HomeMy WebLinkAbout024-140-04024-14-40 0*0
KILBY
0:)4-
286 Evans Reimer Rd., Gridley
024-140-040 PERMIT#95-3074
ALLEN, Jacquelyn
286 E Evans Reimer Rd., Gridley
L �f
Cont; Cousin Gary's_ ---
MH ' onf Perm F,nd,
024-140-040 PERMIT#95-3132
ALLEN, Jacquelyn,
286 E' Evans" Reimer Rd.,, Gridley
! Cont; Ray Drummond p ��
Repairs/Well House
024-140-040 - PERMIT 96-0149
ALLEN, Jacquely�. -�- /�
286 E Evans Reimer Rd..,,Gridley
Mobilehome Utilities-___=
�---- ------ -- r=te
ELECTRIC
GAS LINE
COMPACTION TEST REQ
SUPPORT STRUCT RE
024-140-040 PERMIT#96=0150
ALLEN, Jacquelyn
286 E Evans R)'e_ims3r Rd. Gr ' dley
Cont; C6usi:n Gary's.
Mobilehome' Installation C-9/01 �6
i
i
, _ __I 1__ � f� �
+ ' i
..., ,..,. ., ... � �... 111 � �.._....._�i
DECAL (LICENSE) NUMBER(S) SERIAL NUMBER(S) TRADE NAME.
,SECTION I. CERTIFICATION OF MISSING TITLE
The original HCD Certificate of Title or DMV Ownership Certificate (pink slip) was:
® Lost, ❑ Stolen. If the title was lost or stolen after receiving it from a party other that the Department, enter the
party's name here:
❑ Illegible, ❑ Mutilated. A mutilated or illegible title must be surrendered to the Department.
❑ Not Received from the Department. This box can only be checked by the Legal Owner of Record (lienholder), or if none,
the Registered Owner of record.
I/We certify under penalty of perjury under the laws of the State of California that there are no liens against this unit other
that those shown on this application and the statements made on this application are true and correct.
I/We agree to indemnify and save harmless the Director of the Department of Housing and Community Development for any
loss suffered resulting from the issuance of said duplicate Certificate of Title.
Executed on 9/07/09 at Gridley CA
(Date) (Ci,ty) (Sla"o)
_ AI/�1 n I -N
Sig
Printed Name of Person Completing Certification
SECTION II. RELFASE OF OWIUFRSHIP AND/OR INTFRFST
1 A.
RELEASE OF REGISTERED OWNER
Ma Al 1
RELEASE DATE
B.
RELEASE OF REGISTERED OWNER
Jonn A 1
RELEASE DATE
C.
RELEASE OF REGISTERED OWNER
RELEASE DATE
A.
RELEA I
EGA OWNE (
DER)
RELEASE DATE
B.
RETENTION OF LEGAL OWNER
DATE
C.
ASSIGNMENT OF LEGAL OWNER
DATE
SECTION III'. DEALER'S RELEASE OF ACQUIRED UNIT
A. NAME OF DEALER
DEALER NUMBER
B. RELEASE OF DEALER RELEASE DATE
SECTION IV. NEW REGISTERED OWNER SIGNATURE(S)
4 A. NEW REGI STERE 0 !CR SIG A Kathle Pul S If this transfer is the result of a
sale, the sale price and sale
date must be entered below.
B. NEW REGISTERED OWNER SIGNATURE PURCHASE PRICE
$44,000
C. NEW REGISTERED OWNER SIGNATURE PURCHASE DATE
9/07/09
HCD 480.4 Side 2 (REV 09/07)
.signature of Applicant
HCD 481.2 (7/97) '
' DEPARTMENT USEZNLY
'' STATE OF CALIFORNIA '
BUSINESS, TRANSPORTATION AND HOUSING AGENCY
DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT ��:'
DIVISION OF CODES AND STANDARDS
REGISTRATION AND TITLING PROGRAM
APPLICATION FOR DUPLICATE
REGISTRATION CARD
'DEPARTMENT USE ONLY -
TRANS CODE
'
NEW DECAL p
STICKER N
slTus cc
OLD DECAL a
Manufacturer Trade Name
SKYLINE
ILT Exemptiun
Date First Sold New
1996
DECAULICENSE p
MANUFACTURER SERIAL NUMBER(S)
HUD LABEL OR HCD INSIGNIA p
ULI 421671
ULI 421672
TMENT
EUSEONLY
USE CODE EXPIRATION DATE
TAX TYPE ORIG COST CODE
YR CLERK'S INITIALS
PPF
ILT
EXT
LPT
PPT
RF
RECEIPT NUMBER(S)
RECEIPT DATE(S)
ILT
Registered
Owner(s)1.
[print true
name(s)]
Last
ALLEN
First Middle
MARK
MRF
PENT
2. ALLEN JOANN
PEN2
7.
Current Mailing
Address
street p0 BOX 385
TRF
city GRIDLEY OY'PrE CWe 959419
TOD
Future Mailing
Address (if
different than above ]
Street
DUPT
Com' County State Zip
DUPR
SUBD
SHUS (location)
Address of unit
Street
2 8 6 E. EVANS
RE IMER ROAD
CONF
city GRIDLEY County BUTTE state CA 951848
REPO
Legal Owner
(Iienholder) [print true
name(s)]
RREG
RSF
Mailing Address
Street
City State
zip
PLT
First junior
Lienholder
(print true name)
SIT
UTP
RT
Mailing Address
Street
city StateASF
Zip
CCP
Second Junior
Lienholder
(print true name)
TOTAL
Mailing Address
Street
city State
Zip
Mobilehome
Park
Parr Name
Operator Name
11We certify under penalty of peqgy under the laws of the State of California %hpt the foregoing is true and correct and that the
registration card has been: IN Lost, ❑ Stolen, ❑ Mutilated, ❑ Illegible, or ❑ Not Received
Executed on September 7 2 O9 at Grid" .CA
ate) C )
(Date /� / (c it / r /\ =` (State)
.signature of Applicant
HCD 481.2 (7/97) '
93-24675
LOT 32, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "GRIDLEY COLONY",
WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE
COUNTY OF BUTTE, STATE OF CALIFORNIA, ON JUNE 7, 1905, IN BOOK 4
OF MAPS, AT PAGE(S) 37.
EXCEPTING THEREFROM THE FOLLOWING DESCRIBED PARCELS OF LAND!
PARCEL A:
THE WEST 152 FEET OF LOT 32, AS SHOWN ON THAT CERTAIN MAP
ENTITLED, "GRIDLEY COLONY", WHICH MAP WAS RECORDED IN THE OFFICE
OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON
JUNE 7, 1905, IN BOOK 4 OF MAPS, AT PAGE(S) 37.
EXCEPTING THEREFROM THE SOUTH 359.16 FEET.
PARCEL B:
THE EAST 150 FEET OF THE WEST 302 FEET OF IAT 32, AS SHOWN ON
THAT CERTAIN MAP ENTITLED, "GRIDLEY COLONY", WHICH MAP WAS
RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE,
STATE OF CALIFORNIA, ON JUNE 7, 1905, IN BOOK 4 OF MAPS, AT
PAGE(S) 37.
EXCEPTING THEREFROM THE SOUTH 359.16 FEET OF THEREOF.
PARCEL C:
THE EAST 150 FEET OF THE WEST 452 FEETOF LOT 32, AS SHOWN ON
THAT CERTAIN MAP ENTITLED, "GRIDLEY COLONY", WHICH MAP WAS
RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE,
STATE OF CALIFORNIA, ON JUNE 7, 1905, IN BOOK 4 OF MAPS, AT
PAGE(S) 37.
EXCEPTING THEREFROM THE SOUTH 359.16 FEET THEREOF.
END OF DOCUMENT
4,
.-\nd when recorded mail to:
Building Division
47 County Center Drive
Oroville, Ca. 9.5965
X00
FEB 411996
AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT
FOR RESIDENTIAL DEVELOPMENT
Section 26-8 of the Butte County Code requires this acknowledgment to be recorded prior to issuance of a building permit. The
property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this
property may be subject to inconveniences or discomfort from the use of agricultural chemicals. including. but not limited to
herbicides. pesticides. and fertilizers: and from the pursuit of agricultural operations including, but not limited to cultivation.
plowing, spraying, pruning. and harvesting which occasionally generate dust. smoke. noise, and odor. Butte Count- has established
agricultural purposes and residents %%-ithln Said zones and on adjacent property Should be prepared to accept such inconvenience or
discomfort frorn normal. necessary form operations.
All that real property situate in the County of Butte. State of California, described as follows:
D:ttc: ' PROPERTY OWNERS:
State of California )
Count• of )
OnA�w before nie� �-
personally appearedher+ll?
koowA-W; m (or proved to me4n the ba. is of satisfactory evidence) to be the 1)erson(4 whose name(a) is/amts subscribed to the
within instrument and acknowledged to me that M/she/tom, executed the same in.4ok/her/Qw4r authorized capacity(isw), and
that by ids/hcr/Ntpr signature* on the instrument, the person($ or the entity upon behalf of which the person( acted,
executed the instrument.
WITNESS my hand and official seal.
DONNA L KNIGHT
Commission #1076664 Z
,� w Z OMMV
Notary Public — California r
Si �natus —� aTl�yt Seal: Butte County
Comm. Expires Oct 22. IM
A.I'.~ 0 a-/ — /5'O — e, 9/v
'
NOTE TO RECORDER: no No'r RECORD ,rms s1DE - A.A. - I
AGRICULTURAL ST'ATEME�IT QF.ACKNO . F' G�IYIEIYT
Instructions for recording Agricultural Statement of Acknowledgement:
I. Insert the legal descriptiondescription of the property in the space provided on the other side of this
form. The legal description is the narrative description of the property - which will be on
your decd. If you don't have access to the deed. the Recorders Office can provide this
information. ( The description may be handwritten or typed in the space provided or attached
on a separate sheet if more space is required).
2. Property owners must sign in the presence of a Notary Public and have the form notarized.
3. ivtake a coPy of the form and then take the original and copy to the Recorder's Office at 25
County Center Drive, Oroville (the Administration Center building). The Recorder will
record both the original and copy. They will keep the original and return the copy to you.
Just bring the copy back to the Building Division at 7 County Center Drive.
RECORDER'S FEES: $6.00 - Ist. Page
$3.00 - Each Additional Page
RECORDER'S OFFICE HOURS: 9:00a.m. - 3:00p.m. (Monday - Thursday).
OVER
9.3-24675
LOT 32, AS SHOWN ON THAT CERTAIN MAP ENTITLED, 'GRIDLEY COLONY",
WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE
COUNTY, OF BUTTE, STATE OF CALIFORNIA, ON JUNE 7, 1905, IN BOOK 4
OF MAPS, AT PAGE(S) 37.
EXCEPTING THEREFROM THE FOLLOWING DESCRIBED PARCELS OF LAND:
PARCEL A:
THE WEST 152 FEET OF LOT 32, AS SHOWN ON THAT CERTAIN MAP
ENTITLED, "GRIDLEY COLONY", WHICH MAP WAS RECORDED IN THE OFFICE
OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON
JUNE 7, 1905, IN BOOK 4 OF MAPS, AT PAGE(S) 37.
EXCEPTING THEREFROM THE SOUTH 359.16 FEET.
PARCEL B:
THE EAST 150 FEET OF THE WEST 302 FEET OF IAT 32, AS SHOWN ON
THAT CERTAIN MAP ENTITLED, "GRIDLEY COLONY", WHICH MAP WAS
RECORDED -IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE,
STATE OF CALIFORNIA, ON JUNE 7, 1905, IN BOOK 4 OF MAPS, AT
PAGES) 37.
EXCEPTING THEREFROM THE SOUTH 359.16 FEET OF THEREOF.
PARCEL C:
THE EAST 150 FEET OF THE WEST 452 FEET OF IAT 32, AS SHOWN ON
THAT CERTAIN MAP ENTITLED, "GRIDLEY COLONY„, WHICH MAP. WAS
RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE,
STATE OF CALIFORNIA, ON JUNE 7, 1905, IN BOOK 4 OF MAPS, - AT
PAGE(S) 37.
EXCEPTING THEREFROM THE SOUTH 359.16 FEET THEREOF.
END OF DOCUMENT
31ds[�W, M, - giez:f-
RESIDENTIAL
024-140-040 PERMIT#96-0149
ALLEN, Jacquelyn
-r.-286 E Evans Reimer Rd., Gridley
Mobilehome�-Util-ities
ilk I V z
s.
OFFICE COPY
Address -52-9 �"
GAS Dated 73/2
Meter BY
ELECTRIC Date
Meter B
JOB FINALED (Date) CJ ';L
Signature
V=OK
r.
0 = Not OK
3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
'= Applicable
MOBILE HOMES '
Nott Ready
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
Date
MOB OME UTILITIES Plans OK except #'s
. g Requirements - Setbacks - Easements
Soils; Special MH Support Sketch
3. S r• ocation-Test-Fall-C/O-Concrete
er. Location -Test -Easement Needed (Sketch)
Electricity; Location-Clearances-Gmd-/ /Amp -Concrete
6. GgXLLocation-Test-Wrap; / PI.2ft.
/ t r/ /"L"ft./ /LPG
Date
77. Clearance & Disconnect
Date
8. Utility Clearance
Date Card B-1 Date Card B-1
Date Card B-1 ._ . Date Card B-1 -
Date MOBIL HOME INSTALLATION Plans OK except #'s
o ' g Requirements -Setbacks Easements
s; Size -Spacing -Marriage Line
UeSectricity; MH Test -Crossovers -Breakers -Clearances
rain; MH Test -Fall -Flex Connector
Z;..�aterwid S6mef onnected C/O to Grade -HD Approval
8. nd Electricity Tagged
,Vlie D wns-Type-InstaIla tion Cert.
-kits; Insp.-Sketch
la -Q61 of Occupancy'
Date Card B- Date Card B.1 A
Dat jajb, Card B-1 Date Card B-1
��as3 fya 2g, CoereA- sP )CeLl AJ
�.
� J .
0
MISCELLANEOUS
10
2.- Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rftrs.-Connectors
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-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, Distance-GFI
5. Elec.; Pool Lighting; 15 Volts-GFI
6. Elec.; Enclosures; Conduit Entries-Terminals-Usted
7. Elec.; Bonding; Metal w/6 -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-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
10
'J OK
O = Not OK
= Not Applicable
= Not Ready
Date UNDERFLOOR (Plans) OK except #'s
1. Zoning -Setbacks -Easements -Flood -Slope
2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped
6. Stemwalls, Garage; Steel -Bloc kouts-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. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test
11. Water Pipe; Test -Anchor -Regulator -Service Test
12. Electric; Underground
13. Pienums & Ducts; Clearance -Material -Support -Ins.
RESIDENTIAL (Single & Duplex)
Date FRAMING
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
15. Access & Ventilation
16. Insulation
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date PLUMBING (Permit),OK except 1r'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 a's
22. Fixture & Transformer Clearance -Ins. Protection
--------- ------------- ------------------------------- I-----------------------
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
-----------------------------------------.-----
26 Equip. Ground made up wrMech. Fastners-Bond Gas & Water
-----------------------------------------------._.._... ........ ..........
27. 2 Appliance Circuts in Kitchen & Conductor Size,GFI
------------------------------------------...------- --
28. Subfeed Wire Size ga. Cu or AI-A.C. Wire Sze ga.
Cu or At
-------------------------------
29.
-------- 29. Range Circ r , ga. Cu or AI -Oven Circ. r ga. Cu or Al.
Insulated Neutral ❑ Yes 1 ❑ 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
--------------- I ------------- . ......-_............. ....I .. ....... ....... ..
Date Card B-1Date Card B-1
---------------- ....... ---- -- . -- --
---------------- --- --- --- --- --- -
Date Card B-1 Date Card B-1
Date MECHANICAL (Permit) OK except P's
34. A C. Ducts Insulation & Support
---------------- ------ --------- --._.....- - ----............I... ... .. ....
35. Vent Fan: Exhaust above insulation
--------- ------ - -- .. ............... ..
36. Condensate Dram & 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 a'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 -Stags -Chases -Tub
44. Headers & Beam -Size & Bearing
(Continued)
45. Hangers -Post Caps -Anchors -Connectors
46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Rfng.
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. -Properly Line Firewall & Openings _
52. Ext. Doors -One 3=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
-------- - --...----------------------------- -
Date Card B-1Date Card B-1
------------------ -----------------------
Date Card B-1 Date Card B-1
Date FINAL (Plans) OK except a's
61. Ext. Steps -Door & Sidelight Protection -Landings
-------------------- - --
62-.- Smoke Detector
----- ------------------------------------ - -
63. Furnace: Vents -Clearance -Comb. Air -Connector -
In Garage: Above Floor -Ducts -Meth. 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.
.----------------70. Kit.Fixl. & Appliance: Grnd.-Air Gap -Cooking Clearance
- - - ----------------------------------- --
71. Elec. Outlets & Receptacles at Kit. Counter
72. Garage Fire Door: Swing -Landing -Closer
_ -- ----------------------
73.
---- --------- -----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
7, 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-Firep lace. -Clearance to
Openings,
------------ -
n -------- --------------------
84 Water Well: D sconnect. 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-CrO 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:
1
=KYCRE=T
CONTRACTORS VERIFICATION
I certii'v that T have installed the Around loc tie down system as
per the instatlati.on instructions. I have made no modifications
to the tie down system or to the build.ina structure.
Skvcr.est Bui.ldiniz Systems - Chico
13468 Hwy. 99
Chico. CA 95973
(916) 342-2694
Contractor's Licens #29541
Installer':
-- -- --- ----- --- -- --- ...-
For Customer Name:
S.i t e AddressQ._.......__/�t�_�✓�—f
Permit Number G�- fJ /{� Serial Number
State Contractors License Number 295412
13468 HWY. 99, CHICO, CA 95926 (916) 342-2694 .
r
COUNTY OF EtUTTE-DEPARTMENT OFrDEVEti:OPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER 24-140-040
ZONING A-5
BUILDING PERMIT
OWNER JACQUELYN ALLEN
TIONE4322
SO. FT. OCC. BUILDING VALU
OWNER'S MAILING ADDRESS 206 E EVANS REIMER GRIDLEY
CONTRACTOR'S NAME
TELEPHONE
CONTRACTORS MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNMOWN
Total Valuation is
Filing Fee
$ 20.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ 23.00
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Penalty
$
BUILDINGADDRESS 286 E EVANS REIMER
PERMITFEE
$ 23.00
PLUMBING PERMIT
Filing Fee 20.00
GRIDLEY, 95948
Each Trap
7.00
LOTNO.
SUBDN510N'SNAME
PARCEL MAP
Solar or heat pump water heater
23,00
Water piping
15.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehomdb Other
SPECIFY
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities IN Installation ❑ Other ❑
Describe Work: 26 X 60 3 BEDROOM 2 BATH
—
Mobile Home S V}(
920.00 60.00
PERMITFEE
J$ 80.00
Contractor
ELECTRICAL PERMIT
Filing Fee 1 20.00
Main Service ( 2000A 00A OR LESS OR LESS )
23.o0 23.00
Main Service ( 200A TO 1000A )
46.00
LICENSED CONTRACTOR'S 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 the Business and Professions Code,
and my license is in full force and effect.
License Class Lic. No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ 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.
JR I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
NEW CONST. DWELLING OCCUR
OR NS. ( 8 ACC. )
SO.
3.52 FT.
TLE
CONST. MULTI -OUTLET
NEW CT
NON-RESIO. ( BRANCH CIRCUITS )
97.50
POWER APPARATUS
(a SINGLE OUTLET CIR. )
Ex. Occup. ( OUTLET OR FIXTURES )
20 ® 1.00
BAL a .30
Ex. Occup. ( ounEEDrs PLNS j EA )
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00 20.00
Misc. Wiring
23.00
PERMITFEE
$ 63.00
Contractor
WORKERS' COMPENSATION DECLARATION
1 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 is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
MECHANICAL PERMIT
Filing Fee 20.00
9
Heating
Cooling
Hood
6.50
Ventilation
PERMITFEE
$
Contractor
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 1 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 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 Date el—;9 g — �'G
Sign atu Of pplicqA Owner Contractor ❑ Agent
An O411A p rmit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee
$
Energy Inspection Fee is
Occ
CONST. TYPE
TOTAL FEE $ 1 66.00
HAZ.
1 0. FEES
I IMP
FLOO
CDF PARCEL PD I HD
UE
This permit is hereby issued under the
of the Butte County Code and/or
indicated above for which fees have
By
PERMITEXPIRESON
applicable provisions
Resolutions to do work
been paid.
�y
Date
L %D.D.S.-B.D.
(ateJ
rReceiptNo. 190686
CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
310.x_.
A LRA
TURES AND. ED-tio-f p-=n�lc1U Np--- --
S SHALL BE CLEAR OF ; c,. F'S>EME K CF`0E NDFROM THE_REARPROrROM TWE -ROAD CELT.-_ = =HAL BEwTRUCTURES AND EQU:114Y cXC !�'FAVE' VERHM -- ---- --
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JAN OS 196 1408 SKYLINE W' 'LAND ;fie "S 916347' 196 P•3 P.04
(M/\0kfdd1V
iN3VV del"
.---.APPROVED.,. - , ,
Butte County �� AiNrloo 3Uf%
En)ironmental Health
- - u Dae------ i 'd
Signaturey
4 C
v
m
N
N
9661 y Z Nvf
aline io unmoO
TO:
FROM:
SUBJECT:
Building Department
Environmental Health
Sanitation Clearance
Owne Location
Plan Approved for: Sewage Disposal �� Water Supply:
Clearance for bedroom mobile home. Other
Fold final for:
Final clearance O.K. for:
NOTE:
Public
O.H. USE ONLY
Plot Phu Afta&W
Flo" Pim AUR&ed
Sent to B.D. I — ,7 S 76
g- — I Y,!. b
AP#
Private Well
Environmental Health Specialist Date
2/01)
r
* },"'
COUNTYOF BUTTE - DEPARTMENT.OF EyELOPMENTSERVICES -BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE (916) 538-7541
PERMIT APPLICATION DATASHEET
OWNER �Gt C Ix A. P. No. -2
Proposed Building se 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 BY
1. All items have been submitted . ....................................... .
2. Plot plans, 3/4 sets, signed by preparer of plans . ......................... .
3. Complete plans, 3/4 sets, signed by preparer of plans. ..................... .
4. Engineered plans and talcs, 3/4 sets,.with wet signature on plans . .............
5. Hazardous Material Form. ...... *.....................................
6. Energy Design Compliance and supporting documentation . ..................
7. Statement of Intent for Non -Heated and A/C Buildings . ......................
8. Engineered truss details and layout in duplicate (required prior to plan check). ... .
9. Mobilehome data and manufacturer's installation instructions, 2 sets. ...........
10. Fees of $ ..........................................
11. Impact fees as shown on attached schedule. ............................. .
12: California Department of Forestry plan approval/fees. ....................... .
3. Flood elevation letter (100 year flood) by California Engineer . ............... .
Sanitation and plot plan approvalvrHealth Department . ............
15. City of Chico plumbing permit . .........................................
16. Plot plan and business license approval from City of Biggs/Gridley. .............
17. Planning approval for (A) Use: (B) Parking: . .........
18. Contact Land Deyelopment.about (A) Improvements (B) Drainage. .......... .
-19. Driveway permit (construction approval required prior to occupancy). .. .
Pre -Inspection re.quest
20. Pre -inspection for required. . to Building Inspector (Date)
21. Contractor's license information. (No., Name Style, Classification) . ..............
22. Certificate of Workmans Compensation Insurance . ..........................
23 Owner -Builder Verification (Given to owner Mail to owner _). ......... .
.-24. Recorded copy of Agricultural Acknowledgement Statement . ..................
25. Letter of,signature authorization . ............:°.......................... .
26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... .
27. Letter of intent on building use .........................................
.
28. Mobilehome utility clearance . ......................................... .
29. Documentation of legal access . .....................:................. .
30. Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning area and frontage requirements. ............... .
31. Existing violations/expired permits . ......................................
32. Plan check list . ............... .............................. - ......
33. �.a--
34.
Whe ou issue thg, rmik frrQcess as follows: Malt �w�ej. Mail to contractor.
l/ Telephone and Y t� and hold for pickup at �� V/ ((� office. Deliver with inspector.
Other
Parcel Creation
Acreage Applicant ti^ - Date
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date
Copy of plans sent Health Dept. F're Dept. Other Date By
The following data must be submitted prio ermit 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 _ mail Counter by _ Date
Contractor, designer, owner, was advised of above required data by _ phone_ ma' C e _ Date
Plans checked by Date Plans approved by Date
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Works
m
N
W�r7m
`�'N i� n�EkSoJ
k.4C_ Cj6dt4a
cad cf�f llq
It
m
I
MOBILEHOME INSTALLATION ACCEPTANCE
COUNTY OF BUTTE It
DEPARTMENT OF DEVELOPMENT SERVICES R
BUILDING DIVISION ---7 COUNTY CENTER DRIVE
OROVILLE, CA 95965 --PHONE (916) 538-7541
APN:
PERMIT NO.:
—/ 0 —0 L/
to bI5 a
Owners:
Name: (x e
J
+s
Owners:
�,
p /
eG
n
a/
Address: / /
% P/ !`"t�(
: "//
Mobilehome
Year of
I G
Manufacturer -L_
Manufacture:
;Serial number
Insignia or
or V.I.N. 0 "d(l i - 2
HUD number: LL �-T
a 1(a-1 2 -
Official approviing installation:
Official
Date:
dw
Gy
If the mobilehome is mimed 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 -Bldg Gold -Assessor
COUNTY OF BUTTE- DEPARTMENT 01.101EVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATION AND PERMIT ��
ASSESSOR PARCEL NUMBER 24-140-040
ZONING - A-
BUILDING PERMIT
OWNER JACQUELYN ALLEN
TQ 4"&-4322
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS 206 E EVANS REIMER GRIDLEY, 95948
CONTRACTOR'S NAME
COUSIN GP.RY' S
TELEPHONE
CONTRACTORS MAILING ADDRESS
Fireplace
CONSTRUCTION LENDERUN
KNOWN
Total Valuation $
LENDER'S MAULING ADDRESS
Filing Fee
$ 20,00
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS 26 Y 66 3 EEDROOif 2 BATIT.
PERMITFEE $ 43.00
PLUMBINGPERMIT
Filing Fee 20.00
Each Trap
7.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Solar or heat pump water heater
23.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome CI Other
SPECIFY
Water piping
15.00
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Unities ❑ Installation IN Other ❑
Describe Work:
Mobile Home IS I GI W
@20.00
PERMITFEE
S
Contractor
ELECTRICAL PERMIT
Filinq Fee 20:00
Main Service000V OR LESS
( 200A OR LESS )
23.00
Main Service ( 200A TO 1000A )
46.00
LICENSED CONTRACTOR'S 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 the Business and Professions Code,
and my license is in full force and effect.
License Class Lic. No.
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ 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.
I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
NEW CONST. DWELLING OCCUR.SO.
OR ADDNS. ( & ACC. BLDS. )
3.5¢ FT.
NEW CONST. MULTI.OUTLET
NON-RESID. ( BRANCH CIRCUITS )
@7.50
( POWER APPARATUS )
8 SINGLE OUTLET CIR.
Ex. Occup. (OUTLET OR FIXTURES)
20 @ 1.50
BAL 50
Ex. Occup. ( FIXED((ROE)
EREESID.A
5.00
Temporary Service
`23.00
Mobile Home Facilities
20.00
Misc. Wiring
»
_3.00
PERMITFEE
$
Contractor
WORKERS' COMPENSATION DECLARATION
1 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 is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMITFEE
$
Contractor
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 1 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 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 Date 4ir1, cl 2�1�r�_
Sign atVf of plican - Owner Contractor ❑ A ,nt
An O9KA permit is required for excavations over 50" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee $ 100,00
Energy Inspection Fee $
OCC
CONST. TYPE
TOTAL FEE $ 143.00
HAZ.
D. F S
IMP FLOOD
CDF
PARCEL PD
HD Esu
This permit is hereby issued under the
of the Butte County Code and/or
indicated above for which fees have
By %
PERMITEXPIRESON
applicable provisions
Resolutions to do work
been paid.
/
Date �Z b
Z
( ate)
Receipt No. 190686
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
a
4 " .+vt»,%a5'LI'F•lg.«j- ,, n �a
COUNTYOF BUTTE - DEPART
ME !OFVELC
7COUNTYCENTERDRIVE-O OVIIaLE;1IFOF
ES - BUILDING DIVISION
IA95965 - TELEPHONE (916) 538-7541
PERMITAPPLICWTION DQ►TASHEET
/ Q,
OWNER �a(11A9- Al �/ rl A. P. No°F'q_ l qo 12 yU
Proposed Building Ve M Hlc sBuilding Inspector Date /-2 Z - gL
At time of permit application, I was advised the following data=must be submitted prior to permit processing and/or issuance:
DATE RECEIVED BY
1. All items have been submitted . ........................................ i
2. Plot plans, 3/4 sets, signed by preparer of plans. .......................... L
3. Complete plans, 3/4 sets, signed by pieparer of plans . .......................
4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . .............
5. Hazardous Material Form . .............................................
6. Energy Design Compliance and supporting documentation . ..................
7. Statement of Intent for Non -Heated and A/C Buildings . ......................
8. Engineered truss details and layout in duplicate (required prior to plan check). .
O 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... -9(, 1�3
10. Fees of$ ....................................
11. Impact fees as shown on attached schedule. . A;A40Kakt,-N-ea
12. California Department of Forestry plan approv es ....................... .
13. Flood elevation letter (100 year flood) by California Engineer . ................. .
14. Sanitation and plot plan approval Health Department . ............
15. City of Chico plumbing permit. ........................................ .
16. Plot plan and business license approval from City of Biggs/Gridley. .............
17. Planning approval for (A) Use: (B) Parking: . ........
18. Contact Land Development about (A) Improvements (B) Drainage. .......... .
19. Driveway permit (construction approval required prior to occupancy). . .
20. Pre -inspection for to BuispetIns reGu�
p required. . to Building Inspector (Date)
21. Contractor's license information. (No., Name Style, Classification) . ...............
22. Certificate of Workmans Compensation Insurance . ..........................
23. Owner -Builder Verification (Given to owner , Mail to owner, ........... .
24. Recorded copy of Agricultural Acknowledgement Statement . ..................
25. Letter of signature authorization . .............^.......................... .
26. Copy of recorded deed of parce reatign and 60 right of way to a public road. .. .
27. Lett r of on
ntent
28. Mobileholme utility clearance �..u. %. ,(J ' �C4.. . Pt . t
29. Documentation of legal acce s.- ... ...........:............' .
' 30. Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning area and frontage requirements . ............... -
31. Existing violations/expired permits . ......................................
32. Plan co�
check list.-/S/r9L
33. PADO
34.
When you issue thepp,ermit process as follows: Mail to owner. Mail to contractor.
TelephonesU-g3ay and hold for pickup at D/ -v L,'; /lam office. Deliver with inspector.
Other
Parcel Creation
Acreage Applicant ter" G�r''t`- Date 9G
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
1. Index permit for above items No: _
2. Additional items required:
issuance: (Circle new item not checked above).
Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date
Contractor, designer, owner, was advised of above required data by - phone_ mail un er by _ Date
Plans checked by Date Plans approved by�X_ Date
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Worsts
COUNTY OF BUTTE
DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 -COUNTY CENTER DRIVE, OROVILLE CA 95965 TELEPHONE (916) 538-7541
A.P. # o2q — Al -0Y
-PROPOSED BUILDING USE DATE ,/I/l
REC-. # DATE REC
SCHOOL DISTRICT FEES
(paid at District Office)
SHERIFF FEES (paid at Building Division)
Residential...... x
unit amt.
Commercial (sq.ft.). x
3. URBAN AREA FEES
(paid at Building Division)
Residential (per unit) . x = $
#units amt.
Commercial (sq.ft.). x _$
sq.ft. amt.
4. RECREATION DISTRICT FEES
(paid at District Office)
5. THERMALITO DRAINAGE DISTRICT FEES
$400.00 (paid at Building Division)
6.. SRA FIRE INSPECTION AND PLAN CHECK
$89.00 (paid at Building Division)
7. WATER TENDER FEES
(BATTALION# )
$200.00 (paid at Building Division)
8. CSA 87 TRAFFIC FEE
$2500.00 (paid at Building Division)
9. OTHER
At time of permit application, I was advised the above fees are required to be paid prior to issuance of the
permit.
APPLICANT DATE
F�,.a,f-»....t-+:.r.+,.:..t ;icr,,�.,.ti;.7'� {„"`'F-1 ..rs.,¢,�.'�✓a i'.s%,�; r: ri,%I'n '-rii,'.!�'rr+h'�§�'�''-.�x}a. ` „���„ey„w._w.—.�....,...,-rt_x,,,+i,
1
BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One Form Per Building) .
0
School District V� Building Department No.
A.P. Number 027_/4/19— eY6 Jurisdiction City ® County
Property Owner
Property Location/Address
Subdivison
Residential Development
No. of Living MHI
Units
Commercial/Industrial
Lot No.
Sq. Footage & y,/
Addition (Group R)
Sq. Footage
New Addition (Including Exterior
Roofed Areas)
Building Department Rep esen t ve Date
(Floor Plans reviewed by School District Personnel)
09
` District Identification No.� S r
N . S School District certifies that .
(Ap cant)
(Street Address) (Phone Number)
(City) (State) (Zip Code)
has complied with the requirements of Resolution No. by payment of $
0
representing $^DU square feet, ❑ Check here if fee received represents "Full Mitigation".
District,Fiep resentative
��/ 96
Date
a
Paid by Check # Remarks:
Bank Number
Paid by Cash
loe
If, subsequent to the School District Representative signing this Butte County Schools Impact Fee
Certification Form, the School District is notified by the applicable Local Planning Agency that this project
is being reviewed under. the California Environmental Quality Act (CEQA), this project may be subject to
additional school fees to fully mitigate its impact on the school district's schools.
White (applicant), Yellow (building department), Pink (school district) feeformmk, (a/ea)
BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One Form NpBuilding)
or _ .
School District �, ; W&I P 1 a � '
A.P. Number 2q-1 1/0 -o4 p Jurisdiction: 0
Property Owner 1� c._ GG ii P_ l q wJ 41 l -C
Building Department No.
City County
Property Location/Address�/e
Subdivison Lot No,
K I
Residential Development
Per 4mA No. of Living
(�ePle�I q hour ` w)a1- Units
mnob� le y-.54.1.15 hvuge- I,VS Z¢'
Commercial/Industrial e
Building Department
IZI Sq. Footage
MHI Addition (Group R)
Sq. Footage
New Addition (Including Exterior
Roofed Areas)
(Floor Plans reviewed by School District Personnel)
12- 1-6- 45
Date
District Identification No.
UAM'71X4W$chool District certifies that
Applicant)
Led - 9/6 - 846 - L173
(Street Address) (Phone Number)
95 Nk
(City) (State),, (Zip Code)
/
has complied with the requirements of Resolution No. i by payment of $
representing square feet. As 2926 $ F
FULL MITIGATION $
School District Representative Date
Paid by Check #
Bank Number
Paid by Cash
Remarks:
It, subsequent to the School District Representative signing this Butte County Schools Impact Fee
Certification Form, the School District is notified by the applicable Local Planning Agency that this project
is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to
additional school fees to fully mitigate its impact on the school district's schools.
White (applicant), Yellow (building department), Pink (school district) teeformmkl (1 t/94)dmm
a
COUNTY OF BUTTE
s: BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
1469 Humboldt Roan -Chico, CA - (916) 891-2751
7 County�Center Drive, Oroville, CA - ('916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
R
11a:��lit�ra
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please notify this office when correction of work
is completed. If you have any questions pertaining to this matter, or need additional explanation,
please cont this office immediately.
t Fx
Date / o Inspector
REV 10/92
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
1469 Humboldt Roa8, Chico, CA - (916) 891-2751
7 County Center Drive, Oroville, CA - (916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307 v:
4
CORRECTION NOTICE
OWNER PE MIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please notify 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.
fZ7 rCTC CC.// 4f,f/ //f/1'S
7//e G 6oyL S%O dfe
Date �� j ` (� Inspector
REV 10/92
4
JAN 05 '96 14:08 SKYLINE W ,LAND :•r s
C13 OUddV
jNanwvd3a eNta-una
•---.APPROVED
Butte County
Environmental Health
Da e( 'Q
Signaturey
` A
r I
` +
�•1 �yi � _'" � 0 t0
..r (
,Y.
91634- 196
P.3 P. Aa
4*7>4�f r:g /7-
X1 �w
69
w no
m
0
� d
M
it
Mobilehome Manufacturer: Manufacture Year: 1 c� 9 5—
If other than single -wide, furnish Setup Model Number:
Width: A( (ft.) Length:_( �— _(ft.) Tagalong or Expando Size _ (ft.) x . -= -(ft.)
On all mobilehomes manufactured. after October 7, 1973, furnish -manufacturer's -
installation manual and structural setup sheets.
FOOTINGS: Wood pressure treated or foundation gradeDC] Other.
SUPPORTS: Concrete block[X-] Other:
Provide Tie Down Specifications for all Mobilehomes: .
Pier Footings Sizes and Location -
SINGLE WIDE -
Line 1.
MULTI -WIDE
Lme 2 . -
.................._ ............. Main Beams
Lice2 ... ......................................................... ..............
Line 1
Main Beams .
............................................... --Line S
Tag or Triple e 4
ine 1
Line 1 Piers: '
Size minimum: r to x r3o i.
Spacing maximum: `
From ends -maximum: `
Line 2 Piers:
Size minimum: x [ 3a 1
Spacing maximum: ` G `
From ends -maximum: `
Line 3 Roof Loads:
Size minimum
Location (from front).
Line 5 Roof Loads:
Size minimum:
Location (from front):
—Line 1
i Line 2
%Line 2
— Liae 3
o- Line 2
. Line 2 '
Line 1
Line 1 Openings
Size minimum: [ 19 1 x[ 301.
Each side of openings
with width over: I`
Line 4 Piers:
Size minimum: 01 [
Spacing maximum: `
From ends -maximum: `
�VX30 3G',(30 A9X30 ,24X30 V 9x30 1ayX o x3
I a �91N 131,N 13S, 4 1, 5-,p'b , 0166`0
OVER
APp�pVE.D
1. Owner's Name: A e U E A/
2. Assessor's Parcel Number:. Z i.c+ o o c -C c _ -
3. Installer's Name: S hC y cR C 5T 5.0 1 LD / Al G y S? Nl S
4. Is the site currently under permit? Yes[ ] No Permit No.
5. -Is the site an existing site? Yes [xJ No[ ] (If yes, furnish two plot plans).
_ . 6._ What is the electrical rating of the. mobilehome? 6 o Amperes.
- 7. - � What is the mobilehome site circuit breaker rating? n n Amperes.
8. What is the electrical rating of the mobilehome site? ) e p Amperes.
9. Is the main service remote from the mobilehome site? Yes[ ] -No[X] If it is, what is
the rating? Amperes.
10. Is there any other electric load to be served by the mobilehome site electric service
(i.e. well, garage etc.)? Yes[ ] No[)( If -yes, please identify the load and size:
a) The mobile home site:
Load- Amperes -
b) The main service:
Load- Amperes -
11: Type of gas service at mobilehome site: Natural[ ] Propane[}(] None[' ]
12. Size of gas pipe at the mobilehome site' from the meter or
tank: 3 inches.
13. What is the gas pipe length from the meter or tank to the mobilehome?�&).
14. What is the mobilehome gas demand? B.T.U.*
*(This information is not required if the pipe length is less than 6 feet on natural gas or
less than 50 feet on propane).
THE OTHER SIDE OF TRIS FORM MUST BE COMPLETED IN ORDER TO
PROCESS THIS PERMIT APPLICATION
• 4
f, k.
May 1995
r'
8.5
CENTERLINE SUPPORT REQUIREMENTS
THIS SHEET TO BE INSERTED WITH SUPPLEMENT
TO FIELD INSTALLATION MANUAL FOR ZQ.tI ROOF
SNOW LOAD
I
rL
I_J y7O
O
~
34>✓Olk
-
- -
-C-L
SCod-kik _
i
I
I
I
I'
EVIEW[.:, Y.F.NG, _.,.
ISJl/EI) III- NEERING
j ,.
Jl.. yV ;: i nEI T,
I
FILE MH 9321
J IIVIC ES uerr•
VOL 1
JANt)
J A N
ITEC. •
12.199
l./. J �
ILL. 51 PO. 6-
-om
' •+OF?A ' 'N
01
C k
w
a
SERIES
DESCRIPTION
NO.
%*W,�WAn� hoac.
20 A I: ROOF
LIVE LOAD
c3T
DWD. 8v
CHECKED
SHT. OF
!�U
COUNTY OF BUTTE
Oroville, California
GENERAL CLAIM
CLAIMANT: JACQUELYN ALLEN
ADDRESS: - 206 E EVANS .REIMER RD
CITY &STATE: GRIDLEY, CA 95948
DATE OF CLAIM: 1/22/96
suRMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES
IMPORTANT:
SEE INSTRUCTIONS
ON REVERSE SIDE
DATE
DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) -
AMOUNT
OWNER CHANGED FOUNDATION'OF MOBILE HOME.=OBTAINED NEW 'PERMIT.'
B.P.#95-3074, A.P.#24=140=040, RECEIPT#190706:DATED 12/18/95,
OWNER: JACQUELYN ALLEN. .
TOTAL AMOUNT PAID ....................... .:..........$622.17
RETAIN REFUND PROCESSING FEE.............$25.00
RETAIN FILING FEES .......................$60.00
TOTAL AMOUNT RETAINED ...............................$ 85.00
AMOUNT TO BE REFUNDED .................................. TOTAL
$537
17
I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is true
and correct as stated.
Dated this day of 4 "� 192L, at Calif. G
/ Signature of Claimant
I, the undersigned, hereby certify that, to the best of my knowledge, the services ora les specified above_ have Veen performed or delivered and
that there is a Budget Appropriation [ I or Specific Board Approval [ I (Check one) fort eo meZ /
Dated this day of 19�(.at OROVTT,T.F Calif.I t/��-�/�
22ND TAN"
epartment Head or Authorized Deputy
Dept. Code 440-002 Exp. Code 4210500 PAYABLE FROM CONSTRUCTION PERMITS FUND
DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY
DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO.
INV. DATE
ENCUMB. GROSS AMT.
1
FOR BUILDING DIVISION USE:
;,."
Receipt Information: c ,
Number:
Date: Date:
Issued To:
Y
Amount: $ �o�? •� %
Fees Retail ed:
v Proces
✓ Bldg F
t//Plbg F
VlElec F
Mech F
Energy
Plan C
Inspec
Total Amount -Ret
TOTAL REFUND DUE
sing
Fee:
$
C2
i 1 ing
Fee
$
iling
Fee
$
02 •nom
i 1 ing
Fee
$
i1ing
Fee
$
P/C
Fee
$
heck
Fee
$
tion
Fee
$
ained
$06
$ 5W ?.),I
CLAIMANT'S NAME
REFUND CLAIM APPLICATION
CAL
MAILING ADDRESS
ASSESSOR PARCEL 0 "(I p �/ (� PERMIT # / 5 r 30`7 q
RECE I PT NUMBER (S )
Request a refund of -fees paid on the above receipt number(s) for
the following reasons:
_�_� ./Jr,... ;off l � � _ _ � . i -� � -..� _ �� l . tee. ��.� •
Y
. I
Please refund any applicable fees in the following categories:
(Check those categories which you wish to have refunded.)
[
Building
Permit Fees
[ ] Sheriff Fees
[ ]
SRA Fee
(CDF Fire Planning)
[ ] Urban Area Fees
Disposition of plans:
[ ] Plans returned to me at counter.
[ ] Please mail plans to me at above address.
[ ] Please dispose of plans.
SIGNATURE
17
DATE Z" 9e-,
COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 .County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO.
_-t APPLICATION AND PERMIT 95-307(4
ASSESSOR PARCEL NUMBER 024-140-040
ZONING A-5
BUILDING PERMIT
OWNER JACQUELYN ALLEN
TELF�1�jL� E 4322
SO. Fr. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS 206 E EVANS REIMER RD GRIDL,EY
CONTRACTOR'S NAME
COUSIN GARY'S
TELEPHONE
CONTRACTORS MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNIOJOWN
Total Valuation $
Filing Fee
$ 20.00
LENDER'S MAILING ADDRESS
Permit Fee 2
$ 299.50
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ 194-67
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
286E E ��VA;JS REIMER RD
PERMITFEE
$
GRIDLEY
PLUMBINGPERMIT
Filing Fee 20.00
Each Trap
7.00
LOT NO.
SUBDNISION'SNAME
PARCEL MAP
Solar or heat pump water heater
23.00
USEOFSTRUCTURE
SF ❑ Duplex E Mobilehome 13 Other
SPECIFY
Water piping
15.00
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
TYPE OF WORK
New ❑ Addition E Remodel ❑ Utilities ❑ Installation EX Other ❑
Describe Work: 3 BEDROOM 2 BATH 28'X60'
PERMANENT FOUNDATION
Mobile Home I S I G W 1
920.00
PERMITFEE
g
Contractor
ELECTRICAL PERMIT
Filina Fee 20:00
Main Service OOOV OR LE
( zooA oR LESSSS
)
23.00
Main Service ( 200A TO 1000A )
46.00
LICENSED CONTRACTOR'S 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 the Business and Professions Code,
and my license is in full force and effect.
License Class Lic. No.
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ 1, 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.
3j 1, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
NEW CONST. DWELLING OCCUR
OR ADONS. ( & ACC. BUDS. )
s0 .
3.5Q FT.
NEW CONST. MULTI -OUTLET
NON-RESID. ( BRANCH CIRCUITS )
97.50
( POWER APPARATUS )
8 SINGLE OUTLET CIA.
Ex. Occup. (OUTLET OR FDCTURES )
20 Q 1.00
00
BAL .50
Ex. Occup. ( OUTUETS(RES . RR.A )
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMITFEE
$
Contractor
WORKERS' COMPENSATION DECLARATION
1 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 is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMITFEE
$
Contractor
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
JM 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 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 /yip i _ Date ���_9,^_
Sign aKd of plicantwner ❑ Contractor ❑ Agent
An O A permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee
$
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 622.17
HA2.
I D. FEES
KMOFLOOD
I CDF In
PD I HD
ISSUE
This permit is hereby issued under the
of the Butte County Code and/or
indicated above for which fees have
By
PERMITEXPIRESON
applicable provisions
Resolutions to do work
been paid.
Date
(Date)
Receipt No. 190706 — 622.17
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
�4�"F7•�^ii�`'e�E+i4s�a�`.��"r.'+�'.;i�,�'ski^".(fa-0.i.i.+,-..;:; '"r' r•+«��.�� � x'��." �_� �`Kc� }.�c. .a,�
' COUNTYOF BUTTE - DEPARTMENTt3F-DEYELOPMENT SERVICES - BUILDING DIVISION
7COUNTYCENTER DRIVE - OROVILLE, CALIFORNIA95965 -TELEPHONE (916) 538-7541
f PERMIT APPLICATION DATA SHEET
OWNERCt' C-41 U e Av Alfe-411 A. P. No. a Z - 1 4� O - 0-/ 0
Proposed Building Use Building Inspector 46 Date
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED BY
1, All items have been submitted. .
C.!e- 2. Plot plans,®4 sets, signed by preparer of plans. ......................... .
3. Complete plans, 3/4sets, sigp�d by preparer of plans . ......................
4. Engineered plans and cal :s, 3 sets, with wet signature on plans . .............
5. Hazardous Material Form . ............................................
6. Energy Design Compliance and supporting documentation . ..................
7. Statement of Intent for Non -Heated and A/C Buildings . ......................
8. Engineered truss details and layout in duplicate (required prior to plan check). ... .
9. Mobilehome data and manufacturer's installation instructions, 2 sets. ...........
10. Fees of $ ..........................................
��11. Impact fees as shown on attached schedule . ..............................
12. California Department of Forestry plan approval/fees. ....................... .
13. Flood elevation letter (100 year flood) byCaliforniaEngineer. ................. .
14. Sanitation and plot plan approval 000' II f- Health Department . ............
15. City of Chico plumbing permit . .........................................
16. Plot plan and business license approval from City of Biggs/Gridley. .............
17. Planning approval for (A) Use: (B) Parking:
18. Contact Land Development about (A) Improvements (B) Drainage. .......... .
19. Driveway permit (construction approval required prior to occupancy). ...P;n;1 oe�tioo r6q�est
20. Pre -inspection for required. .. to Building inspector (Date)
21. Contractor's license information. (No., Name Style, Classification) . ..............
22. Certificate of Workmans Compensation Insurance . ..........................
23. Owner -Builder Verification (Given to owner , Mail to owner _). .......... .
24. Recorded copy of Agricultural Acknowledgement Statement . ..................
25. Letter of signature authorization . ........................................
26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... .
27. Letter of intent on building use . .........................................
28. Mobilehome utility clearance . ..........................................
29. Documentation of legal access . ..................... :..................
30. Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning area and frontage requirements . ...............
O� Cvinhinn ciinhhinno/ovnirc'1 norm the
When you issue the permit, process as follows:y Mail to owner. Mail to contractor.
Telephone and hold for -,pickup at office. Deliver with inspector.
Other
Parcel Creati
Acreage Applicant �iw Date
Copy of Haz-Mat form sent Health Dept. Fire Dept. V Air`Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submitted prior to
1. Index permit for above items No.
2. Additional items required:
it issuance: rcle new item not checked above).
? I) a I ( i�
Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date
Contractor, designer, owner, was advised of aboveMwPlans
by _ phone _ mail Counter by _ Date
Plans checked by Date approved by Date
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Works
COUNTY OF BUTTE
DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 COUNTY CENTER DRIVE, OROVILLE CA 95965 TELEPHONE (916) 538-7541
OWNER i„ •+J A.P. #' D
PROPOSED BUILDING USE MoA; It % o4w e A,"i DATE 1.2---1'W— 95
P/` REC. #
c� 1. SCHOOL DISTRICT FEES G ; -e
(paid at District Office)
2SHERIFF FEES (paid at Building Division)
� I Residential....... I x 3G6 =$
unit amt.
Commercial (sq.ft.). x =$
3. URBAN AREA FEES
(paid at Building Division)
Residential (per unit). x =$
#units amt.
Commercial (sq.ft.).. x =$
sq. ft. amt.
4. RECREATION DISTRICT FEES
(paid at District Office)
5. THERMALITO DRAINAGE DISTRICT FEES
$400.00 (paid at Building Division)
6. SRA FIRE INSPECTION AND -PLAN CHECK
$89.00 (paid at Building Division)
7. WATER TENDER FEES
(BATTALION # )
$200.00 (paid at Building Division)
8. CSA 87 TRAFFIC FEE
$2500.00 (paid at Building Division)
9. OTHER
DATE REC
/--;A: _
At time of permit application, I was advised the above fees are required to be paid prior to issuance of the
permit.
APPLICANTlr� „� A„l C�� DATE
V
LAND DEVELOPMENT.
BUILDING %lgNVIRONMENTA RAOW -PERMIT CLEARANCE Building Permit ft.
OWNERS A.P.
NAME: L �P in C� Q ! `r? ( \ o- NUMBER:
PRINT LAST NAME FIRST
COUNTY ZONING \
DESIGNATION: FLOOD ZONE: A X FLOOD MAP: S iS Q
APPROVED: l/ CONDITIONALLY APPROVED: RESOLVE PROBLEMS PRIOR TO APPROVAL
PARCEL CREATION BY DEEDS
DEED INFORMATION:
DATE OF CREATION: %� 3
OR MAP
DEED REFERENCE:
LEGAL ACCESS PROVIDED: _)0 YES NO LEGAL ACCESS REQUIRED: YES _NO_
COMPLIES WITH COUNTY STANDARDS FOR DEED CREATION: YES NO
COMMENTS/CONDITIONS: Pr^✓ Cdr 33. G C 'Y/ g.`! 3 �f
our 17
MAP INFORMATION:
DATE OF RECORDING
LOT BOO
PAGE
COMPLIANCE WITH OLD SUBDIVISION LOT ORDINANCE REQUIRED? (MAP RECORDED PRIOR TO BOOK 17 OF MAPS AT
PAGE 23): YES NO . IF YES, MARK APPROPRIATE ITEM(S) BELOW:
A. Construct road to B. Meet parcel size required by zone. C. Meet current E.H.D. requirements.
CHECK SPECIAL CONDITIONS WHICH APPLY TO MAP: ALL FEES TO BE PAID TO THE BUILDING DIVISION UNLESS OTHERWISE NOTED.
1. Maintain a 50 ft. building setback from centerline of road.
_ 2. Maintain a ft.building setback from right-of-way/centerline of "
3. Maintain a 100 ft. leachfield setback from all existing wells.
4. Maintain a ft. leachfield setback from
5. Pay water tender fees in the amount of $ to Battalion Number of the Butte County Fire Department.
6. Meet the Fire Safe Regulations of Butte County and P.R.C. 4290.
_ 7. Connect to a public water supply.
_ 8. ,Connect to a public sewer system.
9. Automatic fire suppression sprinkler systems shall be installed in all residential structures in accordance with the National
Fire Protection Association Standard for the installation of sprinkler systems in one and two family dwellings and mobile
homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet Fire Department
specifications, serves the parcel. I
10. Pay T.D.D.,(Thermalito Drainage District) fee in the amount of $
11. Meet the requirements of the Department of Fish and Game for the preservation of oak trees. (See phone number below)
_ 12. Obtain approval from the Department of Fish and Game for vegetation removal. Contact Fish & Game at 916-355-7010.
_ 13. A traffic mitigation fee for each new or additional living unit shall be paid. Pay the amount of $ as stated
in the Oroville Area Traffic Mitigation Fee Agreement. Payment to be made to dw PAwx*g Div Wm.
_ 14. All new residential buildings shall be constructed to comply with the requirements of the Uniform Building Code for seismic
safety. Mobile homes shall be constructed on a permanent foundation system which complies with the Seismic Zone 3
requirements of the Uniform Building Code.
_ 15. Deer Mitigation fees are to be paid, if such"fees have been adopted by the Butte County Board of Supervisors.
X 16. Pay school impact mitigation fees.
X 17. A development impact fee for sheriff facilities shall be paid pursuant to the provisions of Chapter 3, Article II of the Butte
County Code.
_ 18. Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California
Clean Air Act of 1988 as amended.
19. If any cultural resources are encountered during ground disturbing activities, all work shall cease in the area of the find
pending examination of the site by a professional archaeologist. This person would then be able to assess the site
significance and suggest appropriate mitigation measures.
20.
21.
22.
23
24.
25
NO iO NdO13A30 OW
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LD 9/95 . C:\WP51\FORMS.K\8LDOPERM.CLR
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LAND DEVELOPMENT
BUILDING / ENVIRONMENTAL HEALTH.- PERMIT CLEARANCE Building Permit No.
NOWNERS AAME. I NUMBER: l/ �f-' 0 0 �
PRINT LAST NAME FIRST
COUNTY ZONING
DESIGNATION: FLOOD ZONE: % FLOOD MAP: S7
APPROVED: CONDITIONALLY APPROVED: RESOLVE PROBLEMS PRIOR TO APPROVAL:
PARCEL CREATION BY DEEDS OR MAP %C
DEED INFORMATION:
DATE OF CREATION:
LEGAL ACCESS PROVIDED: YES NO
DEED REFERENCE:
LEGAL ACCESS REQUIRED:
COMPLIES WITH COUNTY STANDARDS FOR DEED CREATION: YES
COMMENTS/CONDITIONS:
MAP INFORMATION:
DATE OF RECORDING
NO
YES NO
G/Li/JLL,n Cc-Lom f /VO /
LOT 43 BOOK PAGE 3 I
COMPLIANCE WITH OLD'SUBDIVISION LOT ORDINANCE REQUIRED? (MAP RECORDED PRIOR TO BOOK 17 OF MAPS AT
PAGE 23): YES NO . IF YES, MARK APPROPRIATE ITEM(S) BELOW:
A. Construct road to B. Meet parcel size required by zone. C. Meet current E.R.D. requirements.
'V071O vS WHICH APPLY TOM ALL FEES TO BE PALO TO nL c PLLn nMIG O!y S1FQAj UNLESS 0THEP n/i S A10TED
CHECK SPEC{:,� C:,. �� � �..� .,
1. Maintain a 50 ft. building setback from centerline of road.
2. Maintain a ft.building setback from right-of-way/centerline of
3. Maintain a 100 ft. leachfield setback from all existing wells.
4. Maintain a ft. leachfield setback from
5. Pay water tender fees in the amount of $ to Battalion Number of the Butte County Fire Department.
6. Meet the Fire Safe Regulations of Butte County and P.R.C. 4290.
7. Connect to a public water supply.
8. Connect to a public sewer system.
—9. Automatic fire suppression sprinkler systems shall be installed in all residential structures in accordance with the National
Fire Protection Association Standard for the installation of sprinkler systems in one and two family dwellings and mobile
homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet Fire Department
specifications, serves the parcel.
_ 10. Pay T.D.D. (Thermalito Drainage District) fee in the amount of $ "v
_
11. Meet the requirements of the Department of Fish and Game for the preservation of oak trees. (See phone number below)
_ 12. Obtain approval from the Department of Fish and Game for vegetation removal. Contact,Fisht & Game at 916-355-7010.
_ 13. A traffic mitigation fee for each new or additional living unit shall be paid. Pay the amount of $ as stated
in the Oroville Area Traffic Mitigation Fee Agreement. Payment to 6e mad® to the banning Dhdsiay.
14. All new residential buildings shall be constructed to comply with the requirements of the Uniform. Building Code for seismic
safety. Mobile homes shall be constructed on a permanent foundation system which complies with the Seismic Zone 3
requirements of the Uniform Building Code.
15. Deer Mitigation fees are to be paid, if such fees have been adopted by the Butte County Board of Supervisors.
X 16. Pay school impact mitigation fees.
X 17. A development impact fee for sheriff facilities shall be paid pursuant to the provisions of Chapter 3, Article II of the Butte
County Code.
_ 18. Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California
Clean Air Act of 1988 as amended.
19. If any cultural resources are encountered during ground disturbing activities, all work shall cease in the area of the find
pending examination of the site by a professional archaeologist. This person would then be able to assess the site
significance and suggest appropriate mitigation measures.
20
21
22
23
24.
25
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.. A•a+41•r9'�lr✓y A:�.r•',xr'#;.. X�. .,.-'r�,.•>"j:N., d1R. 'q Tyttn-.`�• .1s•, �!•�.� yF .:•}y .r..- _ •.. ..;.`�".. f.,�
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIV/95-3132
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-754PERMIT NO.
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
ZONING
BUILD I PERMIT
01ROQUELYN ALLEN
TELE P,FjQ —4332
SQ. FT. OCC. BUILDING VALUATION
- "Kn ESMFEIMER ROAD, GRID EY
FST 3,080
T ELE3
- QcAATLMON7I �;
cGi 24TOKUOVD61 HEFT, YTJBA CITY GA 95 391
Fireplace
CONSTRUCTION LENDER
Ui "OWN
Total Valuation Is
LENDER'S MAILING ADDRESS
i
Filing Fee
$ 20.00
Permit Fee
$ 6 00
•
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Energy Plan Checking Fee
$
Penalty
$
B b T EVANS REIMER ROAD, ('MR►LEY
PERMITFEE
$ 93.00
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
LOT NO.
—DIVISION'S NAME
PARCEL MAP
Solar or heat pump water heater
23.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other tTLI, fT01ME
SPECIFY
Water piping
15.00
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other OX3:
Describe Work: REPIACE SIDING, REPAIR RY & PATCH? ROOF
-
' W/Cory
Mobile Home ISI GI W
@20.00
I]
PERMITFEE
$
Contractor
ELECTRICAL PERMIT
Filina Fee 20:00
Main Service a OR LESS
( 200A OR LESS )
.5 Liu
23.00
Main Service ( 200A TO 1000A )
46.00
LICENSED CONTRACTOR'S 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 the Business and Professions Code,
and my license is in full force and effect.
License Class S1� 7: S Lic. No. rr Pt-ey�` ( `l
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ 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.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( s ACC. BUDS. )
S O.
3.50 FT.
NEW CONST.MULTI-OUTLET
NON-RESID. ( BRANCH CIRCUITS )
97.50
( POWER APPARATUS )
d SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES)
20 Q 1.00
BAL .50
Ex. Occup. OUTLEETS RESID.) OR
( 1 )
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMITFEE
$
Contractor
WORKERS' COMPENSATION DECLARATION
1 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 is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMITFEE
$
Contractor
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
I,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 workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensate n.,provision;j ef,section 3700 of the Labor Code, I shall
forthwith comply witfthose prov"§ions.'
I c�j/
X i -J Date _' ?� "" _
Signatu{� f`pp{ cant - ❑ Owner ❑ Contractor ❑ Agent
An OSFrA permit its required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee
$
Energy Inspection Fee $
Occ
I CONST. TYPE
TOTAL FEE $ 126.00
HAZ.
I D. FEES
I IMP FLOOD
CDF
PARCEL I PD I HD
I ISSU
This permit is hereby issued under the
of the Butte County Code and/or
indicated above for which fees hav
BY li
I 1277915'
PERMITEXPIRESON
applicable provisions
Resolutions to do work
bee%T paid.
12/27/95
Date
(Date)
19014V ;
rReceipt No.
HITE-D.D.S.-B.D.CANARY-ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISIO
7 .County Center Drive - Orovire, �Galiforrma 95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATION AND PERMIT 95-3132
ASSESSOR PARCEL NUMBER
024 -14 -n -04n
ZONI"G
A-5
BUILDI PERMIT
07A`COUELYN ALLEN
TELT4� —4332
C}(�
SO. FT. OCC. BUILDING VALUATION
FST 3,080
DLV T!"G.9 iM REIMER ROAD, GRIDLEY
DTTff T0l T,N, O1D
TELEP 113-0112
t7
Gyf{
DV0A t T `D EET, YUDA CITY CA 95991
Fireplace
CONSTRUCTION LENDER
UNIOJOWN
Total Valuation is
Filing Fee
$ 20.00
LENDER'S MAILING ADDRESS
Permit Fee
$ 63.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
' 9'6 QST EVANS REIMER ROAD, GRIDLEY
PERMITFEE $ 83.00
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
Solar Or heat pump water heater
23.00
USE OF STRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other wF.T.T. i4nu F'
SPECIFY
Water piping
15.00
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑n
Describe Work: REPLACE SIDING, REPAIR FDN & PATCH ROOF
W/C0111P
Mobile Home IS I GI W 1
@20.00
PERMITFEE
$
Contractor
ELECTRICAL PERMIT
Filina Fee 20:00
Main Service a v OR LESS \\
( 200A OR LESS . J
23.00 23.00
Main Service ( 200A TO 1000A )
46.00
LICENSED CONTRACTOR'S 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 the Business and Professions Code,
and my license is in full force and effect.
License Class rl/ 3 2 Lic. No. �'�eva -I
(/
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ 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.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
NEW CONST. DWELLING OCCUR
OR ADDNS. 8 ACC. BLDS.
( )
SO.
3.52 FT._
NEW CONST. MULTI -OUTLET
NON-RESID. ( BRANCH CIRCUITS )
97.50
( POWER APPARATUS )
8 SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES )
20 Q 1.00
BAL .50Ex.
Occup, oFTiEDTSPPLN o.°ea
( )
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMITFEE
$
43 00
Contractor
WORKERS' COMPENSATION DECLARATION
1 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 is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMITFEE
$
Contractor
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
certify that in the performance of the work for which this permit is issued, I shall
,,,,of
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensate provision section 3700 of the Labor Code, I shall
forthwith comply tho a prof ions.
X __ Date —JZ --26, �_
Signatu e p cant - ❑ Owner ❑ Contractor ❑ Agent
An OS per is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee Is
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ 126.00
HAZ.
I D. FEES
IMP
I FLOOD
CDF PARCEL I PO HD
MSu
This permit is hereby issued under the
of the Butte County Code and/or
indicate above for which fees hav
B
12/27/96
PERMITEXPIRESON
applicable provisions
Resolutions to do work
be paid.
12/27/95
Date
(Date)
Receipt No. 190740
I
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
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.A.nd xkhen recorded mail to:
Buildin!,, Division
County Center Drive
Oroyille. Ca. 9905
FEB 0 11996
AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT
FOR RESIDENTIAL DEVELOPMENT
Section 26-8 of the Butte Count -v Code requires this acknovyledgment to be recorded prior to issuance of a building permit. The
propem- described herein is adjacent to land or included within an area zoned for agricultural purposes. and residents of this
propert%- mai- be subject to inconveniences or discomfort from the use of agricultural chemicals. including. but not limited to
herbicides. pesticides. and fertilizers: and from the pursuit of agricultural operations including, but not limited to cultivation.
plowing. spraying. pninina, and harvesting which occasionally generate dust. smoke. noise. and odor. Butte County has established
agricultural purposes and residents %vithin said zones and on adjacent properly should be prepared to accept such inconvenience or
discomfort from normal. necessary Tann operations.
All that real propene situate in the County of Butte. State of California. described as follows:
Date PROPERTY OWNERS:
State of California 1
County of /;-7—m— )
On oJ before nue, l 1
personally appeared Ge_t, kZ i Itc'rw tll1
k.riw-A to 4a (or proved to mel4n the ha. is of satisfactory evidence) to he the pe.rson(4 whose name(,a) is/jw subscribed to the
within instrument and acknov.•ledoed to me that b*/she/ti1M• executed the same ink/her/t4eir authorized capacity(iwe.), and
that by his/her•/NeAr :i nature( -r un the instrument, the person(J$ or the entity upon behalf of which the person(* acted.
executed the instnrrnew.
WI•hNESS niN hand and official seal.
DONNA L KNIGHT
aCommission # 1075664 Z
Z %MMy
aNotary Public — California D
tii natur �3'YYf Seal: Butte County
Comm. Expires Oct 22,1999
L r-7 LO�Irv-c-"tIA,d. *i✓�_c•��NIa.�
IL
X 71P
1s.8e�aM;,
I.) Locate Ground -Lac Hold Downs as shown on the foundation plan(s).
i Vary locations to center of holes to accommodate obstacles such as
rocks, boulders, cross-over ducts, etc. Ground -Loc Hold Downs may
also be placed to the opposite side of the chasis beams than shown, 1
If necessary, but no further than twelve. inches from the beam as
indicated in details 1/1 & 2 1.
/ / Where the center to center !i
dimensions must be exceeded, use another Ground -Loc Hold Down between I
the two GLHD's exceeding the center to center dimension limit, per
j detail 1/1 or 2/1.
.) Dig 10 J nch square4x two feet deep holes as shown in detail 1/1
or 2/1. Spread the soil Inside, along the skirting or enclosure so