM MC MILLAN TRUSTEE
to its Issuance, also requires the applicant for such permit to file a
Owner:
signed statement that he or she Is licensed pursuant to the provisions of
the Contractor's Stale License Law (Chapter 9 commencing with Section
3050 SAN LORENZO
7000) of Division 3 or the Business and Professions Code) or that he or
she is exempt therefrom and the basis for the alleged exemption. Any
CARMICHAEL CA
violation of Section 7031.5 by any applicant for a permit subjects the
95608
applicant to a civil penally of not more than five hundred dollars (8500).):
(916) 485-3962
1 I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure Is not
Intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' Slate License Law does -not apply to an
owner of property who builds or Improves thereon, and who does
such work himself or herself or through his or her own employees,
Applicant: ELIZABETH HANLY
provided that such Improvements are not Intended or offered for
P.O. BOX5
sale. If however, the building or Improvements are sold within one
year of completion, the owner -builder will have the burden of
TAHOMA CA
proving that he or she did not build or Improve for the purpose of
96142
sale.).
(530) 525-5872
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' Stale License Law does
not apply to an owner of property who builds or Improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
Contractor:
❑ 1 am Exemot under Article 3 of the Businds and Professions Code
Dale: 4Owner:
WORKERS' COMPE ATION DECLARATION
I hereby affirm under penally of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -Insure for License #:
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 Architect:
required by Section 3700 the Labor Code, for the performance of
the work for which this permit Is Issued. My workers' compensation Engineer:
Insurance carrier and policy number are:
Carrier:
Policy It: Total Square Ft: 0 S. F.
ul I certify that in the performance of the work for which this permit Is Valuation: $0.00
issued, I shall not employ any person In any manner so as to
become subject to the workers' compensation laws of California, Census Code:
and agree that If I should become subject to the workers'
compensation provisidns of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date:
Applicant:
WARNING: Fallure to secure workers' compensation coverage Is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), In addition to the cost of
compensation, damages as provided for In Section 3706 of the Labor
code, Interest, and attorney's fees. �� c �qd
CONSTRUCTION LENDING AGENCY This permit Is reby Issued under tKa0plicable provisions of the Butte County Code and/or
I hereby affirm that there Is a construction lending agency for the Resolutions t do work Indicated 40ove f. orch fees have been paid.
performance of the work for which this permit Is Issued (Sec 3097 Civ.) �.
Name: By Dale:
PERMIT EXPIRES ON:
Address: 1 ' (Dare
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
O Notification In accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above Information Is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and slate laws relating to building construction. I acknowledge it Is unlawful to alter the substagce of any official form or document of Butte County. I hereby
authorize representatives of Butte County to enter up n the above mentioned property for Inspection p os s.
Print Name: t Signature: vv \-.
Date:
CJwner CI ContractorAgent for Owner 0Agent for Contractor
BUTTE COUNTY PERMIT NO.
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT BP050839
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
B. C. Building Permit 01-16-04 pg 1
LICENSED CONTRACTORS 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
Issued Date: 04/0112005 APN: 028-330-036-000
the Business and Professions Code, and my license is in full force and
effect.
License Class : License Number:
Site Address: 30 DEMETRI PL BAN
Date: Contractor:
Map Index:
Description: REPLACE EX METER UP GRADE TO 200
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the
AMP
Contractors' Stale License Law for- the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, Improve, demolish, or repair any structure, prior
to its Issuance, also requires the applicant for such permit to rile a
Owner: WILLIAM MC MILLAN TRUSTEE
signed statement that he or she Is licensed pursuant to the provisions of
the Contractor's Slate License Law (Chapter 9 commencing with Section
7000) of Division 3 of the Business and Professions Code) or that he or
3050 SAN LORENZO
she is exempt therefrom and the basis for the alleged exemption. Any
CARMICHAEL CA
violation of Section 7031.5 by any applicant for a permit subjects the
95608
applicant to a civil penally of not more than rive hundred dollars ($500).):
(916) 485-3962
I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure Is not
Intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does, not apply to an
owner of property who builds or improves thereon, and who does
such work himself or herseir or through his or her own employees,
Applicant: ELIZABETH HANLY
provided that such Improvements are not Intended or offered for
P.O. BOX5
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
TAHOMA CA
proving that he or she did not build or Improve for the purpose of
96142
sale.).
(530) 525-5872
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or Improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
Contractor:
❑ 1 am Exempt under Article 3 of the Busin ss and Professions Code
Dale: O� Owner:
WORKERS' COMPE ATION DECLARATION
I hereby affirm under penally of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -Insure for
License #:
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
architect:
required by Section 3700 the labor Code, for the performance of
the work for which this permit Is issued. My workers' compensation
Engineer:
Insurance carrier and policy number are:
Carrier:
Policy N:
Total Square Ft: 0 S.F.
I certify that in the performance of the work for which this permit Is
Valuation: $0.00
issued, I shall not employ any person in any manner so as to
Census Code:
become subject to the workers' compensation laws of California,
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Applicant:
_
WARNING: Fallure to secure workers' compensation coverage Is
unlawful, and shall subject an employer to criminal penalties and one .
hundred thousand dollars ($100,000), In addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
4k ` qd
CONSTRUCTION LENDING AGENCY
This permit Is reby Issued under t a pIfIcable provisions of the Butte County Code and/or
I hereby affirm that there Is a construction lending agency for the
Resolutions ! do work Indicated ove f vXhfch fees have been paid.
performance of the work for which this permit Is issued (Sec 3097 Civ.)'
By:_(7 WW Date:
Name:
PERMIT EXPIRES ON:
Address:
(Date
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safely Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information Is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it Is unlawful to alter the substa a of any official form or document of Butte County. I hereby
authorize representatives of Butte County to enter up n the above mentioned property for inspection p os
�-
Print Name: t Signature: V
Dale: V
wner Cl Contractor Agent for Owner ❑Agent for Contractor
B. C. Building Permit 01-16-04 pg 1
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
Website: www.buttecounty.net/dds
"PLEASE PRINT CLEARLY
APPLICANT NAME
OWNER
La V are I
Flood Zone
r
Fist Del I
Addres
W V `ems 7,0
City
State
Stat
Zi
Phon
b
Fax
E-mail
Planner
APPLICANT NAME
CONTRACTOR
Name
Flood Zone
Address
Strte,
City
Pho eo _ J ZS . S $�2i
State
Zip
Phone
Map Book
Fax
E-mail
Planner
Lic. #
Class
APPLICANT NAME
ARCHITECT/ENGINEER
Name
Flood Zone
Address
Strte,
City
Pho eo _ J ZS . S $�2i
State
Zip
Phone
Map Book
Fax
E-mail
Planner
State License Number
APPLICANT NAME
Name 6L,,—
�'j
Address �� S
Flood Zone
Cro§tzetlyy_\row
Strte,
Zi
Pho eo _ J ZS . S $�2i
Fax
E-mail
Subdivision Name
APPLICANT SIGNATURE
X
Vj 41 \
For office use only:
Zoning
Pro ed Address
v j�t� e��✓iC'Ce
Flood Zone
Cro§tzetlyy_\row
SRA
I Yes
No
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
PERMIT
NO.
BIN #
LOCATION
AP#
Pro ed Address
v j�t� e��✓iC'Ce
ity
Cro§tzetlyy_\row
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
Sheriff
LENDING AGENCY
Name
Address
Description or Scope of Wolk:
Sq. Footage
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
required.
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 REV 2-24-05
Received by Amount:
�v Bldg
SRA
Rec ' #:
Sheriff
SMIP
Date:
`f' t
Other
Total
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 REV 2-24-05
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK.
❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper.!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes!
❑ 4. Energy compliance design and supporting documentation in duplicate.
❑ 5. Statement of Intent for Non -heated and AIC for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in
duplicate.
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Detached Accessory Building Form filled out by the owner (if required).
❑ 12. Hazardous Material Form (for Commercial Buildings only).
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May
require additional plan review upon receipt of the following items.)
❑
1.
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑
2.
Impact Fees.
❑
3.
California Department of Forestry plan approval (if required).
❑
4.
NPDES Form.
❑
5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑
6.
Contractor's license information. (Number, Name Style, Classification).
❑
7.
Worker's Compensation Carrier and Policy Number.
❑
8.
Owner -Builder Verification (if required).
❑
9.
Letter of Signature authorization (if required).
❑
10.
Recorded copy of Agricultural Acknowledgment Statement.
❑
11.
❑ Grant Deed, ❑ M.H. Title/Statement of Facts.
❑
12.
Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, please contact a
Permit Assistant at (530)538-7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits
issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
K:\ ORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05
rol--1 * 7z
Butte County Department of Development Services
ADMINISTRATION' BUILDING t GIS * PLANNING
7 County Center Drive
Oroville, CA 95965
(530)'538-7541 Telephone
(530) 538.2140 Facsimile
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a
pen -nit. Building permits are not required to be signed by property owners unless they are personally performing their own
work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if
that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the city or county. They are also required by law to put their license number on all permits for which they apply.
-If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be
aware of the following information for your benefit and protection:
o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
o If you are an employer, you must register with the state and federal government as an employer and you are subject
to several obligations including state and federal income tax withholding, federal social security taxes, workers'
compensation insurance, disability insurance costs, and unemployment compensation contributions.
o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious
with respect to workers' compensation insurance.
o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and,
if you wish, the _U.S ._Small Business Administration). For more specific information.about your -obligations under
state law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "owner -builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building
permits are not required to be signed by property owners unless they are performing their own work personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N Street, Sacramento, California 95814.
Please complete and -return the enclosed owner -builder verification from so that we can confirm that you are aware
of these matters. The building permit will, not be issued until the verification is returned.
Mic el C. Vieir� C.B.O.
M ager, Building Inspection
�.. BUTTE
C0UNT'Y
MAR 2 9 2005
D$VELOPMENT
SERVICES
NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
a==a";r�ti��u • .c n :3•t �. •,; ,y:4.; y_,��:• J� :C.,
h ''' 3 � iP� y 1_Fi�•.l •i��}r'�:'!t.�,.i `� � ' � •,� �.:
..CL,Si,c.�.::_wg-;....,t--t+aP...'R.,.�...,..v..:t='RSh-s[.,._.... T.:_:"7�✓ii..ry af'2 :a:�"=.fr+
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 material for construction of this proposed
property improvement: YES [ NO [ ].
2. I HAVE [ ] HAVE NOT [iQ1 signed an application for a building permit for the proposed
work.
3. I have contracted with the following person (firm) to provide the proposed construction:
NAME: _
ADDRESS:
PHONE:
CONTRACTOR'S LICENSE NO:
4. I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise, and provide the major work:
NAME:
ADDRESS:
PHONE:
CONTRACTOR'S 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:
DATE:
NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California
Health and Safety Code.
This verification must be completed and returned to our office before we are permitted to issue the
permit.
Rev'd 1111W,04
4 r , �J - � e�/t7V UM
H
n
March 28, 2005
County of Butte
Department of Development Services
7 County Center Drive
Oroville, CA 95965-3397
Attn: Curtis Schnurr
As trustee of the Joanna Hanly Family Trust, I am the legal owner of property in Butte
County at 30 Demetri Place; Bangor (APN 028-330-036-000). Enclosed is an Owner -
Builder Verification form which I have executed. I plan on doing some work on the property
which requires a building permit. This letter is to delegate to my daughter, Elizabeth Hanly,
the authority to apply in person for the building permit required by the County.
If you have any questions or otherwise need to contact me I may be reached at (916)485-
3962.
s
William M. McMillan
3050 San Lorenzo Way
Carmichael, CA 95608-4553
j' =1e
ILIIiiIIIlIILIIIlIIIillllilfllllll
RQcor'clr✓lq r-1 ues-i ecr b�/ 2 04—Ca076795
Qul �Q t� fA evl r e COrGt „�i Recorded I REC FEE 13.00
`-� OfficialRecords
Of
Records I MONUMEN 10.00
p %0. S e r e4t w✓l 4-o Count
BUTTE
A� W c -VK t �Q V1 CANDARe 6RUBBS I
1/V Recorder !
ROSEMARY DICKSON i
'3 O S_ o s'Qt'1 Lorevrw Assistant I Cheryl
03:46PM 16 -Dec -2004 I Gage 1 of 3
Carvn i chi e(1 CA
�S boS For recorder's use only
California Grant Deed 3
A_�,�f, 02�-33o-036
{
X] This transfer is exempt from the documentary transfer tax-, Cbl l t R 3a
[ l The documentary transfer tax is $ and is computed on:
{ J the full value of the merest in the property conveyed
[ ] the full value less the value of liens of encumbrances remaining at the time of sale
The property is located in an [X] unincorporated area [ ) the city of
For a valuable consideration, receipt of which is hereby acknowledged, fin n 4d,11y B°y y e SS
oC -t'1� Joaooa A, 4an1yTrt4s+&4&L-Fc�� Jantcary 31) ZOOZ
hereby grant(s) to Viii 1114 vvx W r- KA 4( (ONA s UL cC e S 5'o r 4r-`" s k_ o f'* he
Joa In dna A-, f4a6 f f:::avht 1y-rr"Sf d&�rj JaoUa r,� 311 Z00 2
the following real property in the GkyW un ivi cornora4d a County of I&e,
. state of California:
Devv\e-r i Pf a cam; Uoav, ,K
or, CA o rl eoC
LITICQI I de-sei be -d iv) 5 -AL It 6f
hers-� a d wta �e a a r-�- Nerea�.
P
Date: V. 22.200
Date:
On Nv a a , 20Fx - before me, (✓ t2j0 L. 6G—c.e0 a notary public in and for said state
personally appeared A N ►v A Aj C> rsonalty known tome V1=
vt nce) to be the n(pKsveV;ip subscribed to the within instrument and
acknowledged thatAs h executed the same in WsQgsignaum on the instrument the p�r I
on behalf of which they acted, executed the instrument.
�,� 4 D �✓ • I;11�W�'1 0 ;'.��t�. DEBRA L.
a X1469336
Signature Of Notary SANTA BUC•CALIFORNIA
o^ M CommBARBARA COUNTY O
.
"e 9 Expires February 1, 2008 —%
EXHIBIT
Description
7be land ref ed to herein is situatod in the State of California, County of Butte, and is described as
follows:
P�IRCSL I•
THE NORTH HALF OP'THE SOUTHWEST QUARTER OF THE SOUTHEAST QUARTER OF THE
NORTHEAST QUARTER OF SECTION 34, TOWNSHIP 28 NORTH RANGE 5 EAST, M.D.B. & M.
RESERVING THEREFROM A RIGHT OF WAYFOR ROAD PURPOSES OVER THE WEST 30 FEET
THEREOF.._...
APN: 028-330-036-000 -
A RIGHT OF WAY FOR ROAD PURPOSES OVER A STRIP OF LAND 60 FEET IN WIDTH; LYING
30 FEET ON EACH SIDE OF THE FOLLOWING DESCRIBED .
BEGINNING AT ATOM. 60 FEET SOUTH OF THE NORTHWEST CORNER OF TBE SOUTH
HALF OF THE SOUTHWEST QUARTER OF THE SOUTHEAST QUARTER OF THE NORTHEAST
QUARTER OF'SECTION 34, TOWNSHIP 18 NORTH, RANGE 5 EAST, M.D.B. K; THENCE
NORTH ALONG THE EAST I.= OF THE SOUTHWEST QUARTER OF THE NORTHEAST
QUARTER OF SAID SEC OW 34, A DISTANCE OF 390 FEET TO THE SOUTHEAST CORNER
OF THE EAST HALF OF THE NORTHEAST QUARTFdt OF THE SOUTHwEaT QUARTER OF THE
NORTHEAST QUARTER OF SAID SECTION 34; THENCE WEST ALONG THE SOUTH LINE
THEREOF A DISTANCE OF 330 FEET TO THE SOUMWEST CORDER OF THE BAST HALF OF
THE NORTHEAST QUARTER OF THE SOUTHWEST QUARTER OF THE NORTHEAST QUARTEK
OF SAIDSECTION 34; T738JCE NORTH ALONG THE WEST LM THEREOF, A DISTANCE OF
660 FEET TO THE NORTHWEST C'ORIM OF THE EAST HALF OF THE NORTHEAST QUARTER
OF -THE SOITTHR EST QUARTER OF TIB NORTHEAST QTJART}3R OF SAID SECTION 34 AND.
THE END OF THE 31 RM. DESCRIBEI)C EN TERU NE.
EXCEPTING THIIR MOM ALL THAT PORTION LYING WTI? [ 4 THE BOUNDS OF PARCEL I
'DESCRIBED gEREN.
PARCEL III;
A RIGHT OF WAY FOR INGRESS; EGRESS AND. PUBLIC VMXrY PURPOSES OVER TRAT
PORTION OF THE EAST 30 PRET OF THE WEST HALF OF THE EAST HALF OF THE
so unmTNT QUARTER OF ME SOUTmAST QUARTER; AND OVER THAT PORTION OF TIE
WEST 30 FEET OF THE EAST HALF OF THE EAST HALF OF THF SOUTHWEST QUARTER OF
THE SOUTHEAST QUARTER OF STICTION' 27, TOWNSHIP 18 NORTH, RANGE 5 EAST, M.D.B.
8t M.; AND OVER THAT PORTION OP THE EAST 30 FEET OF M WEST HALF OF THE EAST'
• 1 hN I:1►
PARCEL III: -CONTDXM
HALF OF T13E NORTIMTEST QUARTER OF THE NORTHEAST QUARTER AND OVER THAT
PORTION OF THE WEST 30 FEET OF THE EAST HAi P OF THE EAST HALF OF TBE
NORTHWEST QUARTER OF THE NORTHEAST QUARTER OF SECPION 34, TOWNS 18-
NORT$ RANGE 5 EAST, M.D.B. & M., ALL LYING SOUTHERLY OF THE LOS VERJELES
ROAD, AS SAID ROAD EMT= ON JANUARY 22, 1959.
A RIQHT OF WAY FOR INGRESS; EGRESS AND PUBuc UTII,ITY PURPOSES OVER THE
.- NORM OMT OF TM $ —ST- —A F OF ffi NORTSMT'QUA'RTBR OF THB SOUTAV BST
QUARTER OF THE NORTHMST QUARTER OF SECTION 34, TOWNSHIP I8 NORTM RANGE
5 EAST, M.D.B. & M.
A RIGHT OF WAY FOR INGRESS, EGRESS AMID PUBLIC U Xr Y' FURPOSES OVER THE
NORTH 60 FEET OFTHE SOUTHEAST QUARTER OF THE NORTHEAST QUARTER OF SECTION
34, TOWNSFUP 18 NORTH, RANGE 5 EAST, M.DM. & M.
PARCEL VL.
A RIGHT OF WAY FOR ROAD AND PUBLIC UIH.ITY PURPOSES OVER THE WEST 30 FEET
OF THE EAST HALF OF THE EAST HALF OF THE NORTHEAST QUAR'T'ER OF THE
NORTHEAST QUARTER OF SECTION 34, TOWNSHIP I9 -NORTH, RANGE 5 EAST, MID$. & M..,
LYING SOUTHERLY OF LOS VERJELES ROADS.
EARCEL 3A
A RIGHT OF WAY FOR ROAD AND PUBLIC UTII TIY PURPOSES OVER THE EAST 30 FEES' OF
THE WEST HALF OF THE EAST HALF OF THE NORTHEAST QUARTER OE THE NORTFIBAST
QUARTER OF SECHON 34; TOWNSHIP 1S NORM. RANGE 5 EAST, M.D.B..& M., LYING
SOUZ IMMY OF LOS VMZJM ES ROAD.
•�rio� - � 0�1 rod g S
March 28, 2005
County of Butte
Department of Development Services
7 County Center Drive
Oroville, CA 95965-3397
Attn: Curtis Schnurr
As trustee of the Joanna Hanly Family Trust, I am the legal owner of property in Butte
County at 30 Demetri Place; Bangor (APN 028-330-036-000). Enclosed is an Owner -
Builder Verification form which I have executed. I plan on doing some work on the property
which requires a building permit. This letter is to delegate to my daughter, Elizabeth Hanly,
the authority to apply in person for the building permit required by the County.
If you have any questions or otherwise need to contact me I may be reached at (916)485-
3962.
William M. McMillan
3050 San Lorenzo Way
Carmichael, CA 95608-4553
LttF'v r G.•:.i �: L s -i {- . ,:.vx•:9i: =•i..•..' LA::'l. ), . - • •.. -
I �:
.{.zs Lars
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 material for construction of this proposed
property improvement: YES NO [ ].
2.. I HAVE [ ] HAVE NOT [,-ZI signed an application for a building permit for the proposed
work.
3. I have contracted with the following person (firm) to provide the proposed construction:
NAME:
ADDRESS:
PHONE: CONTRACTOR'S LICENSE NO:
4. _ I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise, and provide the major work:
NAME:
ADDRESS:
PHONE: CONTRACTOR'S 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:
PROPE
DATE:
NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California
Health and Safety Code:
This verification must be completed and returned to our office before we are permitted to issue the
permit
4
A
:cP" U N TO PUBLIC WORKS
i
91-034693 I
I
Recorded
Official Records I
County of I
Butte I
Candace J. Grubbs I
Recorder I
8:41am 22 -Aug -91 I
AP NO. 3.3 - 3 6 3 8
NOTICE OF CONSTRUCTION
Rec Fee
7.00 j
STF 1.00
Cash 8.00
X 2
AFFECTING ADJOINING PROPERTY
'i1ie undersigned, BENJAMIN L. CULET AJ MARIAN CULET
. AS TR[[STFF$�, rt n , T•. .
OF THE 1984 CULET LIVING TRUST do hereby declare as follows:
BATED MARC .,
1. I am, (We are), the omier(s) of that certain real property situated if] the
County of Butte, State of California, described in attached Exhibit A.
2. I, (We), intend to apply to the County of Butte for a building permit and,
pursuant to said.permit, to construct improvements on the said property.
I, (We), do hereby place all subsequent purchasers and encwnbrancers on notice
that such improvements will be constructed over a parcel or lot line(s) as
described in the above noted Exhibit A, acid that subsequent purchasers and
encuwnbrancers should be.aware of the location of such improvements.
3. So long as such improvements remain, said parcels or lots caiuiot be sold
separately.
DA'Z'ED: 11IT-y 311-1991
.=.rte �• , •
Signature of owner of record Signature of owner of record
STATE OF CALIFORNIA
ss.
COUNTY OF BUTTE
On ul3y 3i'i g9i , 19 91_ , before me, the undersigned, A Notary Public in
and for the State of California, residing therein, duly commissioned and sworn,
personally appeared BENJAMTN T. - C[[r.FT AND -MAl ;-rAM CoLBm
knocm to me to be the persons wlio e named Subscribed to the within instrument
and acknowledged that HR Y execited the
WITNESS my hand and offical seal.
OFFICIAL SEAL
RUBY J. BOAZE
TEE COUNTYmIa
My taomm. Ems. Aug. 21.1892
RUBY J. BOAZE
Name typed or printed
AFTER COMPLETION, THIS DOCUMEM: [NST BE RECORDED IN 7.71E OFFICE OF 171E COUNTY RECORDER.
LD 1540 (5/133)
f
f ti
EXHIBIT "A"
PARCEL ONE:
AP 028-330-024-0
The Southeast quarter of the Southwest quarter of the Northeast quarter of
Section 34, Township 18 North, Range 5 Eas.t, M.D.B. & M.
PARCEL TIDO:
AP 028-330-036-0
The North half of the Southwest quarter of the Southeast quarter of the
Northeast quarter of Section 34, Township 18 North, Range 5 East, M.D.B. & M.
An easement for water line purposes over the East 2.0 feet and the South 20
feet of the land described in Deed recorded February 1, 1979 in Book 2367
of Official Records, at page 375, records of Butte County, California and
as shown on Record of Survey filed October 22, 1981 in Book 84 of Maps, at
page 26.
PARCEL THREE:
AP 028-330-038-0
The North Half of the Southeast quarter of the. Southeast quarter of the
Northeast quarter of Section 34, Township 18 North, Range 5 East, M.D.B. & M.
An easement for water line purposes over the North 40 feet of the Nest
450 feet of the land described in the Deed recorded January 17, 1980 in
Book 2480 of Official Records, at page 373, records of Butte County,
California and as shown on Record of Survey filed October 22, 1981 in
Book 84 of Maps, at page 26.
PARCEL FOUR:
AP 028-330-039-0
The So.uth half of the Northeast quarter of the Southeast quarter of the North-
east quarter of Section 34, Township 18 North, Range 5 East, M.D.B. & M.
An easement for well and water line purposes over the South 50 feet of the
East 250 feet of the land described in Deed recorded October 12, 1971 in
Book 1706 of Official Records, at page 443, records of Butte County,
Claifornia and as shown on Record of Survey filed October 22, 1981 in
Book 84 of Maps, at page 26.
WITNESS.my hand and offical seal..
OFFICIAL SEAL
RUBY J. BOAZE
Notary Public-CoMomla
BUTTE OOUNTY
4"i P..' Mr OOMM. Exp. Aug. 21, 1982
t ure
RUBY J. BOAZE
Name typed or printed)
AFTER COMPLETION, THIS D0CLR9Wf MUST BE RECORDED IN TILE OFFICE OF Z]!E COUNTY RECORDER,
LD 1540 (5/88)
C(\
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RESIDENTIAL
a 1, 28-33-36 203'7-91P,E
CULET, Ben;
30 Demetri Pl,'Bang,or.
(mh util)
OFFICE COPY t
Address �.
r
GAS
Meter By p
ELECT f'
Meter By Date- �� I
4 . Q,7
JOB FINALED
Signature
i
3
i
J=OK
O=Not OK,
Not
= Not Readyable MOBILE HOMES
Date MOBI HOME UTILITIES (Plans) OK except #'s
on equirements-Setbacks-Easements
jIS(Special MH Support Sketch
e er, Location -Test -Fall -C/O Concrete
.4�4ater; Location -Test -Easement Needed (Sketch)
ectricity; Location-Clearences-Grnd-/ /Amp -Concrete
�L"ocation-Test-Wr / PI -ft.
/ /"Nat. or/ /"L" ft./ "LPG
ell Clearance & Di @onnect
—tet,% tility Clearance
Dat / and B- Date Card B-1
Date//-2 -1?Card B-1 Date Card B-1
Date mgAwe'tiOME INSTALLATION (Plans) OK except #'s
J. Zoning Requirements -Setbacks Easements t
otings; Size -Spacing -Marriage Line
as; MH Test-Demand-Valve—Connector i
ectricity; MH Test -Crossovers -Breakers -Clearances 1
rain; MH Test -Fall -Flex Connector +'
t
ater; MH Test -Regulator -Connector
ater and Sewer Connected -C/O to Grade -HD Approval
s and Electricity Tagged
i Sketch
10'-Eert. of Occupancy
Date rd B- Date Card B-1
Date' Card B-1 Date Card B-1 I
MISCELLANEOUS
Date
DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s
4.11 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.; Posts-Beams-Rftrs.-Connectors
Shthg.-Rfg.-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining I ,-
4. Elec.; Receptacles and Lighting, Distances-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/5' Circulating Equip. -Pool Lghtg.
_
Boxes- Enclosures-Panelboards-Ins. to Main in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card R-1
J=OK
O = Not OK
= Not Applicable
NotRESIDENTIAL (;
=�teady- '
V.U
Date NDERFLOOR (Plans) OK except If's
1. Zoning -Setbacks -Easements -Flood -Slope
of 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth
5. Stemwalls, Main; Steel -Bloc kouts-Wraloped
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. Pienums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
15. Access & Ventilation
16. Insulation
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date PLUMBING (Permit),OK except h's
tE. 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 & Archors
Date Card B-1 Date Card B-1
------------------------------------------- - -----------------------
Date Card B-1 Date Card B-1
Date ELECTRICAL (Permit) OK except ft'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/Meeh. Fastners-Bond Gas & Water
------------- - ------------------------------------------------------------
27. 2 Appliance Circuts in Kitchen & Conductor SizerGFI
--------------------------------------------------------'------------------------
28. Subfeed Wire Size r r ga. Cu or AI-A.C. Wire Size / / ga.
_________ ___ _Cu or AI
29. Range Circ / r ga. Cu or AI -Oven Circ. / / ga. Cu or Al.
Insulated Neutral ❑ Yes 0 No
--------------------------------------------- -
30. Service -Riser Conductors & Ground -Main Disconnect
------------------------------------------------------------------------------------
31. Equip Clearances Panels-Motors-Mech. Equip.
------------- --- - ----------------------------- - -- ---- - -
32. Clothes Closet Light -Shower Light -Spa Light
-------------------------------------------------------------
33. Smoke Detector
---------------------------------------------------------------------------------
-
Date Card B-1 Date Card B-1
--------------------------------------------------------------------- -------------
Date
-----------
Date Card B-1 Date Card B-1
Date MECHANICAL (Permit) OK except ft's
34. A.C. Ducts Insulaticn & Support
----------- ----------------------------------------------
35. Vent Fan Exhaust above insulation
--------------
Condensate Drain & Overflow: Size & Grade
--------------------------------------------------------------------------
37.
------------------
37. Furnance-Vent: Access -Comb. Air -Return Air Vent -115 outlet
-----------------------------------------------------------------
38. Attic Access & Platform if Furnance in Attic
-----------------------------------------------------------------------------------
---------------------------------------------------------------------------------
Date
•---------------------------------------------
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date FRAMING (Plans) OK except 4's
39. Sils. Proper Material & Anchors
------ -------------------------------------------------------------
40. Walls Studs -Nailing Spacing & Bracing -Plates -Sound
-------------------------------------
41. Bearing Walls over Girders & Floor Nailing
---------------•-- ---------------------------------------------------------------
42. Draft Stop in Walls (rat proof)
--------------------------------------- -----------------------
43.-
----------------------
43. Fire -Stops: Furred Ceilings -Stairs -Chases -Tub
- ----------------------------
44. Headers & Beam -Size & Bearing
►ingle. & Duplex) , -
Date •FRAMING (Continued)
45. Hangers -Post Caps -Anchors -Connectors
46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Ring.
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 Protection -Skylights -Plastic `
58. Shear Walls; Nailing -Bolts
59. InsulaJon-Walls-Ceilings
60. 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
61. Ext. Steps -Door & Sidelight Protection -Landings
62. Smoke Detector
------------------------ -
63. Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor -Ducts -Meeh. Protection
-------------------- ------------------
64. Bedroom Exiting
---------------------------------- -�
65. G.F.I. & Bath Fixtures & Tub Access -Spa ,
----------
66. Elec. Trim & Subpanel: Breaker Sizes & Labels
-----------------
-----------
-------_________ 67. Stairs -&-Rai-Is _
68. Fireplace or Stove Clearances -Hearth
----------------
69.
--------- 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
-.--------------- -------------------- --
74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.
In Garage; Above Floor -Meth. Protection
75. Plb.. Elec. & Mech. Equip. Listed for Location
76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection
----------------------------------- ---
7 . 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 ❑ Yes
80. Following inslld.; Drive ❑ Yes ❑ No; Walks ❑ Yes
Planters ❑ Yes ❑ No
❑ No;
--------------------------------------------
81. Stucco_Brown_------_--- _
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.
---------------89. Gas Test -Meters Tagged; Gas -Electric
--------------------- - -----
90 .
Water & Sewer Connected -C/O to Grade -HD Approval
--------- --------------------------
91. 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:
MOBILEHOME INSTALLATION ACCEPTANCE
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE
OROVILLE, CALIFORNIA 95965 — TELEPHONE: (916) 538-7541
PERMIT NO.,r� 03-7
Address or location of mobi lehome p� C?Rif f
Owner's name
Owner's address
Insignia or hud number
Manufacturer's name
Seri a um er of V.I.N.,-k 5%/ - A-- ��d Year of manufacture
(Official Approv%fg Installation
IF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION.'
ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE'
MOBILEMOME IS INSTALLED ON A FOUNDATION SYSTEM.
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 = Telephone: 916.`538-7541
APPLICATION AND PERMIT
PERMIT NO.
92-2076
ASSESSOR PARCEL NUMBER
28-33-36
ZONING
A5
BUILDING PERMIT
OWNER
Ben Culet
TELEPHONE
533-8892
SQ.FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
PO Box 1082 Oroville 95965
CONTRACTOR'S NAME
Owner
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
1
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee $ 15,00
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $ 20.00
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee $
Penalty $
BUILDING ADDRESS
30 Demetri Pl Bangor
Permit fee $ 35.00
PLUMBING PERMIT Filing Fee 15.00
Each Trap 5.00
Solar or heat pump water heater 20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping 7.00
Each qas water heater or vent 7.00
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome® Other
SPECT FY
Gas piping system 1 - 5 outlets 5.00
Building sewer 15.00
Mobile Home S I GJWJ 15.00
TYPE OF WORK
Newr" Addition ❑ Remodel ❑ Utilities ❑ InStallationER Other ❑
Describe work: mhi 500 sq ft min (MHU#91-2037 _
-1
Permit Fee $
Contractor
ELECTRICAL PERMIT Filing Fee 15.00
Main service 200AORLESS 18.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (Check One):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business/POER
and Professions Code and my license Is In full force and effect.
License No. Classification
�l, as the owner,'or my employees with wages as their sole compen-
sation, will do the work,and the structure Is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
Main service 200A TO IOOOA) 37.50
NEW CONST. DWELLING OCCUPM 3.64sq.ft.
OR ADONS. ACC. BLDGS. I/
NEW CONSTR ULTI.OUTLET
NON -REST BRANCH CIRCU ITS @ 5.00
APPARATUS
SINGLE OUTLET (UR.")
Ex. Occ Up(ouTLETS OR FIXTURES 20 76
FIXED APP LHS. OR
Ex. Occup. OUTLETS (RESID.) EA.� 3.00
Temporary service 15.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $
—
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT FiIingFee 15.00
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 County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
X f�����-�6–��� Date
Mobile Home Installation Fee S 70.00
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEES 105.00
I I
HAz
1 DFEES I
IMP
FLOOD
I COF
PARCEL
PD
HO
ISSUE
This permit is hereby issued under the applicable provi-
sions of the Butte County Code and/or resolutions to do
worSi'cate, aba for which fees have been paid.
OR OF IC WORKS
ByDate -- Z
PERMITE PIKES ate
—
Signature of App icons Owner ❑ Contractor E] Age
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Receipt No. 117062
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
' � +t�Y�j�f��i'rt+.4i?-`r.� �(�r . {� •`1� �Aarti,�'1� r11,'ats'� +�'3�;;3' ,F' f �,((',y�� ` ' ?:�- ., i
CQUNTY OF BUTTE PA;RTMENT OF PUBLIC WO - .BUILDING DIVISION
SSii '' W �k �� 1J►k % iS � 1►
` 7 COUNTY CENTER DRIVE - ORO.Vlet, CALIFORNIA 95965 - 'TELEPHONE (916) 538-7541
PERMIT APPLICATION DATA
LcAj OWNER
Proposed Building Use Building Inspector i
SHEET
P. No. Oa 3.30 '63(�
Date T z -
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 . .......................... l
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). . .
Pre -Inspection reque-fs-
Pre-inspection for required. .. to Building Inspector (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.............................ti............. .
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-r-equirgments. .............. .
Existing violations/expired permits . .......................................
Plan check list . .....................................................
When u issue the permit,,,Pf,ocess as follows: Mail to wner. Mail to contractor.
Telephone S73- -ate 2- and hold for pickup at 0 � office. Deliver with inspector.
Other
Parcel Creation
Acreage Applicant Date G Z_
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: t
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 2 l- ' Plans approved by %W Date 22
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Works
COUNTY OF BUTTE —
DEPARTMENT OF PUBLIC WORKS —
BUILDING DIVISION
7 COUNTY
CENTER- DRIVE--
OROVILLE, CALIFORNIA 95965 —
TELEPHONE
(916)5387541
, vim A %
�I I/i��
e v un
(/��`
3, � LJ
PROPOSED BUILDING USE DATE
= REC. # -DATE REC
- -
1. School Distric Fees -oleo
(paid at District Office) ......................
2. Sheriff Fees
(paid at Building -Depa-rtment) -
Residential . .. . X C
unit amt.
Commercial(per sq.ft.) X =$
sq.ft. amt.
3. Urban Area Fees
(paid at Building Department
Residential (per unit) X =$
# units amt.
Commerical(per sq.ft.) X =$
sq.ft. amt.
4. Recreation District Fees
(paid at District Office)
5. Drainage District Fees
(Contact Land Development)
6. Other
7. Other
At time of permit application, I was advised the above fees are required to be paid prior
to issuance of the permit. ,
APPLICANT DATE ��
COUNTY OF BUTTE -DEPARTMENT OF PUBLIC WORKS �PEERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone: 916!538-7541 �� �—tJ
APPLICATION AND PERMIT.
ASSESSORPARCEL NUMBER rU� rD
20NINGw
BUILDING PERMIT
OWNER
E
TELEPHONE
533 -cg6
SO. FT. OCC. BUILDING VALUATION
OWNER,M6 4Gv ADDRESS 9-Z rZo 95 4��
CONTRAC OR'S N E
TELEPHONE
CONTRA TO(VRr\''S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
Filing Fee
$ 15.00
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
Permit fee
$ DS - p
PLUMBING PERMIT
Filing Fee 15.00
N
Each Trap
5.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
1
PARCEL MAP
11
Water piping
7.00
Each pas water heater or vent
7.00
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome[GL Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.001
Mobile Home S I G W 1
15.00
TYPE OF WORK
New ❑ Addition ❑ RemodelD Utilities ❑ Installations Other ❑
Describe work: a _
_ —
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
_
Main service 600V OR LESS 1-18.501
200A OR LESS
Main service 200A TO 1000A1
37.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License.:Jo. Classification
❑FIXED
I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044} _
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044) -
❑ I am exempt under Sec: , Business and Professions Code
for this reason
OCCUP.tr\"
NEW CONST. ( DWELLING OR ADDNS. ACC, BLDGS. /
3.64sq.ft.
NE CONSTR ULTI.OUTLET
NON.RESID BRANCH CIRC ITS
@ 5.00
POWER APPARATUS tr .
(SINGLE OUTLET CIR. I
Ex. Occup(OUTLETS OR FIXTURES
20 LW 76d
EX. Occup. OUTLETS-P(RESID IREA.)
1 3.00
_ _
Temporary service
15.00
Mobile Home Facilities
15.00
Misc. Wiring �_ - --
g
15.00 "
Permit Fee
$
—
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor _
MECHANICAL PERMIT
Filing Fee 15.00
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 County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Bu a against
all liabilities, judgments, costs, and expenses which may In a y y crue
against said County in consequence of the granting of this per "t.
X Date i
Si nature of Applicant - Owner
9 pp ❑ Contractor ❑ Ayent
An OSHA
ion of structures t over 3gstorie''�s in heigvhttions over 5;0" deep and demo ition or construct.
Mobile Home Installation Fee S v
Energy Inspection Fee $
DCC
CONST TYPE
TOTAL FEES
HAZ
DFEES
IMP
FLOOD
--_
CDF
PARCEL
PD
HD
ISSUE
This permit is hereby issued under the
sions of the Butte County Code and/or
work indicated above for which fees
DIRECTOR OF PUBLIC
By
PERMIT EXPIRES Date
applicable provi-
resolutions to do
have been paid.
WORKS
Date
Receipt No..IZO&L
'!INITE-D.P.W., rEL LOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
COUNTY OF BUTTE - Department of Public Works COflMTyQpgtlTTE
7 County Center -Drive, Oroville, CA 95965 Phone"PILD9116�=c538_7541
1 6 1992
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 terials for construction of
the proposed propert •,im ovement (yes or no)
61
2. I a/h v_e_-not) signed an application for a building permit
for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed
construction:
Name
Address City
Phone Contractors License No.
4. I plan to provide portions of this work, but I have hired the following person
to coordinate, supervise, and provide the major work:
Name
Address City
Phone Contractors License No.
5. I will provide some of the work but I have contracted (hired) the following
persons to provide the work indicated:
Name Address Phone Type of Work
a
.Signed:
Property Owner
Social S c rit umber
Date
NOTE: This Owner. -Builder Verification is sent to you as.required by-Sections.:19831.:and.
19832 of -the. California. Health and Safety Code.
Thisverification must be completed and.returned to,our office before..we.are per-
mitted to issue the permit..
1. Owner's Name:
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS
7 County Center Drive, Oroville; CA
PHONE: 538-7541
MOBILEHOME INSTALLATION SHEET
f
OoUtg o B TTL
J e� b
Fs co w0y'n
?*AL" CCEA7ZN,1CC
2. Installer'.s 'Name:
3... Is the site currently under permit? Yes ;�. No
(If yes, furnish permit number O 3 % — ( ) OR
Is the site an existing site? Yes � No 5.00 SQ. FT. MIRIIMUM ,n
nP!1 F.4
(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 Vj_ NF]
o
(If no, clarify
What is the mobilehome electrical rating? --------------- ��� Amps
What is the mobilehome site service rating? ------------- X' %c;�5 Amps
Ji What is the mobilehome site circuit breaker rating? ----- w 4-a�10
d Amps
8. Is there any other electric load to be served by the
mobilehome site service. -- Yes � No
(If yes, identify the load and size: (Load) (Amps)
9,i What is the mobilehome site gas pipe size? -------------- y (in.
10.-.Vtll'at is the type of gas -service? .--------------- --- Natural T.PG
11. What is the gas pipe length from meter or tank to the r
mobilehome?------------------------------- --- ---- -- ( t )
�12. What -is the mobilehome gas demand? --'-------=------------ (BTU)
This information not required if pipe length less than 6 ft. on
natural gas or less than 50 ft, on, LPG.) BUTTE COUNTY
NEXT PAGE MUST BE COMPLETED TO PROCESS PERMIT APPLI W11 r1ING DEPARTMENT
d Amps
8. Is there any other electric load to be served by the
mobilehome site service. -- Yes � No
(If yes, identify the load and size: (Load) (Amps)
9,i What is the mobilehome site gas pipe size? -------------- y (in.
10.-.Vtll'at is the type of gas -service? .--------------- --- Natural T.PG
11. What is the gas pipe length from meter or tank to the r
mobilehome?------------------------------- --- ---- -- ( t )
�12. What -is the mobilehome gas demand? --'-------=------------ (BTU)
This information not required if pipe length less than 6 ft. on
natural gas or less than 50 ft, on, LPG.) BUTTE COUNTY
NEXT PAGE MUST BE COMPLETED TO PROCESS PERMIT APPLI W11 r1ING DEPARTMENT
MOBILEHOME SUPPORT DATA
—3'
� If other than single wide, MYSI� ,y 3
Mobilehome rift. i'✓ �L''Gfi�- V furnish Setup Model No S7 Year
Year / /
Width(ft.) Box Length�_(ft- ) Tagalong or Expando Size .—,ftt,. x ft.
ins i� i
On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's -installation
manual and structural setup sheets (if not on Ile with the County of Butte).
FOOTINGS (check one) . Wood -pressure treated or foundation grade. 1XI2. Other (specify)
SUPPORTS (check one). Concrete block.2. Other (specify)
Pier Footing Sizes and Locations
SINGLE -WIDE
MULTI -WIDE
Llne 1
Line 1
Main Beams
i2
--
Li
Lin
— — — —
— — -+ Line 2
— — — —
Main Beams
— — — — — —•_
— — —
— — s Line2
• Line 1 Piers:
Size-Min-------------
.� n
Spacing -Max.
From Ends -Max. -------
Line 2 Piers:
Size-Min.------------
Spacing-Max ---------
----------
Spacing-Max.------- '� �_ 6
From Ends -Max......... —
Line 3 Roof Loads:
Size -Min. ---------
Location (From Front)
Line Y
Tag or Triple
line 4
.� Line 1
Line 1•10ye6ings:
Size -Min. -----------------
x
Each Side of Openings
With Width Over ---------
Line 3 Piers: (Under Bearing Wall Only)
Size -Min -------------------
Spacing-Max -
------------------
Spacing-Max.-_-------------
From Ends -Max .------------- �-
Line 4 Piers:
Size -Min ------------- nx
Spacing -Max.-------- r n
From Ends -Max --------
Line S Roof Loads:
Size -Min. ------------
Line 5 Piers: (Under Bearing Walls Only)
Size -Min.------------------
"x
Spa cing-Max----------------
From Ends -Max .-------------
"x "x11x _"x "x "x "x "x
Location (From Front)
AP #
OWNER Lb 0 U T-
.
PERmrr 7
Ml UTIL.CLEARANCE DATE
INSPECTOR V—I�AA
ELECTRIC
GAS
Support
Struc.
Compaction
Test .Req.
Service
Size
Other
Load
T
Pipe
Size
Lenjzth
YES! NO
YES I NO
COUNTY OF BUTTE - DEP NT OF PUBLIC WORKS
7 County Center Drjve - Oroville. _ 95965 - Telephone: 916/538-7541
• APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
028_ _
ZONING
'_
BUILDING PERMIT
OWNER
TELEPHONE
SQ. FT. OCC, BUILDING VALUATION
OWNER'S MAILING ADDRESS
P.O. Box oroVille()9()65
CONTRACTOR'S NAME
Ownpr
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
Nnnp
UNKNOWN
Total Valuation $
Filing Fee
$ �Y).AIYl
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE No.
Plan Checking Fee
$ 15.00
Energy Plan Checking Fee
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
e GP
Permit fee
$ 15.00
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME7PARCEL
MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome® Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G I W
10.00ea
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ® Installation[] Other ❑
Describe work: 2 Bedroom MHU _
500 Min.
Permit Fee
$ 40.00
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service ,00 AMP OR00V OR LESS10.00
Main service EA. ADD'L 100 AMP
2.50 2,90
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification.
1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. // DWELLING OCCUP.�
OR ADDNS. 1 ACC. BLDGS.
, h2sgft
NEW CONSTR. MUTI-OUTLET
D, BRANCH CIRC ITS
2.50 ea
_NON
POWER APPARATUS 6
SINGLE OUTLET CIR.
Ex, OCcup(OUTLETS OR FIXTURES
200501
BALI 30
FIXED APPLNS. OR
EX. Occup. OUTLETS (RESID.) EA.)
2.00
Temporary service
10.00
Mobile Home Facilities
1 15.00 15.00
Misc. �Yirin 9
15.00
Permit Fee
$ 37.50
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Cooling
g
Hood
3.00
Ventilation
permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
liabilities, judgments, costs, and expenses which may in any way accrue
against said Countyinconsequence of the granting of this permit. p
Date b �0 —71
Signature of Applicant — Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $
E 92,350
HAz.
CUA
PARK
FLD
,_
P
PD
i HC/1
SUE
7S
This permit is hereby issued under the applicable provi-
sions of the Butte County. Code and/or resoiutiops. to do
work indicated above for which fees have been paid.
xRI TO OF PUBLIC WORKS
/l
BY `- Date
PER IT EXPIRES Date 4
Receipt No. 94066
WHITE-D.P.W., YELLOW-ASOC330R, PINK -INSPECTOR, GOLDENROD -APPLICANT
TO Buildina Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
Owner Location AP#
Approved for: Sewaqe Disposal f l/
Plan Appr —�Water Supply�
Hold final for:
^inal clearance O.K. for:
Clearance forte bedroo i ome.
NOTE * * *
Other
Water Supply
Water Supply
Sanitarian Da
COUNTY OF BUTkTElL�EPARTMENT OFfPUBLIC ,WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OR ;L.E,CALIFORNIA 95965 - TELEPHONE: 916/538-7541
PERMIT `A.IGATION DATA SHEET
l.�L Permit No.
OWNER AVI �u CCS 1 , A. P. No. 6` .�j pO-
133
Proposed Building Use�`/ (/t Building Inspector AM Date
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED APPROVED
1. All items have been submitted. .. .........
2. Plot plans in duplicate/triplicate, signed by preparer of plans ........
3. Complete plans in duplicate/triplicate, signed by preparer. of plans . .
4. Complete engineered plans and calcs, with wet signature on plans ..
5. Hazardous Material Form ......................................... .
6.;,Energy Design Compliance and supporting documentation .........
7. Statement of Intent for Non -Heated and AC Buildings ..............
8. Engineered truss details and layout in duplicate (required prior to plan check)
'~ 9. Mobilehome installation data including manufacturer's installation
instructions.......................................................
10. Fees of $
11. Chico Urban Area fees paid .......................................
12. Park fees paid ....................................................
13. School District fees paid ..............
14. Sanitation approval from Health Department
15. City,of Chico plumbing permit .....................................
16. Plot plan and business license approval from City of
(see City for other requirements)
17. Planning approval for (A) Use: (B) Parking: ......
18. Improvements may be required. Contact Land Development Section DPW
19. Driveway permit (construction approval required prior to occupancy)
20. Pre -Inspection for required Pre-Inspec.request to
Building Inspector (Date) •.
21. Contractor's license information (No., Name Style, Classification) ...
22. Certificate of Workmans Compensation Insurance ..................
23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..
~ 24. Recorded copy of -Agricultural Acknowledgment Statement .........
25. Letter of signature authorization ...................................
26.
27.
' When you issue the permit, process as follows: Mail to owner. Mail to contractor.
_ Telephone 6�i�`$gq and hold for pickup at.�r�7 office. Deliver w/inspector.
Other
C' Applican LZADate_
Copy of Haz-Mat;form sent � Health Dept.. Fire Dept. i fair 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,jRems No.
2. Additional items requ'i`red:
Contractor, designer, owner, was advised of above requi eda//� b_y phone�nail—counter by ..date
Contractor, designer, owner, was advised of above regt ed'H�ta by-phone_mall_counter by date-
r � `
1 PI`ans checked by SLA% Date 61 2AJ 2I Plans approved by NOU Date loft¢
Sets of plans on hold in File cabinet AP folder
Copy—DPW
170185
mcp 0
DUP
TO FROM
SUBJECT DATE
MESSAGE
YS i
oe
SIGNED
r .w-4- -E
:Z.
R.MFORM 4S 468
.. -
NO REPLY NECESSARY REPLY REQUESTED - USE REVERSE SIDE
F
P OLY PAK iO SETS) 4P468
carbonless
W
COUNTY OF, BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
n /9 it ZONING
IAILI ADD ESS
I A I L;;c cA x /fa Y'19 v i
rOR 5 NAME i
NTRACT-OR'S MAILIN
CONS CTION LENDER
IV ✓l —
LENDER'S MAILING ADDRESS
ARCH�I7ECT OR ENGINEER
HITECT OR ENGINEER'S MAILING ADDRESS
BUILDING
NKNOWN
N
LOT NO. I SUBDIVISION NAME PARCEL MAP
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome,Rj Other
(T SPECIFY
' TYPE -OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities Installation[] Other ❑
Describe work' /?j
.. F.� r
Qi /%i i
PERMIT NO.
BUILDING PERMIT "
SO. FT. OCC. BUILDING VALUATION
Fireplace
Total Valuation $
Filing Fee
Permit Fee
Plan Checking Fee
Energy Plan Checking Fee
Penalty
Penult fee
PLUMBING PERMIT
Each Trap
Solar or heat pump water heater
Water piping
Each qas water heater or vent
Gas piping system 1 - 5 outlets
Building sewer
Mobile Home
Permit Fee
Contractor
ELECTRICAL PERMIT
Main service eoov OR LESS
100 AMP OR LESS
Main servi e
~
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
El I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification.
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
-ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
c EA. ADD'L 100 AMP
NEW CONST. / DWELLING OCCUP.y`
OR AODNS. 1 ACC. SLOGS. I
NEW CONSTR. U TI.OUTLET
NN
OZ1:rE1.1D BRANCH CIRC ITs
APPARATUS aI
( SINGLE
NGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES
FIXED APPLES. OR
EX. OCCUp. OUTLETS (REST D.) EA.)
Temporary service
Mobile Home Facilities
Misc. Wiring
Permit Fee
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Heating
Cooling
Hood
Ventilation
Permit Fee
Contractor
I certify that I have read this application and state that the above information Mobile Home Installation Fee I'
is correct. I agree to comply to all County Ordinances and State Laws relating Energy Inspection Fee
to building construction, and hereby authorize representatives of the County orDcc CONST TYPE
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 TOTAL FEE
all liabilities,L' judgments, costs, and expenses which may in any way accrue HACUA PARK SCHL FLD I CDF
against said County in consequence of the granting of this permit.
11
10.00
■�'AM4VW
MINION
IN, ..
NONNI
��
X DateThis permit is hereby issued unser the appiicable provi-
sions of the Butte County. Code and/or resolutions to do
Signoture of Applicant — Owner (_1Contractor ❑ Agent ❑ work indicated above for which fees have been paid.
An OSHA permit is required for excavations over 5'0" deep and demolition or construct- DIRECTOR OF PUBLIC WORKS
ion of structures over 3 stories in height.
Receipt No. By Date
WHITE-D.P.W.• TELLOW-Age ESSOR• PINK -INSPECTOR. GOLDENROD-•PRI.ICANT PERMIT EXPIRES not.
COUNTY OF BUTTE - Depar.tment of Public Works
7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541
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) �s .
2: I (have/have not)A6//e /YG7—_signed an application for a building permit
for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed
construction:
Name _
Address _ City
Phone Contractors License No.
4. I plan to provide portions of this work, but I have hired the following person
to coordinate, supervise, and provide the major work:
Name
Address City
Phone Contractors License No.
5. I will provide some of the work but I have contracted (hired) the following
persons to provide the work indicated:
Name Address Phone Type of Work
Signed:
Property Owner
Social Security Number _
Date
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and
19832 of the California Health and Safety Code.
This verification must be completed and returned to our office before we are per-
mitted to issue the permit.
,Z,-
iJ AGRICULTURAL' STA=,NT OF ACKNOWLEDGEMENT
-FOR RESIDENTIAL DEVELOPMENT
1191
26-8.1 of the Butte 'County Code
-es this -acknowledgement be recorded
it to issuance..of a .building, permit.'.... — - - --=- _
The property described herein is adjacent
91-024929
to. land or included within an area zoned Recorded
for agricultural purposes, -and residents Oficial Records
of this property may be subject to incon- County of
veniences or discomfort arising from the Butte
use of agricultural chemicals, including,
but not limited to herbicides, pesticides, Candace J. Grubbs
and fertilizers; and from the pursuit Recorder
of agricultural operations � includino 8:26am 20 -Jun -91
but, not limited to cultivation, plowing,
spraying, pruning, and harvesting which
occasionally generate dust, smoke, noise, and odor.
tural zones which have as a priority use for productiv
within said zones and on adjacent property should be
or discomfort from normal, necessary farm operations.
Rec Fee 7.00
Check 7.00
XX 2
Butte County has established agricul-
agricultural purposes, and residents
prepared to accept such inconvenience'
All that real property. situate in the County of Butte, State of California, described as
follows:
��p 6�_f__3z
Date:
PR PERTY WNERS:
State of ) On this the L� day of 19 q/ before me, the,
.-.SS. underSig
edgry�ubli�c,/,/p/ersona�lly appeared
County of )
:Personally known to me. Proved to me on the basis
OFFICIAL SEAL of satisfactory evidence.
RUBY J. BOAZE to Ibe the person(s) whose -names) f 5
Notary Public-Calitomla
?' ®
BUTTE COUNTY subscribed to the within instrument and acknowledged that
exe uted the same for the purposes therein contained. IN WITNESS,
<. My Comm. Exp. Aug. 21, 1992 gliE 'EOF, I hereunto set my hand and 1 seal.
PresentYA.P. No.%✓�� .�
ota ublic
1. Property location: south of the intersection of Los
Verjeles Road and Da'mron Road.
Bangor area.
2. Assessor's Parcel Number: 28_33-36
Description: All that certain property located in the County
of Butte, State 'of California, more particularly
described as follows:
The North half of the Southwest quarter of the Southeast quarter of the
Northeast quarter of Section 34, Township 18 North, Range 5 Fast,
M.D.B.''& M. 4' °
Together with rights-of-way of record recorded in Book 28'76 of Butte
County Official Records at Page 613.
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196 MEMORIAL WAY 7 COUNTY CENTER DRIVE 747 ELLIOTT ROAD
CHICO, CALIFORNIA OROVILLE, CALIFORNIA PARADISE, CALIFORNIA
891-2727 538-7281 872-6308
BUTTE COUNTY DEPARTMENT OF PUBLIC HEALTH OL't
DIVISION OFENVIRONMENTAL HEALTH . tz;'
SEPTIC TANK INSPECTION CERTIFICA E
Ay
The Septic Tank System was Installed at y
FOR_
SEPTIC TANK
i
Size Gallons
Material
LEACH��GFIELD'
Lengthft•
Width -2L/--in. -
No. of Lines '+
Rock Under Tile���+�
The t
ve dimensions meet the minimum requirements of Butte County Code, Article 19.
Additional leaching area will be required if experience shows it to be necessary.
Remarks:
i
Date
S2 -778R
fl
2
n
BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM 8UiLD:K1G D;E�lr
(One Form Per Building) JVIj ; UJ
n�
J J�
School District Building Department No.
A.P. Number ` r �.C� Jurisdiction [ City � County
Property Owner
Property Location/Address . _ rvi c _�, a` . ;may a c e ` at o r
Subdivison
Residential Development I _ j I �__
No. of Living MHI
Units
Commercial/Industrial
Lot No.
0 Sq. Footage X00
Addition (Group R)
[� Sq. Footage
New Addition (Including Exterior
Roofed Areas)
o—� ok �4 V-\, .... . - .. - -1 —
d='
Building Department Representative Date
�A- ow P,la�s.x�riewed k t3ck►eol D stYi t#'ersorrued)
District Identification No. 2 04 8 8 y
School District certifies thatk—,
(Applicant)
3d
(Street Address) (Phone Number)
(City) (state) (Zip Code)
has complied with the requirements of Resolution No. �(��.� y -- by payment of $
representing square feet.
School District Representative Date
Paid by Check Number
Bank Number j
Paid by Cash ,
Remarks:�1�._—�
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) feeformmkf (4/92)
_es
.,r to
9 1 -24929
P, W AGRICULTURAL' STATEMENT OF ACKiOW=- F EENT
FOR RESIDEITIAL DEVELOPMENT
26-8.1 of the Butte County Code
this 'acknowledgement be•recorded _
issuance ..of a .building. permit.
The property described herein is adjacent
91—M49L9
to. land or included within an area zoned Recorded
for agricultural purposes, and residents ; Official Records
of this property may be subject to incon-
veniences or discomfort arising from the
use of agricultural chemicals, including, Butte
but not limited to herbicides, pesticides, Candace J. Grubbs
and fertilizers; and from the pursuit Recorder
of agricultural operations including, 8:26am 20 -Jun -91
but not limited to cultivation, plowing,
spraying, pruning, and harvesting which
occasionally generate dust, smoke, noise, and odor.
tural zones which have as a priority use for productive
within said zones and on adjacent property should be
or discomfort from normal, necessary farm operations.
Rec Fee 7.00
Check 7. 00
XX 2
Butte County has established agricul-
agricultural purposes, and residents
prepared to accept such inconvenience
All that real property situate in the County of Butte, State of California, described as
follows: I
,/� P 6--) - r __ 33 - ___� 14
Date:
PR PERTY WNERS:
L Lpj�
State of ) On this the 1 G 0 day of 19 e�/ before me, the,
SS. undersig ed N ry ublic, ersonally appeared
County of )
OFFICIAL SEAL
RUBY J. BOAZE
Notary Public-Celitomia
BUTTE COUNTY
My Comm. Exp. Aug. 21,1992
°Personally known to me.P�Proved to me on the basis
of satisfactory evidence.
to ibe the person(s) whose-name(s) 1 c5
subiscribed to the within instrument and acknowledged that
xeIuted the same for the purposes therein contained. IN WITNESS-
JHE'EOF, I hereunto set my hand and 1 seal.
Present A.P. No.
AotaXTublic
3SAOJ .L Yau-
Y71:t�oo-IT O moi..
•^^
I . Property location: south of the intersection of Los 91 — 2 4 9 2 9
Verjeles Road and Damron Road.
' Bangor area.
2. Assessor's Parcel Number: 28-33-36
Description: All that certain property located in the County
of Butte, State of California, more particularly
described as follows:
The North half of the Southwest quarter of the Southeast quarter of the
Northeast quarter of Section 34, Township 18 North, Range 5 Fast,
M.D.B.`'& M.
Together with rights-of-way of record recorded in Book 2876 of Butte
County Official Records at Page 613.
END OF DOCUMENT
91 -3fi93
�
'"" 91-034693 1 Rec Fee
z
I STF 7.00
RETURN TO PUBLIC 14ORKS a. r Recorded I Cash 8.00
Official Records I
County of 1
Butte 1
Candace J. Grubbs I
Recorder 1
8:41am 22 -Aug -91 I X 2
AP Ngo. A8 3 3= 2 =339 3 q .
NOTICE OF CONSTRUCTION
AFFECTING ADJOINING PROPERTY
The undersigned, BENJAMIN L. CULET AND I MARIAN CULET, AS TRUSTF.R..S _ TT D. T
OF THE 1984 CULET LIVING TRUST do hereby declares as follows:
DATED MARCH .,
1. I am, (We are), the owner(s) of that certain real property situated in the
County of Butte, State of California, described in attached Exhibit A.
2. I, (We), intend to apply to the County of Butte for a building permit and,
pursuant to said permit, to construct improvements on the said property.
I, (We), do hereby place all subsequent purchasers and encumbrancers on notice
that such improvements will be constructed over a parcel or lot line(s) as
described in the above noted Exhibit'A, and that subsequent purchasers and
encumbrancers should be aware of the location of such improvements.
3. So long as such improvements remain, said parcels or lots cannot be sold
separately.
DATED: j,jr v 31� 19 g I
�.04
Signature of owner of record Signature of owner of recon
STATE OF CALIFORNIA
ss.
COUNTY OF BUTTE
On-dL19 91- before me, the undersigned,'A Notary Public in
and for the State of California, residing therein, duly commissioned and sworn,
personally appeared BENJAMIN r C -L PT AND p,IARIAN GULET
luiown to me to be the persons _. whoe named subscribed to the within instrument.
and acknowledged that exectted the same.
WITNESS my hand and offical seal."
n -12
OFFICIAL SEAL i ure
RUBY J. BOAZE
Nobly A&W-Ulfomla
B.Um COUNTY RUBY J. BOAZE
Mr Oomm. Exp. Aug. 21,1992 Name typed or printed
AFTER, COMPLETION, THIS DOCUMMT 1,1UST BE RECORDED IN TI -LE OFFICE OF THE COUNTY RECORDER.
LD 1540 (5/88)
EXHIBIT "A"
PARCEL ONE:
AP 028-330-024-0
91y-34693
The Southeast quarter of the Southwest quarter of the Northeast quarter of
Section 34, Township 18 North, Range 5 East, M.D.B. & M.
PARCEL TWO:
AP 028-330-036-0
C�
The North half.of the Southwest quarter of the Southeast quarter`of the
Northeast quarter of Section 34, Township 18 North, Range 5 East, M.D.B. & M.
An easement for water line purposes over the East 20 feet and the South -20
feet of the land described in Deed recorded February 1, 1979 in Book 23.67
of Official Records, at page 375, records of Butte County, California and
as shown on Record of Survey filed October 22, 1981 in Book 84 of Maps, at
page 26.
PARCEL THREE:
AP 028-330-038-0
The North half of the Southeast quarter of the Southeast quarter of the
Northeast quarter of Section 34, Township 18 North, Range 5 East, M.D.B. & M.
An easement for water line purposes over the North 40 feet of the West
450 feet of the land described in the Deed recorded January 17, 1980 in
Book 2480 of Official Records, at page 373, records of Butte County,
California and as shown on Record of Survey filed October 22, 1981 in
Book 84 of Maps, at page 26.
PARCEL FOUR:
AP 028-330-039-0
The South half of the Northeast quarter of the Southeast quarter of the North-
east quarter of Section 34, Township 18 North, Range 5 East, M.D.B. & M.
An easement for well and water line purposes over the South 50 feet of the
East 250 feet of the land described in Deed recorded October 12, 1971 in
Book 1706 of Official Records, at page 443, records of Butte County,
Claifornia and as shown on Record of Survey filed October 22, 1981 in
Book 84 of Maps, at page 26.
END OF DOCUMENT
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1
BUTTE COUNTY AREA
DEPARTMENT OF DEVELOPMENT SERVICES
INSPECTION CARD MUST BE ON JOB SITE
24 Hour Inspection Line (IVR) : (530) 538-4365
Office: (530) 538-7601 Fax: (530) 538-2140 Website: www.buttecounty.net/dds
Permit No: B09-0736 Issued: 7/27/2009
Address: 30 DEMETRI PL, BANGOR
APN: 028-330-036
Owner: MCMILLIAN, WILLIAM
Permit Type: SFD-MOBILE HOME PFS
Description: MH ON PERM FND REPLACES EX
Flood Zone: SRA Area:
SETBACKS for Zoning: AG. SRA. PW
Front: Centerline of Road:
Rear: 5 SRA:
Side: 5 AG:,
f Other:
I Total Setback from Centerline of Road: 55
ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING
Inspection Type
IVR INSP DATE
Setbacks
131
.Foundations / Footings
111
Pier/Column Footings
122
Grade Beams
114
Eufer Ground
216
Forms/Steel/Holdowns
112
Do Not Pour Concrete Until Above are Signed
Pre -Slab
124
Gas Test House or Yard
404
Gas Piping House or Yard
403
Masonry Grout
120
Masonry Bond Beam
119
Underfloor Framing
149
Underfloor Ducts
319
Shear Transfer
136
Under Floor Plumbing
412
Under Slab Plumbing
411
Do Not Install Floor Sheathing or Slab Until Above Signed
Straps/Holdowns
154
Shearwall/B.W.P.-Interior
134
ShearwalUB.W.P.-Exterior
135
Roof Nail/Drag Trusses
129
Do Not Install Siding/Stucco or Roofing Until Above Signed
Rough Framing
153
Rough Plumbing
406
Rough Mechanical
316
Rough Electrical
208
4 -Way Rough Framing
128
Gas Piping House or Yard
403
Shower Pan/Tub Test
408
Fire Sprinkler Test or Final
702
Do Not Insulate Until Above Signed
Permit inal
802
Electrical Final
803
Mechanical Final
809
Plumbing Final
813
Swimming Pools
'Setbacks
Inspection Type
IVR INSP DATE
T -Bar Ceiling/ RC
145
Stucco Lath
142
Stucco Brown
144
Swimming Pools
'Setbacks
131
Pool Plumbing Test
504
Gas Test
404
Pre-Gunute
506
Pool Elec/Bonding/Light Nitch
502
Pool Fencing/Alarms/Barriers
503
Pre -Plaster
507
Manufactured Homes
Setbacks 131
Blocking/Underpining 612 qwex
Tiedown/Soft Set System
611
Permanent Foundation System
Site Utilities/Trench Insp.
613 ,'
137 S
Gas Test Yard
404
t Manometer Test
Continuity Test
Skirting/Steps/Landings
605
602 J D9
610
i
Coach Info
Manufactures Name: CMH Manufacturing West, Inc.
Date of Manufacture: 2009
Model Name/Number: Maui 44011A
Serial Numbers: SAC033655CA AB
Length x Width: 44 X 24
Insignia: RAD 1477822/23
Fina]s
�f
Public Works Fina 538-7681
Fire De artment/CDF 538-6226
Env. Health Final 538-7281
Sewer District Final
"PROJECT FINAL "
rru,ecA rwai is a 1,eruucaie ui vccupaucy Lor-fxeswennai vnry)
PERMITS BECOME NULL AND VOID I YEAR FROM THE DATE OF ISSUANCE. IF WORK HAS COMMENCED, YOU MAY PAY FOR A I YEAR
RENEWAL 30 DAYS PRIQR TO EXPIRATION
Inspector,Copy
I
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING, PERMIT
24 HOUR INSPECTION (IVR)#: (530) 538-4365
OFFICE'#: (530) 538-7601 FAX#: (530) 538-2140
WEBSITE: www.buttecounty.net\dds
Contractor Applicant: Square Footage:
ENGLAND, PENNY Building Garage Remdl/Addn
6366 LINCOLN BLVD 1,041
OROVILLE, CA 95966 Other Porch/Patio Total
(530)533-9117
FEE INFORMATION
DB CA BLDG STANDARDS SB 1473
$5.00
PROJECT INFORMATION
$10.08
Site Address:
30 DEMETRI PL
DBF MH Plan Check
Owner:
DBFIRE Fire Inspection (SRA)
Permit No: $09-0736
APN:
028-330-036
DBFIRE SRA Fire Plan Review (S
MCMILLIAN, WILLIAM
DBMSC Mobile Home Permit Fee.
$361.74
Permit type:
RESIDENTIAL
3050 SAN LORENZO WY
Issued Date: 7/27/2009 By: AAM
Subtype:
SFD-MOBILE HOME PFS
CARMICHAEL, CA 95608
Expiration Date: 7/27/2010
Description:
MH ON PERM FND REPLACES EX
(530) 679-0760
Occupancy: Zoning: A-5
Contractor Applicant: Square Footage:
ENGLAND, PENNY Building Garage Remdl/Addn
6366 LINCOLN BLVD 1,041
OROVILLE, CA 95966 Other Porch/Patio Total
(530)533-9117
FEE INFORMATION
DB CA BLDG STANDARDS SB 1473
$5.00
DB SMIP RESIDENTIAL
$10.08
DBEH Building Review Fee
$78.90
DBF MH Plan Check
$241.16
DBFIRE Fire Inspection (SRA)
$107.00
DBFIRE FIRE INSPECTION (SRA)
$107.00
DBFIRE SRA Fire Plan Review (S
$107.00
DBMSC Mobile Home Permit Fee.
$361.74
LICENSED CONTRACTOR'S DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
I I
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license
is in full force and effect.
X 7/27/2009
Contractor's Signature
Date
I WORKERS' COMPENSATION DECLARATION I
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
❑I have and will maintain a certificate of consent to seffinsure for workers'
compensation, issued by the Director of Industrial Relations as provided for by Section
3700 of the Labor Code, for the performance of the work for which this permit is issued.
Policy No.
❑I have and will maintain workers' compensation insurance, as required by Section 3700
of the Labor Code, for the performance of the work for which this permit is issued. My workers'
Cartier. Policy Number. Exp. Date:
DI certify that, in the performance of the work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that, if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with
those provisions.
X - 7/27/2009
Signature Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN
ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
CONSTRUCTION LENDING AGENCY DECLARATION
I hereby affirm under penalty of perjury that there is a construction lending agency for the
performance of the work for which this permit is issued (Section 3097, Civil Code).
Lenders Name and Address
Lender's Name & Address
City State Zip
DBOMSC Fire Safe Standards Rev
DP Planning. Clearance for Perm
Balance Due: $0.00 Receipt No:
OWNER / BUILDER DECLARATION
$118.98
$78.70
$1
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for
the reason(s) indicated below by the checkmark(s) I have placed next to -the applicable item(s)
(Section 7031.5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the
applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions
of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt from licensure and the basis for the
alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant
to a civil penalty of not more than five hundred dollars ($500).):
I, as owner of the property, or my employees with wages as their sole compensation,
will do U all of or U portions of the work, and the structure is not intended or offered for
sale (Section 7044, Business and Professions Code: The Contractors' State License Law does
not apply to an owner of property who, through employees' or personal effort, builds or
improves the property, provided that the improvements are not intended or offered for sale. If,
however, the building or improvement is sold within one year of completion, the Owner -Builder
will have the burden of proving that it was not built or
improved for the purpose of sale.).
I, as owner of the property, am exclusively contracting with licensed Contractors to
construct the project (Section 7044, Business and Professions Code: The Contractors' State
License Law does not apply to an owner of property who builds or improves thereon, and who
contracts for the projects with a licensed Contractor pursuant to the Contractors' State License
Law.).
I am exempt from licensure under the Contractors' State License Law for the
reason:
7/27/2009
I_ _ PERMIT APPLICANT DECLARATION _ _._ __.I
By my signature below, I certify to each of the following:
am U a California licensed contractor or U the property owner' or U authorized to
act on the property owner's behalf**.
I have read this construction permit application and the information I have provided is
correct.
I agree to comply with all applicable city and county ordinances and state laws relating
to building construction.
I authorize representatives of this city or county to enter the above -identified property
for inspection purposes. California Licensed Contractor, Property Owner' or Authorized
X 7/27/2009
Name of Permittee [SIGN] Print Date
INSPECTOR COPY