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HomeMy WebLinkAbout028-400-01028-40-10 WILLIAM MOORE ��Sunrise Hill Rd, Bango eP rmit#859-88E(200 amp powerkpe &�UVy ser panel for floodlight) (t I 28- 0' 1444-91P,E h = CUNNINGHAM, *eteT • T - _ - - /1 � Y O r" ;--RESIDENTfAL 02 . 8-400-010 r P - ERMIT#9-5 - -23..9-2.-- HENDERSEN, David & Faith 178 Sunrise Hill Rd., Bangor Cont; D & D Mobile Ex MH on Perm Fnd V cS7at c, w e rl © F --t -f q �s ��o �s� ZI'2 6 S6L OFFICE COPY Address GAS Meter By D ELECT Meter Date-' JOB FINALED (Date) Signature ' - ,/' i _ _. '£� J=OK O = Not OK Not = Nbt Ready- MOBILE HOMES l/I,. Zoning Requirements -Setbacks -Easements Soils; Speciaf MH Support Sketch ' 3. Sewer; Location -Test -Fall -C/O Concrete J Water; Location -Test -Easement Neede (Sketch) 5 Electr'city: Location-Clearences-GmdAmp-Concrete 6.s; Locatio - t•Wjw_1 / L / P'Nat. or ' ft./ LPG 7. Well Clearance & Disconnect LA w 8. Utility Clearance Date - ' c, , and B• i Date Card B-1 Date Card B-1 Date Card B-1 Date MOB ECHOME INSTALLATION (Plans) OK except #'s Ll';oK,'ng Requirements -Setbacks Easements Fo ' gs: Size -Spacing -Marriage Line Gas; Test-Demand-Valve—Connector i ectricity; MH Test -Crossovers -Breakers -Clearances r H Test -Fall -Flex Connector •B:Wgtet!fiitH Test -Regulator -Connector Wates Sewer Connected -C/O to Grade -HD Approval 1,�Cert. of Occupancy Date/,�h�/45n'Card/Ot Date Card B-1 Date/ / ' Card 8-1/ Date Card B-1 ' I MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES. (Plans)OK except N's 1. Zoning Requirements -Setbacks -Easements s =• -� 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 Ws 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining . 4. Elec.: Receptacles and Lighting, Distances-GFI S. 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 -Panel boards -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 B-1 =OK O = Not OK �- = Not Applicable Not Ready RESIDENTIAL • = pate UNDERFLOOR (Plans) OK except n's 1. Zoning -Setbacks -Easements -Flood -Slope 2. Fig., Main: Soils-Elec. Grnd.-/ /" Fig. Depth 3. Fig., Garage: Soils-Steel-Elec. Grnd.-/ /" Fig. Depth 4. Ftg., Porches & Decks: Soils -Steel-/ /Fig. Depth S. Stemwalls, Main: Steel-Blockouts-Wrapped 6. Stemwalls, Garage: Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab: Steel -Wrapped S. 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 a's 16. Water Htr.: Vent -Access -Combustion Air -Baffle 17. Water Pipe: Test & Anchor -Nail_ Protection 18. D.W.V.: Test -Fittings & Anchor -Nail Protection - - - ------ - ---------------- 19. Shower Pan: Test. First Floor -Tub Access 20. Test Tub & Shower. Second Floor -Tub Access - 21. Gas Pipe: Size & Anchors Date Card B-1 Date Card B-1 ---------------- ----------------------------------------- Date Card B--1 Date Card B-1 Date ELECTRICAL (Permit) OK except 4's 22. Fixture & Transformer Clearance -Ins. Protection -------------------- ------------------- ----------------------- -- 23. Elec. Receptacles Spacing -Lights & Switches at Doors ------- - - ------ - --------------- --------------- --------------- 24. Size Boxes & No. of Conductors-Stapled ------------------------------------------------------------------------------- 25. ------•---------------------•---- 25. Romex Installed Close to Edge of Studs & C.J. --------------------------------- - ------------------------------------------------- 26. Equip, Ground made up w,Mech. Fastners-Bond Gas & Water ------------------•---•--------------------------------------------•----- 27 2 Appliance Clrcuts in Kitchen & Conductor Size,GFI --------------- ­­----------------------------------------------------- ------ 28. Subfeed Wire Size ga. Cu or AI-A.C. Wire Size , ' ga. Cu or At --------------•---------------------------•--- ------------------------------•--- 29. Range Circ. • ' ga. Cu or AI -Oven Circ. r ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No •-------.._ --- ------•--------------•---------------------------------------- 30. Service -R ser Conductors & Ground -Main Disconnect --•-------- -----------------------..--•------•----------•-•---------- -- 31. Equip. Clearances Panels-Motors-Mech. Equip. ------- ---------------------------------------------------- 32. --•------------------------------- - 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector ---------------------------------------- -------------------------- - ------------ -- ------------------------------------ Date Card B -I Date Card B-1 ------------------._...----------- ....._------------------------- ---•---------- Date Card B -I Date Card B-1 Date MECHANICAL IPermrt) OK except a•s 34. A.C. Ducts Insulation & Support •-•- -•----------............. --............ .......... ......... .... 35. Vent Fan: Exhaust above insulation ---------- .._ - -- ---------- ------ ----- ----------- ----- --- .--- _.._..---- ------- 36. Condensate Drain & Overflow. Size & Grade ..-----•--- .. ............ .._ ... 37. Furnance-Vent: Access -Comb Air -Return Air Vent -115 outlet 38 Attic Access '& Platform if Furnance in Attic ------ -- ---- .. Dale Card B-1 Data: Card B -I Dale Caid B-1 Data Card B.I Dale FRAMING iPlansl OK except *s 39 Sit,; Prooer Material & Anchors 40 Wills Studs-Naiiinq. %mcinq & Bracuiq-Plates•Sound ... .. .11 Blaring Walls over (wool; & Floor N: iliny - 42 Dialt Sluo m Walls !r:rl plot,[)-- .. - 43 Fur titop, Fwr-?d (:rduul5•tilau•;-(;hasei- i un .... 44 Hr•dilrr5 A. Bram-'ivu R Iluanrirl .. .. Single & Duplex) Date FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties- Purlin-roof Brac-Truss-Shthng.-Rfng. 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access: Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Ooors-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 -Fre 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. Insulation -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 il'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.1. & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & S_ubpanel: Breaker Sizes & Labels 67. Stairs &Rails _ - 68. Fireplace or Stove:_ Clearances -Hearth 69. Elec. Outlets at Wood Panel: Int. & Ext. 70. Kit.Fixt & Appliance; Grnd.-Air Gap -Cooking Clearance ------------------ 71. Elec. Outlets & Receptacles at Kit. Counter ---------- ---.---•------------------------- 72. Garage Fire Door Swing -Landing -Closer _ 73. A.C. Duct in Garage -Damper •---- ---------------------------------- 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. ------ --------------------------------- 7d.GuardRails & Deck Construction -Post Caps 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes ..........- - -- ---- -------------- 80. Following instld.: Drive ❑, Yes ❑ No: Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No ------..--...-------------------------------------- - dL Stucco_Brown-Finish _ 82. A.C. Unit Disconnect Electrical Plumbing ---------------------------9 _----�-------- - - 83. Vents Above Roof: Plb App ante -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 ------------- 86 --------- 86 Corrections from Previous Inspections 89. Gas Test -Meters Tagged: Gas -Electric .. - --------------------------- l, 90. Water & Sewer Connected -C O to Grade -HD Approval 91 Energy Compliance Certificate -Other Certificates - -- ------- -------- - -- Date Card 13-1 Oate --_- Card B_1 -- Date C.ird B-1 Date Card B-1 - ---- Date Caro B-1 Date Card B -t Comments at Final: __--_-- -- ------ {------- i COUNTY OF BUTTE BUILDING DIVISION DEPARTMEN1,0F DEVELOPMENT SERVICES 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. Date j— Inspecto REV 10/ 2 COUNTY OF BUTTE- DEPARTMENT OF D�VELOPMENTSERVICES - BUILDING DIVISION 7 .County Center Drive - Oroville, 4alifornia 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT 9d-��33 20 ASSESSOR PARCEL NUMBER 028-400-010 ZONING A5 BUILDING PERMIT OWNER DAVID & FAITH HENDERSEN T&79-2329 SQ. FT. OCC. BUILDING VALUATION 1540 R 83 160.00 OWNERS MAILING ADDRESS P.O. BOX 474 BANGOR, 95914 CONTRACTORS NAME D & D MOBILE HOMES TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 20.00 LENDERS MAILING ADDRESS Permit Fee 2 $ 283.75 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 23.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS 178 SUNRISE :HILL RD PERMITFEE $ 326.75 BANGOR, 95914 PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP Solar or heat pump water heater 23.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome b Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 15.00 Building sewer 15.00 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑X Describe Work: MH ON PERM. FOUNDATION (EXIST. MH) Mobile Home I S I GI W @20.00 PERMITFEE $ 65.00 Contractor ELECTRICAL PERMIT Filing Fee 20:00 Main Service OOOV OR LESS \ ( 200A OR LESS J -23 23.00 -700 Main Service ( 200A TO 1000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, s owner of the property, or my employees with wages as their sole compensation, II do the work, and the structure is not intended or offered for sale. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUR OR ADDNS. 8 ACC. ) SO. 3.5¢ FT. NEW CONST. MULTI -OUTLET UTLE NON-RESID. BRANCH CIRCUITS ) @7.50 8 POWER APPARATUS ) SINGLE OUTLET CIR. Ex. Occup. (OUTLET OR FD(TURES) 20 Q 1.00 BAL .00 Ex. Occup. aunEED PLN D.ORR.a ( ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ 43.00 Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provi ' s. �i X Date _9_ d' Signature of ppli nt - wner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee Is Occ CONST. TYPE TOTAL FEE $ 434.75 HAz. D. FE�a o/ IMP FLOOD CDF� PAR PD HD ISSUE _ This permit is hereby issued under the of the Butte County Code and/or indicated above for which fees have B y applicable provisions Resolutions to do work been paid. at�� (ate) Receipt No. 185916 - 434.75//PERMITEXPIRESON WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Location Plan Approved for: Sewage Disposal Clearance for bedroom mobile home. Other I 1 i . Hold final for: Final clearance O.K. for: NOTE: E.H. USE � /ONLY Plot Plan AwwW Iii Floor Plan Attached X Sent to B.D. /�5 10 Water Supply: Public Private Well,)( Environmental Health Specialist R/Q7 9-�Z!S- Date '�'�1:1•TtR`�`"'*z Fs; \�ti.�. I" 1- -sy -'.ot {a�7�i° .' } :tLs,�'ediA.tK,fAik. ;' `.1,�.�5 .b ri ice. ,V COUNTYOF BUTTE - DEPARTMENTOF DEa/EL6PMENTSERVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER �� Q t /�r� A. P. No. _.:;?-A - 410 a — Proposed Building Use A] Building Inspector � P� Date Z At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECENED BY 1. All items have been submitted . ......... 2. Plot plans, 3/4 sets, signed by preparer of plans . ................ 0 ......... 3. C plete plans, 3/4 sets, signed by preparer of plans . ..................... .�— ngineered plans and calcs, 3/4 sets, with wet signature on plans . .............1v/S azardous Material Form. ............................................ 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... L, 8. Engineered truss details and layout in duplicate (required prior to plan check). .... 9. Mobil home data and manufacturer's installation instructions, 2 sets. .. 0 ........ 0—Fees of $ �i ............... . ............. Impact fees as shown on attached schedule. S� �l0 1 0�xcr .42 . California Department of Forestry plan approval/ ees?.©�. . 13. Flood elevation letter (100 year flood) by Californ) Pag 'in e e r. ................. . % 14. Sanitation and plot plan approval Health Department. ......... 15. City of Chico plumbing permit . ........................................ . 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: I . ........ 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). ... . Preanspection request 20. Pre -inspection for required. . 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 Acknowledgement Statement . ................... 25. Letter of signature authorization . ....................................... . T 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. ..... 27. Letter of intent on building use . ........................................ . 28. Mobilehome utility clearance . .......................................... 29. Documentation of legal access . .......................................... 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ........:...... 31. Existing violations/expired permits . ...................................... . When yo 'ssue the permit, process as follows: Mail to o �er. Mail to contractor. elephone , 2 nd hold for pickup at ' %m office. Deliver with inspector. Other Parcel Creation Acreage Applicant Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: - Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by (�- I G A ays Date Sets of plans on'hold in File cabinet �_ AP folder Copy - Department of Public Works , �...M.x��,r••) _'r�r"'`••7 �"t'rfT,'�..,ins•w�.1..���f•rr,•^�aff.:�f'..+2�i�.'�"�iw.v`}w•�..•�aG4�.�T.�Yv^tv;�`r'fav�'xn...+.�n..,rt�i...r "•!Yti"'``r,Yr.{'i-��-.' •M n.. �u A'!���tyaX.J �"1+^•"li'�„r, t'V.n,.. r J BUTTE COUNTY SCHOOLS IMPACT,FEE CERTIFICATION FORM, (One Form Per Building) n School District 10 �, �w _ �� , S Building Department No. / A.P. Number g Q— (1&0_o/0 Jurisdiction: 0 City �< County Property Owner 7D J t L. !!n J ey sM Property Location/Address Rd Subdivison Lot No. Residential Development 0 0 Sq. Footage is qQ No. of Living MHI Addition Units .,,' Commercial/Industrial F-7 Sq. Footage New Addition (Including Exterior Roofed Areas) . - Building epa en epresentative `" " -Da (Floor Plans reviewed by School District Personnel) District Identification No. �L�QQXC� (Street Address) District certifies that It 1 s1 (City) JJ (State) has complied with the requirements of Resolution No. representing hool District Representative Paid by Check # Bank Number Paid by Cash square feet. Remarks: (Pffo-ne Number) (Zip Code) by payment of $ AB 2926 4i ��S_l N FULL MITIGATION $ Date 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) feeformmkl (11/94)dmm 9 ���'i� (,,)�e;� ne � Yv�Dknl e i s �NAee� W �- �Rr� � hR �e. �1C� / rnab��e ml��e� auk- wi� i � �� Ci�4y,s 0 ��� ��8 mere �,�,��c CA 9�i>y 9i� 6 � 9 a3� 9 Return to: AGRICULTURAL STATEMENT -OF ACKNOWLEDGEMENT Building Division FOR RESIDENTIAL DEVELOPMENT I Section 26-8 of the Butte County Code requires this acknowledgement be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort arising from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural zones which have as a priority use for produc- tive agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: Date: PROPERTY OWNERS: State of California ) County of ) On before me, personally appeared personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Signature Seal: A.P. # LAND DEVELOPMENT BUILDING h-140 ONMENTAL HEALTH,- PERMIT CLEARANCE 80d171ng Permit No. NAMERStjel)A-P—�Ni I /1.1�'I'i NUMBER: C C�''Li�•��i� _ PRINT LAST NAME FIRST COUNTY ZONING DESIGNATION: FLOOD ZONE: X FLOOD MAP: SOC /j APPROVED: DEED INFORMATION: DATE OF CREATION: CONDITIONALLY APPROVED: V RESOLVE PROBLEMS PRIOR TO APPROVAL: PARCEL CREATION BY DEEDS OR MAP DEED REFERENCE: LEGAL ACCESS PROVIDED: YES NO LEGAL ACCESS REQUIRED: YES NO COMPLIES WITH COUNTY STANDARDS FOR DEED CREATION: YES NO COMMENTS/CONDITIONS: MAP INFORMATION: DATE OF RECORDING Q44-, Z4 09z- LOT. BOOK �� PAGE COMPLIANCE WITH OLD SUBDIVISION LOT ORDINANCE REQUIRED? (MAP.RECORDED PRIOR TO BOOK 17 OF MAPS AT. PAGE 23): YES 10 NO . IF YES, MARK APPROPRIATE ITEM(S) BELOW: A. Construct road to B. Meet parcel size required by zone. C. Meet current E.H.D. requirements. CHECK SPECIAL CONDITIONS WHICH APPLY TO MAP: ALL FEES TO BEPAID TO THE BUILDING DIVISION UNLESS OTHERWISENOTED. �A 1. Maintain a 50 ft. building setback from centerline of road. 2. Maintain a ft.building setback from right-of-way/centerline of 3. Maintain a 100 ft. leachfield setback from all existing wells. NO 4. Maintain a SU ft. leachfield setback from _ 5. Pay water tender fees in the amount of $ to Battalion Number of the Butte County Fire Department. 6. Meet the Fire Safe Regulations of Butte County and P.R.C. 4290. 7. Connect to a public water supply. 8. Connect to a public sewer system. 9. Automatic fire suppression sprinkler systems shall be installed in all residential structures in accordance with the National Fire Protection Association Standard for the installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet Fire Department specifications, serves the parcel. _ 10. Pay T.D.D. (Thermalito Drainage District) fee in the amount of $, 11. Meet the requirements of the Department of Fish and Game for the preservation of oak trees. (See phone number below) 12. Obtain approval from the Department of Fish and Game for vegetation removal. Contact Fish &.Game at 916-355-7010. 13. A traffic mitigation fee for each neWO'Fidditionil living unit shall be paid.. Pay the amount of S -' - as stated in the Oroville Area Traffic Mitigation Fee Agreement. Payment to be mach to Me R rmft DAssam. _ 14. All new residential buildings, shall be constructed to comply with the requirements of the Uniform Building Code for seismic safety. Mobile homes shah"6e"constructed on a permanent fpygdaXion syst�r�,. whic�l complies witkhg Seismic Zone 3 t �• requirements of the Uniform Building Code. 15. Deer Mitigation fees are to be paid, if such fees have been adopted by the Butte County Board of Supervisors. X 16. Pay school impact mitigation fees. X 17. A development impact fee for sheriff facilities shall be paid pursuant to the provisions of Chapter 3, Article II of the Butte County Code. _ 18. Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988 as amended. . . _ 19. If any cultural resources are encountered during ground disturbing activities, all work shall cease in the area of the find pending examination of the site by a professional archaeologist. This person would then be able to assess the site significance and suggest appropriate mitigation measures. %G 20. MrC /f (/Y9 /I'�' L� G &Z -2t -7O % /1-N4 /S t/•y EE1771- o Gt! L 2-1. %/��c-� s �✓a �/� Z/)✓ 64 ar i.1or'^rs TZc r,✓'�7Z-'X - /77//llli�i L 1-r 22. 23. 24. 25 '90 N awe 30 A WOO 96619 Z d3 S a3ni303a LD 9195 • C:\WP51\FORMS.K\8LDGPERM.CLR COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 Count/ Centc+Drive - Orovllle. CaJ.lfosnle 95985 - Telephone: 918,'538.7541 APPLICATION AND PERMIT PERMIT N0, Zf AJ3E550R PARCELNUMBER 28-40-10 ZONING A 5 BUILDING PERMIT OWNER CLETE CUNNINGHAM TELEPHONE 534-6192 SO. FT. OCC. BUILDING VALUATION 380 0 2 660 OWNER'S MAILING ADDRESS P.O. BOX 37 BANGOR 95914 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is 2,660 Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ 45.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Check!ng Fee $ 22.50 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 178 SUNRISE HILL ROAD BANGOR 95914 Permit fee $ 82.50 PLUMBING PERMIT Filing Fee 15.00 Each Trap 1 5.00 Solar or heat pump water heater 1 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 F-1 Mobilehome❑ Other DECK SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New7l Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work:__ OPFN FIRCK _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600v OR LESS 200A OR LESS 18.50 Main service 200A TO 1000A) 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. (cense 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) El 1, 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. OR ADONS. l ( DWELLING OCCUP.ACC, BLDGS. / 9 3.54sq.ft. NEW CONSTR ULTI.OUTLET NON•RESI BRANCH CIRCUITS) @ 5.00 POWER APPARATUS e SINGLE OUTLET CIR. ) Ex. Occup(OUTLETS OR FIXTURES 20 751 Ex. Occup. OUTLETS FIXED P(RESID )REA.) I 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 f Consent to Self -Insure. 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 becomesubject 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 g Hood 6.50 Ventilation penult 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 h less the County of Butte against all liabilities, judgments, costs, and ex nses which may in any way accrue again aid C y in consequence of a granting of this permit. X Date `� �� " 74:� Signature of Applicant —r 0 erL� L.ontractor ❑ Agent ❑ An OSHA on of structures toverr3gslrries ineheightlons over 5'0" deep and demolition or construct- Mobile Home Installation Fee S Energy Inspection Fee $ OCC CONST TYPE TOTAL FEE $ $2,50 HAz I DFEES I IMP I FLOOD I CDF PAR-CELl PD I 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. 117201 82.50 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT t. COUNTY OF BUTTE,h PARTMENT Pl1BLIC WO , BUILDING DIVISION r - � Y 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541 ., PERMIT AP LICATION DATA SHEET A. P. No. Q 0 OWNER U)'7{1 )(% h n � v Proposed Building UseQf'7 `,QG Building Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 5. 6. 7. 8. 9. 10. 11. 12. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. All items h e been submitted . ........................................ Plot plan/4 setp, signed by preparer of plans. .... ........... Complete plan /4 sets, signed by pLeparer of plans... ..."...........t.. . 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 U 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 request -- Pre -inspection for required. .. to Building Inspector (Date) Contractor's license infor'rnation. (No., Name Style, Classification) . .............. Certificate of Workmans Compensation Insurance . .......................... Owner -Builder Verification (Given to owner , Mail to owner _) ............ Recorded copy of Agricultural Acknowledgement Statement . .................. Letter of signature authorization . ........................................ Copy of recorded deed of parcel creation.and 60 right of way to a public road. .... . Letter of intent on building use ....... . Mobilehome utility clearance ..... . Documentation of legal access . ........................................ Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... Existing violations/expired permits . ...................................... Plan check list . ...................................................... WhenXu issue the er t y ess as follows: Mail to owner. Mail to contractor. Telephone �( f and hold for pickup at office. Deliver with inspector. Other _ /J Parcel Creation Acreage Applicant Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollutiop%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. -0 _,Z i¢ 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by /2!L/Date 6 Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works' COUNTY OF BUTTE - Department 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)21 sued until this verification is received. personally plan to provide the.major labor and materials for construction of he proposed property improvement (yes or no) 61 (have/have not) _ signed an application for a building permit or the proposed w k. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the fo.14-lowing 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: q 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. 2111 RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: NAME BUILDING DIVISION 7 COUNTY CENTER DRIVE STREET OROVILLE CA 95965 ADDRESS CITY. STATE and ZIP 95-040669 195-040669 195-040669 95-040669'1 Rec Fee .00 I Total .00 Recorded I Official Records I County of I Butte I Candace J. Grubbs I Recorder I 9:28am 16 -Nov -95 I COMS XX 2 SPACE ABOVE THIS UNE FOR RECORDER USE ONLY NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH, INSTALLATION ON A FOUNDATION SYSTEM Recording of this document at the request of the local agency indicated is in accordance with California Health and Safety Code Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all persons thereafter dealing with the real property. DAVID V AND FAITH L HENDERSON REAL PROPERTY OWNER/LESSOR P 0 BOX 474 MAILING ADDRESS BANGOR, BUTTE, CA 95914 CITY COUNTY STATE ZIP 178 SUNRISE HILL ROAD INSTALLATION MAILING ADDRESS. IF DIFFERENT BANGOR, BUTTE, CA 95914 CRY. COUNTY STATE ZIP SAME UNIT OWNER (If also property owner, write "SAME'l MAILING ADDRESS CITY COUNTY STATE ZIP UNIT DESCRIPTION BUTTE COUNTY BUILDING DIVISION LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 COUNTY CENTER DRIVE MAILING ADDRESS OROVILLE, BUTTE, CA 95965 CITY COUNTY STATE ZIP 95-2392 (916) 538-7541 BUILDING PERMIT O. TELEPHONE NUMBER 11/15/95 SIGNATURE OF LOCAL AFICIAL DATE NONE DEALER NAME (If not a dealer sale, write "NONE'l DEALER LICENSE NO. FLEETWOOD 1995 5604B MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER CAFLS 17A&B 18016SH12 60'X25'8" RAD 854284/854285' SERIAL NUMBERS) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION ASSESSOR'S PARCEL NUMBER A.P. #028-40-0-010 SEE ATTACHED LEGAL DESCRIPTION. HCD FORM 433(A) Rev. 8/91 WHITE—County Recorder CANARY—HCD PINK—Applicant GOLOENROO—Building Dept. LEGAL DESCRIPTION A.P. #028 -40 -MIO ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE STATE OF CALIFORNIA, COUNTY OF BUTTE, DESCRIBED AS FOLLOWS: PARCEL I: PARCEL 4, AS SHOWN ON THAT CERTAIN PARCEL MAP ENTITLED, "BEING A PORTION OF THE NW 1/4 OF NW 1/4 OF SECTION 28, T.18N., R.5E., M.D.M.", SAID PARCEL MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON NOVEMBER 1, 1982, IN BOOK 89 OF MAPS, AT PAGE(S) 77. PARCEL H: A 60 FOOT NON-EXCLUSIVE EASEMENT FOR INGRESS AND EGRESS, ROAD AND PUBLIC UTILITY PURPOSES OVER PARCELS 1, 2 AND 3, AS SHOWN ON THAT CERTAIN PARCEL MAP ENTITLED, "BEING A PORTION OF THE NW 1/4 OF NW 1/4 OF SECTION 28, T. 18N., R5E., M.D.M.', SAID PARCEL MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON NOVEMBER 1, 1982, IN BOOK 89 OF MAPS, AT PAGE(S) 77. PARCEL III: AN EASEMENT FOR INGRESS AND EGRESS AND INCIDENTAL RIGHTS, ALONG, ACROSS AND OVER A STRIP OF LAND 25.0 FEET WIDE TO BE LOCATED WITHIN THE WESTERLY 30.0 FEET OF THE SOUTHWEST QUARTER OF THE NORTHWEST QUARTER OF SECTION 28, TOWNSHIP 18 NORTH, RANGE 5 EAST, M.D.B. & M., AND THAT PORTION OF THE NORTHWEST QUARTER OF THE SOUTHWEST QUARTER OF SAID SECTION 28, LYING NORTH 0' BANGOR PARK ROAD. PARCEL IV: AN EASEMENT FOR ROAD AND UTILITY PURPOSES OVER A STRIP OF LAND 60.0 FEET IN WIDTH, OVER THE FOLLOWING DESCRIBED PROPERTY: THE WEST HALF OF THE SOUTHWEST QUARTER OF THE NORTHWEST QUARTER AND THAT PORTION OF THE WEST HALF OF THE NORTHWEST QUARTER OF THE SOUTHWEST QUARTER LYING NORTHERLY OF THE BANGOR PARK ROAD, AS IT EXISTING JANUARY 1, 1957, IN SECTION 28, TOWNSHIP 18 NORTH, RANGE 5 EAST, M.D.B. & M. THE LOCATION OF SAID EASEMENT IS THE SAME AS THE EXISTING ROAD WHICH RUNS FROM BANGOR PARK ROAD IN A NORTHERLY AND SOUTHERLY DIRECTION, AND GENERALLY PARALLELING THE WESTERLY LINE OF THE ABOVE DESCRIBED PARCEL. SAID EASEMENT TO BE FOR THE USE, BENEFIT AND APPURTENANT TO THE NORTHWEST QUARTER OF THE NORTHWEST QUARTER OF SAID SECTION 28. BUILDING PERMIT NUMBER: 95-2392 Address or location of unit: 178 SUNRISE HILL ROAD, BANGOR Legal Description of Real Property: 028-40-0-010 SEE ATTACHED LEGAL.DESCRIPTION. [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: DAVID V AND FAITH L HENDERSON Owner's address: P 0 BOX 474, BANGOR CA 95914 INSIGNIA OF HUD NUMBER: RAD 854284/854285 6, ,.- SERIAL NUMBER OR V.I.N. `r CAFLS 17A&B 18016SH12 FLEETG00 xJ995 rMANUFACTURER'S NAME: YEAR: OFFICIAL APPROVING INSTALLATION: DATE: 11/15/95 PHONE: (916) 538-7541 H.C.D. 513C STATE OF CALIFORNIA t; DEPARTMENT OF HOUSING. -AND COMMUNITY DEVELOPMENT DIV F AND STANDARDS�y' DIVISION 0 CODES r REGISTRATION AND TITLING SECTION STATEMENT OF FACTS This unit is a:2 Mobilehome [] Commercial Coach Floating Home Truck Camper Decal (License) No.(s) Trade Name Serial No.(s) Flee�-K o CA F1- `� ' l 4 91-/6 -- I/We, the �undersigned, hereby /state that the unit described above: / �l !tJ .. /'Y IlYK-Ci f'!.�'.S /!/E'vCiL Lj t-r►s.er .ZN S�-.� /%cit" Affiant further agrees to indemnify and save harmless the Director of Housing and Community Development, State of California, and subsequent purchasers of said unit, for any loss they may suffer resulting from registration of the above-described unit in California, or from issuance of a California certificate of title covering the same. I/We certify under penalty of perjury that the foregoing is true and correct. Executed on 1/—/S— 9,5- at 69o2Dre L"!9 Date (City) (State) Signature of each affiant Printed name of each affiant Address ��1.3 �P•4���� Q►i� City D� o v: Il , State zXXIA HCD 416.6 (Rev 11/86) NIS REQUESTED By TTE COUNTY TITLE CO MY IL TAX STATEMENT TO same as below WHEN RECORDED MAIL TO N.-. st,a„ David Henderson AOUHp 178 Sunrise Hill Rd'. City Bangor, Ca 95914 sut. 2.o IL_—. ORDER NO. ESCROW NO. �d-4l(IJ 92-0427191 Rec Fee I DOC Recorded I Check. Official Records I County of I Butte I Candace J. Grubbs 1 Recorder I 8:00am 24 -Sep -92 I GRANT DEED The undersigned grantor(s) decl re(s65 Documentary transfer tax is S ' ( ) Computed on full value of property conveyed, or ( X) Computed on full value less value of liens and encumbrances remaining at time of sale. ( ) Unincorporated area ( ) City of Tax Parcel No. 28-400-010 ' WILLIAM V. MOOREIand MARCIA F. MOORE, husband and wife FOR A VALUABLE CONSIDERATION, HEREBY GRANT TO DAVID V. HENDERSON and FAITH L. HENDERSON, husband and,wife 8.00 15.95 23.95 BCTC MP 2 (JOINT TENANCY) as JOINT TENANTS, the real property in the County of BUTTE State of California, described as: SEE EXHIBIT "A" ATTACHED HERE'T'O AND MADE A PART HEREOF C Dated: September 22, 1992 �wv William V. Moore (Individual Acknowledgment) County Ipllll Notary Public in and for said County and Slate &S.S —MMArci.a F. Moore Dl S I A rt ur %_r L_,,...,...,.. SS. COUNTY OF. Butte On Sept. 22 __ 19 92 , before me, the undersigned, a Notary Public in and for said County and State, personally appeared Mike Moore known to me to be the person whose name is subscribed to the within instrument as a witness thereto, who being by me duly sworn, deposed and said: that he resides at Bangor, Ca ; that he was present and saw Wi111am V. MooQre —and— Marcia F. Moore __ personally known to him to be the person described in and whose name is subscribed to the within and annexed instrument, execute the same; and that affiant sub- scribed his name thereto as a witness to said execution. WITNESS my hand and official seal. IYVlOy Joe. 0 'FICJAI. SEAL BARBARA A. WOODWARD NOTARY PUJLIC . CALIFORNIA BunE COUIVITY A•IfORN`%� Ply Comm. Evolres Sept. 24,1993 W I o > CCi a u C) u u Z� Ipllll Notary Public in and for said County and Slate &S.S —MMArci.a F. Moore Dl S I A rt ur %_r L_,,...,...,.. SS. COUNTY OF. Butte On Sept. 22 __ 19 92 , before me, the undersigned, a Notary Public in and for said County and State, personally appeared Mike Moore known to me to be the person whose name is subscribed to the within instrument as a witness thereto, who being by me duly sworn, deposed and said: that he resides at Bangor, Ca ; that he was present and saw Wi111am V. MooQre —and— Marcia F. Moore __ personally known to him to be the person described in and whose name is subscribed to the within and annexed instrument, execute the same; and that affiant sub- scribed his name thereto as a witness to said execution. WITNESS my hand and official seal. IYVlOy Joe. 0 'FICJAI. SEAL BARBARA A. WOODWARD NOTARY PUJLIC . CALIFORNIA BunE COUIVITY A•IfORN`%� Ply Comm. Evolres Sept. 24,1993 sec. tar I III•�s•1t'E rsri�s'r'*E�. AM s-o`c.— A10E }!M awPARCEL. / � !i lCrtH AVIANAWAt z h� 00, • � � f llf IC�Ef a OL 4 I1 ,� gess euK l . Al �i w//.�o,� I �f� J F--•so'a�►lPuE � I 11laf�fErEl►!io 10, M AV I g to r-- issl ax ssa Jr!! Alf. I dos "Ov of rGFSErPYEO /AI ti nvE,�E / M►/TER t P b " I abR�ot,� x4ofelz 4 1 �UP ,NN•tI•ss-E r riAv.:raw r o sa onmwe 1 M+� Ar/ /wws I i �•u• 10, M AV I g to r-- issl ax ssa Jr!! Alf. I dos "Ov of rGFSErPYEO /AI nvE,�E / M►/TER i ro t•A.t. "I pis I � rc:/i f� SURI/EYAR'S CERT/F/CaTE COUNTY SURVEYOVS CERT/F/CdrE Tu/S MOO Wd S PRfPIRlD NAIL OR UA//!f? {IYO/QfCT/ON INO MIS MdP CONiORMf W/T// ri/E REOt//RtMFV7S LK na- wo- FAL E. KO.d tE0 //FID.Vd i/fLD SC/RYfY M, CMAlar"".4cf W/ry ruf ^v4vl Y- O/V/S/ov A/dP dCT dN0 Lord[ ORO/NIMCf. MEN75' Oi 7NE SY/I W�V/f/AV rYIIdCT /T7A� AfONifT 6V MSL s�tPO'Y _ l�ii. ///lMIYSTIr'111ofAME� g%4II4*0AW fAVW$ OdTEOS Cams"tf. MSl QF7JVECOCdLd4ENCYllIYEIfEMQaM�OfED1V/T/JGt40TAv'IT!/KAAmAmR 7Wt "'AWmA"t LI/ MW AW"C Q�V�OPAIS7DMFd,*AeoVfp;rVTdTAEMIo.L1/OTS/ffthVA/TJONSAcdJ10- QOVdL7!/EQEOiIMV/CNIYfRfRfOI//Pf4 AC14R//4LFO=,-E. UT/ON/oAY7ICrN7E0/7i/L/NG Oi TIJE Pd?CEL A/dO.Q+ 7NK I/ME.�• Y Cd rLfjtfOaY f /I!!I COt/NTY SLRVI rOR RESIDENTIAL 28-40-10 1444-91P,E CUNNINGHAM, Clete 178 -Sunrise Hill Rd, Bangor (utilities/mh) -��_. OFFICE COPY S6w Address L GAS [ Meter BY ELECTRIC Meter BY JOB FINAL) Signature v=OK O = Not OK Not Ready MOBILE HOMES '•= Not Ready ' Date MQJKE HOME UTILITIES (PlarP) OK except #'s 1. Zoning Requirements -Setbacks -Easements L---2­Soil�Special MH Support Sketch Sewer; Location -Test -Fall -C/O Concrete --- '4water; Location -Test -Easement Needed (Sketch) Electricity; Location-Clearences-Gr mp-Concrete VG` Gas; Location -Test -Wrap: / P L" ft. / /"Nat. oa3 L" ft.1,<PG Utility Clearance Dat and B-1 Date Card B-1 Dat // ar B-1 Date Card B-1 Date MOP4 HOME INSTALLATION Plans OK except #'s oninq Requirements -Setbacks Easemepts V 3. s; MTest-Demand-Valve—Connector Ele ricity; MH Test -Crossovers -Breakers -Clearances n• MH Test -Fall -Flex Connector . W er; MH Test -Regulator -Connector tAater and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged Q9. Exits; Insp.-Sketch 1 Cert. of Occupancy Date 1J'r1Z and B-1 04_ate Card B-1 Date n^ and B- Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s 1. Zoning Requirements-Setbacks-Easementrs 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing- irs-Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Coonectors 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 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-Pane Iboards- 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 B-1 4 O O=Not OK = Not Applicable Not Ready, RESIDENTIAL (� ' = Date UNDERFLOOR (Plans) OK except #'s 1. ZoniritSetbacks-Easements-Flood -Slope 2. Ftr ,main; Soils-Elec. Grnd.-/ /" Ftg. Depth - 3. Pfg., 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. Gas Pipe; Size -Anchors 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. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 16. Water Htr.; Vent -Access -Combustion Air -Baffle 17. Water Pipe; Test & Anchor -Nail Protection 18. O.W.V.; Test -Fittings & Anchor -Nail Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection 23. Elec. Receptacles Spacing -Lights & Switches at Doors 24. Size Boxes & No. of Conductors -Stapled 25. Romex Installed Close to Edge of Studs & C.J. 26. Equip. Ground made up w/Mech. Fastners-Bond Gas & Water 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No 30. Service -Riser Conductors & Ground -Main Disconnect 31. Equip. Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 34. A.C. Ducts Insulation & Support 35. Vent Fan; Exhaust above insulation 36. Condensate Drain & Overflow; Size & Grade 37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet 38. Attic Access & Platform if Furnance in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except #'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. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Headers & Beam -Size & Bearing (NOTE: An entry must be mad 5 angle & Duplex) e each time you visit job site) Date FRAMING (Continfued) 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties -Pu rlin -roof Brac-Truss-Shthng.-Rfng. 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing ' 51. Property Line Firewall & Openings 52. Ext. Doors -One T -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. Insulation -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 t 62. Smoke Detector 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & Subpanel; Breaker Sizes & Labels 67. Stairs & Rails 68. Fireplace or Stove; Clearances -Hearth 69. Elec. Outlets at Wood Panel; Int. & Ext. 70. Kit.Fixt. & Appliance; Grnd: Air Gap -Cooking Clearance 71. Elec. Outlets & Receptacles at Kit. Counter 72. Garage Fire Door; Swing -Landing -Closer 73. A.C. Duct in Garage -Damper 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage; Above Floor-Mech. Protection 75. Plb., Elec. & Mech. Equip. Listed for Location 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection 77. Insulation -Foam -Looked in Attic ❑ Yes 78. Guard Rails & Deck Construction -Post Caps 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No 81. Stucco; Brown -Finish 82. A.C. Unit; Disconnect, Electrical, Plumbing 83. Vents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to Openings 84. Water Well; Disconnect, Electrical, Plumbing 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 86. Ventilation Throughout House 87. Glass Protection 88. Corrections from Previous Inspections 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 ' Date Ca -rd -B-1 Date i Card B-1 Comments at Final: i e each time you visit job site) MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE 4104�ORROVILLE, CALIFORNIA 95965 — TELEPHONE: (916) 538-7541 0� " y0o - o1 0 �' PERMIT NO. 1 Address or location of//mor bilehome O AJ 5,jE Z-- Owner's name�� Owner's address t �fXX [Insignia or hud number ST Manufacturer's name�� Serial IF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE MOBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM. 5138 White - Owner, Yellow - Installer, Pink - D.P.W. IE •_ t:�` - 'rgr `. s'a».'r_e ti'd`i+r`-t"3'k"�y-:.sem..-i;'+1�-;,i'�t'� _ _ COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS . 1469 Humboldt Road, Chico, CA - (916) 891-2751 y 7 County Center Drive, Oroville, CA - (916) 538-7541 i 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work is completed. If youle—any questions pertaining to this matter, or need additional explanation, please?act t office immediately. /11,10rtGeS 1 O /" Gt r o g REV 11/91 COON' YOF BUTTE - DEPARTMI IT OF PUBLIC WORKS 7 County Mer Drlve - Orovllle, CaJlfornla %%965 - Telephone: 916,'538.7541 • APPLICATION AND PERMIT AASESSOR PARCEL NUMBER 28-40-10 ZONING A 5 BUILDING PERMIT OWNER CLETE CUNNINGHAM TELEPHONE 534-6192 S Q. FT. OCC. BUILDING VAfLUATION OWNER'S MAILING ADDRESS P.O. BOX 37 BANGOR 95914 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 20.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS SUN;;ISE HILL ROAD BANGOR 95914 178 Permit tee $ 35.00 PLUMBING PERMIT Filing Fee 15.00 Each Trap 1 5.00 Solar or heat pump water heater 1 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 SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S G W 9 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti litiesEl Installatio FJ her ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600VORLESS 200A OR LESS 18.50 Main service 200A TO 1000A, 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 I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING OCCUP. �\ OR ACDNS. ACC. BLDGS. / 3.64 sq.ft. NEW CONSTR MULTI.OUT LET NON.RESID BRANCH CIRCUITS 5.00 POWER APPARATUS 14 (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 76d FIXED APPLNS. OR Ex. Occup. OUTLETS IRESID•I EA.� I 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 subjectHood 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 g 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, judginents, costs, and expensps which may in any way accrue again in consequence of the anting of this permit. Date�"��r /� Signature of Applicant — 0 er Contractor El Agentl An OSHA permit is require for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee S 70.00 Energy Inspection Fee $ OCC CONST TYPE TOTAL FEES 105.00 I I HAz I o E V-� IMP FLOOD I CDF I PARCEL PD I Ho I ISSUE This permit is hereby issued under the Bions of the Butte County Code and/or work indicated' ab6e, for which fees E R OF IC BY01 PE IT EXPIRES ate applicable provi- resolutions to do have beenaid. p WORKS Dat Receipt No. i =5900 WHITE-D.P.W.. YELLOW-ASSFSSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT Yn-.^t rh, .V� 4��.. f}4 .irNy(,i�^5�_ �•f�, i. �aW. `tk �..^. :L' }Jr. 1f .. • fiWl' • `�f, a�• COUNTY OF BUTTEPARTMENT 0f P81BLIC WO 11. BUILDING DIVISION 7 COUNTY CENTE'R'D IVE - ORAVf-LE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541 y PERMIT APPLICATION DATA SHEET 1, OWNER C� vN/v �/✓ v r Vx Proposed Building Use Building Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1. All items have been submitted . ........................................ 2. Plot plans, 3/4 sets, signed by preparer of plans. ......................... . 3. Complete plans, 3/4 sets, signed by preparer of plans . ...................... 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form . ............................................ 6. Energy Design Compliance and supporting documentation . ................. . 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... Engineered truss details and layout in duplicate (required prior to plan check). . 9 Mobilehome data and manufacturer's installation instructions, 2 sets. ........... Fees of $ mpact fees as shown on attached schedule. . ...5Gk.l,�c,as California Department of Forestry plan appro ................ 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval Health Department . ............. 15. City of Chico plumbing permit . ......................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: . ........ 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy).; .......... . Pre -Inspection reques 20. Pre -inspection for required. . 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 Acknowledgement Statement . .................. 25. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on building use. . 28. Mobilehome utility clearance ........................................ 29. Documentation of legal access . ........................................ 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. P7�t_................................... 33. a . �Tr�Lt�r,� 34. i When you issue the permit, process as follows:11o" Mail to owner Telephone and hold for pickup at Other Parcel Creation Acreage Applicant -4 Mail to contractor. _ office. Delivervith ins Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution We Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone -mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by PM) Date Plans approved by W Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works (/Z//,� Z:_ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovllle, California 95985 - Telephone: 918.'538.7541 APPLICATION AND PERMIT PERMIT NO. A359350141 PARCRU NU- N S� BUILDING PERMIT OWNER� TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNW MAILIZ ADORE3i� J1C" si{ CON CTO 5 N TELEPHONE - CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ 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 AD RESS S7a Permit fee $ 3 ry PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 1 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 1 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex[] MobilehomeOther SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I IS I W @ 15.00 TYPE OF WORK New 11 Addition ❑ Remod ❑Uti 'ti s ❑Installatior9kOther ❑ Describe work: D �j /�/ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A OR LESS 18.50 Main service 200ATOI000A) 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 No. Classification F]I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING OCCUP.6\ OR ADD NS. l ACC. BLDGS. /I 3.54 sq.ft. NEW CONSTRULTI.OUTLET NON -R ESID BRANCH CIRCUITS) @ 5.00 POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES @ 76d 120 460 FIXED APLNS Ex. OCCUp. OUTLET S UTETS (RESIC))"EA.) I 3.00 Temporary service 1 15.00 Mobile Home Facilities 15.00 Misc. byirin g 15.00 Permit Fee $ — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 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 shal I 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 FiIirig Fee 1 15.00 Heating Cooling g Hood 6.50 Ventilation Perrnft 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 a crue against said County in consequence of the granting of this per mi . X Date Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition o construct. ion of structures over 3 stories in height. Mobile Home Installation Fee S r (� Energy Inspection Fee $ OCC I CONST TYPE TOTAL FEE $ / r - HAz DFEES IMP FLOOD CDF PARCEL PO HO 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 �� -5M Receipt No. ! WHITE -D. P. W.. TELLOW-�¢¢1¢¢nP PI---l—�n� nom.. n...._. o-. .....r COUNTY OF BUTTE - Department 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 m labor and materials for construction of the proposed property improvement (yes or no) 2. I (have/have not) D/ 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 44 c Address Phone Contractors License No. City 4. -I plan to•provid.e portions of this work, but I have hired the following person to coo rd' to pervis a rovide 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 p, vide the work indicated: Name Address Phone Type of Work S.ig n ed :. Property Owner C v Social S curity nNumber� Date ���L%7-) 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. COUNTY OF BUTTE - DEPARTMENT'OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916)5387541 OWNER f//Z/z G �/ A. P. NO. O z1a PROPOSED BUILDING USE 1/ / DATE REC . - # -DATE REC 1. School Distric Fees D20 i1iy H S p / (paid at District Office) u l/ Sheriff Fees (paid at Building Department) esidential. y� .... unit amt. - - �i Commercial( per sq.ft.) X =$ sq.ft. amt.. P 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. �� DATE Z COUNTY OF BUTTE BUILDING DEPT BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORJUtj 18 1992 (One Form Per Building) "School District 6IMing Department No. A.P. Number Jurisdiction city ��Coun'ty Property Owner ef %k%A 77 Property Location/Address Subdivison Lot No. jel?Residential Development Sq. Foota p.2-7 No. of Living MHl Addition (Group R) Units Commercial/Industrial 0 Sq. Footage New Addition (Including Exterior Roofed Areas) XF '66r-� t cl� — ;ui I �di n 'De "-aZi�rt m2e n t e re e ive Date District Identification No. A. 2.0 4.9 L Sch*oo"l District certifies th . atza-- p licaht) (Street AdAress) (Phone Nurylber) (City) (State) (Zip Code) has cornl3fi6d with the requirements of Resolution No. by payment of reprdsenjing square feet. law 1/9 /q9z School District Repre enVative Date,) Check 76 Paid by Check Number Remarks: Bank Number V 4A A ji Paid by Cash /gY9 It, subsequent to the s .,School Di t t Rep tatpe signing t s Butte Co rity Scho�ency b Impa,c) Fee U'S rc esen Certification Form, :iI notifie ?ableuLoca tfie School strict is tanning at this 0 st is being reviewe under the lifornia En r mental Qu y Act (CE A), this pTfe,ct:m be sub! ct , s sc I flif ir 12act on 0 , ar, i additional sN I fees to f IV/pa dist t's schooK. V mitiqate its White (applicant), Yellow (building depaftment) , Pink (school district) leeform /roject 't to k1 (4/92) I BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA PHONE: 538-7541. MOBILEHOME INSTALLATION SHEET 1. Owner's Name: 2. Installer's Name: 1.1"-7 3. Is the site currently under permit? (If yes, furnish permit number Is the site an existing site? (If yes, furnish two plot plans.) Yes � No ❑ Yes _) OR No F] 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes No F-1 (If no, clarify 5. What is the mobilehome electrical rating? ------ -------- 122- Amps 6. What is the mobilehome site service rating? --=--------- Amps 7. What is the mobilehome site circuit breaker rating? ----- �(} Amps p 8. Is there any other electric load to be served by the I�--�I mobilehome site service? -------------------------------- Yes No �1 (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome"site gas pipe size? r 10. What is the type of gas service --------------- ---- C/ I Natural LPG 11. What -is the gas pipe length from meter or tank to the mobilehome?--------------------------------------------COUNV (ft.) r BUILDING DEPARTMENT ) * 12. What is the mobilehome gas demand? ----------------------- (BTU) *(This information not required if pipe lensPth e`�s 0vVED- on natural gas or less than 50 ft. on LPG.) Ze 6 I MOBILEHOME SUPPORT DATA If other than single wide, J� Mobilehome Mfr. O furnish Setup Model No. Year Width (ft.) Box Length016 (ft.) Tagalong or Expando Size ft. x ft. On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural ss-etup sheets (if not on file with the -County of Butte). FOOTINGS (check one) //U1. Wood -pressure treated or foundation grade: �r.2;:. Other (specify) ��-- �� SUPPORTS(check one)01. Concrete block.❑ 2. Other.(specify) `t.3�.. Pier Footing Sizes and Locations SINGLE -WIDE MULTI-WIDE Line I -Line-2' Main Beams _ -fie-2�„.__.�qq - ' Main Beams _______ _ r Line 2 � f—Line Y Tag or Triple r Line Line 1 Piers: Line 1 OoeninRs: Size -Min. ------------ k Size -Min. ------------------ Spacing-Max - ----------------- Spacing-Max. ,- Each Side of Openings From Ends -Max.------- With Width Over --------- ” Line 2 Piers: 2 Size -Min. --------•--- / ..x 30' v Spacing -Max.--------- ! S �- & " I/ From Ends -Max.------- /,-0" V Line 3 Roof Loads: Size -Min. ------------ Location (From Front) Line 3 Piers:' (Under Bearing Wall Only) Size -Min .------------------ „ Spacing -Max.--------------- From Ends -Max .------------- �- Size -Min .------------ Spacing -Max.--------- , From Ends: -Max.------- Line 5 Roof Loads: Size -Min. ------------ Location (From Front) Size -Min.------------------ IIx 1! Spacing -Max.--------------- ,- " From Ends -Max .------------- ,.x I. .x ,l. „ nx ..x „x n ,.x ,. nx „ Al� orlm, TS— k , --- I p,.,-t';ces and f Good use inthen' f r o s c 1,40chanical, Codes — NcsiionQI Elertrir.01 Code. LE,CnV PermI. PLO; Ir rn the Depor Of �^ ~t/O04.1 tio VI 0i vllb,6; AP --Z40 lD OWNER CUA) /V �2Q6 tfA4 PERMIT'lk F l UT.IL. CLEARANCE DATE INSPECTOR ELECTRIC GAS Support Struc. Compaction Test RP . Service Size Other Load Tvve Pipe Size Length YES NO YESI NO /YJ TO Buildina Department FROM: Environmental Health ' SUBJECT: Sanitation Clearance �tcnrL�l J 02 = I -or - Owner Location APS Plan Approved for: Hold Hold final for: Sewaqe Disposal Y Water Supply --L— Water Supply Final clearance O.R. for: ,JWater Supply Clearance for (�2— bedroom mobile horse. Other�CISi FXIS�(_rQ �a 0 NOTE * * * SaV��" — Date irian r APr,rIOVED Bute County cnvironmental Health 9 eA - n - 3, 19 do hereby declare as follows: 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, pur,904nt 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 eneumbrancers 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: Signature of owner of record STATE OF CALIFORNIA ss. COUNTY OF BUTTE Signature of owner of record On , 19 , before me, the undersigned, A Notary Public in and for the State of California, residing therein, duly commissioned and sworn, personally appeared known to me to be the person whose name subscribed to the within instrument and acknowledged that executed the same. WITNESS my hand and offical seal. Signature Name typed or printed AFTER COMPLETION, THIS DOCUMENT MUST BE RECORDED IN THE OFFICE OF THE COUNTY RECORDER. LD 1540 (5/88) TO w' Buildina Department FROM: Environmental Health ` SUBJECT: Sanitation Clearance Y-% iV2 S Owner Location AP# Plan Approved for: Hold final for: Sewaqe Disposal--�1--- Water Supply ^incl clearance O.K. for: Clearance for bedroom obile ome. Other NOTE * * * Water Supply Water Supply — • Date Sanitarian • �` Ms,sei'�t��.Pi�s a�t+.d.t.��°he��+�asc.�`�`�' , rnthe Depa? s-s- erpej » �j�Q}erials•� Wot]cm��P St'all� Occorocrtce r,rs .�oo "'� a V ec�use ithet, �, ... V. ;�pres..t. +•�'r ur,,�srg, 1.1;4 liante Co the Nat tonal; F1ec_tctcol .K ., 11,00, t,•) c �C'�• to eb ky ��w � � • t�� t `.JeC 9� e,.43 �oo Eqz- PLC N. ab�or" JED _r Buillo County Envi//c-D :-r-ntal Health ate �� 0200 Sic na r� VtJ ,. a I1 �80� .�_ ' i � I ,: f _.• _� J e� � e �a•3a f-� 3. �{` I ��».� "Mt.. '��..��3 tk �:} `��\Nw �..z �S• i TSi t'jr �. s - .60'- -40'- 20' 40' ..... ..... F ` ` 'fir. .. _. �' _ .. ,....- ZZ .+ S r_.... '_�'v'.•w.:'T�..rr.r..._. ..._ _„�. �etr'n to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT U I _ a U FOR RESIDENTIAL DEVELOPMENT Section 26-8.1 of the Butte County Code' requires this acknowledgement be rbcorded prior to issuance of a building permit. ' The property described herein is adjacent 9 1-0 1 6393 I Ree Fee 7.00 to land or included within an area zoned I Cash 7.00 for agricultural purposes, and residents Recorded of this property may be subject to incon- Official Records 1 veniences or discomfort arising from the f I use of agricultural chemicals, including, County o but not limited to herbicides, pesticides, Butte I and fertilizers; and from the pursuit Candace J. Grubbs I of agricultural operations including, Recorder I VS 2 but not limited to cultivation, plowing, 8:01am 10 -May -91 I spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricul- tural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real :property. situate in the County of Butte, State of California, described as follows: Date: -6 PROPERTY OWNIERS: s. /v State of eCt /il ) On this the _,3 day of "XYZ 19_!L, before me, the SS. undersigned Notary Public, personall appeared County of OFFICIAL SEAL Personally known to me. E] Proved to me on the basis CONNIEANNA of satisfactory evidence. NOTARY PUBUC•CALFORM to be the person(s) whose name(s) !s BUTTE COUNTY RiHa' Myeomm.EWmAu4.31.1993 subscribed ,to the within instrument and acknowledged that executed the same for the purposes therein contained. IN jJI NESS WHEREOF, I hereunto set my hand and official seal. Present A.P. No . ('a s' 00- 00.000 � Notary Public 1 MUT CHICO Tl --L [lo.1-916-8931853 Ma a [, 9:. i-1-:53 No .011 0::., ! •�.» 'ins,-t:t�' c�4:=' �;•'�'�_i��°=k ' t -. ALL THAT CERTAI'( RSAL PROPYRTY SITUATI3 III TIE ITATE OF CALIFURHIA, COUNTY OF ,WTT1:, DISCRIBEP AS F(ILWWSI PARCEL It PARCEL {, AS I:NOWI' ON THAT CERPAIII PARCEL MAP ENTIT:,ED, `BEING A PORTION OF TH'S Will 1/4 OF NW 1/4 OF SECTION 21:, T.18N., R.SE., H.D.N.-, SAID PAItCEL MAP WAtl RECORDED IN THE D]VICE OF THE RECORDER OF THE CCUIJ7'Y OF ISUTTI:, STATE OP CALIFORNIA, ON 110VIN8ER 1, 1982, IN BOOR 89 OF MAPIt. AT PAGE(S) 77. PARCEL ITS A 60 'FOOT NON-EXCLUSIVE FJI:IEMENT FOR INGRESU ANG, EGRSS. ROM AND PUBLIC ZTILITT PUIPOSES OVIM PARCELS 1, 2 AND 9, AS IBOWII ON THAT S CERTAIN PARCEL, MAI ENTITLED, -USING A PORTION OF THE NW :./f (F NW 1/4 OF SECTION 21, T.18N., R.SE., M.D.M.', SAW PJRCEI MAP WAS RECORDEDIN THE (FFICE OF THE RECORDER OF THE COUI TY (P B( TTS, A STATE OF CALIFORK3A, GN NOVEMB:.R 1, 1982, IN 8091( 8t- OF MAPS, AT DPAGE(S) 77. PARCEL .IZX� AN EASEMENT FOR I (GREt:S MI) EGRESS AND INCI:DF.717AL R 10m, MONO, O 70 ACROSS AND OVER Jk BT.tIP of LAND 25.0 FEET NIDE 70 81 LO(ATED -nWITHIN THE WESTEF LY 30.0 FEETOF 771E S0U•.RMEST Q1 ARTE R OF THE O NORTHWEST QUARTER OF SECTION 211, TOWNSHIP 28'NOI7N, RANG:: 8 LAST, .0 frn1;0 X.D.S. i M., AND THKr PORTION OF THE WORTFME;.T 01 ARTS R OF THE M O SOUTHWEST QUARTER OF LAID SECTION 28. WING NORTH 0' SNIGOR PARR G7 m 70 ROAD. Z 0 N PAFXTi�ISL r V-) m AN EASPLEWT FOR IOAD AND UTILITY PURPOSES OVEII A IMAII OF LANs v 0 60.0 FEET IN NID711. MER Tiff FULJAWING DESC41BEII PHCPERTtt C 0 m O THE WEST HALF OF THE SOVTHWEs•F QOARTER OF THE NORT ww, QUTATEP CWENF —1 - AND THAT PORTION LSF TEE WEST H:1LF OF THE NORTHWEST ClIk"M O1' T > Q SOUTHWEST QUARTER LYIIIG NORTHERLY OF THE BRNGOR PAR( RQSD, IS 17 > EXIS7•ED JANUARY 1, 19:17, l:N SICTION 28,-T01(NSHIP 18 NORM, IANGII T S EAST, M. D. a. 6 11. z THE LOCATION OF :LAID EASIMEHT IS THE BAMS AS THE FXIB•ING ROAt WHICH RUNS F1tON 5hHG4IR PARK :ROAD IN A NORTHERLY WD `>OVTIIERLI DIRELTION, AND CMERJ.LLY PARALLELING THE WESTERLY LIMB OF THI ABOVE DESCRIBED P.1RCE1.. SAID EASEMENT TO 8E EOR THE USE, BENEFIT AND APPURI'ENAfR T1- THI NORTHWEST QUARTER OF 11HE NORTM+IEST QUARTER OF SAID 1 ECTI )N E2116� X)GIA rtMT END OF DOCUMENT COUNTY bF BUTTE - Department 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 ma' labor and materials for construction of the proposed property improvement(!yes' r_no) 2. I (have/have 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 S,14 Address City Phone Contractors License No. 4. I plan to provide -portions of this work, but I have hired the fol'lowin_ person to coordinate,su ervise, and provide the major work: Name ,o 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 41 %/% Address . Phone Type of [cork 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. r • • .I COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovllle, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT N0, 1444-91 A "I. ASSESSOR PARCEL NUMBER 28=40-10 ZON . G A5 & BUILDING PERMIT / OWNER Clete Cunningham TELEPHONE 368-1403 SQ. FT. OCC. BUILDING VALUAT,y'ON OWNER'S MAILING ADDRESS NV C.FA.Ti4sQjA�_!eEve TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR LV :WEEP. -71 CENSE NO. Plan Checking Fee $ 15.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 178 Sunrise Hill Rd Bangor Permit tee $ 15.00 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP 7 t Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ MobilehomeK3 Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home IN kG 10.00ea 30,00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities [ Installation❑ Other ❑ Describe work: Permit Fee $ 40.00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 11001 OR LESS 100 AMP OR LESS 10.00 10.00 Main service EA. ADD'L 100 AMP 2.50 2,50 CONTRACTORS LICENSE LAW I declare under penaltyOR of perjury (Check One): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Buslnes$ 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 Cdr sale. (Sec. 7044) y 1!4/1, 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.h ADDNS. ( ACC. BLOGS. , /20sgit NEW CONSTR. MULTI -OUTLET NON-RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS &) (SINGLE OUTLET CIR. ) Ex. Occup(OUTLETS OR FIXTURES 0 5AL@ALe3o FIXED ALNS. Ex. OCCup. OUTLETS P(RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 15.00 Misc. Wiring 15.00 Permit Fee $ 37.50 Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed,revoked. MECHANICAL PERMIT 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 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 expense which may in any way accrue agai oun consequence of the nting of this permit. %� Date Signature of Applicant — Owner Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 92.50 Az. cuA PARK SCHL FLD cDF PAR D ISSUE This permit is hereby issued under the applicable provi- sions of the Butte County. Code and/or resolutions to do work indicated above for which fees have been paid. DIRECT `,R OF PUBLIC WORKS B Date Q %.-- PEAT EXPIRES Date /'-Z/_$ Receipt Receipt No. Q3696 WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT ., qs 'T47 ,T._jVW r`s"AWA"Wat,�-•. .•..�„r� :il.-�crt.+r�rwApr 3z; 4V►7p�+ae".zb�1`�, COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS-"B,UILDING DIVISION i s 7 COUNTY CENTER DRIVE - ORbVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICA N*q*TA SHEET v Permit No. .' OWNER C v�I/V � r A. P. No. �29 l/`0 Proposed Building Use[/ Building In �a 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 . .................................... Plot plans in duplicate/triplicate, signed by preparer of plans ........ 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 .................................................... �I School District fees paid .............. anitation approval from �4Vt2 Health Department % -7 a� 5 . 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) ... 4 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... Recorded copy of Agricultural Acknowledgment Statement ......... Letter of signature authorization ................................... �–Q–C 26. J 27. When you issue the elephone_ Other -di a permit, process as follows Mai I to owner. Mail to contractor. —,Deliver 11 S92 7 Copy of f !az-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 per ance: (Circle new item not checked above). 1. Index permit for above items No. If 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone_-jnail—counter by .date Contractor, designer, owner, was advised of above required data by_phone _mall_c Gnter by date Plans checked by Dat, PI/ns approved by Date s of plans on hold in/ EViVe cabinet "AP folder 'Copy -DPW COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 -County Center Drive - Orovllle, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER _ w w� /'�,j p�CJ ZONING ` N BUILDING PERMIT OWNER cuNN; TELEPHONES G 'SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS u I `_ (i i?L6�� ,`A11e A VO V(��,(/\/ Y 6%oz S-ruck' CONTRACTOR'S NAMEP TELEPHONE .. .... ... , _. - - ...�. _...._... ---- .__� CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LEND -7 UNKNOWN Total Value tion $ Filing Fee $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE ND. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 1^ I iU 02 Permit fee $ 5. 00 PLUMBING PERMIT Filing Fee 10.00 Cid Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping , 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex[] MobilehomeE' Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G 0.00ea 3�.© TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities-tf,9tal-lationno Othr L 11Penult Describe work: 'Al Fee $ YA Contractor ELECTRICAL PERMIT Filing Fee 10.00 OOV OR LESS Main service s100 AMP OR LESS 1000 . , Main service EA. ADD -L 100 AMP 2.50 5b 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 ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING OCCUP.N) OR A.D.S. ACC. BLOCS. +/Z¢sgft NEW CONSTR. MULTI -OUTLET NON.RESID BRANCH CIRC ITS 2,50 ea POWER APPARATUS e (SINGLE OUTLET CIR. ) Ex. Occup( OUTLETS OR FIXTURES e00 @ 9Sot 30 FIXED LNS Ex. Occup. OUT ETSP(RESID )REA.) 1 2.00 Temporary service 1 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ .50 Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ' ❑The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation penult Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature of Applicant — -Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over -3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ iTOTAL CONST TYPE - FEE $ �ZS� 1H CUA cuA PARK SCHL FLD cDF PAR PD ) HD• ISSUE This permit is hereby issued unaer the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date Receipt No. 36 d 2 50 WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT HLUILIKUHNIG HEUUL61LU 1:11 �y AND WHEN RECORDED MAIL THIS DEED AND, UNLESS OTHERWISE SHOWN BEL(K MAIL TAX STATEMENTS TO: Ire, / . NAME (i j/r� ��jlie,, 17 i_7i ; ell -9-2 STREET ADDRESS ��'"r zC� c� % ��v� �i/ �✓ CITY. ZIP STATE YJa...-.•�- m'Y V/'d Title Order No. Escrow No. SPACE ABOVE THIS LINE FOR RECORDER'S USE GRANT DEED DOCUMENTARY TRANSFER TAX $ ❑ computed on full value of property conveyed, or ❑ computed on full value less liens and encumbrances remaining at time of sale. Signature of Declarant or Agent Determining Tax. Firm Name FOR VALUABLE CONSIDERATION, receipt of which is acknowledged, I (We), %t) t /,.)m V /L1 oa<e, t / /M (, /� �J w (name of grantor(s) I grant to AliaLe. A. do WJ,fnghAr4 rgn,O Pl`927, LDf nn�ngh��l (name of grantees) I all that real property situated in the City of (or in an unincorporated area of) U 77`;L�- County, California, (name of County) described as follows (insert legal description): Assessor's parcel No. RIq- yV ( d Executed on 19—V, at (City and State) STATE OF CALIFORNIA SS COUNTY OF On this _t__5day of in the year 19_(�_4 z, before me, the undersigned, a Notary Public in and for said State, personally appeared , personally known to me (or proved to me on the basis of satisfactory evidence) to be the pers(>U-1 whose nafne_'S� subscribed to the within instrument, and acknowl- edged to me that Lhe.� executed it. - WITNESS my hand and official seal. Notary Public In and for said State. MAIL TAX STATEMENTS TO NAME ADDRESS OF IC NNIE AI.DANAM m NOTARY PUBLIC • CALIFORNIA BUTTE COUNTY my corm. Expires Aug. 31,1993 (This area for official notarial seal) gq t"`l Before you use this form, read it. fill in all blanks. and make whatever changes are appropriate and necessary to your WOLCOTTS FORM 778—Rev. 12-85 (Price class 3) particular transaction. Consult a lawyer it you doubt the form's Inness for your purpose and use Wolconx nukes no GRANT DEED representation or warranty, express or implied, with respect to the merchantability or fitness of this form for ae intended use or purpose. Q 1985 WOLCOTTS. INC. vZo m1PTI1m Be - c sell i ALL THAT CZATAI'( RML PROPERTY SITDATIS III TIE !TATE OF CALIFORNIA, COUNTY OF :W=:, DISCRIBED AS FOLLOMIII PARCEL If PARCEL 6, AS I*m! ON THAT CERTAIM PARCEL MAP gazz 8D, 'OEIKO A PORTION OF TH(S NH 1/4 OF NW 1/1 OF SECTION 21;, T. ION., A.M. M.D.M.P, SAID PARCEL MAP NAME; RECORDED IN 'THE OIFICI OF THE RECORDER OF THE COUNTY OF IIUTTI:, STATE OF CALIFORNIA. ON NOVINSER 1, 1957, IN BOOR 89 OF MAP;I. AT PAGES) 77. PARCEL III A 60 TOOT NON-EXCTUSIVC EAIIEMEHrP FOR INCRESI; An mtsS, Rom AND PUBLIC CTILITV PUFPOSES DVIM PARCELS 1, 2 A11D 1. AS ;BOWII OM THAT CERTAIHI PARCEL MAT ENTITLED, •BEING A PORTION 01 THE NW V4 CF NM 1/4 OF SECTION 71, T.16N., R.SE•, M.D.M.', SA7:D PIRCEI MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUtTY (F B(TTE, STATE OF CALIFORNIA, CN NOVEM ER 1, 2982, IN BO)X 8:- OF MAN, AT PAGES) 77. o.fiRCE . I224 AN EASEMENT FOR I(GREI:S AFD EGRESS AND INCADMAL RIG":, mONG, ACROSS AND OVER Ik ST(IP JP LAND 25.0 PEET NIDE TO BY LOCATED WITHIN THE WLSTEF LY ? O. o FEET OF THE SOUTHWEST Q( ARTI R OF THE NORTHWEST QUm.TER OF SECTION 211, TOWNSHIP 10 NOITH. RANG:: S PAST, M.D.B. i M., AND THAT Po:..VTIO11 OF THE NORTHWE:•T Q( ARTS R OF THE SOUTHWEST QUARTER OF ::AID SECTION 28, LYING NORTH 0' BAIIGOR PARE ROAD. YID AN EASEMEH12 FOR I1DAD AND VTILSTY PURPOSES 0VID1 A ITRII OF LAMC 60.0 FEET IN HIM. OS ER THE FULIDNINO DESCRIBED PAC PEAT I i T71E WEST HALF OF THE SOUTHWEsr OVARM OF THE WORT MEV - QUJXM AND THAT PORTION I1F THE NEST ILALF OF THE NORTHWEST CDARTiR 01, THF SOUTHWEST QUARTER LYI110 NORTHERLY OF THE BiWGOR PARC ROM, 13 I1 EXISTED JANUARY 1, 1917, T.M SICTION 28. TOWNSHIP 18 NORM, IANGF 8 EAST, M.D.S. i 11. THE LOCATION OF 11AID EASIMENT IS THE SAME AS THE !XIS"IMG ROA[ WHICH RUNS FTtOM 6ANG4IR PARK :ROAD IN A NC•RTHERLY WD :OUT7IERLT 'DIRECTION, AND c:NMU.LLY PARALLELING THE WESTERLY LrWl 01 THHI ABOVE DESCRIBED P,LRCEl.. SAID EASEMENT TO BE FOR THE USE, BENEFIT AND P.PPURTENAIIT TV THI UARTER OF THE MORT1f4=T QUARTER OF SAID I ECTI )M 211 NOR...... Q ♦i pf X)C1p CENT i i���jiLl�.�A COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS --f County Center Drive, Oroville, CA 95965 PHONE: 916-538-7541 William Moore 130 Lakeland Blvd Oroville, CA 95965 Dear Mr. Moore: With reference to the above subject: Attached is: G Application for permit Building Plans Engr. Calcs Owner -Builder Verification Form DATE i/94/c)n RE: Permit applications for.mobile home utilities and installation. A.P. # 28-40-10 Mobilehome Utilities Installation Sheet Ay Mobilehome Installation Information Sheet Typical Plan Sheet List of Codes Enforced OTHER Recorded Agricultural Acknowledgement Statement / X XWe need the following information: Permit application signed and completed where indicated with all copies returned. Fees of $ payable to Butte County Treasurer. Certificate of Workmen's Compensation Insurance or check exemption statement. Contractor's License Law information or check exemption statement. Complete plans in including plot plans. Plot plans in Structural details in Complete plans and calcs in by registered engineer or architect. Energy design including Street and drainage improvement plan approval from Land Development Section'(DPW). sets of plans in accordance with the changes marked in red. Sanitation approval from Butte County Health Department at: 196 Memorial Way, Chico 7 County Center Dr., Oroville Skyway & Elliott Rd., Paradise Planning approval from Butte County Planning Department, 7 County Center Drive, Oroville, for Completed Owner -Builder Verification form. Recorded copy of deed showing XXX Recorded copy of agricultural acknowledgement statement. YXX/ OTHER Please submit the above ;tem-, so that wP ran .zn_ _rte=.tg The permit applications expire 5/8/90 and rnnnnr he issued after that date Thank vou. Should you have any questions concerning the above, please contact Dopp4,Sp� ng of this office. -\ �� Yours very truly, William Cheff Director of Public Works J.F. Glander JFG/aj ' Chief Building Inspector • COUNTY OF BUTTE - DEPARTMENT, OF PUBLIC WORKS 7 County Center Drive - Orovill�e, Callf&la 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT N ASS S `PARCEL NU ER Z°NIG BUILDING PERMIT tfe, yn AJ0 O� ' SO. FT. OCC. BUILDING VALUATION OWEMAILI G A DRE Stp 9 Y 1VI/I CO R CTOR'S NAME J to n6 Y` TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CON T UC TION LENDER UNKNOWN Total Valuation $ Filing Fee $ LENDER'S MAILING ADDRESS Permit Fee $ ARC I ECT OR ENGINEER LICENSE NO. Plan Checking Fee ,$' Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 6 Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 ©� Solar or heat pump water heater 20.00 LOT NO SUBDIVISION NAME PARAL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ MobilehomeOther SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S fG 4 IJ 0.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Util'tie Installation[] Other ❑ Describe work: o � `•�j',Q� Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service eOOV OR LESS 100 AMP OR LESS 10.00 Main service EA. ADO'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check one): F -1I 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.y` 1 OR ADDNS. ( ACC. BLDGS. / h2sgft NEW CONSTR TI.OUTLET 2,50 ea NON.RESID BRANCH CIRCUITS) POWER APPARATUS e SINGLE OUTLET CIR. I Ex. OCCUp(OUTLETS OR FIXTURES 200501 eAL030 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.I 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 60 Misc. Wiri 15.00 R W1 Loo 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 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 1s correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabi ' ies, judgments, cos s, and expenses which may in any way accrue against sa C y, in se encs of the granting of this permit. g--� X Date Signature of Applicant — Owner Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories In height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE OCCUP. CONST.TYPC SCNooL F o V00, PARCE PD ND ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By — PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS -Date Receipt NO. WHITE-D.P.W.. YELLOW-A7e93301%. PINK -INSPECTOR. GOLDENROD -APPLICANT k .. . u 28-40-10 - 178 Sunrise Hill Rd., Bangor Permit #1401-89P,E�MFP' utilj ELEC . GAS SUPPORT STRUCTURE REQ. COMPACTION TEST REQ. S 0 u 28-40-10 - 178 Sunrise Hill Rd., Bangor Permit #1401-89P,E�MFP' utilj ELEC . GAS SUPPORT STRUCTURE REQ. COMPACTION TEST REQ. TO Buri•ldinq Department FROM: Environmental Health SUBJECT: Sanitation Clearance ---11�c�r-, �`�1ao�� S��►�iJ� i��� �� ag Owner Location AP# Plan Approved for: Sewage Disposal Water Supply Uc-1 Hold final for: Water Supply Final clearance O.K. for: Water Supply Clearance for _—�— bedroom mobile ome. Other NOTE * * * Sanitarian Date 21 Tp Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance ` �lL -' d - ZIQ owner Location flan •Approved for: Hold final for: Final clearance O.R. for: Sewage Disposal Water supply Water Supply Water Supply Clearance for bedroom ®bile home. other Data.- Sanitarian COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET '4/1 1 Permit No. OWNER ©��0- A, P. No. Proposed Building Use Building 1"nspector Date —67 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. Energy Design Compliance and supporting documentation ......... 6. Statement of Intent for Non -Heated and AC Buildings .............. 7. Engineered truss details and layout in duplicate (required prior to plan check) 8. Mobilehome installation data including manufacturer's installation instructions....................................................... 9. Fees of $ .......................... 10. Chico Urban Area fees paid ........................................ 11. Park fees paid ..................................................... ___-_1102. —Districj fees paid ................. 13. Sanitation approval from Health Department Z — g 9 14. City of Chico plumbing permit ..................................... . 15. Plot plan and business license approval from City of (see City for other requirements) 16. Planning approval for (A) Use: (B) Parking: ......... 17. Improvements may be required. 18. Driveway permit (construction approval required prior to occupancy) ... 19. ec Pre -Ins tion for required ... , Pre-Inspec. request to Pre -Inspection q Building Inspector (Date) 20. Contractor's license information (No., Name Style, Classification) ....... 21,/Certificate of Workmans .Compensation Insurance .................... 2. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ........ 23. Recorded copy of Agricultural Acknowledgment Statement ............ 24. Letter of signature authorization ..................................... 25. 26. When you issue the permit, process as follows: / Mail to owner. Telephone and hold for pickup at office Other ` Mail to contractor. _Deliver w/inspector. Date g — Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitted prior to permi is ua ce: ircle new item not checked above). 1. Index permit for above items No. 2. Additional items required: __ Contractor, designer, owner, was advised of above required data by_phone_-nail—counter by date Contractor, designer, owner, was advised of above required data by—phone —mal l—counter by date Plans checked by Date Plans approved by 6 Date —ZZ Sets of plans on hold in File cabinet AP folder Copy—DPW Lv 1 LL i s:�M ►�I �� c j 7 SLI S e NOTE:—A1 Materials & W Ot Good PPac%a est and fl rq �� Accordance with Recognize. the Speciied use in the Of a quaff.: prescri.1t,inor& Mechanical Codes cad Uniforrn QuLding, Fdum g s cid ica4imas T + b" she National Elec#eir.01 Cede. s ., -- _.,a ,+ is unlawful rj kept on t make any cht '"en perm We*, Cm's � trg k 5 d a Se�`p< 0 P a y ea 1 e a O b po{ 5p <\ �e Sha e00) et 's— I G L ?0L,�e(",- Co L COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS ' 7'County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. �d ASS oiPi4j2�EL NU ER ZONIN �(( BUILDING PERMIT o TE EJH V\eL SQ. FT. OCC. BUILDING VALUATION O N R• AI ING ADD ESS �a 1 vOro U' C RAC TORS NAME tELE M NE CONTRACTOR'S MAILING ADDRESS Fireplace CoqATPUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 10,00 Permit Fee $ AR H ECT OR ENGINEER LICENSE No. Plan Checking Fee $/ A,1C V76 77 ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty 3 BUILDING ADDRESS , Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PA EL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE Gas piping system 1 - 5 outlets 5.00 SF ❑ Duplex Mobilehomey�l Other Building sewer 5.00 C -T SPECIFY Mobile Home S I G I W 10.00 ea TYPE OF WORK New ❑ Addition Utilities Ins II tion Other ❑ Permit Fee $ ..�.// 9Ae7delE1 Describe work: -vf'- inij Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V OR LESS10010.00 1AMP OR LESS Main service EA. ADD•L 100 AMP 2.50 CONTRACTORS LICENSE LAW NEW CONST. DWELLING OCCUP.a` / , h2sgft I declare under penalty of perjury (check one): OR ADDNS. ACC. BLDGS. NEW CONSTR ea ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the BUSIneS$ SID .2.50 ..N -RE BRANCH CIRC TS /POWER APPARATUS e I and Professions Code and my license is in full force and effect. (POWER OUTLET CIR. License No. Classification Ex. OCCUp(OUTLETS OR FIXTURES 20050t eAL030 1, as the owner, or my employees with wages as their sole compen- Al FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA. 2.00 sation, will do the work,and the structure is not intended or offered Temporary service 10.00 for sale. (Sec. 7044) ❑ I, the licensed Mobile Home Facilities 15.00 as owner, am exclusively contracting with contract- ors. (Sec. 7044) Misc. Wiring g 15.00 ❑ I am exempt under Sec. , Business and Professions Code for this reason Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): MECHANICAL PERMIT Filing Fee 10.00 ❑ The permit is for $100.00 (valuation) or less. Heating ❑ 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. Cooling g I shall not employ any person in any manner so as to become subject Hood 3.00 to the W. C. laws of California. Ventilation No Ic 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 permit Fee $ provisions or this permit shall be deemed revoked. Contractor I certify that I have read this application and state that the above information Mobile Home Installation Fee $ 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 Countyot Butte to enter upon the above-mentioned property for inspection purposes. TOTAL PERMIT FEE $ O, 'save, 1 also a a to save, indemnify and keep harmless the County of Butte against occuP. CONST.TYPIJ P11 H11 ISSUE all liabili s, costp, and expenses which may in any way accrue ISC1100LIFLOODIPARCE1.1 agains sal C u in c nce of the granting of this permit. �., Seo X Date—v I '57sions This permit is hereby issued under the applicable provi- of the Butte County Code and/or to do Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ work indicated above for which resolutions 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.. YELLOW -Age LSSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT PERMIT EXPIRES Date Permit #1402-8�'.(ingtall MH) 28-40-10 ISSUED --------------- A I COUNTY"OF BUTTE - DEPARTMENT & PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET ��Permit No. OWNER } — t Ln /lel / F ,q 0 ✓ tq— A. P. No. r� Proposed Building Use A 9 1 Building Inspector Date At time of permit application, I was advised the following data must be submitted priorto 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. Energy Design Compliance and supporting documentation ......... 6. Statement of Intent for Non -Heated and AC Buildings .............. Engineered truss details and layout in duplicate (required prior to plan check) 8. Mobilehome installation data including manufacturer's installation instructions....................................................... 9. Fees of $ .......................... 10. Chico Urban Area fees paid ........................................ 11. Park fees paid ...................................................... 12. School District fees paid ................. 13. Sanitation approval from Health Department ... 14. City of Chico plumbing permit ...................................... 15. Plot plan and business license approval from City of (see City for other requirements) 16. Planning approval for (A) Use: (B) Parking: ......... 17. Improvements may be required. 18. Driveway permit (construction approval required prior to occupancy) ... 19. Pre -Inspection for required ...... B� ldingeInspe tort to (Date) 20. Contractor's license information (No., Name Style, Classification) ....... 21. Certificate of Workmans Compensation Insurance .................... 22. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ........ 23. Recorded copy of Agricultural Acknowledgment Statement ............ 24. Letter of signature authorization ..................................... 25. 26. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other Applicant It I I- % VI ZE519- Date Copy of plans sent Health Dept,, Fire Dept., Other Date The following data must be submitted prior t 1. Index permit for above items No. 2. Additional items required: rmit issuance: (Circle new item not checked above). Contractor, designer, owner, was advised of above required data by_phone---naiI—counter by date Contractor, designer, owner, was advised of above required data by—phone —ma II—counter by date Plans checked by ✓`_ Date T1 `II Plans approved by Date— Sets of plans on hold in File cabinet AP folder Copy—DPW 4ENT OF PUBLIC WORKS 28-40-10 92-1598MHI III, a 95965 - Telephone: 916.'538-7541 ID PERMIT PERMIT NO. c • UUNN1NUHRVI, UIULe 178 Sunrise -Hill Rd, Bangor _ 5 E rthi 92 P.O. BOX 37 BANGOR 95914 BUILDING PERMIT SO. FT. OCC. BUILDING VALUATION CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 20.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 178 SUINRISE HILL ROAD BANGOR 95914 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 -77 Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehomej] Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home J S I G JW I @ 15.00 TYPE OF WORK New ❑ Addition❑ Remodel❑ Utilities❑ Installatio �j other ❑ Describe work: 04 -�' %, I, �,� [_— � . "�/ N. _ • Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service LESS 200A OR LESS 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 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- ontract- ors. ors.(Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason Main service 20GATO1000A, 37.50 NEW CONST, / DWELLING OCCUP.t11\ OR ADONS, 1 ACC. BLDGS. II 3.60sq.ft. NEW CON5TR ULTI-OUTLET NON-RESID, BRANCH CIRCLJ ITS @ 5.00 POWER APPARATUS tr (SINGLE OUTLET CIR. Ex. Occup( OR FIXTURES 20 76d RA Ex. Occup. OUTLETS IIRESID )REA.� I 3.00 Temporary service 1 15.00 Mobile Home Facilities 15.00 Misc.�yirin 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. 1 shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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. JIM agree to save, indemnify and keep harmless the County of Butte against abilities, judgments, costs, and expense�s which may in any way accrue ag In i�-Co Y'in consequence of the gfanting of this permit. X yoL �.-.,. -•--.. -� /���- Signature of Applicant — 0 erm Contractor Agent ❑ An OSHA permit is require for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee S 70.00 Energy Inspection Fee $ OCC CONST TYPE TOTAL FEES 105.00 HAz DFEES IMP FLOOD CDF PARCEL PD IID 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 rovi- resolutions to do have been paid. WORKS Date Receipt No. i , cnnn .v . s-�r1� � ,...,:. � C;,?s.. x,.-..� � �. i 4^ ..n ,.ir'�..r :>.d�r_� `��^ .,/`'' '�,1, , r� ,.� � ..�1�. ^'4v� v.,_ .%`t_�^"J• - �f�^�.�� �. Permit#859-88 WILLIAM MOORE R O Sunrise Hill Rd, Y Bangor 4 { 4 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Orovifle, California 95965 - Telephone: 916/538-75416 APPLICATION'AND PERMIT JJ ASSESSOR PARCEL NUMBER cas 110 d ZONING As", BUILDING PERMIT OWNER • 1 %l rA n+� E TELEPHONE Z �- �T SO. FT. OCC. I BUILDING VALUATION _ OWNER'S MAILING ADDRESS 1;-d L KEL►AW &Vn, ' CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICE�0:iE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS '� j Penalty $ BUILDING ADDRESS�� I (LL Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 1 Solar or heat pump water heater 20,00 LOT NO. SUBDIVISION NAME i ♦ PARCEL MAP Water I In piping P 5.00 Each qas water heater or vent 5.00 • USE'OF STRUCTURE , SF F] Duplex❑ ❑ •MobilehomeOther SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home I S I GJWJ 0.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ UtilitiesA Installation[] Other ❑ Describe work: a A •12(,JCA PO LE -4 F:ZVIGE 40A NEL„ 06 ff( oofb, (.) 4 )46r Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 1100V OR LESS 00 AMP OR LESS 10,00 16.60 Main service EA. ADD'L 100 AMP 2.50 a, CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ 1 am licensed under provisions of�Chapt. 9, Div. 3 of the Business and Professions Code and my license is in fulls force and effect. +, �__ /� License No.' `Classification �'as� owner. i "�'` - 1+' M/ I, as the owner, or my-emp�o�ee's•witft.wageslas their sole compen- f"4sation, will do the work,and(the structure is not intended or offered �t ale. (Sec:,7044) n4 El 1, as the owner, am exclusively. contracting "withslicensed contract- ors. ors: (Sec_704a)' -1,. 1�, j CJ''I 'am exempt finder Sec: r' r,`Business and,Professions Code ❑ c for this reason _t- - NEW CONST. DWELLING OCCUP.111 OR ADONS. ACC. BLDGS. , /20sq ft NEW CONSTR U '.OUTLET 2.50 ea NON-RESID BRANCH CIRC ITS APPARATUS a i (SINGLE (SINGLE OUTLET CIR. zoeaoe Ex. OCCUp OUTLETS OR FIXTURES BALD 30 FIXED APPLN5.'OR-' ,EX..000Up. OUTLETS (RESID.! EA.) 2.00 ' Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring , 15.00 . Permit Fee $ Contractor 1 rfr „ WORKMEN'S COMPENSATION'INSURANCE - I declare_ under penalty of,perjury�(checkkone): � F-1Thepermit is for $100.00 (vafuetion)for less:, -,"_7' _ L�t I'have placed on filefwith thetCounty of Butte Building Department a Certificate,of-Workmen'sACompensation Insura_nee or a Certificate of Consent to Self -Insure. r�(� �'It'sFiall not employ any person in any mann r s'o as,to become subject ' to the 1N.'C. laws of California:'• &Kt, /tib. , 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 orthis•permit shall'be deemed revoked.k` }�„ , , MECHANICAL PERMIT. , ,Filing Fee 10.00 Heating ' jr ' 1 t I '•COolirig I Hood :� 3.00 j Ventilation' - Permit Fee $ Contractor, YI I -certify that•I have read this application and state that.the above informatiori is correct. I agree'to•comply to al.l County,Ord Iiiances,andrState 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'harm.lesslthe County of Butte against all liatii ities, judgments, costs, and expenses which may,In any way accrues against s 'd County in'consequen of the granting of,this permit. 7_ C2This X�_ t Date-��� Signature of Applircont - Owner Contractor ❑ Agent ❑ i 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 $ T' /Energy Inspection Fee $ - , ' TOTAL PERMIT. FEE $ C') OCcUP, 1,CONST.TYPEI' - SCHOOL FLOOOJPARCFLJ PD ND 1 permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By - - - � PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date -2 :- - Receipt No. G%iJ WHIT!-D.P.W.• YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD-APPLI CANT N CL 1.91.139 =44.25 .d � N I A V r� l �•'! �J� �'.A� W A W! 1.91.139 =44.25 .d � I r� l �•'! �J� �'.A� W A W! N�`FUA ,S/JPl?l^�E 1 HILL ROAD`n'T�� FEC :13 i!?Ot;—i 9ii':r 1L"iLl 77 \\ I > VJ. i Cn -4 s CX O lb co ° 3 ,o VI 5v 7 co tee,;8.94 a COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7. County Center Drive - Oroville. Cal;fornia 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ms yD Q Q 1 a O//-►�J[' ZONINCy BUILDING PERMIT OWNER TELEPHONE L L I PtM OC7 R E S0. FT. OCC.1 BUILDING VALUATION OWNER'S MAILING ADDRESS I �Lb L KELA �� CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is LENDER'S MAILING ADDRESS Filing Fee $ 10,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee ,$ . ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 r\ Each qas water heater or vent 5.00 USE OF STRUCTURE Gas piping system 1 - 5 outlets 5.00 SF ❑ Duplex❑ Mobilehome❑ Other Building sewer 5.00 SPECIFY Mobile Home S I G 10.00 ea TYPE OF WORK New Addition RemodelUtilitieInstallationOther ❑ ❑ Permit Fee $ O to ee-, frlb 1. F cq Describe work: a A es Contractor Jbit,115L F50(Si 11o0t) L)6-EIr ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 1 00 AMP OR LESS 1000 ``qq . /V,OO Main service EA. ADD'L 100 AMP 2.50 7, 5D CONTRACTORS LICENSE LAW ( DWEACCLLING OCCUP.a) yz2sgft I declare under penalty of perjury (check one): OR ADDNS? NEW CONSTR MULTI -OUTLET I2.50 ea ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business NON-RESID .BRANCH CIRC TS POWER APPARATUS e (SINGLE and Professions Code and my license is in full force and effect. OUTLET CIR. License No. Classification EX. OCCUp(OUTLET3 OR FIXTURES Z0 0 A3 t L0 .200030 I, as the owner, or my employees with Wages as their sole compen- FIXED S. OR Ex. Occup. OUTLETS TS (RE(RESID.) EAJ 2.00 sation, will do the work,and the structure is not intended or offered Temporary service 10.00 for sale. (Sec. 7044) Mobile Home Facilities 15.00 ❑ I, as the owner, am exclusively contracting with licensed contract- Misc. Wirin 15.00 ors. (Sec. 7044) g ❑ I am exempt under Sec. , Business and Professions Code for this reason Permit Fee $ • .50 Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): MECHANICAL PERMIT Filing Fee 10.00 ❑ The permit is for $100.00 (valuation) or less. Heating ❑ 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. Cooling I shall not employ any person in any manner so as to become subject Hood 3.00 to the W. C. laws of California. Ventilation Notce to Applicant: If after making this statement,should you become subject Permlt Fee to the W. C. provisions of the Labor Code, you must forthwith comply with such $ provisions or this permit shall be deemed revoked. Contractor I certify that I have read this application and state that the above information Mobile Home Installation Fee $ 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 or Butte to enter upon the above-mentioned property for inspection purposes. TOTAL PERMIT FEE $ 3 2,,u I also agree to save, indemnify and keep harmless the County of Butte against Occup' CONST.TYPC SCHOOL FLooD PARCEL PD ND S9UE all liab ities, judgments, costs, and expenses which may in any way accrue I A s 'd C in consequen of the granting of this permit. 3_Ra_9$ This permit is hereby issued under the applicable provi- Date sions of the Butte County Code and/or resolutions to do Signature of Applicant — Owner Contractor ❑ Agent ❑ work indicated above for which fees have been paid. An OSHA permit is required for a cavations over 5'0" deep and demolition or construct- DIREC R OF PUBLIC WORKS ion of structures over 3 stories in height. 7� Receipt No. 16 LJ B Date _2 WHITE-D.P.W., YELLOW-ASZEs SOR, PINK -INSPECTOR, GOLDENROD -APPLICANT PERMIT EXPIRES Date U' a t COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 OWNER -BUILDER VERIFICATION Attention Property Owner: Phone: 916 -538 -7541 - 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 ma'or labor and aterials for construction of the proposed property improvement ye or no) 2. -1 (have/have not) /L signed an application for a building permit for the proposed work. 3. I have contracted wit the following person (firm) to provide the proposed construction: Name Address City Phone I Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supery se, 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 ?7, - R f - gS 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. t