HomeMy WebLinkAbout024-130-07724-13-77
LIS MacFARLANE
909 ast Evans Reimer Rd, Gridley
Permit 2346-83P,E(�til, 14H)
ELEC S- -83 20Z,%% eA
GAS 8�/a• 8 -5'75'.../%z-° f, AS._L��t/C�iU/�i�
SUPPORT STRUCTU-%..,'REQ_,V I"I r►A
COMPACTION TESTA
24-13-77 �Iaal$3�
C'ontr: Co,oly's MH Ser, Corning
Permi 678-83MHII
Iss ed
i
77
_ 71K
f PERMIT NO. l2 < 4 2346-83P,E(MH)
j PERMIT EXPIRES
OWNER LOIS MACFARLANE
1 ,
CONTR. owner
ASSESSOR PARCEL 24-13-77
LOCATION 909 East .Evans Reimer Rd, Gridley
di
J.
T
A
'
OFFICE COPY
~ Address 14111 Iwl
Meter Ba"te'��'��-
+ Tem Power `y
Meter By - d Date -7.
Called P�C
Temp. Elec. Service
' Called PG&E
Temp. Gas Service 2— 2
' Called PG&E
JOB FINALED (Date
Signat
S
r
J = OK
O = Not OK
— = Not Applicable
* = Not Ready
MOBILEHOMES
r r�r
MISCELLANEOUS
Date
MOBILEHOME UTILITIES (P606) OK except N's
feoofoning Requirements—Setbacks—Easements
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's
1. Zoning Requirements—Setbacks—Easements
Soils• Special MH Support—Sketch
2. Footings; Size—Depth—Spacing—Connectors
� Location—Test—Fall-C/O—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.—Rfg.—Bracing
5. Electricity; Lo do .lees rnd.— Amp—Concrete
5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures
V -Gas; Location- t—Wrap:W'L"ft./r/"Nat.orL—i"t ft./
6. Carports; Windows—Doors
j;,--6tility Clearance
7. Elec.
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Da Card -BI Date
Card -BI
Date Card -BI Date
Date
MOBIJ,60ME INSTALLATION (P s) OK except N's
Date
POOLS (Plans) OK except #'s
ing Requirements—Setbacks—Easements
1, Setbacks—Easements
F Ings; Size—Spacing—Marriage Line
2. Soils; Compaction—Structure Stability
G , MH Test—Demand—Valve—Connector
3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining
EI tricity; MH Test—Crossovers—Breakers—Clearances
4. Elec.; Receptacles and Lighting; DistariceS7 GFI
Drain; MH Test—Fall—Flex Connector
5. Elec.; Pool Lighting; 15 volts—GFI
r; MH Test—Regulator—Connector
6. Elec.; Enclosures; Conduit Entries—Terminals—Listed
Water and Sewer Connected—C/O to Grade—HD Approval
7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater
Gas and Electricity Tagged
6. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg.
Boxes—Enclosures—Panel boards—Ins. to Main in Conduit
marts; Insp.—Sketch
1 . Cert. of Occupancy
9. Health Department Approval
10. Plumb; Cir. Test—Water Supply Test
rd B -I
Date -4-'2and-BI Date
Card -BI
Date Card -BI Date
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
V 0" 5
O = Not OK r '
Not Applicable
Not Ready RESIDEN�'IAL (Sin-gle.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
54.
Glazing Area -Glass Protection -Skylights -Plastic
8.
D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test
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
Date �, Card -BI Date
Card -BI
Date ',Card -BI Date
Card -BI
Date Card -BI Date
Date
FINAL (Plans) OK except N's
Card -BI Date Card -BI Date
Date
PLUMBING (Permit) OK except q's
14. Water Ht.; Vent -Access -Combustion Air
56.
Ext. Steps -Door & Sidelight Protection -Landings
57.
58.
Smoke Detector
Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
15. Water Pipe; Test & Anchors -Nail Protection
16.
D.W.V.; Test-Fttngs & Anchors -Nail Protection
59.
Bedroom Exiting 4
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
Card -BI
Date Card -BI Date
64.
65.
Elec. Outlets at Wood Panel; Int. & Ext.
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 k'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-Mech. Protection
21.
Elec. Receptacles Spacing -Lights &Switches at Doors
70.
Plb., Elec. & Mech..Equip. Listed for Location -
22.
Size Boxes & No. of Conductors -Stapled
71.
72.
Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
Insulation -Foam -Looked in Attic E] Yes
23. Romex Installed Close to Edge of Studs & C.J.
24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water
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 At
74.
Fdn. Vents & Crawl Hole Door -Drainage &Wood -Earth Clearance
Looked under Floor El Yes
27.
Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or At,
Insulated Neutral ❑Yes El No
75.
Following instld.: Drive E] Yes E] No; Walks ❑ Yes E) No;
Planters ❑Yes El No t'
~@ ,X
28.
Service -Riser Conductors & Ground -Main Disconnect
76.
77.
Stucco; Brown -Finish :11 Il i
A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
29. Equip. Clearances; Panels-Motors-Mech. Equip.
30.
Clothes Closet Light -Shower Light
78.
Vents Above Roof; Pibg.-Appliance-Firepl.-Clearance to Opngs.
79.
Water Well; Disconnect, Electrical, Plumbing .. j` 1
80.
Exterior Elec. Trim; G.F.I. Receptacle -Underground
Card 8-I
Date Card -BI Date
81.
Ventilation throughout House
Card B -I
Date Card -BI Date
82.
Glass Protection
Date
MECHANICAL (Permit) OK except N's
31. A.C. Ducts: Insulation & Support
83.
84.
Corrections from Previous Inspections
Gas Test -Meters Tagged; Gas -Electric
85.
Water & Sewer Connected -C/O to Grade -HD Approval
i_
_
32.
33.
Vent Fan; Exhaust above Insulation
Condensate Drain & Overflow; 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
Date Card -BI Date
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
FRAMING(Plans) OK except q's
Comments at Final:
36.
Sills; Proper Material & Anchors
37.
Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound
_
38.
Bearing Walls over Girders & Floor Nailing
39.
Draft Stop in Walls (rat proof)
_40.
Fire Stops; Furred Ceilings -Stairs -Chases -Tub
41.
Header & Beam -Size & Bearing
42.
Hangers -Post Caps -Anchors -Connectors
_
43.
44.
Cing. Joist-Ritr. _Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. _
Fireplace Ties or Type A Flue -Fireplace Throat
45.
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
46.
Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
47.
Garage Fire Protection Framing
(NOTE: Anentrymust be made each time youvisit jobsite)
=�...ti 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
COCTION NOTICE
/w s�� —�3
OWNER PERMIT NO_
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation( please contact this office immediately.
Inspec
Date .5r1--/4V4e—LS �—-
1�
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Orovi Ile — Phone: 534-4541
Skyway and Elliott Road, Paradise— Phone: 872-2961, Ext. 57
CORRECTION NOTICE
BUILDING OR PROPERTY ADDRESS
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, o.,rAneed
/additional explanation, 'please contact this office immediately.
Inspector//'G���i'�}', �— Date
--"�--<-1r CJ
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE
OROVILLE, CALIF. - 534-4541 ,
r
CERTIFICATE OF OCCUPANCY
This mobilehome has been installed in accordance with the requirements
of the California Administrative Code, Title 25, Chapter 5, under permit
nnmher .7G 7 g VC for the following location:
Owner's Address 0' r r
Mobilehome Mfg. A -I/.,- Model Feta � � �� Year �
Insignia No. =2 7 17 7 ZJ Serial No. N 11 ?7-- u � � •-
It is hereby certified for occupancy at the above described location and
may be occupied.
Director—of Public Works
Date -q.- 2 '�_�- S� gy {�'% /_
THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED
White - Owner, Yellow - Installer, Pink - D.P.W.
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE'
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
l �/�i'1 �7i1'tyt�e4 jri'nf7 !'ha �ti,d� �r �iwI/i+t?
Date_ ta, 2- -2—
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, Galifornia'95965 - Telephone 916/534-4541
APPLICAPON AND PERMIT
PERMIT tJO.
ASSESSO RCEL NUMBER
ZONING
BUILDING PERMIT
OWNER / �/
TELEPHONE
SO. FT. OCC. BUILDING VALU TON
OWNE 'S MAILING ADDRESS
CO RACTOR•S NAME
/ 's
TELEPHONE
z
'
CON ACT S MAILING ADDRESS
P1,6Fireplace
CONSTRUCTION LENDER
NKNOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
Al
04)
LICENSE No.
Plan Checking Fee
,$ 7,7 , V U
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$ S^
BUILDING ADDRESS
PLUMBING PERMIT
Filing Fee 10.00
J
Each Trap
2.00
Solar Water Heater
20.00
Water piping
5.00
LOT NO. SUBDIVISION NAME
PARCE MAP
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
5.00
USEOF ST UCTURE
SF [:JDuplex❑ Mobilehome Other
SPECIFY
Building sewer
5.00
Mobile Home 1SJGJWJ
10.00e
TYPE OF WORK
New❑ Additio Remodel[] tilities❑Installation �Other❑
Describe work' a/ • /t - /7 ,7,JV,6 _ EJ—
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service &Dov OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. ( DWELLING OCCUP.8
OR ADDNS. \ ACC. BLDGS.
2/20sgft
CONTRACTORS LICENSE LAW
I declare der penalty of perjury (Check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professi ns Code and my license is in full force and effect.
S®�.
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.U TI.OUTLET 2.50 ea
NON.RES'D BRANCH CIRC ITS.
NEWCONSTR ( POWER APPARATUS &'
NON -RESID. (SINGLE OUTLET CIR.
20®50a
Ex. Occup(ourLETs OR FIXTURES BAL930
Ex. OCCUp. OUTLETS FIXED P(RESID )LNS REA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring
15.00
Permit Fee $
Contractor
MECHANICAL PERMIT
FiIingFee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
n The permit is for $100.00 (valuation) or less.
I(Ta,00( 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, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
agains s d�County ' sequ nce of the granting of this permit.
%� ��� Date ����
Signature of Applicant —6�wonerg�r 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 $ U
TOTAL PERMIT FEE $ �r
occUP. GROUP
I TYPE OF CONST.
PARCEL
PD
HD Ssu
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTR F PUBLIC
BY
PEDe EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Receipt No._o/ cJ 6.r
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
MOBILEHOME SUPPORT DATA
If
other than single wide,
Mobilehome Mfr. (S�//p('�D
�,fn� S., furnish Setup Model No.
Year
1
Width.f L/ (ft.) Box Length _(ft.)
Tagalong or Expando
r
Size_ft. xft.
4
(SHOW SUPPORT DETAILS BELOW)
"
On all mobilehomes
manufactured after October
7, 1973, furnish manufacturer's installation
manual and structural
setup sheets (if riot on
file'with the County of Butte).
All center supports
measured from front of
mobilehome unless
otherwise specified'.
-
Footings (check one)
_.
Single'
f' '
.
1. Wood either
Xy
�..
pressure,treated or
foundation grade.
(ft.)(in:)
(in.) (in.)
2. Other.' (specify)
Center support
locations*
Center support.
footing sizes
Supporte:(check one)
(in.)
30
1: Concrete block:
(�
L—X�i
CPQ
2. Other. (specify)
(ft.)(in.)
(in.) (in.)
4—Tagalong or`Expando,;
show support details.
(ft.)(in.)
(in.) (in.)
i2., x 30
--
Typical Support
(in.) (in.)
Footing Size
(ft.)(in.)
(in.) (in.)
Max. Pier Spacing
(ft.)(in.)
�.
X
--'
Max. Overhang
(ft.Vin.)
(in.)` (in.)
(ft.)(in.)
BUTTE COUNTY
j; ,;..01
jWjo�%�EpARXE�N�B�
.,
PPR VE®
*If center piers are other than drawn above,,
Z_
_.draw,in.locations,
spacing,. and dimensions.
BUTTE COUNTY.DEPARTMENT OF PUBLIC WORKS
7 County Center Drive, Oroville, CA.
PHONE: 534-4541
MOBILEHOME INSTALLATION SHEET
7 '
1. Owner's name: �O1 /�cL'G1rIahP
2. Installer's name: �QIL4't n� cue, NQM e- -S:C 0-
3. Is the site currently under permit? Yet 297 No
( If yes, furnish permit number :2 2 ?� ) 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? ---------
100
Amps
7..
What
is the mobilehome site circuit
breaker rating? -------------
Amps
8.
Is there any other electric load to
be served by the mobilehome
siteservice?
---------------------------------------------------
Yes L No
/ /
(I£ yes, identify the load and
size: PUM P
(Load)
(Amps)
y h
9.
What
is the mobilehome site gas pipe size? ----------------------
10.
What
is the type of gas service? -----------------------------
Natural —X7 LPG
11.
What
is the gas pipe length from meter or tank to the mobilehome?
SIS
(ft.)
12.
What
is the mobilehome gas demand? --------------------
------
(5d, m0 O
(BTU)
(This information not required_i£
a length less
than 6 ft.
on natural gas
or less than 50 ft. on LPG.)
GURU1 Ac.E
SG, 000
coo
4q 000
(5q too
Itisp To VEPtF`f
a % b 2m
JCOUNTY OF BUTTE - DEPARTME,NT OF PUBLIC WORKS
7 County Center Drive - Oroville, California -95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
"IV -,
PERMIT NO. /
ASSESSOR PARCEL NUMBERG
4
X4
BUILDING PERMIT
OWNER f /
TELEPHONE
SO. FT. OCC. BUILDING VALUATIOU
OWNER MAIL��/�y1j' ADD ESS
/ �
CONTRACTOR'S NAME ELEPHONE
CO T ACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ tT
ENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
14�/Vc
LICENSE NO.
Plan Checking Fee
$ oo
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$ 0
BUILDING ADDRESS
PLUMBING PERMIT
Filing Fee 10.00
��
Each Trap
2.00
Solar Water Heater
20.00
t1� C
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❑ Mobilehome Other '
SPECIFY
Building sewer,Z
5.00
Mobile Home syJ
10.00 e
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities Installation❑ Other ❑
Describe work:
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V OR LESS
100 AMP OR LESS
10.00 aoo
Main service EA. ADD'L 100 AMP
2.50 ✓-Z>
NEW CONST. DWELLING OCCUP.&
OR ADDNS. ( ACC. BLDGS.
t
2hQSgIt
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business(OU20@50C
and Professions Code and my license is in full force and effect.
ense 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.RESID R BRANCH TLETCIRCUlrs 2.50 ea
NEw CONSTR. ( POWER APPARATUS &'1
NON-RESID. SINGLE OUTLET CIR. /
TS OR FIXTURES BAL®30
Ex. OccupFIXED
PR
Ex. Occup. OUTLETS (RESIO.)EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00 O
Misc. Wiring 15.00
C)
Permit Fee $ 5-0
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after.making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
FiIingFee 10.00
Heating
Cooling
Hood
3.00
Ventilation
permit Fee
$
Contractor
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 authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, osts, and expenses which may in any way accrue
again�saidCounty in con equence of the granting of this permit.
X Date T, I cz) 3
Signature of Appcant — Owner Controctor ❑ Agent ❑
An OSHA permit Is required for excavations over S'0" deep and demolition or construct-
ion of structure/s'Jover 3 stories in height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE $
OCcuP. GROUP
I TYPE OF CONST.
�r
1—
PARCE
P
HD
ssuE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECT OF PUBLIC
By
P IT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date%7 2.1 -f_J
/ ZS -9
Receipt No.yy ��7
WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT
FOR RESIDENTIAL- DEVELOPMENT
Section 26-8.1 of the Butte County Code requires this acknowledgement
be recorded prior to issuance of a building permit.
83-231,76 ,.
OFFICIAL RECi)k=
BUTTE COUNTY a JF
.? .C•OP,DS REQUF� 7<'
P R _ y�
property Sr.
H�
Thedescribed herein is adjacent to land or included JUL
within an area zoned for agricultural'purposes, purposes, and residents of ELEANOR M.
this property may be subject to inconveniences or discomfort arising CLERK - RECURDiR
from the use of agricultural chemicals, including, but not limited to herbicides, EE
pesticides, and fertilizers; and from the pursuit of agricultural operations including,
but not limited to cultivation, plowing, spraying, pruning, and harvesting which occa-
sionally generate dust, smoke, noise, and odor. Butte County has established, agricul-
tural zones which have as a priority use for productive agricultural purposes, and
residents within said zones and on adjacent property should be prepared to accept such
inconvenience or discomfort :From normal, necessary farm operations.
All that real property situate in the County of Butte, State of California,
described as follows:
of 71::,6fGRIDLEY COLONY NO. 5, according to the Official Map thereof, filed in
he office of the Recorder of the County of Butte, State of California, April 12,
906 in Book 5 of Maps, at page 23.
XCEPTING THEREFROM the following described parcel of land: Beginning at the
ortheast corner of said Lot 71, andrunning thence Southerly along the East line of
aid -Lot, a distance of 152.0 feet;,thence Westerly and parallel with the North
ire of said Lot, a distance of 123.0 feet; thence Northerly and parallel with the
ast line of said Lot, a distance of 152.0 feet; thence East along theNorth line
f said Lot, a distance of 123.0 feetto the point of beginning.
LSO EXCEPTING THEREFROM the following described parcel of land: Beginning at the
outhwest corner of said Lot 71, and running Bence North 208 feet along the West
ine of said Lot; thence East 105 feet, parallel to the South line of said Lot to
n iron pin; thence South 208 feet, parallel to said West line to a point in the
outh line of said Lot; thence West along said South line 105 feet to the point
f beginning.
Date: July 12, 1983
State of California )
) SS.
County of Butte )
OFFICIAL 3I1AL
WALTER D. SUMMERS
NOTARY PUBLIC . CALIFORNIA
PRINCIPAL OFFICE IN
a,,
BUTTE COUNTY
1AY COMMISSION EXPIRES OCTOBER 1, 1903
PROPERTY OWNERS:
On this the 12th day of July 10 19 83
before me, the undersigned Notary Public, personally
appeared Lois L. Macfarland -- proved to me on
the basis of satisfactory evidence
Aot==x mar to be the person(s) whose name(s) is
subscribed to the within instrument and acknowledged
that she executed the same for the purposes
therein contained. '
IN WITNESS WHEREOF, I hereunto set my hand and official
seal.
�'Jij5
Walter D. Su/mmer!Notary Public
024-- 1-0-077
Present A.P. N(1
rlane also known as
ois
L.
Mac f
Lois
L.
Fra3r
On this the 12th day of July 10 19 83
before me, the undersigned Notary Public, personally
appeared Lois L. Macfarland -- proved to me on
the basis of satisfactory evidence
Aot==x mar to be the person(s) whose name(s) is
subscribed to the within instrument and acknowledged
that she executed the same for the purposes
therein contained. '
IN WITNESS WHEREOF, I hereunto set my hand and official
seal.
�'Jij5
Walter D. Su/mmer!Notary Public
024-- 1-0-077
Present A.P. N(1
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THQ R[souRCit AQKXCY
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