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Home My WebLink About006-680-002} ] MarvinSMU4122 Cams Ct, ChicGAS ' COMPACTION TEST RE� . � � � (ins't'al a-tio . 17 �;, • • {I MOBILETHOME SUPPORT DATA �i If other than single wide, �iobilehome Mfr. �/<�a/f2oo^ furnish Setup Model No. Year 70 Width- Z,47 (ft.) Box Length f - (ft.) Tagalong or Expando Size `7 ft. x % ft. On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of Butte). FOOTINGS (check one) a 1. Wood -pressure treated or foundation grade. ❑ 2. Other (specify) r.� SUPPORTS (check one) a 1. Concrete block. E12. Other (specify) j Pier Footing Sizes and Locations SINGLE -WIDE in Line 2 - ine2 MULTI -WIDE Line 1 Main Beams ------------- Line 2 t.in j1n' j --- Main Beams -- --- — — --- — Line 2 i — Line 2 — — — — — — — — — — — —.r—Line 4 Tag or Triple ---_------- tin Line 1 — Line 1 Piers: Line 1 Openings: Y -----------' Size -Min. 1, Size -Min. Sc 1 x� Spacing -Max. -•------- Each Side of Openings From Ends -Max.------- i_ With Width Over --------- i Line 2 Piers - e, Size-Min.------------ Spacing-Max - -----------Spacing-Max.--------- From Ends -Max -------- Line------- Line 3 Roof Loads: Size -Min. ------------ Location (From Front) Line 3 Piers: (Under Bearing Wall Only) Size -Min .__________________ Spacing -Max._______________ „ From Ends -Max .------------- _ x x Ix1. .x x I. „x x Line 4 Piers: Size -Min ------------- Spacing-Max ---------- . From'Ends-Max.------- „ Line 5 Piers: (Under Bearing 'Walls Only) Size -Min ------------------- Spacing-Max ------------------ From ------------------ Spacing-Max.--------------- From Ends -Max .------------- _ Line 5 Roof Loads: --_ Size -Min .----------- x C , } location (From Front) _ BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA PHONE: 538-7541. -r MOBILEHOME INSTALLATION SHEET 4 1. owner's Name: 2. Installer's Name: 3. Is'the site currently under permit? Yes a No H (If yes, furnish permit number OR Is the site an existing site? Yes No E (If yes, furnish two plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach .j .fields and clear of all setbacks and easements? Yes 5"1 No 7 (If no, clarify 5. What is the mobilehome electrical rating? --------------- 7�41 Amps 6. What is the mobilehome site service rating? ------------- Amps 7. What is the mobilehome site circuit breaker rating? ----- Amps 3. Is there any other electric load to be served /bby the n mobilehome site service. ---------------- v----------- Yes I_'_ No U (If yes, identify the load and size: (Load) 02 S (Amps) 9. What is the mobilehome site gas pipe size? -------------- (in.) 10. What is the type of gas service? ------------------- Natural El LPG :y_ -I 11. What is the gas pipe length from meter or tank to the �r r mobilehome?--------------------------------------------- (ft.) * 1�Z. What is the mobilehome gas demand? ---------------------- (BTU) *(This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft, on LPG.) MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA — 534-4541 PERMIT NO. Address or location of mobilehome 15<2 _C'a,flCS C" Owner's name J' '..4 ., -51py r1<i Owner's address Cf E., "'t.�5/ Insignia or hud number �? �iZ S 7 Manufacturer's name Serial number of V.I.N. Year of manufacture ��7G (Official Approving Installation) (Date) IF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE MOBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM. 5138 White - Owner, Yellow - Installer, Pink - D.P.W. -- - e;w-.. = z"sf•r:-e. _..: .. ,ass _ vc•�¢r� *--..�<.. 1..•..n_s ..._-•,� -t: c�; N COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 538-7541' _ 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. l / rouid,t '12 r0104f Jr r 1' 1 1 Date o /`� r• i Inspector d� b -... ... .-.--+-•-- -c-.-`.- - . 4y yff"�Meitsc: ._ `."rte'. ...=*i=. l+nr"'""" COUNTY OF BUTTE , DEPARTMENT OF PUBLIC WORKS r 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE130 / OWNER OO PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work ,' completed. If you have any question pertaining to this matter, or need addi ' nal explanation, please contact t s office immediately. dc /SSS-� ss�,`. r. N� ams aew�--� Eh-$eJ'C&. V-11 eXOP c'G LyS b Inspector COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS , 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 538-7541 747 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. AppV'OV` 6 stzc,'' or norrchsl' r h2C"' "' "» T1,3777 CSC! C9'J TU`1Pl ay5 755", 77 In77i`J5�750,77 Dated /_��p Ins ector ��t^-- u G n j,' d ems'= R Dated /_��p Ins ector ��t^-- AP OWNER PERmrr 4k /� .�� ' 96 MH UTIL.CLEARANCE DATE INSPECTOR ELECTRIC GAS Support Sltruc.. Compaction Test"Re iervice Uze Other Load .--Type Pipe Size Length YEST NO YES NO t� OIDNAL 6-62-170 17 1-90P,E �gs SMITH, Marvin 4122 Camas Ct, Chico O�Fogl41 �S�la.4di. /)tRr Sf �r b P' ilk y •Y OFFICE COPY / 22 Address iMeter By GAS Date i ELECTRIC Meter By Dat J `JOB FINAL . Signature J=OK 0 Not OK " Not Applicable MOBILE HOMES Date )C,,, jCard B-1 ,5 N Date Card B-1 Date MOWE HOME INSTALLATION Plans OK except Ira 4'ZQAfng Requirements -Setbacks Easements B!Gadr MH Test-Demand-Valve—Connector eity; MH Test -Crossovers -Breakers -Clearances fAH Test -Fall -Flex Connector MH Test -Regulator -Connector and Sewer Connected -C/O to Grade -HD ADM of Date and B-1 S --Date Card B-1 Date Ur YJCard B-1 yy,® ate Card B-1 _� i MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #$ 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; 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 N'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-Panelboards- Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 `OK - Applicable Reedy RESIDENTIAL (; Da • UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. 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. 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 #'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 Al 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral 0 Yes 0 No 30. Service -Riser Conductors & Ground -Main Disconnect 31. Equip. Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector Date Card B-1 Date Card B-1 Date 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 & Bearinq lIngle & 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 Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing 51. Property Line Firewall & Openings 52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers 55. Siding -Nailing Veneer 56. Stucco Mesh -Drip Screed -Fd. Vents-Underfir. 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 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 0 Yes 78. Guard Rails & Deck Construction -Post Caps 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 80. Following instld.; Drive 0 Yes 0 No; Walks 0 Yes 0 No; Planters 0 Yes 0 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 Card B-1 Date Card B-1 Comments at Final: (NOTE: An entry must be made each time you visit job site) ELECTRIC GAS Support Struc. Compactior. Test Re Service Size Other Load Type Pipe Size Length YES NO YES NO 1-70 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville; Cslifoi7oia 95965 - Telephone: 916/538-7541 APPLICATION AND,PERMIT PERMIT NO. l✓ ASSESSOR PARCEL NUMBER 6-020-170 ZONING p,_ BUILDING PERMIT OWNER Marvin Smith TELEPHONE 343-0490 SO. FT. DCC. BUILDING VALUAf ION OWNER'S MAILING ADDRESS 537 Nord Hi hwa Chico 26 CONTRACTOR'SNAME 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 LICENSE NO. Plan Checking Fee $ 00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ 25.00 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. 2 SUBDIVISION NAME 1 PARCEL MAP 1 94-100 Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ MobilehomeK:] Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home 10.00e TYPE OF WORK New❑ Addition❑ Remodel[] UtilitiesysJ Installation[: Other ❑ Describe work: 2 Bedroom l ` _ 7 EL Permit Fee $40.00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V 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): ❑ 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-1 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST.(DWELLING OCCUP.& OR ADONS. ACC. BLDGS. , 2hQSgft NEW CONSTR. ULTI.OUTLET NON•RESID BRANCH CIRC ITS 2,50 ea POWER APPARATUS t1 (SINGLE OUTLET CIR. - . Ex. OCCUp(OUTLETS OR FIXTURES 0050C eA 030 FIXED APPLNS. R Ex. Occup. OUTLETS (RESIO.)EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 1 15.00 1 nn Misc. Wiring 15.00 Permit Fee $ 25.00 Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the 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 liabil' s, judgments co , and expenses which may in any way accrue ;g�ainunty i ns a of the granting of this permit.� (T G 6 Date Signature of Applicant — Owneiq 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 $/'90.()0 HAZ PARK FL PAR PD HD E This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRE OR F PUBLIC By PER I EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date -- Receipt No. 5"�yy WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT To Buildinv Department \( FROM: Enviromiental Health SUBJECT: Sanitation Clearance owner Location AP# Plan Approved for: Sewage Disposal Water Supply Hold final for: Water Supply Final clearance O.R. for: Water Supply Clearance for ``bedroom mobile home. Other NOTE —_ 10 Sanitarian Da e . l�#eLN: Y yr, i F''ti ,►se' `� Y COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION ah�, { 7 COUNTY CENTER'DRIVE - OROVILLE AAliORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLIC'ATIOICDATA SHEET Permit No.- OWNER o. OWNER / "�/tRJ/.� .Si+► i0h' A. P..No. Proposed Building Use �yy ZQ"� •'Building Inspector CS-.% Date—� — At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . ........................ 2. Plot plans in duplicate/triplicate, signed. by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ............... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13. School (strict fees paid .............. Sanitation approval from y� 4 -"—Health Department 15. City -of Chico plumbing permit. ......../.. ....................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occuparicy) 20. Pre -Inspection for required Pre-Inspec.request to Building Inspector 21' Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. y,91.—Owner-Builder Verification (Given to owner ❑, Mail to owner ❑) ..... Recorded copy of Agricultural Acknowledgment Statement ......... a_2 .25. Letter of signature authorization .................................... -26. '27. When you issue the permit, process as follows: C Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w. /inspector. Other /7 1 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—i.. The following data must be submitted prior to permit issuance: (Circ) 1. Index permit for above items No. 2. Additional items required: w item not checked above). Contractor, designer, owner, was advised of above required data by_phone--jnail—counter by �k date Contractor, designer, owner, was advised of above required data by —phone _maII—counter by date Plans checked by Date Plans approved by �`�/ Date a lr Sets of plans on hold in File cabinet AP folder Copy—DPW _ ACRTCULTURAL STATEWNT FOR RESIDENTIAL ' Sr,..ioo 20-8.1 o[ 1 -he Duct.(! County u.'y/irex U`is *cku.`�le0gemen� ho recorded |xrior. Lo i*aoo"'�e of a bvjlJjx8 permit. NOT ��GUNAL COMPARED'' 'I'll(!odescribed e�criheJ horcio is adjacent., ---``'^'`" to |�nd v/ ixcludcd within m, area av'cd |..r oA/in/|/or'`| yvPpoaes, ;n -rd rcsidcnt-s �AK y o*/y |`r w|`i,,\ �v ixux`- . °w� ~ � '� 1O�N ~ ��m ' ", .|isowu[vrt. oti»ing from 1 -hu v,c of uxri.n|1u,x\ ,hCwjCal s. i11c1odixg, |mL m`L |i/''i\n| |" hcrhjrjdpe' poat;iciden, and [crni|iz,r*; and from /)`o pursuit � 9O 0�2�15 "pen/[i^ns iuc]vdjng, �� _ � - - - bill, no/. |imi/''| Lo. co]t.iv:L.i.m`. Plowing, � spraying. |."ming' and hvrvcsLjog which occuaioxa||y gu`eraLe JusL, smoke, noise, and odor. Butte CounLy has esi'J`||,|!^ ..n'�i'xi tvroi a^/c, which huvr as a priority use for yrndocLive agcjcu1/oro\ purposes. '"/`( !rs/.(.'/. widhin said /"xcs and' on ndAarruL property should he prepared to o;cpyt'such iw"x,n'i,^' ' "r ,|is*o/|\.// hum xorwal. necessary [unn operations. Nl Lhn/ /p,| 1)1 -(.)PC 1-1-Y uiLua,c in Ihe Cow" y o[ Butte, Stair o[ -Cu]i(o/xi.`. {"] l"w,: - nol]y known �u ox�. SARA -- '--`----- ^ F-� Proved u` me on U/r |^/�.i` ILIENE PALMER of soKo[ucLury ,,iJ,v.NOTARY, uo -be 1 -he person(s) whose name(s) ' 4�` . and acknovlo|�c'| �i:,t _ executed the same for the purposes Lheteio conLoix'.|. IN w|/i|P ��^/° ~_"/^� hand and o[firia] aoo|. c__ -_-_ |5n; 5-29-90 �7 7^�/--u ._ PROPERTY OWNERS: 5�- /�. ,p7 e" ^� � � lAoLe .`| Calif) On thia the 29 day of ---�------) SS. the mx\erSigdcU Noc,ry Public, yernonn]]y appeared' ' C000Ly "[ . . 'MAJRVI0_ -�� S8�I - nol]y known �u ox�. SARA -- '--`----- ^ F-� Proved u` me on U/r |^/�.i` ILIENE PALMER of soKo[ucLury ,,iJ,v.NOTARY, uo -be 1 -he person(s) whose name(s) ' PUTDICOUNTY auhaczihed to the within instrument and acknovlo|�c'| �i:,t _ executed the same for the purposes Lheteio conLoix'.|. IN w|/i|P WHEREOF, I hereunto aoL my hand and o[firia] aoo|. -_-_ Present, A.|' No. � Now.?r//n�r~- COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT , - (b -2- /7� L/ //,/ G ADDRESS NOR l0 AW y4✓-sy CHI NAME MAILING ADDRESS CONSTRUCTION LENDER NDER'S MAILING ADDR RCHITECT OR ENGIN S MAILIN DING A TELEPHONESQ. FT. 3y3 -04M- - e':f 9l'5'2(a) UNKNOWN LOT NO.ISU BDI VISION NAME PARCEL MAP gy_/0 USE OF STRUCTURE SF [I Duplex[] Mobilehomela- Other SPECIFY TYPE OF WORK New ❑ Addition ]Remodel ❑ Utilities Installation Other ❑ Describe work: 2 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) n�17I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason 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. I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilit s judgments, costs, expenses which may in any way accrue against in co que a granting of this permit. "'� Date [66 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. Receipt No._/ � f�`v WNITE•O.P.W.. YELLOW- ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT PERMIT NO. BUILDING PERMIT OCC. I BUILDING VALUATION Fireplace Total Valuation $ Filing Fee Permit Fee Plan Checking Fee Energy Plan Checking Fee Penalty Permit fee PLUMBING PERMIT Each Trap Solar or heat pump water heater Water piping Each qas water heater or vent Gas piping system 1 - 5 outlets Building sewer Mobile Home Permit Fee Contractor ELECTRICAL PERMIT Main service 8001 OR LESS 100 AMP OR LESS Main service EA. ADD'L loo AMP NEW CONST./ DWELLING OCCUP. OR ADDNS. t ACC. BLDGS. (POWER APPARATUS 6 SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES FIXED APLNS. EX. OCCUp. OUTLETS (RESID )REA.) Temporary service Mobile Home Facilities Misc. Wiring $t y S $ S $ Filing Fee 2.00 20.00 5.00 5.00 5.00 5.00 0.00 e 10.00 10.00 $ Yya Contractor Filing Fee 10.00 10.00 2.50 '/2Csg it 2.50 ea 3.00 Ventilation I 20eooe eAL030 $ 2.00 10.00 $ 15.00 15.00 Permit Fee $ L5 -i Contractor - MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation I Permit Fee $ Contractor Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST TYPE TOTAL FEE $ C7 HAz CUA PARK SCHL FLO I PAR PD I HD I ISSUE This permit is hereby issued under the applicable provi- sions or the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By PERMIT EXPIRES Date Date L V 1,11,j�P,�ms�ch� "'�'4e�i'�Fi�V'bt+''�' �s 5,�ii�,"a.^",�"y►�"�"ln�"qd'�s��if�'ar�'",1�!`m"c�i�'1c`a�isx-- r^..,. --� � , ' a�yri ys 'ns: 1r-�;,,�'",: r-'�, BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM (One Form per`Building) A.P. Number—02-0-/-70 Building Department 9No. School District City U County ICI Jurisdiction Property Owner ' m4 ig (/l Al - <; n4 / 777t Project Location/Address y Subdivision Lot Number Residential Development: Sq. Footage # of Living MHI - Addition (Group R) Units Commercial/Industrial: New Sq. Footage Addition (Including Exterior Roofed Areas) z �v DLL11U1}/'y ucrat�uic ii ncri c�cit �.a �-t vc Date (Floor Plans reviewed by School District Personnel). District Id No. ' /y �n l"0 o l� /1 I (� School licant Name reet Address y has complied with by the payi�e,nt of �4LL District certifies,; that (Phone Number) (State) (Zip Code) - the requirements of Resolution No. �$ Ey-tll jy square feet. School District Representative Date PAID BY CHECK NO. IV BANK NO PAID BY CASH REMARKS: LA50 J , 1 La,JLffl'(9_,- 'of ) 1 ous t white -applicant, yellow -building department, pink -school district SCHOOL.FEE (8/88) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA 95965 PHONE:' 916-53877541 DATE Auguet 13, 1996 Marvin Smith 5375 Nord Hwy Permit appin #268.5-90 for mobilehome Chico, CA 9.5926 installation A. P. if 6-02-170 With reference to the above subject: �1 Attached is: Application for permit Mobilehome Utilities Installation Sheet Building Plans Mobilehome Installation Information Sheet Engr. Calcs Typical Plan Sheet Owner -Builder Verification Form List of Codes Enforced OTHER L_1 We 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 Recorded copy of agricultural acknowledgement statement. �� OTHER Mobile electric rating (call in) Should you have any questions concerning the above, please contact Dave Wasney of this office. (916-538-/541) Yours 9 - - Yours very truly, JFG/aj William Cheff Director of Public Works AF. Glander hief Building Inspector a ReturniL7 DPW ; AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT REQU6TED BY° FORIRESIDENTIAL DEVELOPMENT Section 26-8.1 of the Butte County Code requires this acknowledgement be recorded prior to issuance of a building permit. _ The pr.opert.v described herein is adjacent to land or included within an area zoned 90-022915 Rec Fee 5.00 for- agr.i.cuLtur.al purposes, and residents Cash 5.00 of this property may be subject to -hicon- Recorded ; vena eenccs or d isc omf ort arising from the Official Records ; use of agr.:ic:ul.t:ural chemicals, :including, County of ; but not .1.i.miLed to herbicides, pesticides, Butte ; and ferL:il.izers; and from the pursuit Candace J. Grubbs of agr.i.cu.1 t -ural ope:raLions including,. Recorder ; but not: limited to cultivation, plowing, 9:41am 4 -Jun -90 I BG 1 spraying, pruning, and harvesting which - occasionally generate dust, smoke, noise, and odor. Butte County has established m4ricul.- Lur.al zones which have as a priority use for productive agricultural. purposes, and res i.deuls 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, dccscri.bod as -31 1 Date: 5-29-90 1 .0 -•-J �T ��gs �� - lea PROPERTY OWNERS: State of: Calif ) On this the 29 day of May , 1990 , before me, ) SS. the undersigned Notary Public, personally appeared County of Butte ) MARVIN E SMITH AND CHRISTIE A SMITH •..^-•....u.u.nuunuurec:a!Innllll[?^IIIgIpIR7111111! SARA ILENE PALMER 1- y known to me. [:1 Proved to me on the b<15 is . = of satisfactory evideii(:C. NOTARY r-UBLIC-CALIFORNIA_ PRINCIPAL OFI(CE(N g Lo be the person(s) whose name(s) pyrp BUTTE COUNTY subscribed to the within instrument and acknowledged that The._ My Commission Expires September 24, 1993 executed the same .for the purposes therein contained. 'f N WETNESS I(ilr7(IIII IIIIIUUIIIIlIIIipIpIIIIIII11111L71111!IIIIJILiIi Ui iluil ii] lu a uu I (1[ �. WHEREOF, I hereunto set my hand and official seal. Present A.P. NINYAM1110I Notary Pu .. END OF DOCUMENT m BEAUTY DEPARTMENT OF PUBLIC WORKS WILLIAM (Bill) CHEFF, Director 7 COUNTY CENTER DRIVE • OROVILLE, CALIFORNIA 95965 Telephone: (916) 538-76K Ronald McElroy. - Deputy Director CHN'14GE OF ADDRESS MARVIN SMITH 5375 NORD HWYIN" 0 T I C E CHICO, CA 95926 JUNE 49 1990 Date .Dear Resident(s): AP '# 06-02-i" A county -wide comprehensive address numbering system was adopted October 18, 1977 by. the Butte County Board of Supervisors ebcallsemergency to facilitatefrom postalfire, andsheriff other delivery ambulance services to respond quickly to services. The Public Works Department, with the assistance of your emergency services, currently is assigning%PERMANENT_ROUSE NUMBERS to all,residence§ and businesses in the unincorporated ;territory`of.the county. The address numbering system will replace the various rural 'route numbers previously used. Each residence and place of business will have -its own address, even if you receive mail at the post office.. NEW/NONE and your PERMANENT Your old address was and is effective the ADDRESS is 44-38 MAS COURT I^Hwn, C.Agsa�� 4 day ofJULY_ 19__qo_ . In order to facilitate the delivery of mail, it is the responsibility of each individual property owner or resident to file a change'of=address card with the post office; also please notify all utility companies, magazine subscriptionpublishers, etc., and friends and family you wish to advise of your address change. This will not affect the residents who pick up their mail at the post.office. Street signs and house numbers must be installed at the proper locations. County standards -for mailboxes and residence identification and numbering are shown on the attached diagram. Please install your new address. number promptly. There is no substitute for clear visible numbers properly installed for the convenience of residents in the community. If you have any questions concerning this matter, please contact Doug Arnold of this office at 916/ 538-7339.6 DA/ss Attachment C.C: Assessur - Flections Very truly yours, William Cheff Director of Public Works lac'- 2 Doug, rnold ._ _. Address Coordinator r COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovillle, California 95965 - Telephone: 916/538-7541 APPLICATION' AND PERMIT 101 PERMIT NO. ASSESSOR PARCEL NUMBER 6-020-170 ZONING _ BUILDING PERMIT OWNER Marvin Smith TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 5375 Nord Hwy., Chico 95926 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 LICENSE NO. Plan Checking Fee $15.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $25.00 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome® Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 10.00e TYPE OF WORK New❑ Addition E] Remodel❑ Utilities❑ Installation® Other❑ Describe work: 2 Bedroom _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 n4 :I-ZI 14 Z-/ ! Main service 600V 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): ❑ 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.& OR ADDNS. ACC. BLOGS. , 2h0sq ft NEW CONSTR. MULTI -OUTLET NON.RESID BRANCH CIRC ITS 2.50 ea (POWER APPARATUS &� (SINGLE OUTLETCIR• Ex. Occup(OUTLETS OR FIXTURES SA 0530 Ex. OCC -P- OUTLFIXE -ETS P(RESID .)OR 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ 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. 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. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of 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 s, gments, costs, a expenses which may in any way accrue again ty in y�anting of this permit. d q Date /i z �L Signature o 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 $45.00 Energy Inspection Fee $ occ CONST TYPE TOTAL kE $/70 . HAz CUA PARK AR F S E This permit is Hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OA PUBLIC By PERM EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS ate —1 J =per Receipt No. 70263 WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT IT -1 IT -R' j]�..i = ;''' �`• �.,� .t.`r... p.. 1 COUNTY OF BUTTE - DEPARTMENOF PUBLIC WORKS - BUILDING DIVISION 4 ,7 COUNTY CENTER DRIVE - OROVILL XCIFORNIA 95965 -TELEPHONE: 916/538-7541 r; - C PERMIT APPLICATION DATA SHEET 'Permit No. 0 L1 OWNER. -Vi Aj '9 7-77qA.P.N _OZD'/%d Proposed Building Use - /1/Z�Z 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 APPROVED 1. All items have been submitted . .................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. - 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. Engineered truss details and layout in duplicate (required prior to plan check) %-` Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 1 _ Park fees paid ................... GyS !7 paid . . ............ School District fees anitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) \. ' { fi 11 17. Planning approval for (A) Use: (� 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 (Da 21. Contractor's license information (No., Name Style, Classifications ... r ZviCertificEA'of Workmans' Compensation Insurance .................. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 4. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of sig ature authorization ...,_,...... 27. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone 6111 3404/90and hold for pickup at ,� office. Deliver w/inspector. Other Appl Date F'l C> 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 su itted prior to permit issuarie: (Circl.new item not checked above). 1. Index permit for above items No-`'—i6V 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_mall_c unte by date — vi Plans checked by e Dated P s approved by �/ Date _LLd- _:�!–Sets*of plans on hold in Copy—DPW File cabinet AP folder COUNTY OF BUTTE - DEPARTMENT OF- PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR U PARC E NUMBEii D_ / !7� 7d ZONAJG �(� BUILDING PERMIT OWNER V I N � TELEPHONE S0. FT. OCC.1 BUILDING VALUATION OWNER'S MAILING ADDRESS `3- 3 -7 n 9s z CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation LENDER'S MAILING ADDRESS ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 10.00 Permit Fee Plan Checking Fee $ $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS /zZ Permit fee $ �S-, e2 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 or heat pump water heater 20.00 JSolar LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5 .00 Each qas water heater or vent 5,00 USE OF STRUCTURE SF ❑ Duplex❑ MobilehomejvOther SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G W 10.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installatior}4�z Other ❑ Describe work: lie X1/1 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 1000 AMP ORV OR LESS10.00 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 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.E OR ADDNS. ( ACC. SLOGS. / , h¢sgft NEW CONSTR ULTI.OUTLET NON-RESID BRANCH CIRC 'ITS 2.50 ea (POWER APPARATUS e\ 1 SINGLE OUTLET CIR. I Ex. OCCU OUTLETS OR FIXTURES P 20050¢ eALe 3o¢ FIXED APLN5. OR EX. Occup. OUTLETS IRESIPD.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ 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 FiIi gFBe 10.00 Heating Cooling Hood 3,00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X 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 CT TY ONSPETOTAL FEE HAz cuA PARK SCHL FLD PAR PO HDI SSUE Th;s permit is Hereby issued under sions or the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date Receipt No. WHITE-O.P.W.. YELLOW-ASSr3SOR. PINK -INSPECTOR. GOLDENROD -APPLICANT v COUNTY.OF BUTTE - Depaitment 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. X1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) Ve2 2. I (have/have not) o 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: F Name Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed Pry Soy Da 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. v0 r)?. I p✓T/o.v $ or ... _... .. ..,-. t ovStwne,.9le.«-p•.. Y+f..-ew __. ,.aFi..,..,.-,_..,,.......•,.....r ., y._ee_-: a=+rt•a.•_.^r _k_-� __ v.: -ti_ - •r- .t• w.v. .5.• s .:r=_+: . r!-_ rte. '••• ,: •.•.:i w•. . _ - •..� a •v td -. .. ; - .. r,. _ - - - � - � '_:1 • -� • '• ': .j °' r r^ ..' -..:. .• _ .: 1. _ ,ice _ _ :F' — L�N�r This. set of pler►s' and. spcIf icatiorts MUST be t4 • = xl5T1NG:, kept on the job at -all .times and-!t.=is_unlaw.fu.l.#o make any -•changes or -alt$Ntions -on seme.v:rf#h 1 5 r out written, permission frim the Department of A sotbm* .of V It. from :the _ . . �►�p+ it c e Pubik Works, County of � �pstallafi, of the mob►leh a property 'tinea and -a. setback of . -.. ; ;:,•,: 50 ft:'from the road-, centeriirie'shall be- Q gtruc� equipment -for a 2 caw o�rert�e�rg r ipmen '-e t NOTE. AO Materials &- Wo'rkmarishi' l . 4 _ p Shcll 8e ' fri .: Accordance with Recognized i'Oood Practices and * .T . of a quality prescribed. for the. Sdp ecified use in the r Uniform Building, Mechanicals Codec - Sc 3 *- p•� FJ ?hi :tioripl _EleetriCal CO r • . t- n dB• , _ � <.- rt \ ` Q?,OFESS/�N �N • BA C,ql F IS,/.Erp. y 6 30-93 : •5� r., y f: z:. n 1, 5a W V J (P - .. OF. CAOa 0 Q' P) i, • z !7�! X470 BUTTE COUNTY BUILDING DEPARTMENT APPROVED bW 6/(Igo Ut E 10 50.oar 1 I 5 3 7 5 N O R D C H I- C,o: >=1 FOR 1\1.!a - MAR 0 � 1990'' ---� A C H A - ASSOCIATE, ' - n ✓• a A — __ r ._ _ ._. J � .^ s. "_'_ .� � _•• ` l n . .. � .•. • � e � act �+ a - , t � � / / } t � � \._ � � / k � � \ k � \ / `' ��}) � f \ \ � , . � ID - , t