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Home My WebLink About024-010-0912 - 4 01-91 F � K RIVERA �-• 207 A -er Avenue, Gridley Permit#3 ,0-83P,E(ytil, MH) ELEC GAS /Z-7:8 LP SUPPORT STRUCTUR REQ_ COMPACTION TEST RE r�4JL 24-01-91 L it#3301-83MHI FELKINS, F. R. 1039 ed /��- ��.� Ct .. 24-01-91 Davis Ave. 2501 No. of ArEq r t#3302-83B(new carport & awning Gridley 0 t 2 - 4 01-91 F � K RIVERA �-• 207 A -er Avenue, Gridley Permit#3 ,0-83P,E(ytil, MH) ELEC GAS /Z-7:8 LP SUPPORT STRUCTUR REQ_ COMPACTION TEST RE r�4JL 24-01-91 L it#3301-83MHI FELKINS, F. R. 1039 ed /��- ��.� Ct .. 24-01-91 Davis Ave. 2501 No. of ArEq r t#3302-83B(new carport & awning Gridley H `✓ r i .x...:. .: 33P11 g3 PERMIT NO. 3300-83P2E(MH) PERMIT EXPIRES 10 Aq OWNER FRANK RIVERA r CONTR. owner ti :9 ASSESSOR PARCEL 2401-91 _ LOCATION 207 Archer Avenue, Gridley _ i =i 1 t j . OFFICE COPY Address a j •�. GAS • Meter By Date [� ELECTRIC Meter,,By 6 Dat i' J Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E Temp. Gas Service Called PG&E JOB FINALED (Date) i Signature • r. COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 0 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 :500 1-14rl for the foll wing location: Owners Owner's Address Mobilehome Mfg. Model /�%k�� dYear Insignia No.`� Serial It is hereby certified for occupancy at the above described location and may be occupied."-+ Director -of Public Works --i � A Date A. _ ? ..�-�! By�-� � � THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED White - Owner, Yellow - Installer, rinK - �+•�•••• v_ ' 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 .01 CORRECTION NOTICE Dl— a Us 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, ojAeed additional explanation, please contact this office Immediately. lnspector.-Ji»� �. _ Date 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 RRECTION 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 natter, or need additional explanation, please contact this office immediately. Inspector \ V ( /W+, Date—t ` t� low y J= 0 0 = Not OK - = Not Applicable = Not Ready RESIDEtsIAL (Si'ngle and Duplex) Date UNDERFLOOR (Plans) OK except #'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /'' Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire 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 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access - - 7. Piers -Fireplace Ftg.-Steel 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 54. Glazing Area -Glass Protection -Skylights -Plastic 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. 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 -BI Date Card -BI Date Date FINAL (Plans) OK except k's 56. Ext. Steps -Door & Sidelight Protection -Landings 'Card -BI FDate Date Card -BI Date PLUMBING (Permit) OK except q's 57. 58. Smoke Detector Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meeh. Protection _ 14. Water Ht.; Vent -Access -Combustion Air 15. 16. Water Pipe; Test & Anchors -Nail Protection D-W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. 19. Test Tub & Shower, 2nd Floor -Tub Access Gas Pipe; Size & Anchors 61. 62. Elec. Trim & Subpanel; Breaker Sizes -Labels Stairs & Rails _ 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. 'Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter I Date ELECTRICAL Permit OK except q's 67. Garage Fire Door; Swing -Landing -Closer - 68. A.C. Duct in Garage -Damper -- 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor -Meth. Protection 21. Receptacles Spacing -Lights &Switches at Doors - _ 22. _[let. Size Boxes & No. of Conductors -Stapled 70. Plb., Elec. &Mech. Equip. Listed for Location 71• Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 23, Romex Installed Close to Edge of Studs & C.J. -- 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. Insulation -Foam -Looked in Attic ❑Yes -- 25. 2 Appliance Circuits in Kitchen & Conductor Size 73. Guard Rails & Deck Construction -Post Caps -_26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes F.`r--------- 27. 28. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or AI, Insulated Neutral ❑Yes ❑No - Service -Riser Conductors & Ground -Main Disconnect 75. Following instld.: Drive ❑ Yes E]No; Walks [IYes E)No; Planters Dyes ❑No 76. Stucco; Brown -Finish 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77, A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet _- 30. Clothes Closet Light -Shower Light - 78• Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. --- -- - -- - --- ----- ----- - ---- -------------- Card B -I - _Date_ _ Card -BI -_Date --___ ySard B -I Date - Card -BI Date ,�• 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground 81, Ventilation throughout House 82. Glass Protection ,Date MECHANICAL (Permit) OK except q's 83. - - Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric -_ j- ___._33. 31. 32. A.G. Ducts; Insulation &Support Vent Fan; Exhaust above Insulation Condensate Drain _& Overilow; Size & Grade 86• Water & Sewer Connected -C/O to Grade -HD Approval Energy Compliance Certificate -Other Certificates 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 3--- ?Card -BI Card -BI Date - 35. -Attic Access & Platform if Furnace in Attic - - - --- -- -- ------------ _ Date - - Card -BI - Date Date Card -BI Date FRAMING(Plans) OK except q's Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Comments at Final: 36. Sills; Proper Material & Anchors ( 37. 38. _Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls_ over Girders & Floor Nailing-- - Draft Stop in Walls (rat proof)__ - - _ 40. 41. 42. 43. 44. 45 46. 47. _Fire Stops; Furred Ceilings -Stairs -Chases -Tub Header & Beam -Size & Bearing Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rfir. Ties-Purlin-Root Brat.-Truss-Shthnq.-Rfnq. Fireplace Ties or Type A Flue -Fireplace Throat Attic Access: Size &Romex Protection -Draft Stop -Ins. Baffles Bdrm. Windows or_Exiting Doors -Sill Hgt. & Dimensions - Garage Fire Protection Framing (NOTE: An entry must be made each time you visit jobsite) 11 J = OK 0 = Not OK — = Not Applicable MOBILEHOMES = Not Ready MISCELLANEOUS Date MOBILE OME UTILITIES (Pl2i OK except k's Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's 1 oning Requirements—Setbacks—Easements 1. Zoning Requirements-Setbacks—Easements oils; Special MH Support—Sketch 2. Footings; Size—Depth—Spacing—Connectors Sewer; Location—Test—Fall-C/0—Concrete _ 3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails ater; Location—Test—Easement Needed (Sketch) 4. Wood Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.—Rig.—Bracing 5,-,16ectricity; Location—Clea nces—Grnd.—/ / Amp—Concrete 5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures ^ 6. Gas; Location—T ./ /"L"ft./ /"Nat.or(0 "L"ft.///"LPG 6. Carports; Windows—Doors 7 ility Clearance 7. Elec. C Date:/� Card -BI Date I Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI _ Date Card -BI Date Date MOBI HOME INSTALLATION (PI OK except N's Date POOLS (Plans) OK except N's ontoq Requirements—Se backs—Easements 1. Setbacks—Easements ootings; Size a n Marriage Line 2. Soils; Compaction—Structure Stability ®Gas, a Demand Valve n 3. Pool Structure: Steel—Connections—Thickness—Dead Men—Lining PrElectric MH —Crossovers r Clearances 4. Elec.; Receptacles and Lighting; Distances—GFI r in; MH Test—Fall—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI aH Test—Regulator—Connector 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed ater and Sewer Connected—C/0 to Grade—HD Approval 7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater as and Electricity Tagged B. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg. Boxes—Enc losures— Pane Iboards—Ins. to Main in Conduit its; Insp.—Sketch 12X-06'rt. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test—Water Supply Test Card B -I ate -1' Card -BI Date Card -BI Date Card -BI Date Card B -I at Card -BI Date Card -BI Date Card -BI Date 3300-83 PERMIT NO. 3302-83B PERMIT EXPIRES /7 - OWNER Z -OWNER JAMES RIVERA CONTR. owner ASSESSOR PARCEL 24-01-91 LOCATION k 207 Archer Avenue, Gridley Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E Temp: Gas Service Cal led PG&E JOB FINALED (Date) r v Signature . a J=OK 0 = Not OK = Not Applicable MOBILEHOMES * = Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except #'s Date DEQKS, 0 S, CA ORTS, ETC. (Plans) OK except q's 1. Zoning Requirements—Setbacks—Easements t,,6oning Requirements—Setbacks—Easements 2. Soils; Special MH Support—Sketch 2`f%ootings; Size—Depth—Spacing—Connectors 3. Sewer; Location—Test—Fall-C/0—Concrete _ 7 ers and/or Joists—Decking—Bracing—Stairs—Rails 4. Water; Location—Test—Easement Needed (Sketch) Posts—Beams—Rftrs.—Con nec.—Shthg.—Rfg.—Bracing__ 5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete 5, Awn.; Columns—Connections—Splice—Decal—Enclosures 6. Gas; Location—Test—Wrap:/ /"L"ft./ /''Nat. or/ /"L "ft./ /"LPG arports; Windows—Doors 7. Utility Clearance Card -BI Date Card -BI Date Card -BI gate Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except k's 1. Zoning Requirements—Setbacks—Easements Card -BI Date _ Date Card -BI Date _ POOLS (Plans) OK except N's 1, Setbacks—Easements 2. Footings; Size—Spacing—Marriage Line 2. Soils; Compaction—Structure Stability 3. Gas; MH Test—Demand—Valve—Connector 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining 4. Electricity; MH Test—Crossovers—Breakers—Clearances _ 4, Elec.; Receptacles and, Lighting; Distances—GFI 5. Drain; MH Test—Fall—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI 6. Water; MH Test—Regulator—Connector 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed 7. Water and Sewer Connected—C/O to Grade—HD Approval 7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg. Boxes—Enclosures—Panel boards—Ins. to Main in Conduit 9. Exits; Insp.—Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test—Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date = OK = Not OK = Not Applicable = Not Ready RESIDENTIAL (Single and Duplex) Date UNDERFLOOR Plans OK except N's Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire 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 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic _ 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 -Anchors -Regulator -Service Test 11. 12. 13. Electric; Underground Plenums & Ducts; Clearance -Material -Support -Ins. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date FINAL (Plans) OK except N's 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date _ Date Card -BI Date PLUMBING (Permit) OK except q's 14. Water Ht.; Vent -Access -Combustion Air 57. 58. 59. Smoke Detector Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meth. Protection Bedroom Exiting 15, Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access _ 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19_._ Gas Pipe; Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except q's 67. Garage Fire Door; Swing -Landing -Closer 68. 69. A.C. Duct in Garage -Damper Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection --- 20. Fixture & Transformer Clearance -Ins. Protection 21. Alec. Receptacles Spacing -Lights &Switches at Doors 70. Plb., Elec. & Mech. Equip. Listed for Location 22. Size Boxes & No. of Conductors -Stapled 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 23. Romex Installed Close to Edge of Studs & C.J. -__ 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. Insulation -Foam -Looked in Attic ❑Yes 25. 2 Appliance Circuits in Kitchen &Conductor Size 73. Guard Rails &Deck Construction -Post Caps - 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes - - 27. 28. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral F�Yes 0 N Service -Riser Conductors & Ground -Main Disconnect 75. 76. Following ❑ ❑ ❑ Yes ❑ No; Planteins Ye Drive Yes No; Walks Planters ❑Yes EJ -No Stucco; Brown -Finish - - 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77, A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet _ 30. Clothes Closet Light -Shower Light - 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. ------------ ----- ------------ _-_-_..-- Card B -I _ Date-------Card-BI Date Card B -I Date Card -BI Date 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground 81. Ventilation throughout House 82, Glass Protection Date MECHANICAL (Permit) OK except 1J's 83. _ Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric - 31_ A.C.-Ducts: Insulation & Support -- 85. Water & Sewer Connected -C/0 to Grade -HD Approval _ 32. 33. Vent Fan; Exhaust above Insulation Condensate Drain _& Overilow; Size & Grade 86. Energy Compliance Certificate -Other Certificates 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic Card -BI Card -BI -- --- - - ---._--.---------_-._--_ Date _Card -BI Date Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FRAMING(Plans) OK except q's Comments at Final: _ 36. 37. 38. 39. Sills; Proper Material & Anchors _Walls: Studs -Nailing, Sp_ilcing & Bracing -Plates -Sound Bearing Walls over Girders & Floor Nailing-- Draft Stop in Walls (rat proof) 40. _ _Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. 42. 43. 44. 45 46. 47. Header & Beam -Size & Bearing Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shlhng.-Ring. Fireplace Ties or Type A Flue -Fireplace Throat At Access: Size & Romex Protection -Draft Stop -Ins. Baffles Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions_ Garage Fire Protection Framing _ _ (NOTE: An entry must be made each time you visit jobsite) rt - COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. 3� Ste ' ASSESSOR PARCEL NUMBER NG BUILDING PERMIT IV .OWNER kTELEPHONE, Ad A m� SO. FT. OCC, BUILDING VALUATION U OWNER'S MAILI Aj? ESS CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS F i replace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ CXD ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ &Z, BUIL ADDRESS Agmd_ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF [:1Duplex❑ Mobilehomee Other SPECIFY Building sewer 5.00 Mobile Home S G W 10.00e TYPE OF WORK New ❑ Addition Remodel ❑ Uti ities ❑ Installation❑ Other ❑ Describe work: �� ,�— Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. // DWELLING OCCUP.& OR ADDNS. l ACC. BLDGS. Z1/20sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and m license is in full force and effect. y License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) (X 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 U TI.OUTLET 2.50 ea NON-RESID BRANCH CIRC ITS. NEW CONSTR. POWER APPARATUS &) NON-RESID. SINGLE OUTLET CIR. Ex. Occu 20®sot P�o OR FIXTURES` 9AL®3o FIXED A Ex. Occup. OUTLETS PLNS (RESID IREA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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. 1 also agree to save, in de fSra' eep harmless the County of Butte against all liabilitie judgments cost an �cpenses which may in any way accrue against sai ounty in nsequ n of the granting of this permit. �,�-Z6,-_�� Date Signature of Applicant — Owner Contractor ❑ Agent ❑ An OSHA permit is required for excavations over S'0" deep and demolition or construct- of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP M_1 TYPE of C ST. `rj�� ..flL[-- PAROL PD HD Isco This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIREC OF PUBLIC By PE T EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date /�� Z/ �� eipt No. 0f /� rReE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT _ a 18'x18"XI 4 i .,4 fj� /(91117<o i t 1Qi'X1g' x1�'' � �12Po�271` p'),� \F r 9b-; I�aK. str �� W 7Y I I A setback'.of 5 ft. from tf e property Ines and a setbpck of 50ft. frgm the road i i 'eenterline shall be clear df W structures or equipment dxcept fora 2 ft. have over LGj4C.l� � r This sTt of plans anc� specifications IIMUST �ccorvence tivith Recognize c! Good Practices and make any chanties �r a er �`� ns ivy Esc, ;, �a'n� ��,-cifiede in t e out wr ; n �rnrission from the {� Uniform Building, Plumbing & Mechanical Codes i Public Warks, County o� Butte. and the Nati6nal Electricalde, - , U .. — —'i �I I— :w net �-0 3302 -g3 BUTTE OUN' Y III DlWGn:D a APPROVED- 15-4 PPR V D I , REGISTRATION CARD The undersigned tenant an ner ��Bleeby re e. rental of the lot listed bel the �iis c d ein`; and in the lease Agrees Rules egu ions.? e', DULT CHILDREN (if p milted) �19_tw:zl ��':•- — ----- -- --- Ages 'e`ge J_# �`- ��aa��- _�T� C # ��.��U�•-�_3__ ~ —Age'. Permar.ent Mailing Adess�s��4� -- Employed by-----�` t �'�1[��si — Occupation._.-..------- Social Security NoJ-� 0-7-"f _.�. Employer's Address _ Phone Make of MobilehomeA��&V _�- Length��.� -Serial No.—_ License No ____—_-__ State • Year/9-40: Registered Owner (Nome)/• r-/ Address z2^� _& J1X_ Legal Owner (��Nyyam��e)-_ Address___ Make of Cor-C&KE: �Z �__. Year _ License No _ State— Year Present Bank Bronch ACCESSORY BUILDINGS AND/OR STRUCTURES (Record number and type) ' Awnings);�� %1—a— Corport(s)�_�_�. 3� _' Romada -- Cabana(s): —Porch(s) _ = :` Storoge Cabinet I hereby agree that this rental is for lot No.9 � f at the monthly rate of ; ,�_-,.g plus -all utilities. I have received a copy of the Leasesi Agreement and the park rules and regulations, have read the same, and agree that any breach of-.ahy of the same by myself, family or guests, shall be a failure.to per form and express condition of the terms of my tenancy and the owners may terminate my residency for said breach as provided by law. It is mutually agreed that either party may terminate this tenancy by giving the other party sixty (60) days written notice thereof and rental shall be paid thrRugh that date, or if there be previously paid, unused rent the same shall be refunded when the premises are vacated. If owner employs the',services of an attoiney to enforce the provisions of this agreement I; hereby agree to pay all reasonable attorney's fees, court costs, and expenses. This tenancy is,not'.transferable in any way and the premises cannot be sublet unless the owner first approves in writing. his.Re tration Card and the Lease Agreement and the Rules and Regulations all -constitute the rental agreement for the Space-" mentioned above. -1 Signatur Dat Lot No. Rate 67- ®® Date Due .yP�ly reco mefided by - ) Pyr pager's Signature File No. BUTTE COUNTY For Action 1, 2,3) Public Works Dept. (For Information ✓) r s Director Dep. Dir. Sec. I ' Rd. & Br. Mtca. Shop & Yards u j Bldgs. & Grnds.. - b �idg. Insp. Admin. 5 Design Engr. Bridge Engr. Constr. Engr. Surveys Mapping } V Transp. Land Dev. Drng. /S.1- Sub. & Pcl. Mops Permits { Addr. 'I 1 C� CIL ,' _. 7� r %OOo %)�Q yr i O COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville: California•95965 - Telephone 916/534-4541 �3 APPLICATIOWAND PERMIT All ASSESSOR PARCEL NUMBER ZONING f_f_ &/_ BUILDING PERMIT OWNER _ n _ TELEPHONE SQ. FT. I OCC. BUILDING VALU N OWNER'S MAILING ADDRESS ZO'i .4,t?_Ah�-Q FV- hd-I ADDRESS CONSTRUCTION LENDER (UNKNOWN ENDER'S MAILING ADDRESS R RCHITECT OR ENGINEER'S MAILING ADDRESS NG ADDRESS 07 LOT NO. I SUBDIVISION NAME I PARCEL MA USE OF STRUCTURE SF ❑ Duplex[] Mobilehome�g Other SPECIFY TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ InstallationU Other ❑ Describe work: Aw CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification ❑ 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ® I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) Fireplace Permit Fee ELECTRICAL PERMIT Total Valuation $ Main service 600V OR LESS 100 AMP OR LESS 10.00 Filing Fee $ 10.00 Permit Fee $ 2,50 ea Plan Checking Fee $ EX. QCCUp(OUTLETS OR FIXTURES Penalty $ 2.00 Permit fee $ Mobile Home Facilities PLUMBING PERMIT Filing Fee 10.00 Each Trap 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, in remnify—ariq keep harmless the County of Butte against all liabili ' s, judgme s, cots, an�xpenses which may in any way accrue against s i County ' onse ue ce of the granting of this permit. Date ate` Signature of Applicant — Owner [� Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. 2.00 Solar Water Heater TOTAL PERMIT FEE $ Q, &ID 20.00 Water piping 5.00 Each qas water heater or vent No 5.00 Gas piping system 1 - 5 outlets the applicable provi- resolutions to do fees have been paid. WORKS Date 5.00 Building sewer 5.00 Mobile Home S G W 10.00 e Permit Fee Contractor Permit Fee ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. / DWELLING OCCUP.&` OR ADDNS. C ACC. BLDGS. / 21/20sq ft NEW CONSTR ULTI-OUTLET NON.RESID BRANCH CIRCUITS) 2,50 ea NEW CONSTR /POWER APPARATUS & NON-RESID. %SINGLE OUTLET CIR. EX. QCCUp(OUTLETS OR FIXTURES 20®50eeAL990 FIXED AP Ex. QCCUp- OUTLETS P(RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 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, in remnify—ariq keep harmless the County of Butte against all liabili ' s, judgme s, cots, an�xpenses which may in any way accrue against s i County ' onse ue ce of the granting of this permit. Date ate` Signature of Applicant — Owner [� Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ ❑ I am exempt under Sec. , Business and Professions Code for this reason Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ® I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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, in remnify—ariq keep harmless the County of Butte against all liabili ' s, judgme s, cots, an�xpenses which may in any way accrue against s i County ' onse ue ce of the granting of this permit. Date ate` Signature of Applicant — Owner [� Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ Q, &ID OCCUP. GROUP I TYPE OF CONST. PARCEL PO No I ISS This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTO F PUBLIC By l P IT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. 0 -7117:7 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT . ... t i .. _ •.. oto . ., .. BUTTE COUNTY.DEPARTMENT OF PUBLIC WORKS ...i � . 7 County Center Drive, Oroville;_CA: t. r PHONE: 534-4541 . MOBILEHOME INSTALLATION SHEET 1. Owner's name :�'� 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.) 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? ----------------------- Amps 6. What is the mobilehome site service rating? --------------=------ Amps 7.. What is the mobilehome site circuit breaker rating? ------------- yo Amps 8. Is there any other electric load -to be served by the mobilehome siteservice? --------------------------------------------------- Yee No. (If.yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? ---------------=------ 10. What is the type of gas service? ------- Natural � LPG 1,-qI� 11. What is the gas pipe length from meter or tank to the mobilehome? G 9 (ft.) 12. What is the mobilehome gas demand? ------------------------------ Ob d (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, Mob ilehome Mfr.ad/ a furnish Setup Model No. Year �o Width-4/)_(ft.) Box Length (ft.) Tagalong or Expando Size ft. x_; -ft. (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. Single x (ft.)(in.) (in.) (in.) Center su port Ce ter support locatio * f oting sizes (in.) I —x —J (ft.)(in. /(in.) (in.) (ft.)(in ) (in.) (in.) I Zum, Footings (check one) 1'. Wood either pressure treated or foundation grade. 2. Other: (specify) Supports (check one) 1: Concrete block. -2. Other. (specify) Tagalong or Expando,' show support details. I I I' -Hl Ax3a -- Typical Suppor"t (in.) (in.) Footing Size (ft.) nl ) I (i4•) (in.) (ft.) (in.) (in.) (in.) *If center piers are other than drawn above, -draw in -locations, spacing,. and dimensions. Max. Pier Spacing (ft.)(in.) Max. Overhang (ft.)(in.) BUTTE COUNTY BUILDING DEPARTMENT APPROVED COUNTY OF BUTTE :DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 9§965 - Telephone 916/534-4541 APPLICATION#ND YAERMIT PERMIT NO. �3 Ad - All 7s, 14A / ASSESSOR PARCEL NUMBER ZONING 2 + 0/_ BUILDING PERMIT OWN E EPHONE 4(�� SQ. FT. OCC. BUILDING VALUAT OWNER'S MAILING ADDRESS CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ --46:ee— LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ `g/_&0 Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ fs� 0.0 BUILDING ADDRESS O PLUMBING PERMIT.. Filing Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5,00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF ❑ Duplex[] Mobilehom Other SPECIFY Building sewer 5A sq e2 5.00 Mobile Home W 10.00 ea 50,6e) TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities?!� Installation ❑ Other ❑ Describe work: Permit Fee $ r Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service eoov OR OR L 100 AMP OR LESS �90/� 10.00 CW Ef Main service EA. ADD•L 100 AMP 2.50 NEW CONST.(DWELLING OCCUP.& OR ADDNS. ACC, BLDGS. 1 2/20Sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check One): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification ❑ I, as the owner, or my employees With wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR ULTI.OUTLET 2,50 ea NON."ESID BRAN CHCIRC TS A NEW CONSTR. ( POWER APPRATUS &') NON.RESID, SINGLE OUTLET CIR. 20etr0e Ex. Occup(o TS OR FIXTURES 9ALe3o FIXED FIXED APPLNS, OR EX. Occup. OUTLETS (REBID.) EAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00/S7)&o Misc. Wiring 15.00 Permit Fee $ (� Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on'file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, Inde i keep harmless the County of Butte against all liabilities, judgment , c ts, d expenses which may in any way accrue against VCounty in nse ue a of the granting of this permit. X C/— �-3 Date Signature of Applicant – I-IlOwnerK Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ ocCUP. GROUP I TYPE OF CONST. 1 PARCEL PD ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIR OR OF P LIC r BY 4 PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. C 717% WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT Return to DPW t AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT 13UT,F6C(;�a[��',•NTY�::��. FOR RESIDENTIAL DEVELOPMENT ��CCFiD$ c{� �i�1E ,� ; •: •, �.. TY Section 26-8.1 of the Butte County Code requires this acknowledgement ��P be recorded prior to issuance of a building permit. ��rxLf� �. The property described herein is adjacent to land or included CLERK =R.HE, .. �Q.. within an area zoned for agricultural purposes, and residents of this 83_32033 property may be subject to inconveniences or discomfort arising from the uA of agricultural chemicals, including, but not limited to herbicides, pesticides, and `ortilizers; and from the pursuit of agricultural operations including, but not limited V, . to cu?,tivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural zones which have as a priority use for productive agricultural purposes, and residents.within said zones and on adjacent property should be prepared to accept such inconvenience or disconform from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: C A portion of Lot 18, as shown on that certain Map entitled "Map of Gridley Colony No. 6, near Gridley, Butte Co., Calif.", which map was recorded in the office of the Recorder of the County of Butte, State of California, April 12, 1906 in Map Book 5 at page 20,, more particularly described as follows: BEGINNING at_the Southwest corner of said Lot 18; thence North along the West line of said Lot 18, a distance of 330.0 feet to a point at the Northwest corner of the South half of said Lot 18; thence East along tae North line of the South half of said Lot 18; a dis- tance of 150 feet; thence South and p rallel with the West line of said Lot 18, a distance of 330.0 feet to a point on the South line of paid Lot 18; thence West along the South line of said Lot 18 a distancE c£ 150.0 feet to the point of beginning. ' tXCEPTING THEREFROlMs gtreets as platted and rights of way for necessary irrigation and drainage ditches and canals, as reserved ,4n deed from Irrigated Land Company of California, a corporation, o Homer R. Estes, recorded August 19, 1910 in Book 117 of Deeds, at page 2870 records Of Butte C6unty_ al ti s p e. E r Date: September 26, 1983 Az:, Stat q of California ) On this the 26th day of September 19 83 , before SS. me, the undersigned Notary Public, personally appeared ' County of .Butte ) h Frank V. Rivera'and Edith Rivera { XX/ Personally known to me. / / Proved to me on the basis of satisfactory evidence." to be the person(s) whose names) are ..subscribed,to the within instrument and acknowledged that 1 -bay. executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and,official seal. ° ..� OFFICIAL. SEAL RALPH W- MILLER NOTARY PUBLIC - CALIFORNIA �� '1i✓1`..d BUTTE COUNTY Notary ,Public MY COMMISSION EXPIRES JULY 6; web Ralph W.'Miller 'Present A. P. No. C61)q—O(--Oq{ r i !" A pJrmit will 6e r-equired for the insta)lation of the rpobilehome. �y 0 t I 0\ %, Utility connections shall be within 4_ft. of fhe mobilehom�, either mmobilehliome. _ _Asetback-of 5-ft,frorn-the property lints and a setback of 50ft. frorr the road l ti centerline shall be clear of structures orlequipment except �A i �. f=.a.2.ft.._ea6 oxgrhmv-.._ro__ ' ; I 1 3300 83 �.� UTTE CO NT' 1 BIJILDING OFFART) �PPROIVE lit35 sof oTplan's -ana sp# iTlcafions SIU T b, L Iccordarce with Reconized Goodractice and II Materials WorkmanshipShall Be in kept on the jb at all 'times and it is unlaw �:I of aual t prescribed for the S ecifi d use 9 Yp p e nthe make any ch;:;k+g*.,,s or alter at cans on same wig c, ;bniform uilding, Plumbi g & Mechanical Cods and. writton porn,il,-sion from fhe Department of Pub. {'the National Electrical oda. FIRE, DAMAGE REPORT OWNER: J DATE: C) V� �� p LOCATION: �1�'rl �'�,=4 gkw---. A.P. # 9b) 0 - 09,) CONTRACTOR: ZONING: DATE TO INSPECTOR: PERMITHISTORY:( ) NONE ) S FOLLOWS: BUILDING INSPECTOR'S REPORT Building Description: Commercial/Usage: Residential/# of Units: Currently Occupied Abandoned/Vacant Electric: Yes / No Electric currently On Off Condition of Electric Gas: Natural Propane_ None Currently On—zOff Obvious Problems: Sanitation: Plumbing Working Well Working Potable Water Obvious SewageProblems Description of Damaged Area: Estimate Valuation of Damaged Area: Condition of Foundation: Mobile Home: Condition of Utilities: Inspector. Date e✓ ( Sketch buil g on reverse and indicate area of damage, -off-orb-o°�l =DF/BUTTE COUNTY FIRE INCIDENT LO DATE03/15/2001 INCIDENT NUMBER 2969 LOGGED B LKD REPORT TIME 13:08 LOCAL FIRE NUMBE 10152 s,, RO DORNAN STATE FIRE NUMBER _� .-; ,.: BI CASE NUMBER `F MEDICS GRIDLEY M LOCATION 207 ARCHER AV PRA Y1 ECC ❑ RP TRERESA PHONE NUMBER 8466319 I REPORT METHO 1911 WILDLAND FIRES ❑ ESTIMATED ACRES =0 FIRE INFORMATION STRUCTURE FIRE RESIDENTIAL FIRE INFO SENT HO EMAIL BY =TO DORNA OTHER FIRE 7 -DAY LOGGED INITIALS MAA MEDICAL AIDS INCIDENT NAME RIERA PSA/OTHER START DATE 03/15/2001 START TIME 13:00 HAZ MAT DIAMOND # O COMMENTS CAUSE EQUIPMENT FLU FIRE LAND USE DOMESTIC ACRES0j TYPE OF ACRES DIAMOND 5 ONLY $ DAMAGE TYPE ALL OTHER DOLLAR DAMAGE 1000.00 SAVE 0,00 INJURIES/FATALITIES ❑ # CIVILIAN INJURIES 0 # CIVILIAN FATALITIES 0 EMD ❑ OES ❑ # FF INJURIE 0 # FF FATALITIES of ♦� �I New incident7`. FC -40 INFORMATION FC -40 ❑ DATE OF FC -40 INC AGENCY INC # r INC P# I FC40 COMP DATE + FC -40 COMP BY County Notifications EARS Hard Copy Recieved ❑ EARS Checked Agenst EARS Computer ❑ a • 14, .. .. �. 1 r �,+-K r} oay' �•✓+.1 A rr • 1 y 1 .s L r f.�•y„t�.y # .. _ .. `. / S r L.� h..�aJ�tukl �. � ... 1 � y.' � . - ir{ o a- «,^� c r u 1 t• , +• a 94Y+ Y+_ 7 r i • • I ns 1 • t l r `Ca` _ - i � •i } fi•{ +r.�Y ;•ie �% ,'., ":ti'`'nt :at S _ h71 Ll - 33 I.I.. h ri ape a I '� 4