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HomeMy WebLinkAbout022-203-017■ I t OYLE SAMPLE 22-203-17 ` [Hm,,Y.IGGS S HASTINGS? APPROX. g MI. 99AREA �N. OF PERM I #6108-7 P;E(UTILITIES) MH) ELEC .% � 4 ' A SUPPORT STRUCTUR COMPACTION TEST REQ. I ermit #6151- I -203-17 r Issued t OYLE SAMPLE 22-203-17 ` [Hm,,Y.IGGS S HASTINGS? APPROX. g MI. 99AREA �N. OF PERM I #6108-7 P;E(UTILITIES) MH) ELEC .% GAS �f ' A SUPPORT STRUCTUR COMPACTION TEST REQ. I ermit #6151- I -203-17 Issued �j���� .22-203 -17 lontr: John W. Beutler, Y.0 Permit #2235-78MHI(exist site) +Issued 22-203-17 - Contr: Earle Towne Permit #54 7-78MHI(existing site) Issued "I'll 8' 7 S 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 re uirements of the C lq _ A 'nistrative Code, Title 25 C ter un permit nuynbe kr the ollowing location: Owner_I ) Owner's Addre Mobilehome Mfg Insignia No. Model Year�i Serial I�'1 C It is hereby certified for occupancy at the above described location and maybe occupied. Director of Pu 'c Worl s Date By. THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS IfLOCATED White - Owner, Yellow - Installer, Pink - D.P.W. PERMIT NO. 5427-78MHT PERMIT EXPIRES.y OWNER DOYLE SAMPLE CONTR. Earle Towne LOCATION (A.P. 22-201-17 ) . SIS Hastings, app ?. mi. W' of Hwy 99, Bigg 11 D o) . o A ti Temp. Power Pole ,4 Called PG&E Temp. Elea Serv. C.ed PG&E Tem Gas Serv. Called PG&E JOB FINALED (Date) (Signature) 9. Electrical A. Is service large enaugh to provide adequate:amperage- to,mobilehome (must equal rating of mobilehome with a minimum of 1p amp) and other. facilities on lot,* i.e., water pumps, garage, cabana, etc.? Yes No_ B. Is there.proper clearances around.panels? Yes t, No ` C. Is power supply cord or feeder assembly properly fused? Yes k--No— D. NoD. Is continuity test satisfactory as per the following procedure? Yes_ No 1. De -energize electrical wiring system of the mobilehome at the pedestal. 2. Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected. 3. Switch all breakers and switches in the mobilehome to the "on" position. 4. Connect one lead of a test instrument to the mobilehome grounding conductor and apply the other lead to each mobilehome supply conductor, including neutral. 5. All non-current, carrying metal parts of the mobilehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. 6. Upon completion of the above procedure, the power supply cord or feeder assembly conductors shall be connected to the site service equipment. A further continuity test shall then be made between the grounding electrode and the chassis of the mobilehome. Upon satisfactory completion of theelectrical tests, the lot or site service equipment may be approved for energizing. 10. Is job card signed by Health Department for water and sanitation? 11. If everything okay, sign off card and tag services. MOBILEHOME DATA Manufacturer and/or Namestyle Length Width:L. _ Vehicle Serial No. State Identification No. Additional Information or Comments: El MOBILEHOME INSTALLATION INSPECTION CHECK LIST 1. Is the mobilehome located wit required separation from lot lines and buildings and generally conform to plot plan? Yeso 2. Does the mobilehome have required clearances above ground? (Sec.5085) Yes No 3. Are footings and supports properly sized, spaced, and braced as per approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes �o 4. Is the mobilehome level? (Sec. 5088) yes L/c.No_ 5. If more han a single unit, are crossover connections properly installed? (Sec. 5088) Yes No 6. Water A. Is flexib .e connector of adequate size and properly installed (1/2" ID m -in.)? (Sec. 5566) Ye s B. Test - Does water piping withstand working pressure or 50 lbs. air test? Yes V No C. Backflow - If coach is not State oCalifornia approved, does station have backflow device and pressure -relief valve? Yes_ No 7. Wastes and Drains / A. Is connection made with Schedule 40 DWV and have flex connectors at each end? -Yes v No B. Does it have minimum" per foot slope and is it properly supported? Yes�Ro� C. Are any leaks detected in drainage system after running 3- allons of water through each fixture including washing machine standpipe?.Yes No_ D. If c k- 8. not State of Californiaapproved, does station have required trap and vent? Yes N Gas Piping and Gas Vents A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum mobilehome connector not more than 6 ft. long? Note: All piping is to be at least as large as the mobile a gas line inlet without reductions other than the mobilehome connector. Yes_ No B. Test OK as per following procedure? Yes_ No 1. Open all appliance connector valves. 2. Shut off appliance burner and pilot valves. 3. Air test with manometer to 10"-14" water column, or test with slope gauge (minimum 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without drop. 4. Connect gas meter to mobilehome with connector, turn on gas, test connections with soapy water. C.. Are all appliance vents properly installed? Yes ✓No_ 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 requirements of the California Administrative Code, Title 25, Chapter/5, under permit number's -7 —_7 V for the following location: `�/S �'7 � ` + ►� f S Owner 11t, t i 1'.0 '1 "% N--%, PC I -� Owner's Address j Mobilehome Mfg. r3JA * 1 an P% Model /N I &Q, Year` 1 Insignia No. Serial N '8�, 1x23 CZ77 5� It is hereby certified for occupancy at the .above described location and may be occupied. �.` �� Director of Public Works Date �1g),e)/ � h By (9It THIS CERTIFICATE IS VOID WHEN MOBIL'EHOME IS RELOCATED White - Owner, Yellow - Installer, Pink - D.P:W. aln rsiag. Footin s temwaI I SI Pie Garage Foot i n Stemwa I I Slab Carport Footings Slab Patio Footings Isonry Walls Relnf. Steel Stucco F th Water Piping M08 -Water Piping DATE COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD ' yl i BUILDING BUILDING (Cont'd) PLUMBING Fir wall '411 Piping Para ets t Floor Restro m Finish 2n Floor Window 3rd loor Siding To out Roof Shea Ing Water PI Roofing Se Fdn. Vents 10,Ixtures Garage Vents sulation *0'1Water Htr. Heaters Pr . for ahvsica v A Ilances �Foots yrrro` Final ex. LACE FIRE SPRINKL%RS co ung D cts entilation /Final Elec. Service Sewer RA-------------- Support g C,�b Drainage REMARKS OR CORRECTIONS Cc Gas Piping & Tes Temp. Gas Sanitation Final LECT ICAL Rough Fixtures Motors Water Htr Subpane(s Grd. t Prot. Sery e emp. Pole /Underground Permanent Final Elec. Pedestal Gas Piping Elec. Continuity Gas Piping (NOTE: An entry must be made on this form each time you visit the job site.) J f COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 01nty Center Drive - Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT .. .-, aa� v ca VI 111x. lJVuIILy VI OUIIG lv GIIICI UJJUII 111C above-mentioned property for inspection purposes. X / la( �- v'?�f%a-Q-- Date - 2-70 Signature of Permitee�o°r Agent Receipt No. n �/ White-D.P.W. - Yellow -Assessor - Pink- nspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above hich fees have been paid. 'DI Aexpires PUB WORKS B6_ ) \ D e�Building permDate l BUILDING Owner S��L SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Contractor ArARLC_ 0wa Mailing Address S'�335 �� �eci-E L Fireplace Total Valuation Aif)� � IS,� Te a o. hone -� � Permit Fee Building Address ss. 1145T)A) 45 A i00 . t !� i�� C/z Plan Checking Fee&/or Penalty Permit Fee ® 1z PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 I A. P. No. Z- Z 7 Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 F W S Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 Bldg. Plan ec'd Parcel A roval Plans Approval Lawn sprinkler system 2.00 N EVA,❑ ADDIT19P❑ UTILITIES ❑ OTHER Permit Fee $ a ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Single Family Duplex ❑ Home Others ❑ Mobil HOh� Main service 600V OR LESS loo AMP LESS 5.00 L Main service E4. ADD*100 AMP 2.50 Main service OVER 600V 25.00 100 AMP OR LESS Main service/ EA. AOD'L 100 AMP 1.00 NEW CONST.DWELING OR ACDNS. \ ACCLBLDGS.CCUP. 41 22sgft CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name Stylf: NEW RESID,CONSTBRANCHMULTI-OCIRCUITS) NON.RESID BRANCH CIRCUITS/ 2.50ea ) NEW CONSTR (POWER APPARATUS.6, NON.RESID. SINGLE OUTLET CIR. Ex. Occur){OUTLETS OR FIXTIIPES BAL@t oo / FIXED APPLNS. OR Ex. Occup.(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No.2_!b. 99J Classification C`—C Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. rV I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner o as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 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 Land Development Fee$rg TOTAL PERMIT FEE $ .. .-, aa� v ca VI 111x. lJVuIILy VI OUIIG lv GIIICI UJJUII 111C above-mentioned property for inspection purposes. X / la( �- v'?�f%a-Q-- Date - 2-70 Signature of Permitee�o°r Agent Receipt No. n �/ White-D.P.W. - Yellow -Assessor - Pink- nspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above hich fees have been paid. 'DI Aexpires PUB WORKS B6_ ) \ D e�Building permDate l y MOBILEHOME SUPPORT DATA r� If other than -single wide, Mobilehome Mfr. �f�Q N furnish Setup Model No. d G Year -/728 Width, Z ( (ft.) Box Length ® (ft.)* Tagalong or'Expando Size ft. x ft. (SHOW SUPPORT DETAILS BELOW) On all mobilehomes manufactured aA er October 7,'1973, 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 Wood either pressure treated oz foundation grade. (ft.rns* :) (in.) (in.) her (specify) Center srt Center support locatifooting sizes Supports (check one) (in.) 0 1. Concrete block. 2. Other (s ecify) (ft.EF ) (in.) (in.) <--Tagalong or Expando, show support details. (ft.)(in.) (in.) (in.) ea6 -- Typical Support (in.) (in.) "Footing Size (ft.)(in,) (in.) (in.) -- Max. Pier Spacing (ft.) (in.) Max. Overhang (ft. (in.) (in.) (in.) Sam (ft.)(in.)e 4 .!�4 7 ;j,U 1 ! E, cuU1i I Y 6WILDING DEPARTMENT APPRIOVE1 *If center piers are other than drawn above,. draw in -locations, spacing, and dimensions. BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 1 MOBILEHOME INSTALLATION SHEET o n � 1. Owner's name: ,� ©�{ �i/�' , 2. Installer's name: C-4 L `_&dd JT 3. Is the site currently under permit? Yes / No (If yes, furnish permit number ) OR Is the site an existing site? Yes / / No / / (If yes, furnish two (2) plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes 777- No (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) ( If no, clarify ) 5. What is the mobilehome electrical rating? ----------------------- , Amps 6. What is the mobilehome site service rating.? --------------------- f0 D Amps 7. What is the mobilehome site circuit breaker rating? ------------- Amps 8. Is there any other electric load to be served'by the mobilehome site service? --------------------------------------------------- Yes / / No (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? ---------------------- I (in.) 10. What is the type of gas service? ------------------------------ Natural LPG 11. What is the gas pipe length from meter or tank to the mobilehome? (ft.) 12. What is the mobilehome gas demand? ------------------------------ �r7-, D©d (BTU) (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) Mt 1�1 N, C: lc,�N WFA —1 TIN 0 rd co ca- r C) -tea- ai (A CD (D 0 Q La cr TIN i '`PERMIT NO. 2235-78MHI existing site PERMIT EXPIRES ,OWNER Doyle T. Samnle CONTR. John W'- BeutlPr LOCATION (A.P.22-203-17 ) SIS Hastings, app :1-4 mi. W of Hwy 99, Biggs *i Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E iTempGas Serv. /alled PG&E + FINALED �!- - (Date) (Signature 9. Electrical A. Is service large enough to provide adequate amperage -to mobilehome (must equal rating of mobilehome with a minimum of 100 amp) ani other facilities on lot, i.e., water pumps, garage, cabana, etc.? Yes VoNo_ B. Is there proper clearances around panels? Yes No C. Is power supply cord,or feeder assembly properly fused? Yes_ %ee\3,4 D. Is continuity test satisfactory as per the following procedure? No 1. De -energize electrical wiring system of the mobilehome at the pedestal. 2. Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected. 3. Switch all breakers and switches in the mobilehome to the "on" position. 4. Connect one lead of a test instrument to the mobilehome grounding conductor and apply the other lead to each mobilehome supply conductor, including neutral. 5.. All non-current, carrying metal parts of the mobilehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. 6. Upon completion of the above procedure, the power supply cord or feeder assembly conductors shall be connected to the site service equipment. A further continuity test shall then be made between the grounding electrode and the chassis of the mobilehome. Upon satisfactory completion of the electrical tests, the lot or site service equipment may be approved for energizing. , 10. Is job card signed by Health Department for water and sanitation? 11. If everything okay, sign off card and tag services. MOBILEHOME DATA Manufacturer and/or Namestyle Length Width/ Vehicle Serial No. 6 • ��%(o� State Identification No. Additional Information.or Comments: MOBILEHOME INSTALLATION INSPECTION CHECK LIST 1. Is the mobilehome located wit)a required separation from lot lines and buildings and generally conform to plot plan? Yes V No 2. Does the mobilehome have,required clearances above ground? (Sec.5085) Yes_k No 3. Are footings and supports properly sized, spaced, and braced as r approved` plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) YesNo 4. Is the mobilehome level? (Sec. 5088) YesX_ No 5. If mo a than a single unit, are crossover connections properly installed? (Sec. 5088) Yes No 6. Water A. Is 41,exible connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes No B. Test - Does water piping withstand working pressure or 50 lbs. air test? Yes X No_ C. Bac - coach is rnia approved, does station have backflow device and pressure -relief valve? Yes_ No 7. Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes No B. Does it have minimum k" per foot slope and is it properly supported? Yes_ No C. Are any leaks detected in drainage system after running 3 -gallons of water through each fixture including washing machine standpipe? Yes No D. 1f roach is not Grata of .al;fornia approved, does station have required trap and vent? Yes_ No 8. Gas Piping and Gas Vents A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum mobilehome connector not more than 6 ft. long? Note: All piping is to be at least as large as the mobilehome gas line itilet without reductions other than the mobilehome connector. Ye 74 No B. Test OK as per following procedure? Yesx No 1. Open all appliance connector valves. 2. 2. Shut off appliance burner and pilot valves. 3. Air test with manometer to 10"-14" water column, or test with slope gauge (minimum 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without drop. 4. Connect gas meter to mobilehome with connector, turn on gas, test connections with soapy water. C. Are all appliance vents properly installed? Yes No- COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets list Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor StemwalI Siding To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Stemwa I I Garage Vents Insulation Water Htr. Heaters Slab Carport p Footings Prov. for phsically handicaped Conformance of ex. structure Appliances Gas Piping &Test Temp. as Slab Final Sanitation Patio FIREPLACE. Final Footings Footing ELECTRICAL Masonry Walls Throat Rou h Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES ------------------ Elec. Service Elec_ Pedestal Water Piping Sewer Gas Piping 1 EHOME INSTALLALION - - - - - - - - - - • - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS goo et /amu iNOTE: An entry must be made on this form each time you visit the job site.) J 1 „41 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS • ' t 7 County Center Drive — Orgville, California 95965 i • Telephone: 534-4541 r APPLICATION AND PERMIT BUILDING Owner SQ. FT. OCC. BUILDING VALUATION !1 Fi Mai ling Address Telephone No. Contractor r ,j/,cJ Mai I i ng Address 3`% a Building Address lephone No. I i A. P. No. a OX03 Ad 171 Zoning& Planning F Sadio ion I Fire Dept. Fire Zone Use Permit EQA Parking Parcel Parcel Ma 60' R/W Im rovements Plans Declaration P P Bldg. s Recd Parcel A val Pla pproval NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER C@ Single Family ❑ Duplex ❑ Mobil Home [R Others ❑ Fireplace Total Valuation Permit Fee Plan Checking Fee &/or Penalty Permit Fee PLUMBING PERMIT FILING FEE Each Trap Repair drainage or vent piping Water piping Each gas water heater or vent Gas piping system 1 - 5 outlets Each additional outlet Building sewer Lawn sprinkler system Permit Fee ELECTRICAL PERMIT FILING FEE Main service 600V OR LESS 100 AMP OR LESS Main service EA. AOD'L 100 AMP Main service OVER 600V 100 AMP OR LESS Main service EA. ADD'L 100 AMP CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Profess 'os Code under the name style of: / (•�1t/// NEW RESID. � BRANCH CIRCUITS T NON-RESID. BRANCH CIRCUITS NEWCONSTR, /POWER APPARATUS 6 NON -RESID. ,SINGLE OUTLET CIR, Ex. OccuD(OUTLETS OR FIXTIIRE! EX. OCCu FIXED TS APPLNS. OR P•(OUT LETS RESID,) EA Temporary service Mobile Home Facilities �; �y)r 76� License No. Classification Misc. Wiring IDI am exempt from the Contractors License Laws of the State of California. Permit Fee WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. t'If +k+ th f f th k f h' MECHANICAL PERMIT FILING FEE Heating Cooling $3.00 1.50 1.50 1.50 1.50 1.50 .30 5.00 2.00 $3.00 5.00 2.50 25.00 1.00 !¢sq ft 2.00 10.00 15.00 6.25 $3.00 FEE FEE �I' cer y a In a per ormance o e wor or w Ich MIS Ventilation permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of Hood 1 1 2.00 California. Permit Fee $ Q( 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 rep entative of the County of Butte to enter upon the above-ment' d prope for inspection purposes. y� X Date Signature o `Pe itee or Agent / Receipt No. /7y %'/ 7 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Land Development Fee $ TOTAL PERMIT FEE $ 6 Z This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTO OF UB IC WORKS BY Date S- 7 7� euildi7ng permit expires Date P { J • 'This set of plans and specifications MUST be kept on the job at all times and it is unlawful to make any chorion , c+r alfi�r,�tions on same without wrjitten perr.�ission from the Department of Pub. lic Works, County of Butte, All u locate t_. third i— an the home. EMS ity connections shall be within 4 ft. outside the rear ction of -the mobile home >ft (road) side of the mobile ,,V,,1L2f L -2u —/7 The Setback shall be 5 ft.f om the, -- side property line and 50 ft. from t centerline of the road, permitting a maxi mum of a 2 ft. eave overhang but entirel out of all easements. i v c X23 BUTTE COUNTY BUILDING DEPARTMENT S r / MOBILEHOME SUPPORT DATA If other than single wide, Mobilehome Mfr furnish Setup Model No. Year Width %"Z- (ft.) Box Length S^ (ft.:) Tagalong or'Expando Size %^ ft. xft. (SHOW SUPPORT DETAILS BELOW) 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). All center supports measured from front of mobilehome unless otherwise specified. N, Footings (check one) Single, E]"1. Wood either A A pressure treated or foundation grade. x ( t.)(in:) (in.) (in.) �D 2. Other (specify) Center upport Center su ort locat ns* footing zes Supports (check one) (in.) Concrete block. 2. Other (specify) (ft.)(in. in. in. u ..Tagalong or.Expando, show support details. (ft.)(in.) (in.) (in.) x j I -- Typical Support (in.) (in.) Footing Size x (ft. (in.) (in.) (i .) -- Max. Pier Spacing Max. Overhang (ft.), (in.) (in.) (in.) (ft.)(in.) oU(I� �VUi�i 1 BUILDING DEPARTMEN , APPROVED *If center piers are other than drawn above, draw in—locations, spacing, and dimensions. I BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's none: C - o 2. Installer's name: 3. Is the site currently under permit? Yes / / No (If yes, furnish permit number ) OR Is the site an existing site? Yes %% No (If yes, furnish two (2) plot plans.) y 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes /& No (If no, clarify. ) ( ) 5. What is the mobilehome electrical rating? ----------------------- d Amps 6. What is the mobilehome site service rating? --------------------- U Amps 7. What is the mobilehome site circuit breaker rating? ------------- / C� Amps 8. Is there any other electric load to be served by the mobilehome siteservice? --------------------------------------------------- Yes / / No (If yes, identify the load and size: (Load) 3 (Amps) 9. What is the mobilehome site gas pipe size? ---------------------- ( (in.) 10. What is the type of gas service? ----------------------------- Natural / / LPG 11. What is the gas pipe length from meter or tank to the mobilehome? (ft.) 12. What is the mobilehome gas demand? ------------------------------ (BTU) (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) a 1 3 % 6f ',PERMIT NO. P� E M MH UTIL. :PERMIT N0. 61 08—` 5P: E PERMIT EXPIRES OWNER DOYLF SAMPLF 'CONT,R'OtNNER r` sLOCATION (A.P. 22-202-17 ) ` S/S HASTINGS, APP. g M I . lv OF Hwy 99, BIGGS AREA r f} S 4 i � e 4 .r `1 /ae er P e k-:5 76 + E Serv. G&E tf Serv. tG&E �% ate) • (Signature) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Pipin Z 3 Piers Roofing Sewer Z?i,7 577 Garage Fdn. Vents Fixtures Footings Gara a Vents Water Htr. Stemwall Slab Prov. for physically handicapped Heaters Appliances Carport Footings Conformance of ex. structure Gas Piping & Test Z L Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp: Pole7/a 6ca Finish Ducts Underaround Door Closer I Final I Final DATE REMARKS OR CORRECTIONS e _ E , f`�7 ' /-Z Z. < S- arc- /� ✓� t T f f 1 7 r+ f Electrical <y "�" ASV -76. Is service large enough to provide adequate amperage to mobilehome, (must equal rating of mobilehome with a minimum of 100 amp),and other facilities on lot, i.e., water pumps, garage, cabana, etc,? Ye S4. No �B:• Is there proper clearances around panels? Yes__K No Is power supply cord or feeder assembly properly fused? Yes 11C., No R: Is continuity test satisfactory as per the following procedure? Yes No 1 De -energize electrical wiring system of the mobilehome at the pedestal. 2Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected., Switch all breakers and switches in the mobilehome to the "on" position. XConnect one lead of a test.instrument to the mobilehome grounding conductor and apply the other lead to each mobilehome supply conductor, including neuL•-rai, All non-current, carrying metal parts of the mobilehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. /. Upon completion of the above procedure, the power supply cord or feeder.assembly conductors, shall be connected to the site service equipment. A further continuity test shall then be made between the grounding electrode and the chassis of the mobilehome. Upon satisfactory completion of theelectrical tests, the lot or site service equipment may be approved for energizing. 10. Is job card signed by Health Department for water and sanitation? 11. If everything okay, sign off card and tag s{rvices. I MOBILEHOME DATA Manufacturer and/or Namestyle m Length U Width / 2 Vehicle Serial No. ? State Identification No._ Additional,Information or Comments: MOB11EHOME INSTALLATION, INSPECTION CHECK LIST 1,/ Is the mob ilehomee-located with required separation from lot lines and buildings and generally conform to plot plan? Yes No I ' Does the mobilehome have required clearances above ground? (Sec.5085) Yes,X No ry-)Are. footings and supports properly sized, spaced, and braced as per approved plans? (Note possible variation at spring shackles.) (Sec, 5082 & 5083) Yes No Is the mobilehome level? (Sec. 5088) Yes No 8'p If more than a in le unit, are crossover connections properly installed? (Sec. 5088) Yes�No . 0 Water Is flexible connector of adequate size and properly installed (1/2" ID min:)? (Sec. 5566) Yes No /. Test - Does water piping withstand working pressure or 50 lbs, air test? Yes No C. Backflow - If coach is not State of California approved, does station have backflow device and pressure -relief valve? Yes_ No N A Wastes and Drains A/, Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes No X. Does it have minimum 'k" per foot slope and is it properly supported? Yes No �L. Are any leaks detected in drainage system after running 3 -gallons of water through each fixture including washing machine standpipe? YesNo If coach is not State of California approved, does station have required trap and vent? Yes No AIA �3. Gas Piping and Gas Vents / A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum mobilehome connector not more than 6 ft, long? Note: All piping is to be at least as large as the mobilehome gas line inlet without reductions other than the mobilehome connector. Yes No B, Test OK as per following procedure? Yes -)(—No ,Y. Open all appliance connector valves. Shut off appliance burner and pilot valves. Air test with manometer to 10"-14" water column, or;'test with slope gauge (minimum Ir. 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min, without drop. Connect gas meter to mobilehome with connector, turn on gas, test connections with soapy water. 16. Are all appliance vents properly installed? Yes-4No. COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center DPive`--_' Okville, California 95965 Telephone: 534=4541 APPLICATION AND PERMIT Receipt No. ���Q V By Date�Zr�f' iJ White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant B rlding permit expires Date _ 1,� BUIL IN Owner SQ. FT. OCC. BUILDING VALUATION Mailing Addr 3 i _Tele8h=ne (� Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checki ng Fee &/or Penalty Telephone No. Permit Fee Building Address PLUMBING No. @ FEE PERMIT FILING FEE $3.00 .® Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping /Q .0(j -G-•- Each gas water heater or vent 1.50 A. P. No. �� �d onin� I Gas piping system 1 - 5 outlets .1_w.1,6,0() .1 Each additional outlet .30 F - . Sa ' Fire Dept. Fire Zone Use Permit Building sewer & QQ 16 . C) EQA/� Parking Plans I Parcel Declaration Parcel Map 60' R/W Improvements Lawn sprinkler system 2.00 Bldg. Ps Recd Parce pprovalp-f Plan pprova1 Permit Fee $ — $ �- NEW ❑ ADDITION ❑ UTILITIES OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 e0C) Main service 600V OR LESS 5.00 1QQ 100 AMP OR LESS Main service EA. ADD'L 100 AMP 2.50 I,Su Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service OVER 600V 25.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 1.00 NEW CONST. DWELING OR ADDNS. ( ACCLBLDGS. OCCUP. &) 20sgft NEW CONSTR. MU-TI.OUTLET NON-RESID. ( BRANCH CIRCUITS) 2.50ea NEW CONSTR. (POWER APPARATUS&)l NON.RESID. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of:Ex. Ex. OccUp(OUTLETS OR FIXTURES)50 @ 25:BAL@1 Occup. FIED APPLNS. p•(DUXOR TLETS (REST D.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $SY-1.S'd WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. �j I certify that in the performance of the work for which this .' permit is issued I shall not employ any person in any manner :so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 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. X Date Signature of Permitee or Aaent TOTAL PERMIT FEE This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF OUBLIC WORKS Receipt No. ���Q V By Date�Zr�f' iJ White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant B rlding permit expires Date _ 1,� t A. 't COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT 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. X Date Signat re of Permitee or Agen Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant / TOTAL PERMIT FEE1$801 This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF BLIC WORKS B / nate l Building permit expires Date BUILDING ` Owner SO. FT. OCC. BUILDING VALUATION Mai I i ng Addr Tel bone N Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee ' Building Address S PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No.Zonin a a g &Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fees 1lllE-e Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma p 60' R/W Im rov meats p Lawn sprinkler system 2.00 Bldg. lens Recd Parcel A proval Plans Approval Permit Fee $ W ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No.1 @ FEE P RMIT FILING FEE J$3.00 ain service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (morethan 12) Single Family ❑ Duplex ❑ Mobil Home Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures b 1�2 Receps„ switches & fix outlets CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring ❑ 1 am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ® 1 have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. FA I certify that in the performance of the work for which this permit .is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit,Fee n ne $ 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. X Date Signat re of Permitee or Agen Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant / TOTAL PERMIT FEE1$801 This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF BLIC WORKS B / nate l Building permit expires Date 1. Owner's name: , 2. Installer's name: BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville,.CA. PHONE: 534-4541' ..,I MOBILEHOME INSTALLATION SHEET 3..t Is the site.currently under permit? Yes / No T / (If yes, furnish permit number 4T— .Is the site an existing site? Yes / / No .(If" -yes, furnish two (2) plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and • cleim of all setbacks and easements?. Yes No R(if no, clarify. i ) r .. 5. What is the mobilehome electrical rating.? ----------------------- , (� Q Amps 6. What Is the mobilehome site service rating? --------------------- / D 0 Amps 7. What is the mobilehome site circuit breaker rating? ------------- U Amps 8. Is there any other electric load to be served by the mobilehome site service? --------------------------------------------------- Yes7,3T No If es identify the load�a d size: oa _(Amps) ( yes, y t1 ��� 9. What is the mobilehome site gas pipe size? ---------------------- -��� (in.) _ .,. 10. What is the type of gas - service:_,.T�--_______________________ Natural / / LPG / 11. What is the gas pipe length from meter or tank to the mobilehome? ,3 y (ft.)' 12. What is the mobilehome gas demand? ------------------------------ (BTU) (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) •.. Fto n MOBILEHOML^ 5U PM3KI DATA S u S5 3 Mobilehome Mfr. W� L` Setup Model Wo.K 5 0 0 Year Width (f I (ft.) Length Cc 4 (ft.) Expando Size _ - ft. ' (Draw support details below) 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). (in.) (in.)+ ^If center piers are other than drawn above, draw in locations, spacing, and dimensions. Footings-(check.one) TYJ 1. Wood -either pressure treated or fdn.`grade. LLL 2. -Concrete pad. 3. Other,%specify Supports (check one) /J( 1. Concrete block 2. Concrete piers 3. Steel piers 4. Other, specify -.1 Typical Support Footing Size Max. Pier Spacing in. Max:. Overhang .- in BUTTE COUNTY BUILDING DEPARTMENT APPROVED i VE UT IL v GLUM --w DATE -- - - LISUPPORT ��TT/tp t7� 7�yyq�v���v�Ro9TCy0p�► CM2AOTIOE YES NO It+R�Qe I pji@j;j0MhjQM Mt.IST I�rl NOTE:—All Ma+e,ir�is This set of plans a �ip Shall Be -in kept on the io6. at call times and it is unl-.wf!i! Accordance :w4 Gnnd 11 . . Practices and make any changes or alterations on some %,A+1---' of a qualify rreFCr;*I-,n,4 ''ror ike 'Sn * e,-,�', U ectf* use in the written permission from the Uniform -Building, Plumping &.Machani 'I Codes and -Works, County of Butte. the National Electrical Code. ca All loc .I : on ho utility connections shall. be ed wifhin.4 ff. outside the rear section of the mobile home �e left (road) side of the mobile Septic system and location to be I as per Butte County Health D Ipt. Re quirements. "7 0,6 z 0^ Q%. /moi/� � .��A Theg Sefbec� di -11 be .5, ff. from the side property line and 50 ff. from the centerline of f he road, permitting 0 -maximum of a 2 ff. eave overhang. Ft "4 " . �� BUTTE COUNTY OUIL.D�ING-­ DEPA R­T__M___:EMT- 4- 1 APPROVED