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HomeMy WebLinkAbout022-350-01522-35-5; , r�SANDTREAKINS 2860 2nd St, lot 5, Piche,,City- of -Biges -- _ --------------- Permit -�.._-_.- Permi t # _� -A p . �nee famil r j, 19 a 1677-89B,P,E,M PERMIT NO. PERMIT EXPIRES CHIP SANDRA EAKINS AWNFii Owner CONTR. 22-35-15 ASSESSOR PARCEL 2860 2nd St, lot 5, Pichetta Sub LOCATION City of Biggs l OFFICE COPY Address GAS ate Meter BY j Temp. Power, ELFRIC pate MetAy - — Called PCME-- _r Temp. Elec. Service Called PG&E Temp. Gas Service Celled PG&E JOB FINALED (Date) Signature ENERGY INSTALLATION CERTIFICATE RFCIvED yr P Building Owner Building Permit *#, 5 �• Building -Location L DESCRIPTION OF INSULATION ROOF �. Material Brand Name Thickness(inches) Thermal Resistance (R Value) EXTERIOR WALL Material ,9--t�,a-<� Brand Name CSG F Thickness(inches) 3.5"11 Thermal Resistance(R.Value)• a -t /. CEILING Batt or Blanket Type Brand Name Thickness(inches) Thermal Resistance(R.Value) Loose Fill Type �_,1,C Brand Name_. CDP_fOe-x Minimum Thickness(Inches) 9.3Number of Bags a :Wt. per bag - .2- 9 _lb. Area covered(ft.2). S-tI Thermal Resistance(R Value)_ 12-3 n - FLOOR, ELEVATED Material Brand Name Thickness(inches) Thermal.Resistance(R Value) FLOOR, SLAB Material Brand Name Thickness(inches) Thermal Resistance(R Value) Width(inches) FOUNDATION WALL Material Brand'Name Thickness(inches) Thermal Resistance(R.Value) . I•hereby.certify that the above insulation was installed in.the above building, is consistent with approved building department plans and attachments.and con- forms with requirements of Chapter 2-53 of State of.California Energy Requirements. FIRM NAME/OWNER STATE CONTRACTOR'S LICENSE NO*.�. SIGNATURE OF.INSTALLATION APPLICATOR DATE I hereby certify the required features, devices, and equipment; ab shown on the approved Building Department plans and attachments have been installed and conform to the.appli ance standards and Chapter 2-53 of the State of California Energy requirements.: BUILDING CONTRACTOR/OWNER (Please Print) STATE CONTRACTOR'S LI NSE NO.. (FIRM NAME) SIGNATURE OF B LDING CONTRACTOR/OWNER DATE HVAC FIRM SIE/0 NER (Please -Print) STATE CONTRACTOR'S LICENSE NO. SIGNATURE OF HVAC CONTRACTOR/OWNER DATE THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION APPROVAL AND A COPY SHALL BE POSTED WITHIN THE BUILDING. SEPTEMBER 1988 COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phb—he: 89112751 7 County Center Drive, Oroville — Phone: 538-7541 747 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE 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. ilz Inspector Date__ 1 r 2 G tJ = OK` 0•= Not OK Not'Applic= Not Ready MOBILE MOBILE HOMES MISCELLANEOUS Date MOBILE HOME UTILITIES (Plans) OK except #'s Date DECKS,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 1. Zoning Requirements -Setbacks -Easements ' 2. Soils; Special MH Support -Sketch 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Sewer; Location -Test -Fall -C/0 -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails' 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.- Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap: / P1 ft. / /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors 7. Utility Clearance T Elec. 8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh Card -B1 Date Card -B1 . Date 10. Roof; Shthg-Roofing Card -131 Date Card -B1 Date 11. Ext.; Steps -Doors -Landings Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Card -61 Date Card -B1 Date 2. Footings; Size -Spacing -Marriage Line Card -B1 Date Card -B1 Date 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances Date POOLS (Plans) OK except #'s 5. Drain; MH Test -Fall -Flex Connector 1. Setbacks -Easements ' 6. Water; MH Test -Regulator -Connector 2. Soils; Compaction -Structure Stability 7. Water and Sewer Connected -C/O to Grade -:HD Approval 3. Pool Structure; Steel -Connections -Thickness - Men -Lining 8. Gas and Electricity TaggedDead 9. Exits; Insp.-Sketch ,+ 4. Elec.; Receptacles and Lighting, Distances-GFI 10. Cert. of Occupancy 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 Card -B1 Date Card -61 Date Card -131 Date Card -B1 Date 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Card -1211 Date Card -131 Date Card -61 Date Card -131 Date :l M p =UK 0 = Not OK Applicable - =Not Applicable RESIDENTIAL (Single and Duplex) = Not Ready Date UNDERFLOOR (Plans) OK except #'s Date FR4MING (Continued) 7 oning-Setbacks;- Ease ments-Flood-.Slope . H , gers-Post Caps -Anchors -Connectors Main; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth L4 . Cing. Joist-Rftr. Ties -Purl in -Roof Brac.-Truss-Shthng.-Rfng. Ftg., Garage; Soils -Steel-/ P' Fig. Depth "4-77F pface- ies-orType A Flue -Fireplace Throat Clearance 4. Ftg., Porches &Decks; Soils -Steel-/ /"Ftg. Depth Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 5. Stemwalls, Main; Steel-Blockouts-Wrapped V9. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 6. S walls, Garage; Steel-Blockouts-Wrapped . Garage Fire Protection Framing tV'Slab; Steel -Wrapped 1. Property Line Firewall & Openings 8. Piers -Fireplace Ftg.-Steel If'rExt. Doors -One T -Check Garage -3rd story, 2 exits 7,20 (T72. D.W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test _53,Stairs;-tNidth Headroom -Rise -Run -Landing -Fire Protection ' 10. Gas Pipe; Size -Anchors LZ -gr. -Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 11. Water Pipe; Test -Anchors -Regulator -Service Test �iding-Nailing Veneer 12. Electric; Underground x-56-StGc`co Mesh -Drip Screed -Fd. Vents-Underflr. Access 13. Plenums & Ducts; Clearance-Material-Supprt-Ins. (,57' lazing Area -Glass Protection -Skylights -Plastic 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples -587.head WaT1FNai ' -Bolts 15. Insulation /y -y 9.Insulation-W s -Gig-- 60. Infiltration-Walls-Wndws Card -B1 Date7g_7,01and-B1 Date Card -131 ate and -131 Date Card-Blq.,o DateCard-B1 Date Card -131Z Date -L'LIMI- Card -81 Date Date PLVMBING (Permit) OK except #'s Water6Ht. Vent -Access -Combustion Air -Baffle Date INAL (Plans) OK except #'s 4 -7 -Nater Pipe; Test & Anchors -Nail Protection -Cl. E t. Steps -Door & Sidelight Protection -Landings pBrD.W.V.; Test-Fttngs & Anchors -Nail Protection i8rSmoke Detector �1"hvwerf n,est, irst Floor -Tub Access63-flu-mace; Vents -Clearance -Comb. Air -Connector- In Garage; Above Floor -Ducts -Mach. Protection -20. Test Tab' -Shower, 2nd Floor -Tub Access L-21. Gas Pipe; Size & Anchors 6k7gedroom Exiting G.F.I. & Bath Fixtures & Tub Access -Spa Elec. Trim & Subpanel; Breaker Sizes -Labels Card-131CL�& Datej�2 ��rd-B1 Date 67, Card -131 Date Card -B1 Date 68 Fireplarw or love• clearances -Hearth 6 d -Panel; Int. & Ext. Date ELECTRICAL (Permit) OK except #'s X9f2f22. Flxyre'& Transformer Clearance -Ins. Protection kllb. Kit. Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance 1:2 . lec. 5qceptacles Spacing -Lights &Switches at Doors 1. Elec. Outlets & Receptacles at Kit. Counter ?4.8 a & No. of Conductors -Stapled wing -Landing -Closer _Boxes omexA talled Close to Edge of Studs & C.J. '��/ j / -Damper tr. Htr.; Vents -Clearance -Comb nnector-P.R.V.- 1a^Garage; Above - ec . ro Q & around made up w/Meeh. Fasteners -Bond Gas & Water P Appliance Circuts in Kitchen &Conductor Size/G.F.I. � , B%,., Elec. &Mech. Equip. Listed for Location ire Size / / ga. Cu or AI-A.C. Wire Size / /ga. Cu,or Al P7 . Elec Receptacles in Garage; (G.F.I.)-Romex Protec. L29'.'Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral Yes No 4ff. Insulation -Foam -Looked in Attic 0 Yes Construction -Post Caps -3 . Service -Riser Conductors & Ground -Main Disconnect Hole Door -Drainage & Wood -Earth Clearance Looked under Floor o Yes �Eq$p. Clearances Panels-Motors-Mech. Equip. 3 ., s oset Light -Shower Light -Spa Light 0. Following instld.; Drive es O No; Walks es t7 No; Planters o Yes o No 3. Smoke Detector n- finish Card -61 QEp Date x -j ?_&GjCard-B1 Date 2. A.C. nit; Disconnect, Electrical, Plumbing Card -131 Date Card -131 Date ants Above Roof; Plbg.-Appliance-Firepl.-Clearance to Openings. Date MECHANICAL (Permit) OK except #'s ectrical, Plumbing L -/q? !E!� 4�'A.C. Ducts Insulation & Support erior Elec. Trim; G.F.I. Receptacle -Underground --� L35'Vent Fan; Exhaust above insulation 6. Ug tilation throughout House & Overflow; Size & Grade . G(ass Protection 37. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet . C ections from Previous Inpections -38_At4c-Aecess &'Platform if Furnace in Attic Test -Meters Tagged; Gas -Electric er & Sewer Connected -C/O to Grade -HD val i. Energy Compliance Certificate -Other Certificates Card -131 Datga-jCard-B1 Date 92• Roofing Certificate Card -B1 Date Card -B1 Date Card-B Datelj-/2 rd -131 Date Card -131 Dated /,3- and -B1 Date Date FRA NG (Plans) OK except #'s ��-`/7 I s, Proper Material & Anchors Card -B1 Date Card -81 Date Comments at Final: 140'V.Yal-Is Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls over Girders & Floor Nailing graft Stop in Walls (rat proof) Fire Stops; Furred Ceilings -Stairs -Chases -Tub 1-44. Header & Beam -Size & Bearing (NOTE: An entry must be made each time you visit iob site) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT N0. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL N MBR � � ,.�. t ZONING I BUILDING PERMIT OWNER^ J k h a. TELEPHONE SO. FT. OC . BUILDING VALUATION OWNER'S MAILING ADDRESS o . S Gh << Zr CONTRACTOR'S NAME © !' e ` TELEPHONE CONTRACTOR'S MAILI>or ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 8 Permit fee $ PLUMBING PERMIT Filing Fee 10.00 gr C, Each Trap 2,00 Solar or heat pump water heater 20.00 LOT NO. �7 SUBDIVISION AME �d PARCEL MAP ) Opp Water piping 5,00 Each pas water heater or vent 5,00 USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 1 0.00 ea TYPE OF WORK _0: NewLY1 Addition ❑ Remodel ❑ Utilities ❑ Installafion❑ Other [I 41 Describe work: o k r�o i Permit Fee $ YM Contractor ELECTRICAL PERMIT Filing Fee 10.00 �� ' 'Z?— rM_ 43 Main service 1000 AMP ORSLESS 10.00 Main service EA. ADD'L 100 AMP 2.50 RACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with Jjicensed contract- ors. (Sec. 7044) q} Misc. ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.e ,h2Spft New DONS. ACC. B OMU UTLET NON.RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS y1 SINGLE OUTLET CIR. / Ex. OCcU OUTLETS OR FIXTURES p 5AL0Le3090 FIXED APPLNS, OR \ Ex. Occup. OUTLETS (RESID.) EA.) 2.00 Temporary service 1 .00 Mobile Home Facilities 15.00 Wiring 15.00 Permit Fee S WORKMEN'S COMPENSATION INSURANCE 1' declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. I have placed on filWwith 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 an person in any manner so as to become subject to the W. C. laws of &1ifornia. Notice to Applicant: If after making this statement .should you become sub'ect Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 e Ventilation to the W. C. provisions of the Labof. Code, you must forthwith comply with such Permit Fee $ provisions or this permit shal I be deemed revoked. Contractor I certify that I have read this application and state that the above information Mobile Home Installation Fee $ is correct. I agree to comply to all County, Ordinances and State Laws relating Energy Inspection Fee $ -fa 6V to building construction, and hereby autho ' e representatives of the County of Butte to enter upon the above-mentioned prb�erty for inspection purposes. TOTAL PERMIT FEE I 'also agree to save, indemnify and keep harntless the County of Butte against oc Cup.CONST.TYPE SC/lo L PLOoo PARCEL N+-, 39uE all liabilities, judgments, costs, and expenses which may in any way accrue / against sa' County in conseq nc of the granting ot?'�tho permit. 9:3 v This permit is hereby issued under the applicable provi- %� Date sions of the Butte County Code and/or resolutions to do Signot a of Applicant — Owner ❑ Contractor ❑ Agent work indicated above for which fees have been paid. An OSHA permit is reqfor excavations over 5'0" deep and demolition or construct- ZUBLuiredIC WORKS ion of structures over 3 stories in height. Receipt No. By Dat WItITE-D.P.W., YELL0W-A38E330 , PINK -INSPECTOR. GOLDENROD -APPLICANT PERMIT EXPIRES Date — — b' +i+:v`t.,SWS+r#�r�r"otrvi.t�r.,t`na)i`ad"ri.-^rya�y"` s:s,i :ria- +:`+ar!�: i"dt� t.rr•:rlW J. >�' r COUNTY OF, BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET r Permit No. OWNER ..No. r Proposed Building Use ,4A 0 4) /� Building Inspector Date ;:.�,r�A.;'�: / VVV� 'At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. 'All items have been submitted . ................................... . 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ - 3. Complete plans in duplicate/triplicate, signed by preparer of plans .. 4. Complete engineered plans and calcs, with wet signature on plans.. 5. Energy Design Compliance and'supporting documentation ......... 6. Statement of Intent for Non -Heated and AC Buildings .............. 7. Engineered truss details and layout in duplicate (required prior to plan check) 8. Mobilehome installation data including manufacturer's installation instructions....................................................... 9. Fees of $ .......................... 10. Chico Urban Area fees paid ........................................ `1.1. Park fees paid ..................................................... 12. School District fees paid ................. 13. Sanitation approval from Health Department ... 14. City of Chico plumbing. permit ...................................... 15. Plot plan and business license approval from City of ",(see City for other requirements) 16. Planning approval for (A) Use: (B) Parking: ......... 17. Improvements may be required. j 18. Driveway permit (construction approval required prior to occupancy) ... 19. Pre-Inspec. request to Pre -Inspection for required ...... Building inspector (Date) ,,.• 20. Contractor's license information (No., Name Style, Classification) ....... 21. Certificate of Workmans Compensation Insurance .................... 22. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ........ 23. Recorded copy of Agricultural Acknowledgment Statement ............ 24. Letter of signature authorization ..................................... 25. 26. When you -issue the permit, process as follows: Mail to owner. Mail to contractor.. Telephone l and hold for pickup at office. Deliver w/inspector.`–~ Other Applicant Date Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone---nall—counter by date Contractor, designer, owner, was advised of above required data by—phone _mall—counter by date 1 Plans checked by Date Plans approved by Date 0-1 3 __L__ Sets of plans, on hold in Copy—DPW File cabinet " AP folder �% • - 14- wATe9- o s �✓ ; P�°FIE�T.�. . 2 Z Fg-o r4T l` 5E7DAGFL-. ,1 1 \ to"er-Tiot4.. F6sel. �. PF-1ofL TO: 06CVPA4e- A1.1... LJ'fiLIT1j55 l-wT :.', H r 9-ov:EM e, P4 -T SJ�7 vlspr 000V'1ei4T 1. --"7 ,4 fee; R-o L O M E LX2 E— Vim; KALE 6Asc w,irrrr i 1 b• SSL c� ; e;iJc s7 • o ' °� ��,q�' � SCJ c� ` -(O See Master plan on file for dans. SITE PLAN�,t�sv. PLAN . N° --2i42 - LOCATIO N: ►�. �C 167-�_gg NOTEB: Y 2bCP0. N STQ e� _ COMMUNITY:.; .`: ":HOUSING.. IMPROVEMENT :PROGRAM P.1 C-40-tA. SUboiv�spt-1 81 G GS 429 NORMAL AVE. CHICO f BUTTE OOUNTY - .. LOT NO.: s AP WWLDING DEPARTMENT APPROVED OWNER.:KrNS- - DATE : -.1-S S e pT 19 >38. SCALE: ` « ~ i °" Qrtificate of Compliance: Residential Project Title MA'S TE k %16-1 Project Address / r BUILDING DATA Conditioned Floor Area 9,11 Number of Stories lO lWsed Floor Number of _Units �— Q< Single Family Detached (SFD) [ ] Addition Alone [ ] Single Family Attached (SFA) [ ] Existing Building [ ] Multi -Family (MF) [ ] Existing -Plus -Addition BUILDING SHELL INSULATION Component Insulation Location/Comments Type R -Value (attic, to garage, typical, etc.) Wall .............. R-11 EX:r kiA.1_g Wall.............. Roof ............. Roof .............. Floor ............. Floor ............. Slab Edge..... GLAZING R-30 CX I UNC �O 5 LRf3 Shading Devices Climate Zone 11 NA67-FP- V2S 125- 1; S Bu utg Permit M r -5-g9 Checiced By i Date Enforcement Agency Use Only Glazing Area Glass Type Interior Exterior Overhang Framing Type Orientation (sf) (single. double) (bolter blind etc.) (shadescreen. etc.) (yes/no) (metallwood) North 2-4 CA, 0 rATT-XL. Eats So ch (►� � 3 [ South ( ) West (►� West ( ) Skylight....... 0 Ar �► �. THERMAL MASS Type/Covering Area Thickness (slap/exposed, tile, etc.) Glass Area % Glass North t 3.0 HVAC SYSTEMS Minimum Duct �� Type (furnace. air i West 14 conditioner, heat um) Skylight 0 tuh or approved equal) Total 100 1 .3 Glazing Area Glass Type Interior Exterior Overhang Framing Type Orientation (sf) (single. double) (bolter blind etc.) (shadescreen. etc.) (yes/no) (metallwood) North 2-4 CA, 0 rATT-XL. Eats So ch (►� � 3 [ South ( ) West (►� West ( ) Skylight....... 0 Ar �► �. THERMAL MASS Type/Covering Area Thickness (slap/exposed, tile, etc.) sr tncnes rocaaorvuescn aon xttchen, oath, etc. -5t- L 70T t pC �T/ Lav HVAC SYSTEMS Minimum Duct Type (furnace. air Efficiency Location Duct Output Manufacturer / Model # conditioner, heat um) (SE, SEER.HSPF) (attic, etc.) R -Value tuh or approved equal) FU Maximum Furnace Heating Output: Btuh HOT WATER SYSTEMS Tank Manufacturer/Model# System Type (storage gas, etc.) Capacity (or aaaroved equal) I SPECIAL FEATURES/REMARKS (Add extra sheets if necessary) M; -4 . P�M COUNTY OF BUTTE Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) YES 2. I (have/have not) T.TA\r- signed an application for a building permit for the proposed work. 3. I plan to Provide portions of this vurk but I have contracted withthe followinagency g p� to provide +4e--p�e&e-d- construction technical assistance to coordinate and supervise the major work. Name Co ini tv 1-1oti.i na DiiproyPmnt n _Wr-ini Address 429 Normal Ave City Chico, CA Phone 891-6931 Contractors License No. 390764 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 N/A 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 Buttacav li Industr. lo15 Yuba Str., Yuba CityCA 741-2619 Insulation Caldwell Ent., P.O. Box 787, Gridley, CA, 95948 846-4142 Cabinets & CounLEFEbc Coleman Concrete Constr., 91 Lone Tree Pd. Oroville, CA 534-3303 Cun berland Plumbina,40 Oakvale Ct., Oroville 534-0589In 12 ing Foothill Electric, 5887 Orrin Lane Paradise, CA 877-1357 E ec ica Fox CO., 3995 Olive Hvl., Oroville, CA, 533-270 ea inq Trojan Truss Co. , P.O. Box 85, Orland, CA, 9596.3, 865-232 0o russes Signed: S44 -G: a d 24""5 Property Owner Social Security Numbbr_ Date NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and _reti.,rned to our office before we are per- mitted to issue the permit. ATTORNEY-IN-FACT AGREEMENT I/We hereby appoint the Community Housing Improvement Program and/or any of its authorized agents as my/our attorney-in-fact for the purpose of executing any notices of completion, waivers of liens and/or stop notices and/or release of liens and/or stop notices and building permits relating to that certain real property described as follows: All that certain land situate, lying and being in the County of ate , State of California, described as follows: Lot 5 of pidmtta &tx7.ivisicn , as shown on that certain map filed for record in the office of the county Recorder of the County of Butte , State of California, on Jarnary 15 , 198B ; in Book 108 of Maps and Surveys, at page 59 April 13, 1989 az Date Wher Date Owner STATE OF CALIFORNIA County of E= OFFICIAL SEAL LINDA F. WILSON 3 NOTARY PUBLIC • CALIFORNIA BUTTE COUNTY My Comm. Expires Feb. 15, 1992 On this13t� day of April in the year 1989 , before me T,; nda F. Wilson son , a Notary Public, State of California, duly commissioned and sworn, personally appeared Sandra J. Eakins personally known to me or.proved to me on tie basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument, and acknowledged to me that (s)he executed the same. IN WITNESS 14HEREOF I have hereunto set my hand and affixed my official seal in the County of Butte on the date set forth above in this certificate. e ' Notary -Public State of California My'commission expires 2/15/1992 ,y"`�ji+iti\,,,rv3#.k�"r�yZn..,�V:vvL�'''i.t'"wy�;H""'�v..ww.si�.,�;yi1r'rit7Flv..i}„� _94e:Y�.;,. s,.ni},;r;,,1,pw•ir'r"wr.� ,..�+.<h��i.. ..ti. •. . _ CA BUTTE COUNTY SCHOOLS DEVELOPMENTFEE CERTIFICATION FORM ( One Form pbr' BLfil ding ) 1 A.P. Number 2,7- j - /�J Building Department No. •School�District City A�Coun y ED Ju 's iction Property, Owner S Q,, G/� /I/ s Project Tocation/Address 2_ 0 2- S � O �` 71 Subdivision rf fho Lot Number Residential Development: l/ a a a Sq. Footage # of Living MHI Addition (Group R) 'Units Commercial%Iridustr'ial :rs ' tib'. r Sq,. Footage, ; 31 } New Addition (Including'Exteri&r M 4Roofed Areas) 116, Building DepartmentsRepresentative.'T Date J (Floor Plans reviewed by School District Personnel) District Id No. l deo/ School District certifies that (Applicant Name) r° (Phone Number) (Street Address) A ( City) + 4 (S tate) ( Zip` Code ) has complied with the requirements of Resolution No. by the payment of representing 0/J square feet. chool District Representative- J ate PAID BY CHECK NO., BANK NO-3505�Z!/ 57 PAID BY CASH REMARKS: white -applicant, -'yellow -building department, pink -school district SCHOOL.FEE (8/88) 0