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Home My WebLink About021-160-00821-16-08 BOB SCOTT West Liberty Rd, 900'E Lewis Oak, Grid eM.-I-11, Pearmi:t��-1'2'C)O.-83P,E(,,util. 'Wm) Z,,4 ELEC GAS b -Z 3 -6-? SUPPORT STRUCTURE R COMPACTION TEST REQ .21-16-08 SMITH., --9, 5,; Olt I tA 2: <� Permit#12 83MH-I(for 1200-83) is df I m V, ,'� �� r� �� CSI �� BUTTE COUNTY DEVELOPMENT SERVICES COMPLAINT FORM This information is not available to the public!!!!!!! D 0 NO T COP Y FOR THE P UBLIC OR THE FIELD INSPE CTOR!! The following information is required for Housing Complaints and the Complainant MUST BE the person living at the complaInt address! Complainant Address Phone Number: The above information, is not available to the public!!!!!'.'. (2) KAFORJOS\Complaint Form revl.doc PERMIT NO. 1200-83P.E(NH) PERMIT EXPIRES- -OWNER BOB'SCOTT owner tvCONTR. ASSESSOR PARCEL 21-16-08 LOCATION S/S West Liberty, 900'E Lewis Oak J, Rd, Gridley f AA 4 A 11r Temp. Power Pole Called PG&E Te/p. Called PG&E Temp. Gas Service CalledPG&E JOB FINALE' D (Date) Signature� A� 4 1 COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the =ement.s of the California Administrative Code, Title 25, Chapter. 5, permit number —for the following location: 0 w n e r 4 Owner's Address L Y Mobilehome Mfg. Model Z" ear Insignia No.—' L Serial No. It is hereby certified for occupancy at the above described location and may be occupied. Director, of Public Works Date By THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED White - Owner, Yellow - Installer, Pink - D.P.W. If J COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise— Phone: 872-2961, Ext. 57 CORRECTION NOTICE e— ft� 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. I/ OK (5 Not E)K Not Applicable MOBILEHOMES MISCELLAN�OUS Not Ready Date MOBILE E UTILITIES (Plans) OK except #'s ..t� - 4-"foq�WRequirements-�etbacks-Ea�pments Da te — DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'s 1. Zoning Requ i rements-Setbacks- Easements a,�V, . Special MH SuppqK-Skereg 2. Footings; Size -Depth -Spacing -Connectors L5,-tewer; Local4eK-Tegri�Fall-C/0-Concrete 3. Decks: Girders and/or Joi§ts-Decking-Bracing-Sta-irs-Raiiis Water; Location-Test-EasementAt!&_ed ISketch) 4. Wood Awn.; Posts--Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing .(sp,!��ctricity; Lo*0on-CIear�VesKGrnE.%0t2! mp-Concrete 5. Alum. Awn.: Columns -Connections -Splice -Decal -Enclosures be"Gas; Locptol;�Test-vVrap:/D/"L"fi�*/�t-,f'Nat.or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors 7. Utility- Clearance 7. Elec. Card -BI D a I e 'j;- ',r_k7YPCard-Bl . Date Card -BI Date Card -BI Date Card -BI Date 1!211�,��Card-Bl Date Card -BI Date Card -BI Date Date OBILEHOME INSTALLkTION (PlOd�OK except #'s -1/'23n,ng Requ irements-Setbacks- Easements Date POOLS (Plans) OK except #'s 1. Setbacks- Easements tings; Siz -Spacing-Marriage Line 2. Soils; Compact i on -Structure Stability Gqjs; MH Test -Demand -Valve -Connector 3. Pool Structure; Stee I -Connect i ons�-Th ic kness-Dead Men -Lining i4.K—tricity; MH Test -Crossovers -Breakers -Clearances 4. Elec.: Receptacles and Lighting; Distances-GFI &-*00rain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI %/W-aier: MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 1,-W-ater and Sewer Connected -C/0 to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. �e and Electricity Tagged 8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lght6. Boxes -Enc losures-Pane I boards- Ins. to Main in Conduit *o"Exits; Insp.-Sketch lvcert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card B-1 (5_Z 'Date 2,�_ Card -B I Date 1 I Date Card -BI Date Card B -I Date Card -Bl Date —ard-B Card -BI Date Card -BI Date ) -).-5rf 2 / t dw OK 0 = Not OK - = Not Applicable * = Not Ready RESIDENTIAt (Single and Duplex) Date UNDERFLOOR (Plans) OK except# s Date FRAMING (Continued) 1. Zoning requ irements-Setbacks- Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- Ftg. Depth 49. Ext. Doors -One X -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -F ire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers _-5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 6. Sternwalls, Garage; Steel-Blockouts-Wrapped-Slab 52. 53. Sid ing-Nai I ing-Veneer Stucco Mesh -Drip Screed-Fdn. Vents-UnderfIr. Access -7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protect i on -Sky I Ights-P last ic 8. D.W.V.: Fall -Fittings -Test -2 way C/0 -Sewer Test 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe: Test -A ncho, s-Regu lator-Sery ice Test 11. 12. Electric; Underground Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Card -BI Date Card -BI Date Date Card -BI Date Card -B I Date Card -BI Date Date FINAL (Plans) OK except #'s Card -BI Date Card -BI Date Date PLUMBING (Permit) OK except #'s 14. Water Ht.; Vent- Access -Combustion Air 15. Water Pipe; Test & Anchors -Nail Protection 56. Ext. Steps -Door & Sidelight Protection -Landings 57. Smoke Detector 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access Test Tub-& Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels - ---1-8. ___19- Gas Pipe; Size & Anchors 62. 63. Stairs & Rails Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -B I Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. 67. Elec. Outlets & Receptacles at Kit. Counter Garage Fire Door; Swing�Landi ng -C loser Date ELECTRICAL (Perrrit) OK except #'s 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -C leara nce-Comb. Air-Connector-P.R.V. In Garage; Above Floor-Mech. Protection 21. Elec. Receptacles Spacing -Lights & Switches at Doors 70. 71. Plb., Elec. & Mech. Equip. Listed for Location Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 22. Size Boxes & No. of Conductors -Stapled 23. Romex Installed Close to Edge of Studs & C.J. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. 1 nsu lat ion- Foam- Looked in Attic E] Yes 73. Guard Rails & Deck Construct i on -Post Caps 25. 2 Appliance Circuits in Kitchen & Conductor Size 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor El Yes 26. Subfeed Wire Size ga. Cu or AI-A.C. Wire Size ga. Cu or Al ---Insulated 27. 28. Range Circ. / / ga. Cu or Al -Oven Circ. ga. Cu or At, Neutral EYes ONo Service -Riser Conductors & Ground -Main Disconnect 75 . . Following instld.: Drive 0 Yes E] No; Walks El Yes E) No; Planters OYes [JNo 76. Stucco; Brown -Finish 29. 30. Equip. Clearances; Pane I s- Motors-Mec h. Equip. Clothes Closet Light -Shower Light 77. 78. 79. A.C. Unit; Disconnect-Cirnces-Brkr. & Cond. Size -115V Outlet Vents Above Roof; Pl�g.-Appliance-Firepi.-Clearance to Opngs. Water Well; Disconnect, Electrical, Plumbing Card B -I Card B -I Date Card -BI Date Date Card -BI Date 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground 81. 82. Ventilation throughout House Glass Protection Date MECHANICAL (Permit) OK except #'s 83. 84. 85. 86. Corrections from Previous Inspections Gas Test -Meters Tagged; Gas -Electric Water & Sewer Connected -C/O to Grade -HD Approval Energy Compliance Certificate -Other Certificates 32. 33 . A.C-.-Ducts: Insulation & Support Vent Fan; Exhaust above Insulation Condensate Drain & Overilow; Size & Grade 34. Furnace -Vent: Access -Comb. Air -Return Air Vent -115V outlet __35_._ Attic Ac -cess kPlatform -if Furnace in.Altic Card -BI _r_ __ .Ca d7di __ Date Card -BI Date - - -Eard- B IF Date Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FRAMING(Plans) OK except #'s Comments at Final: 36. _37, 38. 39 . 40. Sills; Proper Material & Anchors Wall - s; Studs -Nailing, Spacing & Bracing -Plates -Sound -- Bearing Walls over Girders & Floor Nailing Draft Stop in Walls (rat proof) Fire Stops: Furred Ceilings -Stairs -Chases -Tub 41. 42. 43. 44, 45. 46. 47. Header & Beam -Size & Bearing Hang-ers-Post Caps -Anchors -connectors- - - - Flmf 6 ac. - §h Cing. Joist-13fir. Ties-Purlin- r Truss- thnp.-Rfnq. Fireplace Ties or Type A Flue -Fireplace Throat Attic - Access:_Size &-Rom ' ex Protect ion -Draft Stop -Ins. Baffles Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions Garage Fire Pnotection-Framing (NOTE: Anentrymust be made each time youvisil jobsite) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS i 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 �/_ . - 4 'VE R "' APPLICATION AW MIT PERMI T' X ASSESSOR PARCEL NUMBEQ a I - 110- 4 BUILDING PERMIT OWNERICI r� L4 > LAa TELEPHONE N6 3 W-0 SQ. FT. OCC. BUILDIN&VAtUATION OWNER'S mAILIN" I TDRE55 (0 re,�e_n'n 2 CONTRACTOR'S NAME 0 CA2% VA- TELEPFJONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER Ai UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER /VV_A 12 ILICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDINGZADDRESS PLUMBING PERMIT FilingFee 10.00 QAAJ Is. Each Trap 2.00 Solar Water Heater 20-00 at r piping 5.00 LOT NO. SUBDIVISION NAME 1 ARCEL MAM Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF S RUCTURE SF [:J DupIexF_1 Mobileh ��01 her SPECIFY Building sewer 5.00 Mobile Home FS G W 10-00ea TYPE OF WORK New F� Additio Remode I Uti I ities D Installation Er—other Describe Work: *0 y— .2,24L -f- Y3 Permit Fee $ Contractor - ELECTRICAL PERMIT FilingFee 10.00 Main service 600V OR LESS 1 00 AMP OR LESS 10.00 bX,6_`4 -4- Main service EA. ADD'L 100 AMP 2.50 NEW CONST. ( DWELLING OCCUP.&) OR ADDNS. ACC. BLDGS. 21/20sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): F1 I am licensed under provisions of Chapt. 9, Div. 3 of the Bus I ness and Professions Code and my license is in full force and effect. License No. Classification X1, 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) 0 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 CON5T MULTI-2UT,4ET NON . RE SI D.R` ( BRA NC C C, ITS) 2.50 ea I NEW.CONSTF;L (POWER APPARATUS&I NON RESID. SINGLE OUTLET CIR. I 20@50t Ex. Occup(OUTLETS OR FIXTURES IBALOSOC FIXED APPLNS. OR Ex. OCCUP- OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15-00 Permit Fee $ Contractor MECHANICAL PERMIT Fi I ing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): r-] The permit is for $100.00 (valuation) or less. E] 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-lns�ure. I shall not employ any person in any manner so as to become subject too 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 shal I be deemed revoked. Heating Cooling Hood 3. 0 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 t ' he above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities . dgments, costs, d expenses which may in any way accrue .' C _-4Q against said - int In c on,, qu cef of granting of this permit. _C4 X 117-2 � iZ .11"A A-3 XZ Date Signature of Appli/ant — 0-ner)< ContractIrEl Agn7, .X' An OSHA permit is required for excavations over 5'0" deep and d . emolition or construct- ion of stru tures over 3 storiesin height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ -7 0, Z)C) occuP. GROUP I TYPE oF CON5T.] W PARCEL PD I H This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which PUBLIC BY PERMIT EXPIRES Date— the applicable provi- resolutions to do fees have been paid. WORKS Date T_,510_6�3 Receipt No. __Ezz 3,fo WNSTE-D.P. Y �'LLOW-ASSFSSOR, PINK -INSPECTOR. GOLDENROD-APPL I CANT 'IV OUNTY OF BUTTE - DEPARTMENT OF PUBLic WORKS - BUILDING DIVISION �47 OUNTY CENTER DRIVE - OROVILLE-, C'K_C1'06Rk'A-_9'5965 - TEL . EP , HONE: 916/534-4541 Z PERMIT APPLICATION DATA SHEET Permit No. 4 % A. P. N o. OWNER 'A A A A Proposed Building Use Permit Fee Based Upon: —Complete contract Price —DPW Valuation -he Txplain) Building Inspector. Al Date 41 At time of permit application, I Was advised fhe 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 . . . . . . . . . . . 3. Complete plans in duplicate/triplicate. . . . . . 4. Complete engineered plans and calcs . . . . . . . 5. Plans with Energy Design Compliance Statement . . . . . . 6. State Energy Forms No. " . * * * * 1 7 Statement of Intent for Non -Heated and AC Buildings. . 8. Fees of $ . . . . . . . . . 9. Letter of signature authorization . . . . . . . . . . . 10. Sanitation approval from Health Dept. . . 11. Planning approval for (A) Use ' :_(B) Parking: - 12. Certificate of Workmen's Compensation Insurance . . . . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to ownerEl, Mail to owner ts may be required . . . . . . . . . . . .. bi eh Orr Installation Data. . . . . . . . . . . . 8_Z3 -115 _ sp Pr,-Inspec. request to MProe I'n ei ion for. Required. Building Inspector - 18. Other Date) When you issue the permit, process as follows: to owner. —Mail to contractor. Telephone and hold for picl�up at —office. —Deliver w/inspector. Other Applicant Date Copy of plans sent —Health Dept., —Fire . Dept., — dther Date During the plan checking proc�ss, the following data must be submitted prior to permit issuance; (For required items not checked above�a . .�ime of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Plans checked by Plans aDDrovedtb, Other: Copy—DPW was adv ised of above required da y elephone —Mail —Other By Date Date Date - a- Z3 -.6 Y_ COUNTY OF BUTTE �epartment of Public Works County Center Drive, Oroville', CA. 959651 Phone: 916-534-4541 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your nameand bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary'delay in processing and issuing your build- ing permit.' No building permit will be issued until this verification is received. 'I personally plan to provide the major labor and materials for construction of the proposed property improvemen or no) 2. 1 (have/have not) signed an appliJ� for a building permit for the proposed work. 3. 1 have contracted with the following person �firm) to provide the proposed construction: Name Address. City Phone Contractors License No - 4. 1 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. 1 will provide some of the work but I have contracted (hired) thefollowing persons to provide the work indicated: Name Address Phone' Type of Work S igned: Property Owner Social'Security number Date 2 7 1,--Y S -- 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 permitted to issue the permit. l.. owner's name: 2. Installer's na BUTTE COUNTY.DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: -534-4541 MOBILEHOME INSTALLATION SHEET Is the site currently under permit? Yeb. N o XZ (If yes, furnish permit number Is the site an existing site? Yes JVI No (If yes, furnish two.(2) plot plans.) OR, 4. Will the mobilehome be located at least 5 ft. away from septic tank and1each fields and clear of all setbacks.and easements? Yes IVI No (If. no, clarify 5. :What i's the mobilehome electrical rating? ---------------------- Amps 6. What is the mobilehome site service rating? ----------------- Amps 7.. What is the mobilehome site circuit,breaker rating? ------ Amps' 8. Is there any other electric. load to be -served by the mobilehome siteserv'ice? ------------------------------------------- Yes NO ELL pipti (If yes, identify the-J,oad and size., M 1b '(Load) 20 (Amps) 9. What is the mobilehome site gas pipe. size? ------- ---------- ------ 10. What is the type of gas service? ----------------------------- Natural LPG 11. What is the gas pipe length from meter or -tank to the mobilehome? 12. What is the mobilehome gas demand? ------------------- ------ /IV 0 0 0 (BTU) (This information not required if pipe length less than 6 ft. on natural gas or -less than 50 ft. on LPG.)' MOBILEHOME SUPPORT DATA If other than single wide, Mobilehome Mf r. fu-rfiish Setup Model No. Yeu�. Width (ft.) B ox Lengt h (it.) Tagalong or Exp'ando Size 7 t t (SHOW SUPPORT DETAIL§ BELOW) -7 3e 2 - On all mobilehomes manufactured after October 7, 1973j furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of Butte). All center supports measured from front of mobilehome'unless otherwise specified. Footings,(check one) Single Center s locati Wood either pressure treated or foundation grade. 2.. Othei (specify) Supporta (check one) 1, Concrete* block. .2 i Other.. ( a p e c i 1�01' I ,ragalong or Expando,' show support -details. Typical Support Footing Size . Pier Spacing N01-83 BUTTE COUNTY BUILDING DEPARTMENI *If center piers are other than drawn above, APPROVED ,draw in. -locations, spacing, and dimensions. Return to DPW AGRICULTURAL STATEMENT -OF ACKNOWLEDGEMENT OFFL' .9EC FOR RESIbENTIAL DEVELOPMENT co.I� i q Section 26-8.1of the Butte County dode.requires this acknowledgement be recorded prior to issuance of a building permit. 2 -PHI 11-T The property described herein is adjacent to land or included LEAJN R - M. 34E within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort arising &3-14253 "f-g�E' from the use 6f.agricultural chemicals, including; but not limited to herbicides, .pesticides, and fertilizers; and from the pursuit of agricultural operationi including, but not limited to cultivation, plowing, spraying, -pruning, and harvesting which occa- sionally 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 propert� situate in the County of Bu . tte, State of California, described as follows: Zo-T _?3 aee� cet,�a,4'_ f,417 X."- -Z% 4 Date: PROPERTY OWNERS: 4f State of On this the /'q'a . LZ day of 'M 9 0--) SS. before me, the undersigned Notary Public, personally County of appeared '� 0 t t, , OD_t7— PAT ALLRED NOTA'K'Y PUBLiC Butte County State of California 'oloonimission Expires Dec. 5, 1983 Present known to me to be the person(s) whose name(s) subscribed to the within instrument and acknowledged that — A e- executed the*same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Notiry Public . ..... .. ....... 7 STATE OF ss. COUNTY OF in the year before On this ;9- day of fiv i- Ily appeared me, the undersigned, a Notary Public in and for said State, persona 474 ry evidence) personally known to �mefor Proved to me on the basis of satisfacto to be the person whose name is subscribed to this instrument, and acknowledqed that he (she or they) executed it. WITNESS my hand and official seal. PAT ALLRED L) NOTARY PUI�l (Siqnature of Notary Butte CountY 47 i, A' State of Califo. nia ion Expires Dec. 5, 1983 my Commiss A Pr,. (Norhe - Typed or inted) S0294(1282) Present T 'W % 4; g # 4 A 4, VV 4 4 �G J �� COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATIOWAND PERMIT PERMIT NO Z ASSESSOR PARCEL NUMBER a I — //1 _Z) 9-1 "A'-Lko BUILDING PERMIT OWN_& 10 'S -t TELE HONE M SQ.FT. OCC.1 BUILDING VALUAtION OWNER'S MAI L;W _�DRESS W�. A 1 .0 1 A 6 0. CONTRACTOR'S NAM. 0 W HONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER ___7NOWN Total Valuation $ Filing Fee $ i 9. 88 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER 'S MAILING ADDRESS Permit fee $ BUI DRESS qlL � qn, rrv-, PLUMBING PERMIT Fi I ing Fee 10.00 I LOAd LS. Each Trap 2.00 Solar Water Heater 20.00 G r -I Water piping 5.00 LOT NO. SUBDIVISION NAME 1 T-ARCEL MAP 1 Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SFF1 Duplexn MobilehomeKa""Other SPECIFY Building sewer 5.00 Mobile Home I CerF,-�HalO-100ea 1 1 TYPE OF WORK New R Addition [I Remodel 0 uti lities e-_`l'nstallation 1:1 OtherFJ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT FilingFee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 lo (W Main service EA, ADO'L 100 AMP 2.50 NEW CONST DWELLING OCCUP.&) ADDNS. ACC.BLDGS. 21/20sqft NTRACTORS LICENSE LAW I declare under penM'foperjury (check one): F-1 I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and e f fect. 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) El 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 CONSTR. ULTI-OUTLET NON RESID. (MBRANCH CI RCU ITS) 2.50 ea NEW.CONSTR. (POWER APPARATUS &) NON RESID. SINGLE OUTLET CIR. 20@500 Ex. OCCUP(OUTLETS OR FIXTURES IBAL@ 30C FIXED APPLNS. OR Ex. OCCUP- OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 lot) Misc. Wiring 15.00 - 1 H.r Permit Fee $ Contractor MECHANICAL PERMIT Fi I ing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare undonalty of perjury (check one): F-1 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-Inswe. 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. 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 sai ounty in conse anting of this permit /7 7nm Date /4f Signature of Applicant - _w`nner F� Contractor El Agent)Q An OSHA permit is ryuired for excavations over 5'0" deep and demolit.ion or construct- ion of structures over stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP.'GROUP I TYPE OF CONST. PA�� ISS This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIR=E,,, OF BLIC By- PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt N 0. WHITE-O.P.W., YELLOW-;SSESSOR. PINK -INSPECTOR. GOLDENROD-APPLI CANT t COUNTY OF -BUTTE -DEPARTMENT OF PUBLIC WORKS -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, C—ALIFOMNIA 95965 - TELEPHONE: 916/534-4541 PERMIT APPLICATION DATA SHEET Permit No.— OWNER— 4 6=t� A. P. No. Proposed Building Use 7 f Permit Fee Based Upon: Complete Contract Price —DPW Valuation __.,,LPLhgrjExpIain) Building Inspector. �-7- X(47-- Date 2-2-7 At time of permit application, I was advisA the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . . . . . . . . . . . . TIL -2— Plot plans in duplica / riplic`a�te:) . . . . . . . . . . ic It _ipI 3. Complete plans in dSp`c—a1!_e_/_tripIicate . . . . . . . . . 4. Complete engineered plans and calcs . . . . . . . . . . 5. Plans with Energy Design Compliance Statement . . . . . . 6. State Energy Forms No. 7 Statement of Intent for Non -Heated and AC Buildings. 8..- Fees of $ Letter of signature authorization. Sanitation approval froff-�F_l Health Dept. 11. P lann I ng approva I f or (A) Uee: (B) Parking: -,- 12. Certificate of Workmen's Compensation Insurance . . . . . . iA% Contractor's License Information (no., name style, classif.) ��i_4 Owner -Builder Verification (Given to owner[], Mail to owner1Z) 15. Improvements may be required . . . . . .. . . . . . 16. Mobilehome Installation Data . . . . . . . . . . . . I'md"spec. request to 1 Pre-Insp ction for a Required. Buildin g, nspector bbe) 8 Other _UA When you issue the permit, proceqv;ls fol lows: Mt -I �-;t0aeQw.---; Mail to"c'"ontracto Telephone and hold for pickup at Deliver w/inslqktor. Other Date Applicant Copy of plans sent —Health Dept., —Fire Dept., —Other Date During the plan checking process, the following data must be submitted prior to permit issuance; (For required items not checked above aMagicatign, circle item.) 1. Index permit for above Items No.-, 2. Additional items required: (Contractor, Desig ne was advised of above required data by _,n Tielephone -I-q!Mail 'Other 7T,^ By Date. .Plans checked bvi MIA Date Plans approved by�__� Date Other: Copy—DPW lo: 3.,.; j L ;-.�.nt 7y, r or. onrnentn,",_ He a I t __011 0 e a _�rl c 00011, Lon-, 'Pin -o7; ed', I-ro r: - F -D 1. -ter su-oly Firna -1 clearance 0. K. for: water supply Clea--,ancc for bed.room. o b Ja e home. Other NO TE A--, Date COUNTY -OF BUTTE - De�ar�ment of Public Works' 7 County Center Drive, Oroville, CA. '95965 Phone:' 916-534-4541 OWNER -BUILDER INFORMATION Dear Property Owner: An application for a building permit has,been submitted in your name listing yourself as the builder of the property improvements specified. For your protection, you should be aware that as "owner-builder"'you are the responsible party of record on such a permit. Building permits are not required to be signed -by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may pro- tect yourself from possible liability if that person applies for the proper permit in his or her'name. Contractors are required by law to be licensed and bonded by the State of California and to ha ' ve a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your bene- fit and.protection: If you employ or otherwise engage any.persons other than your imm diate family, and the work (including materials and other cos ts) is $200 or more for' the entire project, and such persons are not licensed as contractors or subcontracto'rs, then you may be an employer. If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers' compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious wit� respect to worker's compensation insurance. For more specific information about your obligations under Federal Law,contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact 'the Depart- ment of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed con- tractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an flowner-builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contrac- tors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete and return the enclosed owner -builder verification form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. JFG,: dd Enclosure Very truly rs, J.F. Glander.- Chief Building Inspector NOTE: This Owner -Builder Information i's sent to you as required by Section 19830 of the California Health and Safety Code. J COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Orovill6, CA. 95965 OWNER -BUILDER VERIFICATION Attention Property Owner: I Phone: 916-534-4541 An "owner -builder" building'permit has been appl ied for in your nameand bearing your signature*. 'Please complete and return this information in the envelope provided at your earliest opportunity to avoid.unnecessary dplay in processing and issuing.your-build- ing permit. No building 'Permit will be issued until this verification is received. I personally plan to provide the major labor and materials f6i construction of the proposed property improvement (yes or -no) Ala 2. '1 (have/have not) Ab 40�a signed an application for a building permit for the proposed work. 3. 1 have contracted -with the following person (firm) to provide, the proposed construction: Name Address. City_ Phone Contractors License No: 4. 1 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 Lic—ense—N-or.- 5. 1 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 S igned: Property Owne 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. Tl�is verification must be completed and returned to our office before we are permitted to issue the permit. 60._, NOTE: -All Materials & Workmanship Shall Be in Practi Accordance with R-ecognized Goo This Set of plans.and specifications MUST be ,,-:4ty prescribed for the Specified use in the ep o 'k t n the job at all �imesVh§ �7s unla4AD&F Building, Plumbing & Mechanical Co&4. UnKr m MA -P -a angesorralterat, S On same., Electrical Co5e. and the gational o6t writte4err ission f m the Department of 'V-:"'v",,FubHc Wo-jrR, of V., A setback 4wf rom setba& property lines and a 5'0 -P+ of 50ft. from the road centerline shall be clear of pment except structures or equi R%fj .Xt' A for a 2 ft. eave- verhang. 43 >- M061 It Home A permit will be re�,uirecl for tie Or P/f IV 0 0 installation of the m6bilehome, 554 )< 54- 0 onnections sh'=q within Uti 61- ither -6&v AMeS 4 ft. of the mobilehom e directly behind or withih'the rear side (lef' of thq e road half oi th X mobil( hop�- t ��4_ >< \< i X x X 7 K F "4 \'4 Ne" X A BUTTE 106NT'Y )<BUILDING KPARTMF=W' APPROVED. 7' 7, 43 x x X'! 1.\] C-- A� # OWNER 'PERMIT4 M IL. C 19, -3 -INSPECTO ELECTRIC GAS� Compaction Struc. TestReq. Sery , ice .Size Other. Load ..Support Pipe Type Size Length YES NO YESI NO