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HomeMy WebLinkAbout024-130-0804 24-13-80 Lee F. Bell f. NIS Keith ve.,app.650'E.of River Ave.; Gridley P �1f70�. Permit A 570-77P,E(util.,MH) ELEC. GA S SUPP T T UCTURE REQ. yLp COMPACTION TEST REQ. ,p 4 L3/;V� W24 -8 �ontr: Sc midt 3� Permit #937-78mui Issued 24-13-80 CLIFFORD DALE FARMER 865 Keith Ave, Gridley r ' Permit #283-86P,E(util MH) eRVIP,n '(' ELEC okP# - U* -Lt, a�;4• GAS L -PG All 001A ' /0416 24-13-50 Lit#284-8613(MHF/existin ite) ed i st 1F 4-13-80 Contr: e�*r PErmit#3240-87B(new garage) ,24'-13-80 2558-90B FARMER', Dale 865 Keith Ave, Gridley, 7 9� (pumphouse),_ � 2 Permit#2'548-90E Y24-13-80 (elecoar —ga age) , 3.9 z Permit#2832-90P,E ---(MH 1on perm fndn) 024-130-080 93-3948.' FARiMER,* DALE & TERRY 865 KEITH AVE.,GRIDLEY / ELE SER CH/SF &SHOP / Z/pto /� 3 87) 024-130-080 CALIFORNIA BP041024 UNION PROPERTIE 865 KEITH AVE., GRIDLEY ELE SER CHANGE CA UNION PROP, 865 KEITH AVE, GRIDLEY CONT: OWNER OPEN DECK/COVERED PORCH CCII . y 009 -130 057 0<1 -R k,i I I MI h) LQA � G( -9!5I - t'h Pruc new Rom Ute, dyad t 024-130-080 06-1225 RODRIGUEZ, LAGRO 865 KEITH AVE, GRIDLEY Cont: FOUR SEASONS ROOFING RE ROOF r B08-1329 MISCELLANEOUS 024-130-080 Re -Roo REROOF GARAGE 8 SQ.'S COMP 865 KEITH AVE KILLOUGH, EVERETT LEROY i r 1 11, v ---" (\rte V BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION (IVR): (530) 538-4365 OFFICE: (530) 538-7541 FAX#: (530) 538-2140 ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds FOUR SEASONS ROOFING FOUR SEASONS ROOFING Building Garage RemdVAddn 11 COMMERCE CT. #1 • 11 COMMERCE CT. #1 CHICO, CA 95928 CHICO, CA 95928 Other Porch/Patio Total (530) 895-0418 (530) 895-0418 _ .. FEE. INFORMATION DBMSC Re -Roofing $119.00 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires FOUR SEASONS ROOFING 659073 / C39 / 11/30/2008 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. X 07/11/2008 Contractor's Signature Date WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ZI HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by �j Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; Carrier. State Fund Policy Number: 1850644 Exp. Date:07/01/2008 (This section need not be completed if the permitis for oneand reed dollars ($100) or less. 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 Workers' Compensation Laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. X �q( 07/11/2008 Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lenders Address City State Zip , 7 ota► Charged: $119.00 Fees Paid: $119.00 Balance Due: $0.00 Receipt No: B7958 OWNER/ BUILDER DECLARATION, I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500]; Please check one of the following: I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). ❑I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code: The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). ❑ I AM EXEMPT under Section B. & P.C. for this reason: 07/11/2008 Owners Signature Date I hereby certify that I have read this application and state that the above information is correct. I agree [ to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the property owner oa�; a o ed to act on the property owner's behalf.' /� 07/11/2008 Owner ❑ Contractor OR 0Agent for Owner gAgent for FILE COPY PROJECT. INFORMATION Site Address: 865 KEITH AVE Owner: Permit NO: B08-1329 APN: 024-130-080 KILLOUGH, EVERETT LEROY Permit type: MISCELLANEOUS 865 KEITH AVE Issued Date: 07/11/2008 By TMP Subtype: Re -Roof GRIDLEY, CA 95948 Expiration Date: 07/11/2009 Description: REROOF GARAGE 8 SQ.'S COMP, (530) 846-3525 Occupancy: Zoning:A10 FOUR SEASONS ROOFING FOUR SEASONS ROOFING Building Garage RemdVAddn 11 COMMERCE CT. #1 • 11 COMMERCE CT. #1 CHICO, CA 95928 CHICO, CA 95928 Other Porch/Patio Total (530) 895-0418 (530) 895-0418 _ .. FEE. INFORMATION DBMSC Re -Roofing $119.00 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires FOUR SEASONS ROOFING 659073 / C39 / 11/30/2008 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. X 07/11/2008 Contractor's Signature Date WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ZI HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by �j Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; Carrier. State Fund Policy Number: 1850644 Exp. Date:07/01/2008 (This section need not be completed if the permitis for oneand reed dollars ($100) or less. 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 Workers' Compensation Laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. X �q( 07/11/2008 Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lenders Address City State Zip , 7 ota► Charged: $119.00 Fees Paid: $119.00 Balance Due: $0.00 Receipt No: B7958 OWNER/ BUILDER DECLARATION, I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500]; Please check one of the following: I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). ❑I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code: The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). ❑ I AM EXEMPT under Section B. & P.C. for this reason: 07/11/2008 Owners Signature Date I hereby certify that I have read this application and state that the above information is correct. I agree [ to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the property owner oa�; a o ed to act on the property owner's behalf.' /� 07/11/2008 Owner ❑ Contractor OR 0Agent for Owner gAgent for FILE COPY BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION* OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds PLEASE PRINT CLEARLY PERMIT NO. BIN # "When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. OWNER INFORMATION Last Name K/GGOuG First Name L.EE d' CH�e/ Mailing Address �CoS KE�Trt p"�E City ` O State e Zip Phone $ _ 3 5 Fax E-mail APPLICANT SIGNATURE X PROJECT LOCATION API Property Address S KP (J City a U WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than licensed contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK. Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use onl : CONTRACTOR Name Fo,.,,e Address Cor►1vn.Q'vC2 �- SL_)_ City C t-1 IC -0 IC-0 State C A Zip I S4 Zz Phone �—C• Fax 89S—�2G/ E-mail E-mail Lic. # X45-9 U73 Class APPLICANT SIGNATURE X PROJECT LOCATION API Property Address S KP (J City a U WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than licensed contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK. Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use onl : ARCHITECT/ENGINEER Name /2Scy Address SRA City No State Zip Phone Fax E-mail State license Number APPLICANT SIGNATURE X PROJECT LOCATION API Property Address S KP (J City a U WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than licensed contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK. Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use onl : APPLICANT INFORMATION Name /2Scy Address SRA City No State Zip Phone Fax E-mail APPLICANT SIGNATURE X PROJECT LOCATION API Property Address S KP (J City a U WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than licensed contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK. Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use onl : Zoning FloodZonLType SRA Yes No Occ. nst. BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE M (530) 538-7541 PERMIT NO. BP061225 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 05/23/2006 APN: 024-130-080-000 the Business and Professions Code, and my license is in full force and effect. /c -g License Class : G 32 License Number: ,� /07 Site Address: 865 KEITH AVE GRI Date: Z3 Contractor.�Dv.! cook Map Index: I D@SCrtlOn: REROOF W/COMP 20 p OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: RODRIGUEZ LAGRO to its issuance, also requires the applicant for such permit to file a 865 KEITH AVE signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section GRIDLEY, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95948 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: FOUR SEASONS ROOFING owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, #11 COMMERCE COURT provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one SUITE #1 95928 year of completion, the owner -builder will have the burden of 530-895-0418 proving that he or she did not build or improve for the purpose of sale.). O I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: FOUR SEASONS ROOFING and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). #11 COMMERCE COURT O I am Exempt under Article 3 of the Business and Professions Code SUITE #1 95928 530-895-0418 Date: Owner: License M 659073 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: Cl I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. ZZI/I have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: r.Ct^ an Total Square Ft: 0 S. F. Policy #: I/ 75-19Z Valuation: $0.00 O 1 certify that in the performance of the work for which this permit is Census Code: issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: - - WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. Xe CONSTRUCTION LENDING AGENCY This permit is hereby issyed under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Name: Resolutions to d ndicate above for which fees have been paid. /l By: PERMIT EXPIRES Address: ON: Date ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage; handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health 8 Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official for r document of Butte County. I hereby authorize representatives of Buttej County to enter upon the above mentioned property for inspection purposes. Print Name: c k9o� �� 1 Gam- Signature: Dale: ❑ Owner ❑ Contractor ❑ Agent for Owner,t TAgent for Contractor B. C. Building Permit 01-16-04 pg 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name/1" ', 11U First Name1. L t e Address 6S t' City IG r j If State GA Zip of S9�/ Phone G �� _ . Z5� Fax E-mail CONTRACTOR Name S�sod. r-ey(',' Address C-00AWY Address City G(� , StateG Zip Phone �9 S _Oy ?S Fax E-mail Lic. #G o73 Class,,, APPLICANT INFORMATION ARCHITECT/ENGINEER Name Address Address CityC-G. % Gc� City Zip State Zip Phone Planner Fax E-mail State License Number APPLICANT INFORMATION Name � r Flood Zone Address I Yes I No CityC-G. % Gc� State C� Zip Phone O , q_D y Iif l O Fax E-mail Planner APPLICANT SIGNATURE X For office use only: Zoning Flood Zone SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT BP BIN # PR` OOJECT LOCATION\ r� AP# UQ �j, J v v U Property Address S City C Cross Street WORKER'S COMPENSATION Policy Number C Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Page 1 of 2 Description or Scope of Work: d cv?w g !1c >v� (� �v c- C 0'-'- Z.C7 S Sq T- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. R ed Amount: / / U Bldg SRA Re e� � Sheriff �L SMIP Dates a 3 Other Total REV 8-12-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Building Permit Application Without Required Clearances Form ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 CA BUTTE COUNTY PERMIT NO. DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION BP 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) , OFFICE #: (530) 538-7541 DATE: APN: -136 &) ZONING: AA WNER'S LAST NAME: OWNER'S FIRST NAME: PHONE: 1)-ro r,')C' (.A,,;0 14, �-30 'JSTREET ADDRESS:-/ bz F 30) CITY. ZIP: / E-MAIL: SITE ADDRESS: _ CITY, ZIP: c f-4C/a 9d -vie% NEAREST CROSS STREET: TRACT/LOT P APPLICANT NAME: � PHONE: (20)�' a _ 33/� STREET ADDRESS:/ c / FAX: LS 3 O 6 73 3 CITY, ZIP: E-MAIL: CONTRACTOR NAME: / / PHONE: STREET ADDRESS: ' FAX: CITY, ZIP: AIr a E-MAIL: LICENSE NUMBER: /JI LICENSE TYPE: n / ARCHITECT/ENGINEER NAME: f PHONE: STREET ADDRESS: / FAk CITY, ZIP: r/!/ LICENSE NUMBER: E-MAIL: DESCRIPTION OR SCOPE OF WORC: ❑ Stru ture Built without perp its ❑ Proposed Change of Occu fancy (note previous use) EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR REFUNDS Refunds can only be made upc4 written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan 't checked and other de artme costs are not refundable. For office use only: Notes: Application Received by: Date: Receipt number: e2 D Amount eceived: Master application 3-4-04 M TO: Buildat—j'Department FROM: Environmental Health SUBJECT: Sanitation Clearance Com(,, c bus Owner Location Plan Approved for: Sewage Disposal VVNer Supply:,w �Pu Clearance for dwelling. Other Hold final for: Final clearance O.K. for: NOTE: E.H: 8E ONLY Plot Plan AttecMd Flooa Plan At4nchad San% to B.D. ! 13 1) --zr-U AP# li Private Wel l 1�5 Environmental Health Specialist Date 8/96 , YY ' . `.. �.� -.. „� n... "r �. ti.-*h....rt-T..y. . �.... "Lim• ""� . 1' . -ri - o..�+.. _ _ �.'. „N........ �`.`ry �,.--r^. `�• .� COUNTY OF BUTTE -DEPARTMENT OF_ DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center -Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: ASSESSOR PARCEL NUMBER Proposed Building Use: Counter Technician: Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. . ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and.signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs V❑❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner 14. Hazardous Material Form 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. ❑ 16. Other r Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) �0 17. Fire Sprinklers............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ......., ❑ 20. Erosion Control Plan Required........................................................................ ........ ❑ 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 22. City of Chico Plumbing permit....................................................................... a, ❑ 23. California Department of Forestry plan approval ❑ paid. Sent by: ............. °. ❑ 24. Planning approval (A) Use: (B)Parking: (C) Parcel Check: ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... ❑ 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Pre -Inspection for required....... r _ _ ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... "W'' ❑ 31. Owner -Builder Verification.(_ Given to owner, _Mailed to owner) .:................... 32. Letter of Signature authorization .................................. ....:......,............ ...,...... ❑ 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ' ❑ 34. Manufactured home utility clearance............................................................... ❑ '35. Existing violations and/or expired permits......................................................... ❑ 36.' Deed Restriction......................................................................................... ❑ / 37. ❑ Grant d, ❑ M.H. Ti /St tement f Fact rtter fro Legal Owner, ❑ Check to H.C.D $ Lof 38. Other:_ (1�.�1 / f-;511 wt� 6 � de COVer rnob1 lehorne. ❑ 39. Other: When issued Telephone and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: Date: 1. Index permit application for the ove ite s numbere : Plan Check Letter 2. Additional items required Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, adv' d of the above dat b� y q phone, ❑ mail, ❑ counter r Date: Plans reviewed by: "' Date:_(�L D Plans approved by: i - Date Structural reviewed by: Date: Structural approved by: Date: Note transfer by: 1 - .t Date: Yellow: Building Division Building Permit Number: D`7 —1/5-/ Owner Name: (tr;ov) Proper4�t-4' Residential Construction Requirements IMPORTANT This set of plans and specifications MUST be kept on the job site at all times and it is unlawful to make any changes or alterations on same without written permission from the Building Division, County of Butte. All materials and workmanship shall be in accordance with recognized good practices and of a quality prescribed for the specific use in the 2001 California Building Code (2001 U.B.C), 2000 California Plumbing Code ( 2000 U.P.C.), 2000 California Mechanical Code (2000 U.M.C.) and the 1999 California Electrical Code (1999 N.E.C.) ' COMPLY WITH ITEMS CHECKED BELOW Your parcel lies within a designated 100 -year flood plain. Finish floor, electrical, H.V.A.C. equipment and services shall be a minimum of one foot above the elevation shown on the attached Flood Elevation Certificate. A Post Flood Elevation Certificate will also be required l ' Note: We will normally accept the following as compliance with the flood elevation requirements: 1. Building is anchored to concrete stemwall system with conventional anchor bolts. 2. Building plate on top of stemwall to be one foot or more above the 100 -year flood elevation. (Plate height less than 24" above grade, or engineered design required). 3. Electrical, heating, ventilation, plumbing and air conditioning equipment and facilities located above the plate. 4. At least 2 openings in exterior walls, located on opposite or adjacent walls with a total net area of not less than 1 square inch for every square foot of enclosed area. 5. The bottom of the openings shall be no higher than 1 foot above grade. 6. The openings may be screened or covered with other devices that will permit automatic,entry and exit of floodwater. Page 2of 2 Building Permit Number: Owner Name: Cal) f UIrl I on AT e��� Parcel lies within the State Responsibility Area (SRA). Comply with attached requirements. Fire sprinklers are required in this structure. The followinp- parcel map requirements shall be met: _ All structures and ,e ui ment including overhangs shall be clear of all easements. A setback of (3A eAeom the side ander M -feet om the rear property lines and 20 feet (25 feet if Federal Aid Route) from the edge of the right of way shall be clear of structures and equipment except for a 2 foot overhang. Expansive soil may be encountered on this site. This condition may require the foundation to be designed by a California registered engineer or licensed architect. Y_ dp ©' 11 � d cL- t i a n ZI Y_ dp ©' 11 � d cL- t Q' s r- h � 19 '� 1� _ 3- 0 c' T r' CIO m ri l) _ 3- a�F 0 r' a�F 6' TYP.4'xro" 1._ .16 PLYWOOD Cr, EXT. ' to _ _ -1 _ j!� m F76 Z MO. CLIP L__j • 2' x 12" STAIR STRU16ER. 48•e.c.. MAX. 12'xl2'PITS "TDP VIEW • ion VF YI!' lti.e. otl1'1�� ...�-- HAl,IDQAIL NOT 5NOW14 •FDR URRITY. Z4'1#VDF*2•• ,Zoll V DECKING lka) 3/1 BOLT ' S bac eci :50 4hcL+ a- GIRDERS _ s y' ( Srhere. Ca rt n� 1'/s' TSG PLYWOOD CC EXT: Indoa/YJ 41) ro -, j MOBILE NDME OR DEE. C.I� MTL. FRIN — — I MAX. CLIP (ER. DE 9'MIN. v TOW ' 4'x4' POST 2 >< 12 to E Zlk4" PRESSURE' z �TUARD[�AIL� Q c� "S�v%�- "21]F... rRr11t£[� 00t �44r /� �' o f ��� a"MIN• 13QLTS REDWOOD' /.AT E DECKIWG' G DER e0 : "mitt.. ' LU PRECAST 4x4" POST Bc ER ADL�'4U4TE DIACONAL /0-30-Gy 3 I� BRACING. TYPICAL RFSlDE'AM1,4I__ SrAPS A^'o/QD�C� • • G. , ' ` •, BOUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS MIN. FoorrNG 7 County Center Drive — Orovllle. California 95965 Telephone: BUTTE COUNTY DEPARTMENT OF DFVELOPMENT SERVICES BUILAG PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP041024 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 05/03/2004 APN • 024-130-080-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 865 KEITH AVE GRI Date: Contractor: Map Index: - Description: NEW ELECTRIC METER Descr OWNER43UILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the p Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a CALIFORNIA UNION PROERTIES LLC permit to construct, alter, improve, demolish, or repair any structure, prior Owner: to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of 1562 TULLY RD, STE A the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or MODESTO, CA she is exempt therefrom and the basis for the alleged exemption. Any 95350 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): 530-848-3400 530-668-8679 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does pp CALIFORNIA UNION PROERTIES LLC Applicant: such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: O I am Exempt under Article 3 B and Professions Code iess Date Owner: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for License #: workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of Architect: the work for which this permit is issued. My workers' compensation Engineer: insurance carrier and policy number are: Carrier: Total Square Ft: 0 S. F. Policy #: I certify that in the performance of the work for which this permit is Valuation: $0.00 issued, I shall not employ any person in .any manner so as to become subject to the workers' compensation laws of California, Census Code: and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor interests -3 5q 1 (p -- 4/13/04 - code, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code anrvor I hereby affirm that there is a construction lending agency for the Resolutio s to do work indicated above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.)— "'-' 5 • 3 4 Name: By Date: • PERMIT EXPIRES ON: S ' e) • S Date Address: O 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. O Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance ofan��yyy---o�official form or document of Butte County. I hereby authorize representatives of ButteCounty to enter upon the above mentioned property for inspection 7!10 L "1 Print Name: r , . e! o Signature: Date: ❑ Owner 0 Contractor r0kAgent for Owner ❑ Agent for Contractor . .+.+,+...v�+t.+.r �.:�...-_.may"n.1.�S.r 1-."��.a �: i.'.fL'�'R.^moi "'•XSv �--cv .. , v+'y.., r.Y �1lrV 4-.i'�-r,Yr's�TO.-��t'"�'a"i�a .r�'.' ,7r�'Ll�' ��+1',� - �. ,Y ,.. , COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, tCaA 9565 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: C ASSESSOR PARCEL NUMBER " (� Proposed Building Use: C Counter Technician:�ordera Date: 1 �' Items required in order to apply for a permit. All boxes MUST be checked OR marked NA i ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for'truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ❑ 14. Hazardous Material Form ❑ 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. ❑ 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ p 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ❑ 20. Erosion Control Plan Required........................................................................ ........ ❑ 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 22. City of Chico Plumbing permit........................................................................ ❑ 23. California Department of Forestry plan approval ❑ paid. Sent by: ............. ❑ 24. Planning approval (A) Use: (B)Parking: (C) Parcel Check: ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... ❑ 26. NPDES Form........................................................... ........ .............. ......... ❑ 27. Encroachment Permit f. div ayfr�m�the,Pu lic Works Dept ........................... 28. Pre -Inspection for M (..t Y �" required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... ❑ 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ 32. Letter of Signature authorization......................................:............................. ❑ 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 34. Manufactured home utility clearance............................................................... ❑ -35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction......................................................................................... ❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ❑ 39. Other: When issued Telephone 1 X all' --A" d 'old for Plc up.� '1 I have been informed -of n f the above items and requirements for obtaining auilding permit. Applicant: r �I _=l� Date: 1. Index permit application for the above items numbered: Plan Check Letter / 2. Additional items required Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: Date Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division M41 (Ccs,, tre� O.B.— I 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. GII personally plan to provide the�najor labor and materials for construction of the proposed propertyimprovement:YESNO E3I HAVE 0 HAVE NOT �gned an application for a building permit for the proposed work I have contracted with the following person (firm) to provide the proposed construction: NAME: ` . M11 ADDRESS: PHONE: CONTRACTOR'S LICENSE NO. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: ADDRESS: may; PHONE:. CONTRACT'OR'S LICENSE NO. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME PROPLRTYO ADDRESS PHONE TYPE OF FORK This Owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. • OWNER BUILDER INFORMATION Dear Property Owner: OB. -I An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible party ofrecord on such a permit Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yotnself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply - If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $300 or more for the � entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to seveial obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contrUnrti.ons. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. For more specific information about your obligations wader Federal Law, contraet the Internal Revenue Service (and, if You wish, the U.S. Small Business Administration). For more specific information about your. obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their conditions. work personally or through their own employees, without a licensed contractor or subcontractor, only under limited A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building Permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner guilder• Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. rely, Mic 1 C. Vi ira, CB.O. M er, Building Inspection NOTE. This Owner Builder Information is required by Section .19830 of the California Health acrd Safety Code t LAS •,�� 9 OVER 05/02/2003. 07:44 5306688679 KEN SWANGER PAGE 01 CALIFORNIA UNION PROPERTIES, LLC 1562 Tully Rd.StrIF. A, Modesto, CA 95350 Tuesday, April 13, 2004 To ~ it may concem; 1r,his letter is to serve as aufhorizadan for PG & E and Butte County for Lee Kiilougt to do what necessary on our behalf to get any/all inspections done in order to get the power or at M KEITH AVE. GRIDLEY, CA. Thank you, If any questions please call me at 530-848-3400 Sincerely, 7 Ken Swanger, pi rtner RECORDING REQUESTED BY: Fidelity National Title Company Escrow No. 3030965 -DO Title Order No. 03-407927 When Recorded Mail Document and Tax Statement To: Mr. & Mrs. Everett Leroy Killough 2561 California Park Dr. Apt # 216 Chico, CA 95928 204—��368 1 S Recorded Official Records County E f CANDACE J. GRUBBS Recorder ROSEMARY DICKSON Assistant 09:00AM 18 -Jun -2004 REC FEE 10.00 TAX 203.50 Shauna Page 1 of 2 APIC-05a--23U--19W GRANT DEED SPACE ABOVE THIS LINE FOR RECORDER'S USE The undersigned grantor(s) declare(s) Documentary transfer tax is $ 203.50 [ X ) computed on full value of property conveyed, or [ I computed on full value less value of liens or encumbrances remaining at time of sale, [ X ) Unincorporated Area City of FOR A VALUABLE CONSIDERATION, receipt of which Is hereby acknowledged, California Union Properties, a Limited Liability Company hereby GRANT(S) to Everett Leroy Killough and Cheri Ann Killough, Husband and Wife, as Joint Tenants the following described real property in the County of Butte, State of California: Se+e- 0V��2 c� DATED: June 16, 2004 STATE OF CALIFORNIA COUNTY OF STANISLAUS ON June 16, 2004 before me, Diane M. O'Brien - no�tc:vj personally appeared John A. Mvrtakis ******* *********** personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument, Witness my n and o Signature. ignaturefficial seal. ' Calif,No operties, a LLC By: John A. Myrtakis, Member DIANE M. O'BRIEN COMM. #1291478 k . a NOTARY PUBLIC -CALIFORNIA n 2 STANISLAUS COUNTY ' N My Comm. Expires Jan. 28, 2005 MAIL TAX STATEMENTS AS DIRECTED ABOVE FD -213 (Rev 7/96) GRANT DEED Title No. 03-407927 ® Locate No. CAFNT0958-0958-0051-0000407927 LEGAL DESCRIPTION EXHIBIT "A" THE LAND REFERRED TO HEREIN BELOW IS SITUATED IN THE UNINCORPORATED AREA, COUNTY OF BUTTE, STATE OF CALIFORNIA AND IS DESCRIBED AS FOLLOWS: A portion of Lot 30, as shown on that certain Map entitled, "Map of Gridley Colony No. 5, near Gridley, Butte Co., Calif.", filed in the Office of the County Recorder of Butte County, California, on April 12, 1906, in Book 5 of Maps, at Page(s) 23, more particularly described as follows: COMMENCING at the Southwest corner of said Lot; thence North 1013' East, 387.20 feet along the West line of said Lot to an iron pipe; thence North 89013' East, 112.50 feet to an iron pipe; thence South 1013' West, 387.20 feet to a point on the South line of Said Lot; thence South 89013' West, 112.50 feet along said South line to the point of beginning. APN: 024130-080 CLTA Preliminary Report Forth (1/1/95) i PRE -INSPECTION REPORT OWNER: ' V ��D ��t�/ DATE: + l b =�t`t7�� A.P. #0>91f - LOCATION: CONTRACTOR: U `lrr oQ i ZONING: REASON FOR PRE -INSPECTION DATE TO INSPECTOR: PERMIT HISTORY (• •) NONE SEE ATTACHED i BUILDING INSPECTOR'S REPORT Building Description: Commercial/Usage: r Residential # of Units:Mobile home # of Units: Currently Occupied ( ) Yes ('' Abandoned/Vacant: Electric: Electric Currently ( ) On Condition of Electric Gas: _ Currently ( ) On ( ) off,— Condition ff"Condition Sanitation: Plumbing Working ( ) Yes ( � -- --- .- Obvious Sewage Problems ( ) Yes (e,�<o i ACTION RECOMMENDED: ISSUE ) Yes (� Hold for permits or verify: /�'` ,SL. 4/�IQJ/i%� 1 I -✓L- u, flrios t- *9 zZm4-7" C� l 7 �" ��'lrrvat'�l 7 S4 19&7W olf Inspector: �- Date: r • ► DOCS . _,.- 4 � 7S �!J BUTTE COUNTY PERMIT NO. DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION BP 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 o* f' ,'"' DATE: (� O APN: )^ O ZONING: OWNER'S LAST NIAME.k OWNER'S FIRST NAME: PHONE STREET ADDRESS: _11w1S� FAX -� S ao �t CITY,7. L 9 S 3s"b E-MAIL: SITE ADDRESS: LS CITY, ZIP: CG ];_,�Li9/ NEAREST CROSS STREET: TRACT/LOT P. APPLICANT NAME: PONE: 5�323-11 STREET ADDRESS: F ' oi"6-7 3 CITY, ZIP: C - qs 7-19 E-MAIL: CONTRACTOR NAME: PONE: STREET ADDRESS / 'FAX- AX/ CITY, ZIP: ll E-MAIL: LICENSE NUMBER LICENSE TYPE: ARCHITECT/ENGINEER NAME: PHONE: STREET ADDRESS: FAX: CITY, ZIP: LICENSE NUMBER: E-MAIL: DESCRIPTION OR SCOPE OF WORK: c—) ❑ Structure Built without permits ❑ Proposed Change of Occupancy (note previous use) EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. For office use only: Notes: Application Received by: Date Receipt number: Amount eceived: I Master application 3-4-04 24-13-80 Lee F. Bell ,. NIS KeitA570-7/ ve.,app.650'E.of River Aven.; Gridley�Permit7P, (til.,MH)# ELEC. -9//,Z- 1 -10 GAS SUPPORT STRUCTURE REQ. Tui COMPACTION TEST REQ. •-yLp 24- 3-80,,� ontr : Sc mi.dt iso Permit #937-78MIJI Issued 24-13-80 CLIFFORD DALE FARMER Fi 865 Keith Ave, Gridley �r 11/�©% Permit #283-86P,E(uti_l�j MH) ex si a °� 0-ELEC � # bdf..Z '-aC f GAS f..F & Wk/ /d ' Permits#284-8-5B(MHI/existin50 Issued F.. 3/IM47 �t /F 4-y13-80 Contr: PErmit#3240-87B(new garage) /—/3 _ItF, 24-13-80 - — FARMER, Dale 865 Keith Ave, Gridley (pumphouse) --------------- Permit#2548-90E (elec o ga age) 2558-90B 24-13-80 -/3-g2-, a8a 4 -13-80 Permit#2832-90P,E (MH on perm fndn) 024-130-080 93-39948 FARMER,: DALE & TERRY 865 KEITH AVE., ELE SER CH/SF GRIDLEY I •l`�' & SHOP 2 �dt0 A a8a COUNTY OF BUTTE BUILDING DIVISION bEPARTMENT OF DEVELOPMENT SERVICES' 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE yOWNER v l/l ' `IIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP042650 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 09/09/2004 APN• 024-130-080-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 865 KEITH AVE GRI Date: Contractor: Map Index: Description: new propane line and tank OWNER43UILDER DECLARATION I hereby affirm under penalty of perjury that I. am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: KILLOUGH LEE AND CHERT permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 865 KEITH AVE signed statement that he or she is licensed pursuant to the provisions of GRIDLEY, CA the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 95948 she is exempt therefrom and the basis for the alleged exemption. Any 530-846-3525 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the properly, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: KILLOUGH, LEE AND CHERI Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor: RELIANCE PROPANE not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law:). r 6426 SKYWAY ❑ I am Exempt under Article 3 o s' ss and Professions Code PARADISE, CA 95969 530-872-9200 x206 ��.. Date: Oct Owner: - License: 7343-- i �= WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of p;96ury one of the following declarations: O I have and will maintains certificate of consent to self -insure for ` OFFICE COPY workers' compensation, as;•.provided for by.;Section 3700 of the Labor Code, for the performance of the work' for which this permit Architect: Address is issued. Engineer: ❑ I have and will maintain workers' compensation insurance, as —:� required by Section 3700 the Labor Code, for the performance ofGAS the work for which this permit is issued. My workers' compensation Meter B I y insurance carrier and policy number are: D� ELECTRIC Carrier Total Square Ft: Meter By Date _ Policy #: Valuation: Census Code: 7 ( Ot 1 certify that in the performance of the work for which this permit is 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, _ Vissued, , ( /5 and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: `7 L Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of i compensation, damages as provided for in Section 3706 of, the Labor c`od`e; interest, and altomey s fees. -i` CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code anrvor I hereby affirm that there is a construction lending agency for the of the work for which this is issued (Sec 3097 Civ.) Resolutions to do o in icated-a ove for which fees have been paid. performance permit By: Name: Date: EXPIRES Address: PERMIT ON: (Date) O I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. O Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. O Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any-oifi I form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection pu ass's Print Name: I Signature:. L Date: Cl -�l - O L/ Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor BUTTE COUNTY r- 1 DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAM (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP042650 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 09/09/2004 APN• 024-130-080-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 865 KEITH AVE GRI Date: Contractor. Ma p Index: Description: new propane line and tank OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: KILLOUGH LEE AND CHERT permit to construct, alter, improve, demolish, or repair any structure, prior , to its issuance, also requires the applicant for such permit to file a 865 KEITH AVE signed statement that he or she is licensed pursuant to the provisions of GRIDLEY, CA the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 95948 she is exempt therefrom and the basis for the alleged exemption. Any 530-846-3525 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: KILLOUGH, LEE AND CHERI Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor: RELIANCE PROPANE not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 6426 SKYWAY ❑ lam Exempt under Article 3o s' ss and Professions Code PARADISE, CA 95969 Owner: 530-872-9200 X206 Date: _LL�Z License #: 734318 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. Engineer: ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 0 S.F. Pony #: Valuation: $0.00 Census Code: 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 workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: - `7 Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages s provided for in Section 3706 of the Labor code, interest, and attorneyfees. _ I CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Coda anry r affirm I hereby arm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Resolutions to do o I in icated"a ove for which fees have been paid./^��q Q Name: BY Date: 1 , Address: PERMIT EXPIRES ON: Date ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of an"IfliI forth or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection pu s Print Name:� ' � Signature: �-� ^ Date: —CI — O �J I Owner 13 Contractor ❑ Agent for Owner 13 Agent for Contractor RESIDENTIAL 24-13-80 2832-90B,p,E _-- FARMER, Dale 865 Keith Ave, Gridley (MH on perm fndn) 11l v Gc��r�W ot") ;k V �y2 7� . Y v 4 JOB FINALE • Signature J=OK O = Not OK -=Not Applicable Not Ready MOBILE HOMES' - ` MISCELLANEOUS = Date MOBILE HOME UTILITIES (Plans) OK except #'E 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -fall -C/O Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap: / /" L" ft. / /"Nat. or/ /" L"ft./ /"LPG 7. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 10. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Coonectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmq; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 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 -Panel boards -Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 *J=OK O = Not OK = Not Applicable Not Ready RESIDENTIAL,(; ' = Date U DERFLOOR Plans OK except #'s 1. oning-Setbacks-Easements-Flood-Slope Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth f♦/5 Stemwalls, Main; Steel -Bloc kouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. Gas Pipe; Size -Anchors 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Insulation Date - Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 16. Water Htr.; Vent -Access -Combustion Air -Baffle 17. Water Pipe; Test & Anchor -Nail Protection 18. D.W.V.; Test -Fittings & Anchor -Nail Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection 23. Elec. Receptacles Spacing -Lights & Switches at Doors 24. Size Boxes & No. of Conductors -Stapled 25. Romex Installed Close to Edge of Studs & C.J. 26. Equip. Ground made up w/Mech. Fastners-Bond Gas & Water 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or AI. Insulated Neutral ❑ Yes ❑ No 30. Service -Riser Conductors & Ground -Main Disconnect 31. Equip. Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 34. A.C. Ducts Insulation & Support 35. Vent Fan; Exhaust above insulation 36. Condensate Drain & Overflow; Size & Grade 37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet 38. Attic Access & Platform if Furnance in Attic Date Card B-1 Date Card B -1 - Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except #'s 39. Sils, Proper Material & Anchors 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound 41. Bearing Walls over Girders & Floor Nailing 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Headers & Beam -Size & Bearing ►Ingle &- Duptex) Date FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Ring. 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing 51. Property Line Firewall & Openings 52. Ext. Doors -One T -Check Garage -3rd Story, 2 Exits 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers 55. Siding -Nailing Veneer 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 57. Glazing Area -Glass Protection -Skylights -Plastic 58. Shear Walls; Nailing -Bolts 59. Insulation -Walls -Ceilings 60. Infiltration -Walls -Windows r Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & Subpanel; Breaker Sizes & Labels 67. Stairs & Rails 68. Fireplace or Stove; Clearances -Hearth 69. Elec. Outlets at Wood Panel; Int. & Ext. 70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 71. Elec. Outlets & Receptacles at Kit. Counter 72. Garage Fire Door; Swing -Landing -Closer 73. A.C. Duct in Garage -Damper 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage; Above Floor-Mech. Protection 75. Plb., Elec. & Mech. Equip. Listed for Location 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection 77. Insulation -Foam -Looked in Attic ❑ Yes 78. Guard Rails & Deck Construction -Post Caps 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No 81. Stucco; Brown -Finish 82. A.C. Unit; Disconnect, Electrical, Plumbing 83. Vents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to Openings 84. Water Well; Disconnect, Electrical, Plumbing 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 86. Ventilation Throughout House 87. Glass Protection 88. Corrections from Previous Inspections 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: (NOTE: An entry must be made each time you visit job site) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 Ccunty,Ceriter Drive - Oroville, CaliforrCia 95965 - Telephone: 916/538-7541 APPLICATION Aft PERMIT PERMIT NO. 4no Z—qt ASSESSQR PARCEL NUMBER - ' ZONING BUILDING PERMIT ow R Dale Farmer 846- TELP ONE 504 SQ. FT. OCC. BUILDING VALUATION 1608 64320. OWNER'S MAILING ADDRESS 865 Keith Ave, Gridley 95948 CONTRACTOR'S NAME Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee ,$ 1Q,QQ LENDER'S MAILING ADDRESS Permit Fee $ 164.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee _ $ 82.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 865 Keith Ave Gridley Permit fee $ 246.00 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 5.00 Each qas 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 I S I G JW I OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[ Other ❑ Describe work: MHT an porn fdtn _ Existing mobile burned — has been removed !!ETYPE Permit Fee $ 20.00 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 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 CONST. DWELLING OCCUP.g A l 2�xQsgft NEW CONSTR. ULTBI.OUTLET NON•RESID BRANCH CIRC IT$ 2.50 ea POWER APPARATUS 9 ( SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20@SOC BAL®30 FIXED Ex. Occup. OUTLETS PIRESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. byirin 9 15.00 Permit Fee $ 22.50 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 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. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating. Cooling g 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 t said County consequence of the granting of this permit. VDate 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 $ Energy Inspection Fee $ + occ CONST TYPE A TOTAL FEE $ E 288.50 HAZ cuA PARK F PAR PD H Th's permit is nereby issued under Bions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC BYS�/�Date PER T EXPIRES Date— the applicable provi- resolutions to do have been paid. WORKS (! ZZ—P� 9�Z=�" L/ Receipt No. 7 WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT 77 COUNTY OF BUTTE -, DEPARTMENT OF :PUBLIC WORKS - BUILDING DIVISION ' 7 COUNTY CEN R''DR E' - OROV¢LLEXj� OF R8t11�4 5 65 -TELEPHONE: 916/538-7541 t . 3,0 + - . ,- I :.PERMIT APPLICATION DATA SHEET - -' Permit No. n OWNER 013CL rAMLZ r , a A. P. No. _ Proposed Building Use jii UYI 04M. tLid- Building Inspector 1AQ 24- /3- 9 0 Date 8 / `f- - 96 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 . . Ok 4. Complete engineered plans and caics, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .............................................. C 13. C, I e 0 L k� chool District fees paid .............. 14. Sanitation approval from �O Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required ... Pre-Inspec. request to Building Inspector 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans'Compensation Insurance .................. Ot 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) 0_ 4. Recorded copy of Agricultural Acknowledgment Statement 5. Letter of signature authorization ................................... J Telephone Other Ok�2�.r< ��'1(!/Y�� G &Cf 't A ��' � . (Ac*plicant .QJ�J1.C- � Date 8 /4 QCT Copy of Haz-Mat Torm sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By 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: rFfY, process as follows: MaiI to owner. Mail to contractor. -0504- and hold for pickup at _YOoffice. Deliver w/inspector. Contractor, designer, owner, was advised of above required data by_phone---jnail—counter by .date Contractor, designer, owner, was advised of above required data by_phone_mallounter by date Plans checked by Copy—DPW Date Pj(ans approved by Sets of plans on hold in ' File cabinet VAP folder Date °} TO Buildinv Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner �� t� n Plan Approved for: Sewaqe Disposaly Water Supply Hold final for: Final clearance O.K. for: Clearance forbedroom mobile home. Other u�* Sanitarian Water Supply Water Supply COUNTY O BUTTF = Depattment'.of Public Works 7 County,Center Drive, Oroville, CA 95965 Phone: 916-538-751E]. 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) 2. I (have/have not) h2ye_ signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construcEi.on: Name Address ._ laity Phone Contractors License No. 4. .I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major tonrk Name _ Address City Phone Coftt.ractors License No. 5. I will provide some of the worfc but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed: - Property Owner ji:h - Social Security Number Date 91/4 ICU). NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA PHONE: 538-7541 MOBILEHONE INSTALLATION SHEET 1. Owner's Name: 2. Installer's Name:�F� 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 plot plans.) 4. Will the mobilehome be located at least 5 ft. awa. ?iom tic tank and leach septic fields and clear of all setbacks and easements?c.� Yes No o (If no, clarify 5. What is the mobilehome electrical rating? --------------- 0 Amps 6. What is the mobileho-Se site service rating? ------------- C _ 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), 0 (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? ------- -------------------------------------- 00 �e 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:) 26 O :,::: /Ty J oPT. _. �:..:_:-._-,__;_?.._?..;_s_;_:_ may. -U7/1/7 �- a i OO',116,4DO . - + 3 i I ROMAN «r. tiI TUB...... ------------ Q I ?-?- i I O • f_• _I..s=s_ i WALK -/N C(OSET M,4STER BEDROOM 121- l o"X/ 4'-2" 60'-0" -------1 00 BAR ,DINING .iJJ_.LLLLL..LLi. W_LLt.LL;. JJ � Lei ARER .IJP° ' ' ! L I `LLQ �a .� LL.. KITCHENH T _ I �L I I �i ,„t, LT L / V I NG ROOM OPT. RECESSED ENTRY I r MODEL 4603D 3 BEDROOMS, 2 BATHS APPROX.116W SO. FT. c/n ,3EDROOM 0 l 0'- l 0 X l 0'-4" ,DEN 121- /0"X/ 9'-0" TEN OPT SUN ..ROOM. s, 1 OPT. WDW. ; B6DR00M l 0'- l 0'X 10'-,3 fr OPT. FRONT WINDOWS *ASK ABOUT OUR OPTIONAL 6' FRONT PORCH ua SMDiM4''OOD BY FLEETWCX�D. =: �;: r SW/17/JAN90 '.DEN OPT. SUN AdLAk ..ROOM F-7-71 qW OPT. ' 1 OPT. O O'HEAD -- $ ------ O i O ql L /NEN__T 1-7_n,:_T.-t^-::._ • _- J �i.aJ_LL' Ll DINING 1. wDw. BUT/L /TY . OLAR 7'OP7. LL L L.L AREA Li -J._ _. 1 t~ SNKDEN aL.-i__y12'-10'X19'-0" OPT.KlTCHN IjI `,. _ 3 i ROMAN -i i 7 B Lsj.r:zl2�._:. IIi -----------, WAK-/ _ ZC OPT. CLOSEWDW. LI'mec 0 ------------- 26 -8' ------------26-8' -----------7,I i; [-o C/NE MASTER BEDROOM L / V/ NG ROOM BEDROOM 0Iff t3EDR00M . . l2'-l0'X/4'-2" l2' -10'X18'-4" l0' -10'X10'-4" h l0'-l0'X1O'-3" b` OPT. RECESSED ENTRY D tr OPT.. FRONT EN7RA1VCL6 WINDOWS *ASK ABOUT OUR OPTIONAL 6' FRONT PORCH MODEL 4603D �, t'z• 3 BEDROOMS, 2 BATHS sANDAi,,LVOOD APPROX. 1690 SO. FT. BY FLEETWOOD. SW/17/JAN90 j � ani �•I_ fly '��* �++..F"...'+'"^'�a}v.�w,.•�ri7.�wis'lr"`�'a3ds_h'=i+•.�ysr•.�;n..r�.a,:F7i`i1�°y}'��'�"?r.hi'F•�v+w'-�+'ti �"�"�'..ti"���""-�,:� , s�_�^�''+.�'1"'.�'r"''i''r��^''M •';^.4 {,� Y��. • 4 i/ BUTTE COUNTY SCHOlb�S DEVELOPMENT FEE CERTIFICATION FORM ,%One"Form per Building) 'A.P. Number o17- 13 �a Building Department No. School District AT -P161 City E] County [= Jurisdiction Property Owner Ae/-z l . "AAS Z.., Project Location/Address Subdivision Lot Number Residential Development: # of Living MHI �u�� Units &e '" Commercial I dustria New a El Sq.. Footage/000 Addition (Group R) Sq. Footage Addition (Including Exterior Roofed Areas) Building Department Representative Date ******************************************************************* (Floor Plans reviewed by School District Personnel) t - District Id No. V (App cant Name) aCz� Street Address) School District certifies that N/, - DSo3/ (Phone Number) (Ci ) (State) (Zip Code) has complied with the requirements of Resolution No. n- ki & by the ayme of $ representing square feet. Sch 1 District Representative Date PAID BY CHECK NO. BANK NO PAID BY CASH white -applicant, yellow -building department, pink -school district SCHOOL.FEE (8/88) i ANO WHEN RECORDED MAIL T0: taWE COUNTY OF BUTTE STREET Dept. of Public Works ADDRESS 7 County Center Drive CITY, Oroville, CA 95965 STATE, ,.d a .9..o 4..so7 (77, 1 90-041607 Total .00 Recorded 1. Official Records. County of + Butte Candace J. Grubbs 0 1 Recorder JJ 1 i I 2:25pm 27 -Sep -90 ABOVE THIS LRE FI NOTICE OF MANUFACTURED HOME, (MOBILEHOME), OR COMMERCIAL COACH, INSTALLATION ON A FOUNDATION SYSTEM Recording of this document al the request of the locoi agency indicated is in accordance with California Health and Safety Code Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all per- sons thereafter dealing with the real property. DALE C. & TERRI L. FARMER Butte County Building DeP artment REAL PROPERTY OWNER/LESSOR 865 Keith Ave. MAILING ADDRESS Gridley, Butte, CA 9.5948 CITY COUNTY STATE ZIP Same INSTALLATION MAILING ADDRESS, IF DIFFERENT CITY COUNTY STATE ZIP Same UNIT OWNER (If also property owner, write "SAME") HAILING ADDRESS CITY COUNTY STATE ZIP UNIT DESCRIPTION LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 County Center Dr. MAILING ADDRESS Oroville. Butte, CA 95965 CITY COUNTY STATE ZIP 2832-90 (916) 538-7541 BUILDING PE NO. TELEPHONE NUMBER 9/27/90 SI TU OF LOCA AGE OFFICIAL DATE Executive Homes DEALER NAME (If not a dealer sale, write "NONE") 92081 DEALER LICENSE NO. Fleetwood 9/90 Sandalwood 46030 MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER CAFLL17AB12109SW 26'8" x 60' RAD 559300 and 559101 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION ASSESSOR'S PARCEL NUMBER A.P. #024-13=0�08T NO. 5, NEAR GRIDLEY, BUTTE COUNTY CALIFORNIA", WHICH MAP WAS FILED IN THE OFFICE _OF THE RECORDER OF THE COUNTY OF BUTTE STATE OF CALIFORNIA APRIL 12 1906 TN BOOK 5 OF MAPS, AT PAGE 23. HCD FORM 433(A) 4/86 EN® OF DOCUMENT ENT OF hOGs/i o r' 0+*'41Nrrr oEa o � 0 a I o" -0e Addrwss or to Legcl DescriO Real Prop*rty Mal 7gok. 18111 oil- mam 00% 0615 MT—A"j 4 4 Mba w R NO. 2832-90 A PORTION OF LOT 30, AS SHOWN ON THAT CERTAIN MAP ENTITLED, v "MAP OF GRIDLEY COLONY NO. 5, NEAR GRIDLEY, BUTTE COUNTY, CALIFORNIA", WHICH MAP WAS FILED IN THE OFFICE OF THE RECORDER .OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, APRIL 12, 1906, IN BOOK 5 OF MPAS, AT PAGE 23. A ®Mobilehome/Manufactured Home Commercial Coach has been affixed to the real property described above by installation on a foundation system pursuant to Health and Safety Code Section 18551. Ownrr's home:. DALE C. & TERRI L. FARMER Owner's address: 865 Keith Ave., Gridley, CA 95948 INSIGNIA OR HUD NUMBER:RAD 559300 & 559301 SERIAL NUMBER OR V.I.N. CAFLL17AB12109SW MANUFACTURER'S NAME rleetwoo ►.r_a 5 1 x nieoi YEAR OF MANUFACTURE: 9/27/90 __n .1990 (916) 538-7541 _ Security Pacific Housing Services, Inc.. 2001 GATEWAY PLACE, SUITE 401 EAST, SAN JOSE, CALIFORNIA 95110.1045 " TELEPHONE (408) 453-1190 .August 13, 1990 _.._ Butte County Building Dept. 7 County Center Drive Oroville,'CA 95965 RE: Dale & Terri Farmer_ 865 Reith Avenue Gridley, CA 95948 To Whom It May Concern: As the lender for this transaction, Security Pacific Housing Services, Inc. is aware that this home will be on a permanent foundation. Please feel.free to call me if questions arise. Sincerely, SECURITY PACIFIC HOUSING SERVICES, INC. J homas inson Jr. er Service Manager JTV/mm SUBSIDIARY: SECURITY PACIFIC CORPORATION • ltegypfs� N Masten title Insurance C40pany Aey matt ae00Mtf/ WK To .... r Dale C. renin end Terri L. ...116.6 rerat r 3710 ArboAa feel a�.ew L Naryeville, Ca. 95901 J TldsordsrNe- 2]i63 Pepr}b ilea$ rare same as above Ase«« 0.04 a as -0395 tr tease st antaAi ts:eaos a tin n tlotWttawotaoa At role MAW of IImtinmuCGO. 696 FU -4. Ail Ile 12 EAL1it�D7v10�R W. �BEEr,C[i�a 86— 3945 Y] $0446 Apwa THIS NNa POR MCCDADaA'a Nae >apeattAn" trLmte W I.. 1!:25...•......... .. 133 Compat6d ea fall .0404 st srore,ty foa..ra, ar ri Calepsted m rmu Teioe left lMae eM eaewn►raneee reatWtaa Waw a waw of Wo. ?Jif..VWAiCB,gYGl1C0•.GRl19TA8S............ ' 1 tP#02 13-0-080-0 kbib'buat 0rdnt'etb _.... t • �a*sA.I nYLe roe.l 04.16$ FO RF.CEr*IZ- Wtsley bell and Geraldine Bell, Nuaband sad wife i L3RAPrrYfD Dole C. rarmsr and Terri L. raryKr. 1luabsnd and wife, bo Joint Tenants all0iurealprepatysls"mbathe Unincorporated area of CDtmry of Bu t to , State of California, described as follows: - All that certain real property situate in the County of*Buttt, Stste of California. 'described as follow$: A portion of Lot 30, as shown on that certain map .atitlad, "MAP OF 011t)LEY COLOtfT NO. S. near Cridley, Butte 'Co'., Calif.", which map was filed in the office of the Recorder of the County of Butte. Staee of California. April i2, 1906 in Book S of Map$, at page'23, more particularly deacribe4 4Y follows: Cosmu+Aciag At the Southwest cotter of said Lot; thancf North 1'13' East, 387.2 j feet along the West line of said Lot to an -'iron pipe; thence North 89'13' East, ! 112,50 foot to as iron pipe; thence South 1'13' Weat, 287.2 fete to a poine on the South line of slid Lot; thence South 89'13' West, 112.50 feet along said j South line CO the point of beginning. fAJanuary 28th 19 86 a i A'@ Set STAt2 Op CAUFORMA Comm r) iAzfI_ Oa � i tttet. ea. MeAMe�y, , tfenry le,e. rraagferwb �7iiler Bell And ' Cereldine Dell , P1fl0e,lb �\ 4 O, A flare$ b fit w esu teq 1 e.eiA�wrr wtArr tt M Ifs feeoe� 66,04 esu „Z„ r drl prate a owet Ye - t^b.�.O,�/ cbm r `x �.m IL M. -L I.A►1.11 FOA NOTARY deAL 011 STAMP . UiTICUL Stn "" MA�1Cxft l ' ,.ulw. . ulRif R P. 0—i 1 a Security Pacific Housing Services, Inc. 2001 GATEWAY PLACE, SUITE 401 EAST, SAN JOSE, CALIFORNIA 96110-1045 TELEPHONE (408) 453.1190 August 13, 1990 Butte County Building Dept. 7 County Center Drive Oroville, CA 95965 RE: Dale & Terri Farmer 865 Keith Avenue Gridley, CA 43940 To Whom It May Concern: As the lender for this transaction, Security Pacific Housing Services, Inc. is aware that this home will, be on a permanent foundation. Please feel free to call me if questions arise. Sincerely, SECURITY PACIFIC HOUSING SERVICES, INC. &J.rhomas inson Jr. ervice Manager jTV/mn TOTAL P.01 STATE OF CALIFORNIA DEPARTMENT OF"HOUSING•AND"COMMUNITY DEVELOPMENT DI'VIrSI.ON OF CODES AND STANDARDS -a REGISTRATION AND TITLING SECTION STATEMENT OF FACTS This unit is a:R Mobilehome 11 Commercial Coach [] Floating Home Truck Camper Decal (License) No.(s) Trade Name Serial No.(s) p s n/o I/We, the undersigned, hereby state that the unit described above: The above described unit has been placed on an approved permanent foundation system. Cc.,c,d J Affiant further agrees to indemnify and save harmless the Director of Housing and Community Development, State of California, and subsequent purchasers of said unit, for any loss they may suffer resulting from registration of the above-described unit in California, or from issuance of a California certificate of title covering the same. I/We certify under pena ty of perjury that the foreg ing is true and correct. Executed on �3 c)at LL�� J� (Dat ) (City) (State) Signature of each affi Printed name of each affiant Address State RESIDENTIAL. 24-13-80 2558-90B FARMER,, Dale 865KeithAve, Gridley (pumphouse) N, JOB FINAL ED (Date) Signature J=OK O=Not OK - = Not Applicable = Not Ready MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2 Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O Concrete' 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap: / P'L"ft. / P'Nat. or/ /"L"ft./ '/"LPG ' 7. Utility Clearance - - Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector. Z 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 10. Cert. of Occupancy Date Card B-1 Date Card B-1 _ Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs: Coonectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Rooting 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 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 -Panel boards -Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 r Y� d=OK O=Not OK -=Not Applicable RESIDENTIAL (S = Not Ready Date UNDERFLOOR (Plans) OK except If's 1w-zo'n ing-Setbacks-Easemen ts-Flood-Slope g., Main; Soils-Elec. Grnd.-# Viftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth . emwalls, Main; Steel-Blockouts-Wrapped 6:-Steffwm4s-Garage; Steel-Blockouts-Wrappad rte" Nati rtnwns and Special Anchors Steel -Wrapped B -Piero -Fireplace Ftg.-Steel 9r•B VO6 - all -Fitting -Test -2 Way C/O -Sewer Test _ 1 Anchors 11--yMeter'Pfpe; Test -Anchor -Regulator -Service Test 1.2�t tric,. nderground ?3:-P4ewmms-& Ducts; Clearance -Material -Support -Ins. 14 Z44efs=Sills-Anchor Bolts -Joists -Vents -Cripples 1 . sulation Date i /J Card B-iaU Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except If's 16. Water Htr.; Vent -Access -Combustion Air -Baffle 17. Water Pipe; Test & Anchor -Nail Protection 18. D.W.V.: Test -Fittings & Anchor -Nail Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors Date Card 671 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except q's 22: Fixture & Transformer Clearance -Ins. Protection 23. Elec. Receptacles Spacing -Lights & Switches at Doors 24. Size Boxes & No. of Conductors -Stapled 25. Romex Installed Close to Edge of Studs & C.J. 26. Equip. Ground made up w/Mech. Fastners-Bond Gas & Water 27. 2 Appliance Circuts in Kitcren & Conductor Size/GFI 28. Subfeed Wire Size / / glotu or AI-A.C. Wire Size / / ga. Cu or At 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No 30. Service -Riser Conductors & Ground -Main Disconnect 31. Equip. Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector Date Card B-1 Date Card B-1 D C d 0_, Date Card B-1 ingle & Duplex) Date FRAMING (Continued) 4 ost Caps -Anchors -Connectors 4f_JQIrtg-.-Joist-Rftr. ties -Pu rlin -roof Brac-Truss-Shthng.-Ring. 47-Ferephree-Ties-er Type A Flue -Fireplace Throat clearance 4&_ARie-Aeeess-51ze & Romex Protection -Draft Stop -Ins. Baffles 4 or Exiting Doors -Sill Hgt. & Dimensions 50,C'aaraga-Fire-Protection Framing .94- P -pally rewall & Openings 52 c + name-nnw 3' -Check Garage -3rd Story, 2 Exits i h -Headroom -Rise -Run -Landing -Fire Protection .%,-I0'ywoccJ.on Roof Overhang -Attic Vents -Rafter Outriggers mg -Nailing Veneer 3e""9leeee-Me3h-Drip Screed -Fd. Vents-Underflr. Access 5q--649=mg-ATea-Glass Protection -Skylights -Plastic. s; Nailing -Bolts 58 Ins, dation-Wills-Ceilings itW IR11ikrettt>15-NaIIs-Windows 40 Date Card B-1 Date Card B-1 r Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except If's 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector i 1 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & Subpanel; Breaker Sizes & Labels 67.'Stairs & Rails 68. Fireplace or Stove; Clearances -Hearth 69. Elec. Outlets at Wood Panel; Int. & Ext. 70. Kit.Fixt. & Appliance; Grnd: Air Gap -Cooking Clearance 71. Elec. Outlets & Receptacles at Kit. Counter 72. Garage Fire Door; Swing -Landing -Closer 73. A.C. Duct in Garage -Damper 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage; Above Floor-Mech. Protection 75. Plb., Elec. & Mech. Equip. Listed for Location 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection 77. Insulation -Foam -Looked in Attic ❑ Yes 78. Guard Rails & Deck Construction -Post Caps 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 80. Following instld.; Drive ❑ Yes ❑ No: Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No 81. Stucco; Brown -Finish 82. A.C. Unit; Disconnect, Electrical, Plumbing ate Date ar MECHANICAL (Permit) OK except If's - 83. Vents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to Openings 34. A.C. Ducts Insulation & Support 84. Water Well; Disconnect, Electrical, Plumbing 35. Vent Fan; Exhaust above insulation 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 36. Condensate Drain & Overflow; Size & Grade - 86. Ventilation Throughout House 37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet 87. Glass Protection 38. Attic Access & Platform if Furnance in Attic 88. Corrections from Previous Inspections 89. Gas Test -Meters Tagged; Gas -Electric - 90. Water & Sewer Connected -C/O to Grade -HD Approval Date Card B-1 Date Card B-1 • 91. Energy Compliance Certificate -Other Certificates Date Card B-1 Date Card B -t Date FRAMLNG (Plans) OK except N's Date Card B -t Date Card B-1 Sils. Proper Material & Anchors Date Card B-1 Date Card B-1 4 tuds-Nailing, Spacing & Bracing -Plates -Sound Date Card B-1 Date Card 8-1 Bearing Walls over Girders & Floor Nailing Comments at Final: 44iraft Stop in Walls (rat proof) �ire Furred Ceilings -Stairs -Chases -Tub ors & Beam -Size & Bearing each time you visit job site) /NOTE: An entry must be made COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center -Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATIOWAND PERMIT PERMIT NO. 2558-90 PARCEL NUMBER 24-1-3-80 ZONING Ain BUILDING PERMI OWNER Dale Farmer TELEPHONE 846-0504189 SQ. FT. OCC.1 BUILDING VALUATION M 2 646 OWNER'S MAILING ADDRESS 865 K h v 1 CONTRACTOR'SN ME Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 38.50 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 16.25 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 865 Keith Ave. Permit fee $ 64.75 PLUMBING PERMIT Filing Fee .10.00 Each Trap 2.00 Gridlev Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5,00 USE OF STRUCTURE SFO Duplex❑ Mobilehome❑ Other Pump House SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00e TYPE OF WORK NewU Addition❑ Remodel❑ Utilities❑ Installation❑ Other❑ Describe work: P1imp House _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service BOOV OR LESS 100 AMP OR LESS 10.00 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): El 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) ❑ 1 am exempt under Sec. , Business and Professions Code for this reason Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING 0CCUP.s OR ACDNS. ACC. BLDG S. 21hQsgit NEW CONSTR. ULTI-OUTLET NO N.RESID BRANCH CIRC ITS 2.50 ea (POWER APPARATUS a) SINGLE OUTLET CIR. Ex. Occu Occup(OUTLETS OR FIXTURES 20@50teAL®30 FIXED APPLNS. EX. Occup. OUTLETS (REST 0.)REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ . 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 shat l be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling g 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. I also agree to save, indemnify and keep harmless the County of Butte against all liabiliti , judgments, costs, and expenses which may in any way accrue against Id o i c quence of the granting of this permit. X, ._ a q — % Q Date 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 $ Energy Inspection Fee $ OCC I CONSTTYPE TOTAL FEE $ 64.75 HAZ I CUA PARK I SCHL FLD I PAR I PD HD I ISSUE Th;s permit is nereby issued under Bions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PER EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date ��� Receipt No. 704Q7 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION er ilS . ' .4 -�r 7 COUNT C NTER DRIVE - OROVIt1_4K%' A''?0RNIA 95965 - TELEPHONE: 916/538-7541 �c • PERMIT APftlCkTION DATA SHEET R Permit No. r OWNER f} 1 r �i i "' A. - r �y lG Proposed Building Use � ,.Building Inspector Date 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. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13. School District fees paid ............... 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW / 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner o, Mail to owner o) .... . 24. Recorded copy of -Agricultural Acknowledgment State ent ......... 25. Letter of signature authorization ................. ............... 26. 27. When you issue the permit, process as follow Mail to owner. - Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other ::;g� 0 Applicant Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date The following data must be submitted prior to permit issuance 1. Index permit for above items No. 2. Additional items required: By (Circle new item not checked above). Contractor, designer, owner, was advised of above required data by_phone_-nail counter by -.date Contractor, designer, own ,was advised of above required data by—phone —mal l_counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW COUNITY 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 th1..s 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),�_. 2. I (have/have not)signed an application fora building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City _ Phone Contractors License N_o. 4. .I plan to provide portions of this work, but I have hired the following person to coordinate, sup;-.rvise,,and provide the major work: Name Address Y 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 Signed: Property Owner _ Social Security er 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 returned to our office before we are per- mitted to issue the permit. .. .. ... .. Y.. ��. .. .. ..: .......... � ... . ... �pl�C' DPP � �: .. .:.i ::: a .._ �. .. . ...... � .. .. ... .. Y.. ��. .. .. ..: .......... � ... . ... �pl�C' DPP PERMIT NO. existing site PERMIT EXPIRES OWNER CLIFFORD DALE FARMER CONTR. owner r ASSESSOR PARCEL 24-13-80 LOCATION 865 Keith Ave, Gridley v� f Tem Power P OFFICE COPY p. Address Called PG I Temp. Elea Se GAS Meter By Date ELECTRIC Called PG Meter By Dat 7 - Temp. Gas Ser Cal led PG& E JOB FINALED (Date) e [t (1 Signature_ \ e JOK 0 = Not OK — = Not Applicable = Not Ready 7 MOBILEHOMES MISCELLANEOUS Date M OME UTILITIES (Plans) OK except #'s Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'s ing Requirements—Setbacks—Easements 1. Zoning Requirements—Setbacks—Easements So' ; Special MH Support—Sketch 2. Footings; Size—Depth—Spacing—Connectors 3. ewer; Location—Test—Fall-C/0—Concrete 3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails Water; Location—Test—Easement Needed (Sketch) 4. Wood Awn.; Posts—Beams—Rftrs.—Cohnec.—Shthg.—Rfg.—Bracing 5. Elec city; Location—Clearances—Grnd.—/ / Amp—Concrete S. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures 6. as; Location—Test—Wrap:/ /"L"ft./ /"Nat.or/ /"L"ft./ /"LPG 6. Carports; Windows—Doors 7. 'ty Clearance 7. Elec. Card -BI Card -BI Date Date Card -BI Date Date Card -BI Date M0B1_jd9h0ME INSTALLATION (Plans) OK except #'s Card -BI Card -BI Date. Date. Card -BI Date Date Card -BI Date POOLS (Plans) OK except #'s . Zpaing Requirements—Setbacks—Easements 1. Setbacks—Easements Foo ' gs; Siz —S acin rri Line 2. Soils; Compaction—Structure Stability a ; M De d—V a—Conn or 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining i I ctricil MH fes Crossovers—Breakers—Clearances 4, Elec.; Receptacles and Lighting; Distances—GFI H es — all—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI r; MH st—Regulator—Connector 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed W er and Sewer Connected—C/0 to Grade—HD Approval 7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg. Boxes—Enclosures—Panel boards—Ins. to Main in Conduit qK 9. Exits; Insp.—Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test—Water Supply Test Card B- Date r Card -BI Date Card -BI Date Card -BI Date Card B-1 Dated Card -BI Date Card -BI Date Card -BI Date A 'D. o. t3 i u7 qas V_= OK 0 = Not OR = Not Applicable * = Not Ready RESIDENTIAL (S1n'gle'apd 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 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 51. 52. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 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. 55. Glazing Area -Glass Protection -Skylights -Plastic 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 Card -BI Date Card -BI Date Date Card -BI Date Card -11 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 N's 14. _Water Ht.; Vent -Access -Combustion Air 57. 58. 59. Smoke Detector Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection Bedroom Exiting 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.: Test-Fttngs & Anchors -Nail Protection _ 17. Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18 _Shower 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 Card -BI Date Card -BI Date Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except N'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. 22. Elec. Receptacles Spacing -Lights &Switches at Doors 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. o Insulation -Foam -Looked in Attic El Yes 73. Guard Rails Deck Construction -Post Caps 25, 26. 2 Appliance Circuits in Kitchen &Conductor Size Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 74. Fdn. Vents & Crawl 4ole Door -Drainage & Wood -Earth Clearance Looked under Floor '❑ Yes' 1 27. 28. 29. }30. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated_Neutral _;Yes ❑No Service -Riser Conductors & Ground -Main Disconnect Equip. Clearances: Pane Is-Motors-Mech. Equip. 75. Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑Yes []No 76. 77, Stucco; Brown -Finish A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet Card B -I Card B -I _ Clothes Closet Light -Shower Light - - -. - - Date - Card -BI Date Date Card -BI Date 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 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 N's 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric _ Card -BI Card -BI 31. 32. 33. 34. 35. A.C. Ducts_ Insulation & Support _ Vent Fan: Exhaust above Insulation _ _ Condensate_D_rain & Overflow; Size & Grade Furnace-Vent_Access-Comb. Air -Return Air Vent_ -_115V outlet Attic Access & Platform if Furnace in Attic - - - -. - Date Card -1311 Date Date Card -BI Date, 85. Water & Sewer Connected -C/O to Grade -HD Approval 86, Energy Compliance Certificate -Other Certificates Card -BI Date Card -BI Date Card -BI Date Card -BI Date -.. Card -BI Dale Card -BI Date Date FRAMING(Plans) OK except q's Comments at Final: _ 3_6. 37 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. Sills; Proper Material &_Anchors__ _ Walls: Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls over Girders &_F_loor Nailing_- Draft Stop in Walls (rat proof)_ Fire Stops: Furred Ceilings -Stairs -Chases -Tub Header & Beam -Size & Bearing Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Ring 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:Anentrymust be made each time youvisit jobsite) MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNA — 534-4541 �y / PERMIT N0. —� li �— t��n s 'Address or location of mobilehome ( I Owner's name 0—)/ 1-A l ;� Owner's address .:-Insignia or hud number ) T E2_< i Manufacturer's name - .71.161- P ( ej Serial numbe�ojf V. i ./ �'� Year of manufacture —[�_ (Official Approvinjjnstal lotion (Date) IF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE MOBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM. 513B White - Owner, Yellow - Installer, Pink - D.P.W. MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE y� �> OROVILLE, CALIFOR I — 534-4541 Address or location of i/PERMIT NO./��i�r, } f M6 i'1Pi ,A Al/p. on 3-j Owner's name_ Owner's address Insignia or hud number 14 " ! `7 aC 6— Manufacturer's Manufacturer's name rim P �',Serial number f AI:h J974 V.I.7'ri l Year of manufacture (Official Approvinglinstallation ,tIF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE MOBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM. 4, 4, 415138 White - Owner, Yellow - Installer, Pink - D.P.W., ; COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT, Ny / 7 County Center Drive - Oroville, Calitornia 95965 - Telephone 916/534-4541 ((J/ i/ APPLICATION. AND PERMIT ASSES U ARC �U p _ ZONI G BUILDING PERMIT OWN V — TEL HONE �— SQ. FT. OCC. BUILDING VALUATION OWN 'S M IL G ADDRESS on k 0. CONT AC ORS'AM^ Y TELEPHONE CONTRA O 5 MAILING ADDRESS Fireplace CONST CTION LENDER 149 UNKNOWN Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHI CT OR ENGINEER ® LICENSE NO. Plan Checking Fee ,$' /Q v Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL AP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex[]Mobilehome[V' Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 10.00 P;" TYPE OF WORK ,,mo�ii New Addition Remo el Utilities❑ Installationlpl Other ❑ Describe work: (( _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 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 � DWEACCLLING oR CONST GOCCUP.8d) 2yz2sgft S.I NEW CONSTR. ULT' -OUTLET NO N.RES'D BRANCH CIRC ITS 2.50 ea POWER APPARATUS &) SINGLE OUTLET CIR. / Ex. Occup(OUTLETS OR FIXTURES 20®SOC 0ALO 30 Ex. QCCUp. OUTLETS ((RESID ) FIXED APPLNS. REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. �Yirin 15.00 g Permit Fee $ 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 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. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation Pennit 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. I also agree to save, indemnify and keep harmless the County of Butte against all liabilit'es, judgments, costs, and expenses which may in any way accrue against ai County lnsequence of the granting of this permit. X Date a Sign Kure 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 $ Energy Inspection Fee $ TOTAL PERMIT FEE $ Occup. CONST,TYPIJ FL ARCE PD HD 39UE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECT OF PUBLIC BY PER EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date!/— Receipt No. �� WHITE-D.P.W., YELLOW-ASSESSO , PINK -INSPECTOR, GOLDENROD -APPLICANT i 1 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION w 7 COUNTY CENTER DRIVE - OROVILLE'C':4LI'F<0'WIA 95965 - TELEPHONE: 916/534-4541 PERMIT APPLICATION DATA SHEET '-- OWNER . C1 ` oY Proposed Building Use Permit No, ✓ �� - /.3 - 1-0 A. P. No. Permit Fee Based Upon: Complete Contract Price DPW Valuation Other (Expl in) Building Inspector 4M Date f� 8-6 At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED All items.have been -submitted. . . . . . . . . 2.. Plot plans iKquplic riplicate. 3. Complete plans in duplicate/triplicate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. CUSD "Fees Paid" Stamp on Floor Plan . . . . . . . . 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . Letter of signature author izati % V 10. Sanitation approval from_ ueOU / f Health ,Dept.. 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ ) T 1Y. Improvements may be required.. . 16. Mobilehome Installation Data.,',,.. . . . . • .. Pre-Inspec. request to (O ) �/17-1 Pre -Inspection for Required. Building Inspector tte 18. Recorde o A.g ' Vul1Pr I Acknowledgment Statement. 19. Other �:tc]iA rA11'Construction approval required prior to occupancy When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at Oyb office.' Deliver w/inspector. r Other A p p I i c a n t �G'� ( Date.— Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone Mail Other By Date Plans checked by Date Plans approved by Date Other: Copy—DPW To: Building Department From: Tnvironmental Health :ubject: Sanitation Clearance L Ui%mer, Location AP-// Plan AppToved for: Sewage disposal water supply Hold final for: water supply Final clearance O.K. for: water supply Clearance for bedro m mobile ome.. Other D7077L Sanitarian Da _ Utility'conne — �4 ft. of the m directly behi -NOTE: gp_Materials &_ Workmanship Shag Be in _ Accordance with Recognized Good - Practices and - of .a quality prescribed for the Specified use in the Uniform Building, Plumbing & Mechanical -Codes and — _ fhe. National. Electrical Co_ de. _ _ _ This set of plans and specifications MUST be _kept on -the iob. at all times and it is unlawful to make any changes or alterrtions on some without written, permission from the Department of Publie Works, County of Butte. ct ons shall be, within _ _ _ _ _ _ _ _ • _ -, _ _ _ -- -- _ -- _ -- _ _ - o ileho e, either " nc or wi hin the rear - - - - - - half mobilehome. of the- - - - - - - - - - r A setback offt. from the 44 property lines and a setback, of 50ft. from the road --- -- t� - - - - - - - - - centerline shall be clear of - i structures or equipment exceof - j - - - - for a 2 ft. eave overhang, I, ii 4 1 - 4 1I fJ ,c.0 -r - o up BUTTE COUNTY _ .BUILDING _DEPARTMENT - - - - A RPR O V E -D �� 44 ,c.0 -r - o up BUTTE COUNTY _ .BUILDING _DEPARTMENT - - - - A RPR O V E -D �� v 1. Owner's Name: BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET c k + +Ord - LcAe.* ifct v ,iv\ e v- 2. Installer's Name: D��X_C (K d yQae_, 3. Is the site currently under permit? Yes, No T-1 0 _ (If yes, furnish permit number ) OR Is the site an existing site? Yes No ❑ (If yes, furnish two 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 F] (If no, clarify 5. What is the mobilehome electrical rating? --------------- �` Ampp 6. What is the mobilehome site service rating? ------=-.----- ' q Q 0 �, 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. ------------- -- �L ` ---- Yes ® No F1W (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? -------------- ��: (in.) YPe g ? ------------------- 10. What is the t of as 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? ---------------------- *(This information not required if•pipe length less than 6 ft. on .natural gas or less than.50 ft. on LPG.) (BTU) BUTTE COUNTY BUILDING, DEPARTMENT " APPROVED MOBILEHOME SUPPORT DATA / If .other- than single wide, Mobilehome Mfr.i%e�� wocd furnish ,Setup Model No. Year Width12_ (ft.) Box Length__� 0 (ft.) Tagalong or Expando Size__t6_ft. x -1,2 ---ft. 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). FOOTINGS (check one)a. Wood -pressure treated or foundation grade. 1:112. Other (specify) SUPPORTS (check one)ID1. Concrete block. F12. Other (specify) Pier Footing Sizes and Locations SINGLE -WIDE Line 1 Piers: Size -Min. ------------ Spacing -Max. --------- From Ends-Max.------- Line 2 Piers: - - Size -Min .------------ Spacing -Max.--------- From Ends -Max .-----=- Line 3 Roof Loads:. Size -Min .-----------:- Location (From Front) MULTI-WIDE Line I Line 2 Main Beams -0 Line Lice 3 Main Beams Lin ne Tag or Triple. Line I Openings: Size -Min. ------------------ x Each Side of Openings With Width Over ----'---- _ u Line 3 Piers: (Under Bearing Wall Only) Size -Min ------------------- „ Spacing -Max---------------- r „ From Ends -Max.------------- - e v niers Size-Min------------- Spacing-Max - ------------Spacing-Max.---------Prom Ends -Max.------- Line 5 Piers: (Under Bearing Walls Only) Size -Min .------------------ „x „ Spacing -Max.--------------- From Ends -Max .------------- Line 5 Roof Loads: Size -Min. ------------ ,.x 1. „x Location (From Front) E. ,- {� �j11q i1 eturn to DPW.. A"'RICULTURAL. STATEMENT OF ACKNOWLEDGEMENT R_CORDEDINOFFICIAL RECORDS NOT COMPAREDVA'H FOR RESIDENTIAL DEVELOPMENT OF BUTTE COUNTY, CALI FORN IA p ,}NA�CaCGt.� f+4 _ AT Tn REOUESTOF Section 26-.8.1 bf the Butte County Code- requires- this acknowledgement PARri SHOWN b'e recorded.pr.for to•issuance of a building permit_. 1986 FEB —7 PB 3: 00 The property described herein is adjacent to land or included within.an area zoned for agricultural purposes, and residents of this ELEANOR M.BECKER property may be subject to inconveniences or discomfort arising from CLERK-RECORF the use of agricultural chemicals, including, but not limited to herbicides, pe "d e.3 acid fertilizers; and'from the pursuit of.agricultural• operations including, but not limited .tq cultivation, plowing, spraying, pruning., and harvesting which occasionally generate dust, smoke,.Inoise., 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 All that cer'tain.real property situate in the County of Butte, State of Calif- ornia, described as follows: 'A portion of Lot 30, as shown on'that certain map entitled, "MAP OF GRIDLEY COLONY N0. •5, near Gridley,'Butte Co., Calif.", which map was filed in the office of the Recorder of the.County of Butte, 'State -of California, April 12, 1906 in Book 5 of :1 Maps,. a•t page 23, more particularly described as follows: Commencing at.the Southwest corner of said Lot; thence North 1°13' East, 387.2 feet along .the West line of said -Lot to an iron pipe; thence North 89°13' East, 112.50'feet to an iron pipe; thence South 1°13' West, 337.2 feet to a point on the South line of said Lot; thence South 89°13' West, 112.50 feet along said South line to the point of beginning. Date. 7/n 6,6 State of Co- L: ) 71 Cdunty of Ti --) S5. On this the day of- / me, the undersigned Notary Public, 19 before lly appeared J Personally known to me. i1/ Proved to me on the basis of satisfactory evidence. to be the person(s) whose name(s), -subscribed to the within instrument and acknowledged that ZCc_ executed .the. same for the purposes therein contain d. IN WITNESS WHEREOF, I hereunto set my hand and of icial seal. '- Notary Public AP # T- /3 —Po OWNER QA--- PERMIT d, MH UTIL.CLEARANCE DATE INSPECTOR 9c) ELECTRIC GAS Support Struc. Compaction Test eq. Service 3iz�e` Other Load- Type Pipe Size Len th YES NO YES NO �V Permit #285-86 D D Farmer 865 ,Keith Ave, Gridle} et r COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541yl- APPLICA`i"IOWAND PERMIT ASSESSOR PARCEL -NUMBER a14 :-• R70- ZONING� I( BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS _ A 10 CONTRACTOR'S NAME r i r, t In f t/' TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER i )�- `- It UNKNOWN Total Valuation Is FilingFee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER �`� `� LICENSE NO. _1,Plan Checking Fee $ Ener Plan Checking Fee 9y g ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS /� Permit fee PLUMBING PERMIT ' Filing Fee 10.00 Each Trap 2.00 C.7 ' "/ /n 1J Solar or hea0pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas 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 Is G W 10.00ea Pi Cn TYPE OF WORK New ❑ Addition ❑ . Remodel ❑ Uti-Cities ❑ Installation❑ Other ❑ ff Describe work: ff;' r 116re. �r ✓ ti, (� �J�� P Permit Fee $ 10.0 r Contractor ELECTRICAL PERMIT Filing Fee 10.00 OR L Main service ;0000 AMP ORSLESS 10.00 /y) Main service EA. ADD -L too AMP 2.50 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 CONST. DWELLING OCCUP.n , CC. BLDGS. 2h¢sgft New CONSTR.(AMULTI-OUTLET NON-RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20@50t eAL@3o FIXED EX. OCCUp. OUTLETS ( R RESID,)EAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 g Permit Fee $ C; i 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 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. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against.saidiCounty in consequence of the granting of this permit. X _ b _ 2r f. Date �+ Signature of Applicant — Owner El Contractor ElAgent❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. g Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ Occu P, CONST.TYPC IFLOODIPARCELI PD I HD I ISSUE This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR,OF PUBLIfr WORKS ByV . /,�LvWl'_Iltol1.(X p e PERMIT EXPIRES Date ' �/, /Y Receipt No. 141 t 1 WHITE-D.P.W., TEL LOW-ASSE35OR, PIN K -INSPECTOR. GOLDENROD -APPLICANT `. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AWPERMIT PEgn? /Oy,,�, ASS R PARCEL NU BER _JoBUILDING ZON NG PERMIT OWNER_ ^^ /171 l` Ka r mea TEL^ PHONE SQ. FT. OCC. BUILDING VALUATION OW 'S M I I A DRESS CO TR CTOR'S NANIFE ELEPHONE C RA TO 'S AILING ADDRESS Fireplace CON UCTION LENDER UNKNOWN LENDER'S MAILING ADDRESS Total Valuation $ Filing Fee Permit Fee $ 10,00 $ ARCHIT CT OR ENGINEER LICENSE No. ARCHITECT OR ENGINEER'S MAILING ADDRESS Plan Checking Fee Energy Plan Checking Fee Penalty $ $ $ BUILDING ADDRESS I / Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 c Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PA EL MAP Water piping 5.00 Each gas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer4f) Mobile Home S 0.00 ea ov- 00 :t45.00 TYPE OF WORK New ❑ Addition ❑ Rem del ❑ Ut' ies ❑ Installation Other ❑ Describe work: �(� Y) 74 CCS (z Ir t/ j [t / "!'9 �� _ Permit Fee $ .00-00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V OR L 00 AMP ORSLESS 10.00 .00 Main service EA. ADD'L 100 AMP 2.50 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 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) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.a ,h¢sgn A New CONSTFL ODUTLET MULTI -OUTLET NON.RESID BRANCH CIRC ITS 2.50 ea (POWER APPARATUS 6 (SINGLE OUTLET CIR. p OUTLETS OR FIXTURES ewL Ex. Occu 20 O30 FIXED APP LNS, OR Ex. Occup. OUTLETS (RESID.) EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 /s _ Misc. Wiring 15.00 Permit Fee 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 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. MECHANICAL PERMIT Filing Fee 10.00 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. I also agree to save, indemnify and keep harmless the County of Butte against all liabilit' s, judgments, costs, and expenses which may in any way accrue agains ai Co ty in of the granting of this permit./ / x ������� Date 2 " 6 — Fp 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 $ Energy Inspection Fee $ TOTAL PERMIT FEE $ oCCUP. CONST.TYPEJ �FLOODIPARCIZI. PD ND I IME This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRE C R F PUB BY PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. I WORKS Date C-AReceipt No. WNIT!-D.P.W.. YELLOW-ASSl9SOR, PINK -INSPECTOR, GOLDENROD -APPLICANT V y PERMIT NQ,,., 6570=77P,E PERMIT EXPIRES OWNER Lee F. Bell CONTR. owner LOCATION (A.P. 24-13-80 N/S Keith Ave.,app.650'E.of River Ave., Gridl r_ Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E J JOB r FINALED • (Date) /J 1 (Signature)�� F Bond SPRIN ''tucco I Final ISubpanelK Mesh MECHANICAL Grd. F941t Prot. Scralih I HeatirA I Servl BrqWn Coo ng COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD F nish DOS BUILDING BUILDING (Cont'd) PLUMBING Se ck ewall Ski Piping For Pa Dets 1 t Floor Mai Bldg. Rest om Finish 2n Floor Fo tins Windo4 3rd Noor Stem all Siding To out Slab Roof SheaNing Water Pi I Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Stemwal I Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for physical handicapped Conformance of ex. structure V Appliances Gas Piping 2- T--# Temp. Gas Slab Final Sanitation Patio F REP ACE Final Footinas Footina E ECTRIC L F Bond SPRIN ''tucco I Final ISubpanelK Mesh MECHANICAL Grd. F941t Prot. Scralih I HeatirA I Servl BrqWn Coo ng Tjfrnp. Pole F nish DOS nder round Inferior Lath V4ntilation Permanent oor Closer anal 4Final MOBILEHOME UTI TIES .. .............. Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping E MEINSTALLATI N ------Support Water Piping Drainage Elec. Continuity Gas Piping DATE REMARKS �ORR�CORRECTIONS oZold ef � _ (NOTE: An entry must be made on this form each time you visit the job site.) 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 Ad inistrative Code, Title 25, Cha tern 5 under permit number ✓a� % for the following location: /O Owner Owner's Address ,hyo -P�-. �e Mobilehome Mfg. � �"-���'� A Model Year "7 Insignia No. �0 9-1,- Serial No. It is hereby certified for occupancy at the above described location and may be occupied. Date Director�Public orks By THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED t — i I COUNTY OF BUTTE c. 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 q-77-� 7� for the following location: Ao /A' � -;P' —00' -&-:7 -- - . .r ./ - i/ Owner r - x-- % Owner's Address Mobilehome Mfg. Model Year1yry Insignia No. A,p0 9.41.74.,7 .'' Serial No. It is hereby certified for occupancy at the above described location and may be occupied. Director.of Public Works Date ByL•4�"' 0 THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED 9. Electrical A. Is service large enough to provide adequate amperage -to mobilehome (must equal rating of mobilehome with a minimum ofj.100 amp) and other facilities on lot, i.e., water pumps, garage, cabana, etc.? Yes Ai No B. Is there proper clearances around panels? YesK_ No C. Is power supply cord,or feeder assembly properly fused? Yes No_ D. 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. ++� i . 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 Namestyle1 Length Widths Z"; Vehicle Serial No. State Identification No. Additional Information or Comments: 11 1 MOBILEHOME INSTALLATION INSPECTION. CHECK LIST 1. Is the mobilehome located h required separation from lot lines and buildings and generally conform to plot plan? Yes No 2. Does the mobilehome have,required clearances above ground? (Sec.5085) YeVK No 3. Are footings and supports properly sized, spaced, and braced a�r approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes No 4. Is the mobilehome level? (Sec. 5088) Ye s7. No 5. If mo a than a single unit, are crossover connections properly installed? (Sec. 5088) Yes No 6. Water A. Is 1 xible connector of adequate size and properly installed (1/2" ID mjin.)? (Sec. 5566) Yes No B. Test - Does water piping withstand working pressure or 50 lbs. air test? Yes No C. Bac not State o California 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" per foot slope and is it properly supported? Yes No C. Are any leaks detected in drainage system after runnin 3,gallons of water through each fixture including washing machine standpipe? Yes No 11 / D. If c aa roved, does station have required trap and vent? Yes No " 8. Gas Piping andVents A. Connector - Is mobilehome connect d to the gas supply with an approved 3/4" minimum mobilehome cnector not more th 6 ft. long? Note: All piping is to be at least as large as the m bilehome gas line inlet without reductions other than the mobilehome connector. Yes No B. Test OK as per fol owing'proc¢dure? Yes_ No 1. Open all applia ce conne for valves. 2. Shut off applianc &, bur -Ver and pilot valves. 3. Air test with man omWer to 10"-14" water column, or test with slope gauge (minimum 6oz.-maximum 8 oz.) librated in tenth pound increments. Test for 10 min. without drop. 4. Connect gas mete to mob'lehome with connector, turn on gas, test connections with soapy water. C. Are all appliance/Vents properIX installed? Yes_ No COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS ^� 7 County Center Dri �5 / e — Oroville, California 95965 6�7 �r / y Telephone: 534-4541 ((((((((���� ti' / / APPLICATION AND PERMIT A -�il���d(%te /-I /�— i% Signature of Permittee or Agent �a Receipt No. - 1 l r White-D.P.W. – Yellow -Assessor – Pink -Inspector – Goldenrod -Applicant ine rsutte t;ounty c;oae anoior resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PJdBLIC WORKS '7 By I Date —7/ permit expires Date , BUILDING Owner L SQ.FT. OCC. BUILDING VALUATION Mailing Address JY0 a2 -(Z 9t 0a �lephoneLo. L �� Fireplace Contractor Total Valuation Mailing Address Permit Fee P I an Checking Fee &/or Penalty e Tlephone No. Permit Fee All Building Address V_ PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 'Lon 9);erif eafion OnIY �i Each gas water heater or vent 1.50 o A. P. No. o Z0 Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F Sa on Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Parcel60' 'Plans Declaration Parcel Ma R/W Im rovements P Lawn sprinkler system 2.00 Bldg. ns Recd Parce pproval Plans pproval Permit Fee $*w NEW ❑ ADDITION ❑ UTILITIES EjOTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 100 AMP ORV OR LESS5.00 ) Main service EA. ADO'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Q�Others ❑ Main service 1100EAMP OR LESS 25.00 Main service EA. ADD'L too AMP 1.00 NEW CONST. DWELLING OCCUP. & OR ADDNS. ACC. BLDGS. ) 2¢sgft NEW CONSTR MULTI.OUTLET NON.RESID. BRANCH CIRCUITS) 2.50ea NEW CONSTR. /POWER APPARATUS & (POWER NON -R E,SID. 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. Occup(OUTLETS OR FIXTURES)@L 250 BAL@1 FIXED APP LNS. OR Ex. Occu P•(OUT LETS (RE51 D.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 f License No. Classification Misc. Wiring 6.25 1 am exempt from the Contractors License Laws of the State of California. Permit Fee $ J 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. 11 I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 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 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-mentinnPri nrnnprty fnr inen—t;nn n„rnn p TOTAL PERMIT EE , This permit is hereby P y issued under the applicable provisions of A -�il���d(%te /-I /�— i% Signature of Permittee or Agent �a Receipt No. - 1 l r White-D.P.W. – Yellow -Assessor – Pink -Inspector – Goldenrod -Applicant ine rsutte t;ounty c;oae anoior resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PJdBLIC WORKS '7 By I Date —7/ permit expires Date , - COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS ?'County -Center Drive — Qroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned pr�opertrty for inspection purposes. X C�tiL-e JY�C�I%„ Date 3 Signature of P/e�mitee or Agent Receipt No.7+D�� White-D.P.W. ellow-A�_ Pink -Inspector — Goldenrod -Applicant 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 PUBLIC WORKS BIv iu�llding permit expires Date BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mail i ng Address Telephone No. Contractor Mailing Address Fireplace Total Valuation TeleperNgf ((gyp Permit Fee Building Address Plan Checking Fee&/or Penalty Permit Fee _ S PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each TraD 1.50 Repair drainage or vent piping 1.50 A. P. No. O — �V Zoning 8 Planning Water piping 1.50 Each gas water heater or vent 1.50 SnniiaTZt Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans I Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 Bldg. s ec d Parcel A royal Plans pproval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER EZ Permit Fee $ $ S ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 600V OR LESS 10o AMP OR LESS 5.00 Single Family Duplex Mobil Home Others s v ❑ p ❑ j�- ❑ Main service EA, ADD'L 100 AMP 2,50 Main service OVER 600V 25.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 1,00 NEW CONST. DWELLING OCCUP. y OR ADDNS. (, ACC. BLDGS. 20sq ft CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: y 6 �'/�/� T 7 �/'/�� �$ L ✓r NEw CONSTR. BRANCH CIR T NON-RESID � BRANCH CIRCUITS) 12.50ea NEWC CONSTR. POWER APPARATUS D NON-RESID. SNGLE OUTLET CIR. Ex. Occur){OUTLETS OR FIXTURES 5 L� Ex. Occup. FIXED APPLNS. OR p•(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. J% a 3a,3 Classification G 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. have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 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 La TOTAL PERMIT FEE _ $ authorize representatives of the County of Butte to enter upon the above-mentioned pr�opertrty for inspection purposes. X C�tiL-e JY�C�I%„ Date 3 Signature of P/e�mitee or Agent Receipt No.7+D�� White-D.P.W. ellow-A�_ Pink -Inspector — Goldenrod -Applicant 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 PUBLIC WORKS BIv iu�llding permit expires Date /?7 13 o x 5�3 i T�V4, d o o 4 et R6),,EV R) u, R o47,) C BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner' s name: is the mobilehome site gas pipe size? ---------------------- 2. Installer's name: OL -J k S L'/Y/YI/ T 7- /a'�/%� �.t %� ✓ 3. Is the site currently under permit? Yes Natural / . / PG 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 tankland leach fields and clear of all setbacks and easements? Yes /r// No ( If no, clarify ) 5. What is the mobilehome electrical rating?----------------------S� Am"'N 6. What is the mobilehome site service rating? -------- Amp s 7. What is the mobilehome site circuit breaker rating? ------------- Is 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? ---------------------- (in.) 10. What is the type of gas service? ----------------------------- Natural / . / PG 11. What is the gas pipe length from meter or tank to the mobilehome? (ft.) 12. What is the mobilehome gas demand? ------------------------------ fJ (B) (This information°,.not.,required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) s :--kk MOBZLEHOMESUPPORT DATA Mobilehome Mfr. S/1 VE R C R k s T Setup Model No. 412,2m TGA year Width - 2 (ft.) Length D ft. ( ) o Size /D ft.x 36ft. (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). Center Center Support Support Ce Footing Sizes Locations f (in.) i x: -0 L,2 I/ X3 0 ;33-y X 3d, (ft) -(in) (in.)(in.) •Y�O lG - (f in. p` (in.)(in.) *If center piers are other than drawn above, draw in locations, spacing, and dimensions. c2X3 Om �- - ' Max. Pier (ft.)('in.) Spacing j Max. Overhang (-f C.V7(in_. ) BUTTE C:OUN I Y BUILDING DEPARTMEN APPROVED (check one) /Footings /7/ 1. Wood either pressure treated or fdn. grade. 2. Concrete pad. 3. Other, specify Supports (check one) 30 .. \37, 1. Concrete block 2 / / 2. Concrete piers o A4 14< `4< / / 3. Steel piers 30 ��� 4. Other, specify .' 0Z b Typical Footing Support Size c2X3 Om �- - ' Max. Pier (ft.)('in.) Spacing j Max. Overhang (-f C.V7(in_. ) BUTTE C:OUN I Y BUILDING DEPARTMEN APPROVED 4 . •� t f ' J •� t f COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT'SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 Telephone (916) 538-7541 �y_,,,, .MIT,NfG• 1. APPLICATION AND PERMIT -S"yf�y5 ASSESOfl PARC LN MBER Ul�—�:iU—w ZONING A10 BUILDING PERMIT OWNER DALE & T"RRY FARI►ER TEL846-0504 ONE SQ. FT. OCC. BUILDING VALUATION / OWNER'S 8b5 ARP. hl AVEIME. GRIDLEY 95948 CONTRACT R' NAt,ME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 865 KEITH AVENUE, GRIDLEY PERMIT FEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SF C1 Duplex ❑ Mobilehome O Other GARAGE SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 Ed TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities OXInstallation C3Other 1:1Contractor Describework: REPLACE PLAIN SERVICE I PERMIT FEE $ Fee 20.00 ELECTRICAL PERMIT Filin0V SUPPLIES '17C,HOUSE 0 SHOP OR LESSg Main Service ( 20OAORLESS 1 23.00 Main Service ( 200A TO IOOOA ) 46.00 NEW CONST. DWELLING OCCUP. SO. OR ADONS. I & ACC. BLDS. ) 3.50 FT. CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) ❑ I am a licensed under provisions of Chapter 9, Division 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 compensation, 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 contractors. (Sec 7044) ❑ 1 am exempt under Sec. , Business and Professions Code forthis reason NEW CONST. MULTI-OUTLET -NON.RESID. 1 BRANCH CIRCUITS 1 @7.50 ( POWER APPARATUS ) & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES 20 @ 1.00) BAL. @ .50 Ex. Occu FI%ED .OR P• (OUTLETS fRESIRESID.) EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 2 Misc. Wiring JE203*700 WORKER'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Dept. of Development Services, Building Division 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 Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE S Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 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 Butte County Ordinances and California 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, indemnify and keep harmless the County of Butte against all Iiabiliti s, judgments, costs and expenses which may in any way accrue against said Count in consequentof he granting of this permit. Date /2 115193 CAA Signature of Applicant ID Owner ❑Contractor ❑Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC coNsr. rvPE TOTAL FEE $ 43.00 HAZ• D. FEES IMP FLOOD CDF PARCEL PD HD LSU This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work d. indicaid.abovI for which fees have been. KS ,� DIREIOF F PUBLIC/iW/ORKS//� ry By/ // . r :+lf�t/ Date W^ 7 1 (j,,// PERMITEXPIRESON /_o/�� /7— (Darel Receipt No. 153931 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, .Caaifaerlia•9E,965 - Telephone (916) 538-7541 'S 7 T APPLICATION AND PERMIT -S`j �` ASSESSOR PARC LNUMBER 02�i-130-080 ZONING A10 BUILDING PERMIT OWNER DALE & TERRY FARMER TELEPHONE 846-0504 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 865 I:EITH AVENUE, GRIDLEY 95948 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 865 KEITH AVENUE GRIDLEY PERMIT FEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 LOT NO.SUB DIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other GARAGE SPECIFY Gas piping system 1 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 TYPE OF WORK v New ❑ Addition ❑ Remodel ❑ Utilities ❑/� Installation ❑ Other ❑ Describework: REPLACE MAIN SERVICE PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 SUPPLIES A'IFG HOUSE &SHOP 600V OR LESS Main Service ( 200A OR LESS 1 23.00 23.0 Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADONS. ( & ACC. OLDS. ) S 3.50 FO.,. CONTRACTORS LICENSE LAW 1 declare under penalty of perjury (check one) ❑ 1 am a licensed under provisions of Chapter 9, Division 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 compensation, 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 contractors. (Sec 7044) ❑ 1 am exempt under Sec. Business and Professions Code forthis reason NEw CONST. MULTI -OUTLET -NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES 1 BAL. @ 1.50 Ex. Occup.FIXED APPLNS. OR (OUTLETS IRESID.1 EA. 1 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Dept. of Development Services, Building Division 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 Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ 43.00 Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 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 Butte County Ordinances and California 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, indemnify and keep harmless the County of Butte against all liabiliti s, judgments, costs and expenses which may in any way accrue against said Coun in consequence�,of he granting of this permit. T Date �� / ig ture of Applicant - ❑ Owner 1:1 Contractor C] Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ ocC CONST. TYPE TOTAL FEE $ 43.00 HAZ. I D. FEES I IMP FLOOD CDF PARCEL PD HD I Issu This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions indicated ove for which f s have b an I DIRECT PUBLI B PERMIT EXPIRES ON lDe tel provisions to do work aid. KS ate /11 ReceiptNo._ 153931 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLD ENR6D-APPLICANT COUNTY OF BUTTE Department`�of Public Works 7 County Center Drive,_Ofdville, Cd 95965 Phone: 916-538_7341 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 Iyes or no) 2. I. ave have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name' Address City Phone Contractors License No. 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 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 Signed: Property Owner ti Gl-hj Social Security Number Date, ,14 / q-3 NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to. our office before we are per- mitted to issue the.permit. � f 1 ; i 7. i 3240• PERMIT NO. � -87B / PERMIT EXPIRES ( /0 OWNER DALE FARMER CONTR. St !F f! ASSESSOR PARCEL 24-13-80 k' LOCATION 865 Keith Lane, Gridley 41 • OFFICE COPY 4 Addre v i Meter By a e ELECTRIC Meter By Dat" F Temp. Power Pole Called PG&E Temp. Elec. Se Called PG! Temp. Gas Ser Called PGa JOB FINALED Signature = OK 0 = NotOK RESIDENTIAL (Single and Duplex) - =Not Applicable = Not Ready Date UNDERFLOOR (Plans) OK except #'s Date FRAMING (Continued) r 1. Zoning requirements -Setbacks -Easements 44. Hangers -Post Caps -Anchors -Connectors 2. Ftg., Main; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 45. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. 3. Ftg., Garage; Soils -Steel-/ /" Ftg. Depth 46. Fireplace Ties or Type A Flue -Fireplace Throat 4. Ftg., Porches & Decks; Soils -Steel-/ /"Ftg. Depth 47. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles ' 5. Stemwalls, Main; Steel-Blockouts-Wrapped 48. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 49. Garage Fire Protection Framing 7. Slab; Steel -Wrapped 50. Property Line Firewall & Openings 8. Piers -Fireplace Ftg.-Steel 51. Ext. Doors -One T -Check Garage -3rd story, 2 exits 9. D.W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test 52. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 10. Gas Pipe; Size -Anchors 53. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 11. Water Pipe; Test -Anchors -Regulator -Service Test 54. Siding -Nailing Veneer 12. Electric; Underground 55. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 13. Plenums & Ducts; Clearance-Material-Supprt-Ins. 56. Glazing Area -Glass Protection -Skylights -Plastic 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 57. Shear Walls; Nailing -Bolts 15. Insulation 58. Insulation-Walls-Clg. 59. Infiltration-Walls-Wndws Card -B1 Date Card -B1 Date Card -B1 Date Card -B1 Date Card -B1 Date Card -B1 Date Card -B1 Date Card -131 Date Date PLUMBING (Permit) OK except #'s 16. Water Ht. Vent -Access -Combustion Air Date FINAL (Plans) OK except #'s 17. Water Pipe; Test & Anchors -Nail Protection 60. Ext. Steps -Door & Sidelight Protection -Landings 18. D.W.V.; Test-Fttngs & Anchors -Nail Protection 61. Smoke Detector 19. Shower Pan; Test, First Floor -Tub Access 62. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meth. Protection 20. Test Tub & Shower, 2nd Floor -Tub Access 21. Gas Pipe; Size & Anchors' 63. Bedroom Exiting 64. G.F.I. & Bath Fixtures & Tub Access -Spa 65. Elec. Trim & Subpanel; Breaker Sizes -Labels Card -B1 Date Card -B1 Date 66. Stairs &Rails Card -B1 Date Card -B1 Date 67. Fireplace or Stove; Clearances -Hearth 68. Elec. Outlets at Wood Panel; Int. & Ext. Date ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ina. Protection 69. Kit. Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance 23. Elec. Receptacles Spacing -Lights & Switches at Doors 70. Elec. Outlets & Receptacles at Kit. Counter 24. Size Boxes & No. of Conductors -Stapled 71. Garage Fire Door; Swing -Landing -Closer 25. Romex Installed Close to Edge of Studs & C.J. 72. A.C. Duct in Garage -Damper 26. Equip. Ground made up w/Mech. Fasteners -Bond Gas &Water 73. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 27. 2 Appliance Circuits in Kitchen & Conductor Size 74. Plb., Elec. & Mech. Equip. Listed for Location 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga. Cu or Al 75. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral Yes No 76. Insulation -Foam -Looked in Attic ❑ Yes 77. Guard Rails & Deck Construction -Post Caps 30. Service -Riser Conductors & Ground -Main Disconnect 78. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑Yes 31. Equip. Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 79. Following instid.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No 80. Stucco; Brown -Finish Card -B1 Date Card -B1 Date 81. A.C!Unit; Disconnect, Electrical, Plumbing Card -B1 Date Card -131 Date _ 82. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Openings. Date MECHANICAL (Permit) OK except #'s 83. Water Well; Disconnect, Electrical, Plumbing 33. A.C. Ducts Insulation & Support _ 84. Exterior Elec. Trim; G.F.I. Receptacle -Underground 34. Vent Fan; Exhaust above insulation _ 85. Ventilation throughout House 35. Condensate Drain & Overflow; Size & Grade _ 86. Glass Protection 36. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet _ 87. Corrections from Previous Inpections i 37. Attic Access & Platform if Furnace in Attic 88. Gas Test -Meters Tagged; Gas -Electric 89. Water & Sewer Connected -C/O to Grade -HD Approval 90. Energy Compliance Certificate -Other Certificates Card -B1 Date Card -61 Date Card -81 Date Card -131 Date Card -131 Date Card -B1 Date Date FRAMING (Plans) OK except #'s Card -B1 _ Date Card -131 Date 38. Sills, Proper Material & Anchors Card -B1 Date Card -B1 Date 39. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound Comments at Final: 40. Bearing Walls over Girders & Floor Nailing 41. Draft Stop in Walls (rat proof) 42. Fire Stops; Furred Ceilings -Stairs -Chases -Tib. " 43. Header & Beam -Size & Bearing (NOTE: An entry must be made each time you visit ieh citwl = OK 0 = Not OK = Not Readyable MOBILE HOMES MISCELLANEOUS Date MOBILE HOME UTILITIES (Plans) OK except it's Date DECI(S;COVERS,CARPORTS,GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements ' oning Sequirements-Setbacks-Easements \, 2. Soils; Special MH Support -Sketch ootings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Sewer; Location -Test -Fall -C/O -Concrete rg-GeO s; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4_AUeed--twn' Posts-Beams-Rftrs.-Connec.- Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 6. Gas; Location -Test -Wrap: / PV ft. / /"Nat. or/ /"L"ft./ /"LPG 5..AlLm_Aw*.:Columns-Connections-Splice-Decal-Enclosures 87-6efpnctsrlAliwdows-Doors 7. Utility Clearance EIec. s-Anchors-Studs-Rftrs-Trusses iding;,Nailing-Veneer-Stucco-Mesh Card -131 Date Card -131 Date 16-Troof; Shthg-Roofing Card -B1 Date Card -131 Date1+-Ex—f., Steps -Doors -Landings Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements -Card- B Card -131 Card -131 Date ate' '7, ward -B1 Date 2. Footings; Size -Spacing -Marriage Line 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 - Dead Men -Lining 8.. Gas and Electricity Tagged 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 -131 Date Card -61 Date Card -B1 Date Card -61 Date 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Card -131 Date Card -131 Date Card -131 Date Card -131 Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County CenterDrive- Oroville, California 959E5 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER ZONING 24-13-80 ' BUILDING PERMIT OWNER Dale Farmer TELEPHONE 846-0904 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 865 Keith Ave Gridley CONTRACTOR'S NAME TELEPHONE NorthVall CONTRACTOR'S M (LING 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 $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS Permit fee $ 865 Keith Ave Gridley PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE Gas piping system 1 - 5 outlets 5.00 SF ❑ Duplex❑ Mobilehome❑ Other garage Building sewer 5.00 Mobile Home S I G I IN SPECIFY TYPE OF WORK _10-00e New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ® Permit Fee $ Describe work: elec Service (temp) Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service e00v OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 2,50 CONTRACTORS LICENSE LAW NEW CONST. DWELLING OCCUP.& OR ADONS. vtsgft I declare under penalty of perjury (check one): ACC. BLOGS. NEW CONSTR.MULTI-OUTLET El I am licensed under provisions of Chapt. 9, Div. 3 of the Business NON-RESID BRANCH CIRC ITS POWER APPARATUS & 2.SOea and Professions Code and my license is in full force and effect. -SINGLE OUTLET CIR. License No. Classification Ex. OCCU OUTLETS OR FIXTURES P 200.50 8AL030FIXED inI, as the owner, or my employees with wages as their sole compen- Ex. Occup. OUT ETS PIRESID IAPLNS.REA.1 2.00 sation, will do the work,and the structure is not intended or offered Temporary service 10.00 for sale. (Sec. 7044) fV 1, as the owner, am exclusively contracting with licensed contract- ontract- Mobile Home Facilities 15.00 ors. ors.(Sec. 7044) Misc. Wiring g 15.00 1 ❑ I am exempt under Sec. , Business and Professions Code for this reason Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): MECHANICAL PERMIT FiIingFee 10.00 ❑ The permit is for $100.00 (valuation) or less. Heating ❑ 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. Cooling I shall not employ any person in any manner so as to become subject 'T Hood 3.00 to the W. C. laws of California. Ventilation 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 Permit Fee $ provisions or this permit shall 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 $ to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. DCC I CONSTTYPE I also agree to save, indemnify and keep harmless the County of Butte against TOTAL FEE $ 37.50 all liabilities, judgments, costs, and expenses which may in any way accrue HAZ I CUA PARK SCHL FLD PAR PD HD Issu id County in nsequence of the granting of this permit. I I I I ,Ica i X is �, Date This permit is hereby issued under the applicable provi- Bions of the Butte County Code and/or resolutions to do gnature of Applicant — Owner ❑ Contractor ❑ Agent ❑ work i ated above for which fees have been paid. An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. DIR OF PU 1 ORKS Receipt No. B Date WHITE-O.P.W.. YELLOW -ASS SOR. PINK -INSPECTOR. GOLDENROD -APPLICANT PERMIT EXPIRES Date19-1 r .j COUNTY OF BUTTE - DEPARTMENT, OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - ORO ,,VILLEFCA, L•IFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET OWNER Proposed Building Use Building Ins Permit No. �7 A., P. No. CPP4— /3 Date 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. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13. School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (con tructio approval required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec. request to r Building Inspector (Date) 21. Contractor's license 'nformation (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 4. Recorded copy of Agricultural Acknowledgment Statement ......... lv�5. Let�t ^r^of signature authorization 26. M� /�ipDn Ri x PL✓YUC� vr1l� 27. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other Ii Applicant Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent _Health Dept. Fire Dept. Other Date By. 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---nail—counter by ..date Contractor, designer, owner, was advised of above required data by—phone _mall—counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, Califo�l 95965 - Telephone: 916/538-7541 ` APPLIC-ATJN- ID PERMIT PERMIT NO0 ASSESSOR FARC L 3 NUMB ZONq o BUILDING PERMIT OWNE T LLPPHON a, 5E �j" SQ. FT. OCC. BUILDING V L ION 4J F0 M OWNER'S MAI VI ADDRESS CONTRACTOR'S NAME TELEPHONE CONTR-ACTOR'S MAILING A DRESS a�' a� Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ • 56 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS ^ c� Permit fee $ 16 3. PLUMBING PERMIT Filing Fee 10:00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF❑ Duplex❑ Mobilehome❑ Other s ECI FY Gas piping system 1 - 5 outlets 5.00 Building sewer Mobile Home -s G W a ff0-00 TYPE OF WORK New Addition ❑ Remodel ❑ Utilities ❑ Installation El Other ❑ Describe work: O a Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10 00 Main service 1100v OR LESS10010.00 AMP OR LESS Main service EA. ADD'L 100 AMP 2.50 i 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. �%—J License No. X33 % TLi Classification EJ 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) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. (DWELLING OCCUP.y\ '/zQsgft OR ACDNS. ACC. BLDGS. I NEW CONSTR. MULTI -OUTLET 2,50 ea NON.RESID BRANCH CIRC ITS POWER APPARATUS e SINGLE OUTLET CIR. EO(ewL003050' x. ccupOUTLETS OR FIXTURES 20 FIXED APLNS. Ex. Occup. OUTLETS P(RESID )REA.7 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ 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 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. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation pertnit 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, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in co quence of the granting of this permit. %� - Date d 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 $ Energy Inspection Fee $ TOTAL PER T FEE $ o MJ!WEJ_____[7�F,,"JPARC'JPD ND sSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By PEWT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date - l'- 7- Receipt No. WNITE-D.P.W., YELLOW-ASeISSOR, PINK-INePLCTOR, GOLDENROD -APPLICANT ... ��` T e.1. r r .. °}.rlic_4t F; .�..M< `� l •��'� � 4, ,_ 7. } i� � � L. � 1 � . � a ' . COUNTY OF BUTTE - DEPARTMENT OF, PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, �AIRNIA 95965 -TELEPHONE: 916/538-7541 PERMIT APPE>h'A�T-i 7N DATA SHEET ~ Permit No. OWNER -� � 7�l ti �% �A.P. No.6L—.Z?, Proposed Building Use ��Y Cf,�_% Building Inspector Date �F 11-5-7111 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. Plans with Energy Design Compliance Statement. . . . . . 6. School District "Fees Paid" Stamp on Floor Plan. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . 9. Letter of signature authorization. r %/Z 10. Sanitation approval from Health- Dept. D c� 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Cofitractor's License Information (no., name style, classif.) _14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑) — 15. Improvements may be required. . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . . . . Pre-Inspec.request to (Date) 17. Pre -Inspection for__. ..-_ _ _. _ Required- Building Inspector 18. Recorded copy of Agricultural Acknowledgment Statement. 19. Driveway Permit. _i20. PloL plan approval from city of_ 22. _ — — -- When you issue the permit, pi ,,cess as follows: Mail to owner, Mail to contractor_ \_ Telephones3 5_-5y � and hold for pickup a�_office, Deliver w/inspector. Other Applicant Date Copy of plans sent Health Dept.;Fire V $t., Other Date v The following data must be submitted prior to perm' suM c : (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required:__— Contractor, designer, owner, was advised of above required data by_phone---nail—counter by date _ Contractor, designer, owner, was advised ci above required data by—phone _maiI—coun/tan, by date (moi Plans checked by Date Plans approved by ` ' Date Sets of plans on hold in File cabinet AP folder Copy—DPW TO Buildinq Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Location AP# Plan Approved for: Sewage Disposal Water SuvDIv Hold final for: Water Supply Final clearance O.K. for: Water Supply Clearance for bedroom mobile home. Other -Z`'YI'I NOTE Sanitarian Date SITE PLAN ------------- ------------- -------- .. . ;. .. .. .. .. .. .. .. ............ .. .. .. .. ............ .. .. ... .. .. ... _ .. .... _...........f.. ... :w • •3.. .. ...... .....:......:.... " ..:._....:......:.....:.. . . ...:... s.. :�.... ........ �.. .ue qty: !®""= ..$ ... �y.... .. ._ .. .. .. .. ._ ....................... i i� t <.. .. i... <.. , . (J <.. s :.._...'...._.: .... ....... :..... ....:. l :.....:.�+..:.__...:......_. .....:........ .. .. .. .. �. :.... .. ..:.. ..:. .. .. .. .. .. .. .. .. .. .. .. .. �. :�........ .. .. .. .. ............. ...............8.: :.?..:...... ..... -" -- • -- = ..... ...:...... .a. - ..... .. .. ._ -� - _ .. 17 8 d . -O - �.... .O.f�. .. .. .. .. .. .. .. ............. .. .... O jltR,p r .... .. .. , =.- e m 1 .. ' o •.- u z_ = . g: A. �.o�-54 : _ aEv i = s it �. e�tri• . 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Rl — QI30 0 — 10RIP] Scale: 1"= ?,o I Owner Name Address / Phor Site Location 21 re. i _w" &3L L , G,' A_ 1-Q., u C•11 9s q q !i Contact: Name (n D - Phone (S3 0 @ , -11 1 I ( of 6'L�I — n�A�P octebw A 203 ., FOR OFFICE USE ONLY Zoning: General Plan Desig: Size, Acres `— 4.00" PROVIDE FOR ALL ADJACENT PARCELS SIZE (AC): ZONING: GEN PLAN: USES: SITE PLAN { ______... ............................ .. .. - - .f .. .. .. ... .. .. .. .. .. ... ... .. ..............f......:.... ;..... - ,,. -...... ..... ....... :..................:..••-........:.....:_ .:..:........ .. .,,...............,... -- e, a ..:....� �.v4TT .. .. �. � �..... .. .. _ ... .. .. .. �� � t iail =`• ..........:..... :.... :....; .... �3,...:........ ............. -- .. -.l ... .. .. ... .. .. .. -' -- -- -- :.....;..........:..." ......:... :....:..;.. .. .. ...:....:.. :.. ..:. .:.. . . ..... ... ......... ......... ...:................... :....:...... .............:... ... :.. _ . .. .. .. .. .. .. .. .. .. ..:.. :. _ .. .. .. ... 0 4 :6 �% _. .. .. .. .. .. tc�_. .. .. .. .. .. .- V4.. ................ ..................... �.. 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Assessor's Parcel Num Owner Name Address / Phor Site Location Contact: Name El0P-41 — 0Fil® — F21®KI Scale:1"= lol (Qo- - Phone 43-_-m1! , 63-tqLf FOR OFFICE USE ONLY Zoning: General Plan Desig: Size, Acres `— 4.Oo" PROVIDE FOR ALL ADJACENT PARCELS SIZE (AC): ZONING: GEN PLAN: USES: f" a MR