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Home My WebLink About024-160-003MMX—S-GH A.P. 24-16-03 110 0 -0j Z A 7 N1W corner of C -owe & Turner, 900: N. of Turner Permit 342-74P,E (util. for MH) 1 '6-'�j e Ft1l. for MH) A.P.A 24_16_03 ER P� MRS. WALLER W j W� /side.0 'wee AV Ave. mi. N/Turner P (buil _ erm td 233 d ram a Permitd 2337-74B (build ram a 24-16-3 kit, Robert Waller W/S Cowee Ave. app. qQ0.1,N-`o-f Turns71: Ave., Gridley #60&-- ,E,M(addition & ;y -g— Pp M I re .9, 024-166-003 06-2217 WALLER, ROBERT 16 585 COWEE AVE, GRIDLEY Cont: H -H CUSTOM BLDG RE ROOF 0 A �024-160-003 06-2217 / WALLER, ROBERT 1: `'585 COWEE AVE, GRIDLEY NOTES Cont: H -H CUSTOM BLDG o�Mt+' RE ROOF' RESIDENTIAL APH: Pennft No. Owner. Site Address Contractor. Type of Pemdt SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PEkW COMMONS SUBSTANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE DATE JOB FWALED• SIGNATURE: �i i t r cF 6 SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PEkW COMMONS SUBSTANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE DATE JOB FWALED• SIGNATURE: = OK 0 = Not OK MANUFACTURED HOMES DATE LiPERMANENT FOUNDATIONSOFTSET 1 ZoningSetbacks-Easements 2 Soils; Special MH Support Sketch 3 Sewer; Lorin Test; FaRIC/0-Concrete 4 Wtr, Loctn Test -Easement Needed -Regulator 5 Elec Loctn-Dtmcs-Gmd 'Amp -Concrete 6 Yard Gas; Loctn Test Wrap Nat ❑ or LPQ. Inch Sz Ft Lngth 7 Blckng-, SzSpacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-Clmcs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -CIO to Grade 12 Gas and Electricity Tagged 13 Tie Dowris Q Foundation 14 Exits 15 Cert of Occupancy 16 HUD LabeUlnsignia Numbers Serial Numbers a? 4-0— MISCELLANEOUS- 3 E C K S-C.OVE RS -C A R PORTS 'G A RAG E.9 MISCELLANEOUS- 3ECKS•CUVERS-CARPORTS`GARAGES 1 ZontngSetbacks-Easements 2 Figs; SoitsSz-OpthSpacing-CnnctmSteel 3 Decks, Girders/Jotsts-Dddng-Brcing Stairs-GuardMandrails 4. Wood Awn; Posts-Beams-Rftrs.CnnctmShthg_ Frmg-Brcng 5 Alum Awn; Columns-Cnnctns-splice-Decal-Encisrs 6 Carports; Wndws-Doors 7 Electric 8 Fang; Sills-AnchrsStuds4U rs Trtisses 9 Siding; Nailing VeneerStucco-Lath 10 Roof; Shthg-Raofmg 11 E)�11; Steps-Doors-LandiAgs 12 Braced Wall pnLs 1 Setbacks -Easements _ 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Dnnctris Thickness Dead Men -Lining 4 Elec Rcptds/LUng; Distance -GR — 5 Met: IPool Lting; 15 volts-DFi 6 Elec.Eric2cs; Conduit Entries -Terminals -listed . — 7 Elec Bonding; Metal w/W-Crcltng Egp-Htr 8 Dec Grndng; Eqp w/5' Crdtng Eqp-Pool Ightg — Box s-Encisfs-pnitioards-Insultn-to Main Conduit ` 9 Health Dept Apprvl . 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche , 12 Endsn Fencing -Alarms 13 Bonding, Diving board or Slide Drawing = Not OK RESIDENTIAL (Single &Duplex) •' DATE UNDERFLOOR DATE PLUMBING 1 ZoningSetbacks-Easements-FloodSlope .53 Wtr Htr; Vent-Arc-Cmbstn Air Baffle 2 Ftg Main; Soils-Elec Gmd Ftg Dpth 54 Wtr Pipe; Test & Anchr IJail Prtctn 3 Ftg Garage; Soils-Steel-Elec Gmd Ftg•Dpth 55 DWV; Test Fittings & Anchr Rail Prfctn 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth 56 Shwr Pan; Test, Fust fir Tub Are 5 Stemwails Main; Steel-Blockouts Wrapped 57 Test Tub & Shwr, 2nd fir - Tub Ace 6 Stemwalis Garage; Steel-Biockouts Wrapped 58 Gas Pipe; Sz & Anchrs 6a Hold Downs and Special Anchrs 59 Fire Sprinkler, Test 7 Slab, Steel Wrapped 60 Yard Gas Piping 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way CIOSewerTest 10 UF, Gas Pipe; Sz Anchrs-Sz Test 11 Wtr Pipe; Test Anchrs-RgltrSenrice Test 12 Elec Undrgrnd DATE IM E C H A N I C A L 13 Plenums & Ducts; Cirnc-MaterialSupport-Utsultn 61 AC Ducts Insulin & Support 14 GirdersSills-Anchr Bolts-Joists-Vnts-Cripples 62 Vent Fan, Exhatist abv Insulin 15 Ace & VnUtn 63 Condensate Drain & Ovrflw, Sz & Grade 16 Insulation 64 Furnace -Vent Acc-Comb Air RbTuVent 115 Outlet 65 Attic Ace & Pitirm if Furnace In attic DATE IFRAMING 1T Silts Proper Maferials & Andu's DATE FINAL 18 9Ualis Studs -Nailing Spacing & Braces -Plates -Sound 66 Ext Steps -Door & SideU Prtctn-land'mgs 19 Bearing Walls over Girders .4 fir Nailing 67 Smoke Detector 20 Draft Stop In Walls (rat proof)• 68 Furnace Vnts-Cimc-Comb, Air-Cnnctr 21 Fire Stops; Fdrr6a Ceilings -Stairs -Chasers -Tubs in Garage; abv4lr-Ductr.-Mech Prtctn 22 Headers tip BeamsSi &'Bearidg' 69 Bedroom Exiting 23 Hangers-Posi'Caps-Mchrs-Citnc6ts 70 GFl A Bath Fxtrs & Tub Ace -Spa 24 Ceiling Joist -R& Tjes-"-Roof Brae TrussShthg 71 GFl Are Fault 25 Frpie Ties ori* A Flue=F ' Ic Throat Clrnc 72 Elec Trim & Sub pN, Breaker Szs &Labels 26 Attic Sz &Wnk Acr �rtcbr-0raft Stop -Ins Baffles 73 Stairs, Guardniandrails 27 Bdrm Wndws or Ekiting Doors -Sill kit & Dimensions 74 Frplc or Stove, Cimc-Hearth 28 Garage Kre Prtem Fr;"g-RC Channel 75 Elec Outlets at Wood Pnl, Int & Ext 29 Prprty Line Firewall >£ Opngs' . 76 Ktchn, Fxtr & Appinc; Grnd- Air -Gap -Cooking Cimc 30 Ext Doors One T -Check Gaiage 3r4 Story, 2 Exits T7 Elec Outlets & Rcptcls at Ktchn Counter 31 Stairs; Width-Hdrm Rise -Run -Landing -Fire Prtctn 78 Garage Fire Dobr, Swing -Landing -Closure 32 Plywd on Roof Ovrhng-Mc Vats-Rftr Utitrgrs 79 AC Duct In Garage -Damper. 33 Siding -Nailing Veneer 80 Wtr Htr Vnts-Cimc-Com Air Cnntdr-PRV; abv fir 34 Stucco Lath -Weep Screed•Fndtn Vnts-Undrflr Ace Mech Prtctn; LPG Appince Undr House 3' drain 35 Glazing Area -Glass PrtctnSkyL ls-Plastic . 81 Plmb; Elec & Mech Eqp Listed for Loctn 36 Shear Walls; Nailing -Bolts 82 Elec Rcptets in Garage (GFQ Romex Prtctn 37 Brace Int/Ext Wall pnls 83 Insuitn-Foam-Looked in Attic 38 Insultn Walls -Ceilings 84 Guard Rails & Deck Cnstrcbt-Post Caps 39 Infiltration-WalLs-Wndws 85 Fndn Vnts & Crawl Hole Door Dmge & Wood -Earth 86 Cimc Drnge Planters QYes No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Pimb 89 Vnts abv Roof, Plmb-Appinc-Frptc-Cimc to Opngs 90 Wtr Well, Dscnnd, Elec, PImb 91 Ext Elec Trim, GFl Rcptd-Undrgrnd DATE JELECTRICAL 40 Fxtr & Tmsfrrnr Clmc-Ins Prtctn 41 Elec Rcptcls Spacing-l-ts & Switches at Doors 92 Vntitn thru House 42 Sz Boxes & No Of Cndcrs Stapled 93 Glass Prtctn 43 Romex Installed Close to Edge of Studs & CJ 94 Corrections from previous litspctns 44 Eqp Gmd made up w/Mech Fsbus 95 Gas Test -Meters Tagged, Gas -Flet 45 Gmdng Electrode Bond Gas & Wtr 96 Wtr & Sewer Cnnctd-C/O to grade -HD Apprvl 46 2 Appinc Cires in Ktchn & Cndc r Sz GFl 97 Energy Cmpinc Cert -Other Certs 47 Subfeed Wire Sz , ❑CU or DAL 98 Address Posted ' AC Wire Sz ya ❑ CU orAL HAL 99 Fire Sprinkler 48 Range Clic w CU or Oven Circ Qa Q Cu or El AL Insulated Neutral Oyes QNo dr 49 Service -Riser Cndctrs & Gmd Main Dscnnct 50 Eqp Cimcs pnts-Motors-Meth Eqp 51 Clothes Closet LtShwr Lt -Spa Lt 52 Smoke Detector f d; 0 O' 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 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 the Business and Professions Code, and my license is in full force and effect. License Class : License Numbdr: Date: Si -_QT /_q_,contractor. 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 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 State 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).): O 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 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.). ❑ I am Exempt under Article 3 of the Business and Professions Code 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 workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Ud I 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: Policy #:_c /�� 3 -7 PERMIT NO. BP062217 Issued Date: 09/14/2006 APN: 024-160-003-000 Site Address: 585 COWEE AVE GRI Map Index: Description: REROOF W/COMP 42 Owner: WALLER ROBERTC & SANDRA A 585 COWEE AVE GRIDLEY, CA 95948 Applicant: H -H CUSTOM BUILDING z 195 WASHINGTON STREET GRIDLEY, CA 95948 (530) 846-0874 Contractor: H -H CUSTOM BUILDING 195 WASHINGTON STREET GRIDLEY, CA 95948 (530) 846-0874 License #: 299922 Architect: Engineer: Total Square Ft: 0 S. F. Valuation: $0.00 ❑ 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: e a 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. CONSTRUCTION LENDING AGENCY This Permit is here ' sue nder the applicable provisions of the Bntte County Cody anrUor I hereby affirm that there is a construction lending agency for the Resolutions to o cated'a ove for which fees have been paid. ^.�J performance of the work for which this permit is issued (Sec 3097 Civ.) By: ale: Name: Address: PERMIT EXPIRES ON: V ❑ 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 coOnty and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of B to County to 7t2e29.UZo r above mentioned property for inspection purpos:�/-" / / Print Name:-��- —� Signature:ryiw� /_(hh��r Date: ❑ Ownerol�Cntractor ❑"Agent for Owner III Agent for Contractor BUTTE COUNTY 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.buttecciunty.netldds PERMIT NO. 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: 09/14/2006 APN: 024-160-003-000 the Business and Professions Code, and my license is in full force and effect. �9 License Class: 1 License Number: _?_5q rZ2Z- Site Address: 585 COWEE AVE GRI Date:ontractor.7>�rrS'�r �P Map Index: Description: REROOF W/COMP 42 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: WALLER ROBERT C &SANDRA 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 585 COWEE AVE 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 GRIDLEY, CA she is exempt therefrom and the basis for the alleged exemption. Any 95948 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 Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: H -H CUSTOM BUILDING such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for 195 WASHINGTON STREET sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of GRIDLEY, CA 95948 proving that he or she did not build or improve for the purpose of (530) 846-0874 sale.). ❑ 1, 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 Contractor: H -H CUSTOM BUILDING pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Business and Professions Code 195 WASHINGTON STREET GRIDLEY, CA 95948 Date: Owner: (530) 846-0874 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: License #: 299922 ❑ 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. Architect: 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: Policy #: Total Square Ft: 0 S. F. Valuation: $0.00 ❑ I 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: 12 i O 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. CONSTRUCTION LENDING AGENCY This permit is here sue nder the applicable provisions of the Butte County CodR anrvor I hereby affirm that there is a construction lending agency for the Resolutions to o rl cated'a ove for which fees have been paid. n�J performance of the work for which this permit is issued (Sec 3097 Civ.) - Name: I BY ate:/' l ' PERMIT EXPIRES ON: G Address: Date ❑ 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. ❑ 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 co6nty and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of B lte County to enter upon t above mentioned property for inspection purposes. � Print Name: Signature: w H6 r ga ❑ Owner ontractor ❑"Agent for Owner Agent for Contractor 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 OFAPPLICATION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY* ARCHITECT/ENGINEER OWNER INFORMATION Las Name Name i me 0 'p Address E-mail State License Number City r Stag Zi Phone Lot # Fax E-mail City ARCHITECT/ENGINEER CONTRACTOR Address Name Zip Phone E-mail State License Number Fax r Address �[ Page Lot # e C) O I CI Date Approved: City Stl Zlp�tS�Z i L '�f s< Phone Fax ^ o � E-mail Lic. # CI75 , 9.9 9 ZZ ARCHITECT/ENGINEER Name - -- ----- --------- --- Address City State Zip Phone E-mail State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail APP ICANT SIGNATURE X For office use only: Zoning Flood Zone City 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 NO. BIN # PROJECT LOCATION AN Property Address City Cross Street WORKER'S COMPENSATION Policy Number Carrier C< C 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 Desai tion or Scope of Work: Sq FT- 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. J�d/n Amount: C `o--C�>" Bldg I I ) k . \ SRA Receipt # � � Sheriff SMIP Date I �j Total Pade 1 of 2 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 faxesl ❑ 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 bidgs: (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 KAFORMSMILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 PERMIT NO. 608-79B,P,E,M PERMIT EXPIRES OWNER Robert Waller D CONTR. owner 24-16-3 LOCATION (A.P. ) n W/S Cowee Ave., app.900'N.of.Turner Ave., Grid le y } k d y A F T� j . Y It Tempel$ewer Pole Galled PG&E Gly46 Te p. Elec. Serv. Called PG&E emp. Gas Serv. i' Called PG&E JOB FINALED '' (Date) 1 (Signature) ti COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS ' BUILDING INSPECTION RECORD Water Piping — Sewer Gas Piping BILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS 157P-77 T r G-�►- C,6c (NOTE: Anentry must be made on this form each time you visit the job site.) Permit# INSULATION .CERTIFICATION _ Cowee Avenue Number and Street City . - County Subdivision Lot Number — DESCRIPTION OF INSTALLATION ROOF Material Brand Name Thickness (inches) Thermal Resistance (R Value) EXTERIOR WAL.L Material Fiberglass Brand Name _ Certainteed i•. Thickness (inches) –2 Ther (R Value) el)Rcsistance CEILING Batt or Blanket Type jiberglass Brand Name. --Certalnteed 6„ Thickness (inches) Thermal Resistance (R Value) 19 _ Loose Fill Type 10 Brand Name Minimum Thickness (inches) Number of' 6ags e s ^ Weight per bag Ib Area Covered (ft2) Thermal Resistance (R Value) FLOOR,ELEVATED Material _ Brand Name Thickness (inches) Thermal Resistance (R Value) FLOOR, SLAB — u. - - Material` Brand Name Thickness (inches) Thermal Resistance (R Value) _ Width (inches) FOUNDATION WALL Material _ Brand Na'me Ir t nr Thickness (inches) Thermal Resistance (H Value) p HEATING SYSTEM das Furnace _ e J Make Model Description Rated Bonnet Capacity.' DECLARATLON - . - I hereby certify that the above insulation was installed in the building at the above location ir. current regulations setting Energy Conservation conformance with the Standards for new residential buildings (located in Title 24 of the California Administrative Code). ,a, .t: .JCI " . fl. General Contractor (Builder) - License Number N` ( ,� lrSignature and Title _ Date Hawkins Insulation Co.. Inc. 215925 Sub -Contractor (Insulation Applicator) License Number Owner 13179 Signature and Titles j. Date CERTIFICATE REVIEWED BY Pate BIN -029 (Building Inspection Off ice) RES IDENT IAL ENERGY CONSERVATION STANDARDS CONSTRUCTION COMPLIANCE CERTIFICATE THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN INSTALLPD IN/' 0NFORMANCE WITH CURRENT N{ERC, CONSERVATION REGUJ,�TI An, ( l i C _ 1 "�) n, R1[., locatidn) BUILDING PERMIT NO. g ^ _-) 1 A;P. NO. THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS: (Check each item or write N/A if not applicable) INSULATION: n Slab Edge. J� Fdn. Walls At A - Floors --- .Walls Ceiling/Roof Ducts Circulating Pipes APPROVED HEATER APPROVED WTR.HTR. GLAZING: Single Glazed A/A .Special (Insulated) CERT. & LABELED WDS. & SLIDING DRS. _ WEATHERSTRIPPED DRS.' BACK DAMPERED FANS INTERMITTENT IGNITION DEVICES CERT. APPLIANCES I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED.' Insulation Applicator Name Signature of (please print) ' Insulation Applicator State Contractors License No. General Contractor/Owner NameP.t- (please print) Signature of Wate General Contractor/OwnerSContractors _ License o THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION WITHIN THE DWELLING. COUNTY OF BUTTE — 'ti"EPARTMENT OF PUBLIC WORKS 7 County Center Drive -- Oroville, California 95965 Tefephone: 534-4541 0 APPLICATION AND PERMIT aUu Iv — IUPIVQOrlla IIVCJ UI 111C VUUnIy UI DUllc LL)VFILIVI upuFi lrl@ above-mentio ed property for inspection purposes. b. X �� / Date Signature of Permitee or Agent Receipt No. 7V(, ;7 / White-D.P.W. — Yellow -Assessor — 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.,6`FPUBLIC WORKS By Date C-/- Zo' % �7 B ding permit expires Date �� ' ^ i BUILDING Owner SO. FT. OCC. BUILDING VALUATION 6 Mailing Address �`� A 5:L0 ad \ Telephone No. j U . Contractor - Mailing Address Fireplace Icb6 _a.p Total Valuation R IW Telephone No. Permit Fee f �i Building Address Qa�� Plan Checking Fee&/or Penalty Permit Fee / / °Z T7 -)z--T-- LIJ C C__G oma- CA- v 2 . a rf� PLUMBING No. @ FEE ,12 �� u�� PERMIT FILING FEE $3.00 S:� Each Trap 1.50 o � Repair drainage or vent piping 1.50 •7 J Z�oA;ng Plann;ng Water piping 1.50 Each gas water heater or vent 1.50 Fe* W. Sa I a n. FireDept. FireZone Use Permit Gas piping system 1 - 5 outlets 1.50 E Parking Plans ParcelEach Declaration I Parcel Map 1 60' R/W I Improvements additional outlet .30 Building sewer 5.00 `Bldg. ns Recd Parcel A provol Plans Ap oval Lawn sprinkler system 2.00 NEW ❑ ADDITION UTILITIES ❑ OTHER ❑ Permit Fee $ -s-0 A-� , ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 ,()C) Main service 600V OR LESS 100 AMP OR LESS 5.00 Single Family Duplex Mobil Home ❑ Others ❑ 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.. !i OR ADDNS. ACC. BLDGS. 20sgft 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 st le of: y NEW RESID.CONSTMULTI H CIRC NON-RESID, BRANCH CIRCUITS) 12.50ea NEW CONSTR. (POWER APPARATUS a NON-RESID. SINGLE OUTLET CIR. Ex. OCCUP(OUTLETS OR FIXTIIRES) g @L Ex. OCCU FIXED APPLNS. OR p. OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 am exempt from the Contractors License Laws of the State of Cal ifomia. Permit Fee $ $;,L $ C WORKMEN'S COMPENSATION INSURA 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. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 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. No. MECHANICAL @ FEENCE PERMIT FILING FEE $3.00 Heating u a V ri v � ] l V �✓ Cooling Ventilation Hood 2.00 Z.c_0 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 Land Development Fee $ TOTAL PERMIT FEE $ 7 0 tC'r aUu Iv — IUPIVQOrlla IIVCJ UI 111C VUUnIy UI DUllc LL)VFILIVI upuFi lrl@ above-mentio ed property for inspection purposes. b. X �� / Date Signature of Permitee or Agent Receipt No. 7V(, ;7 / White-D.P.W. — Yellow -Assessor — 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.,6`FPUBLIC WORKS By Date C-/- Zo' % �7 B ding permit expires Date �� ' ^ i RESIDENTIAL PLAN CHECKING GUIDE (S.F., DUPLEX, & MISC. ONLY) �� 1 � I � •- Bldg. Permi �k OWNER O �N' A.P. # — A. GENERAL —� Zoning requirements.(sideyards and parking). a!/Valuat ion. ;! Signature by R.C.E. or Architect (if required). B. PLO LAN omplete parcel size and dimensions. �etback!�, sideyards, easements, etc. 3* Other -buildings or structures. s * Grading, fills, drainage. C FLOOR PLAN /�Complete to scale plan with dimensions. �Required windows for light and ventilation (Sec. 1405). �. Required windows for second exit (Sec. 1404). 4Allowable glazing for energy requirements (20% max. per.State law). 5. Human impact glass (Sec. 5406). 6�Required room sizes, ceiling heights (Sec. 1407). 7 G.F.C.I.'s in baths and exterior outlets (Sec. 210-8). Light fixtures, switches, receptacles, and exterior receptacles for maintenance of / mechanical equipment. 9/.' Locations of water heater, heating & cooling equipment, other electrical or gas / equipment, and plumbing fixtures. 18! /garage firewall, door size, and closer (Sec. 503(d)(4)). 1 1 - 3'0" exterior exit door (Sec. 3303d). 12. /Fireplace location. 13 Smoke detectors (Sec. 1413). CTURAL DETAILS Foundation plan complete enough to construct building. Floor construction details complete enough to construct building. Elevations and wall construction details complete enough to construct Roof construction details complete enough to construct building. fireplace construction details and calcs if over one-story in height. Sufficient data and details to satisfy energy insulation requirements E. MISCELLANEOUS ITEMS TO LOOK OUT FOR CCX plywood on exposed locations and overhangs. Stairway details (Sec. 3305).. Guardrail details (Sec. 1716). 4,,0_"Brick or stone veneer (Chapter 30). Exterior plaster - weep screeds (Sec. 4706 & 4708). 6� Proper roof pitch for roof covering (Chapter 32). tsRafter ties or bearing ridge beam. Garage door or porch header sizes. building. (State law). 9�Adequate bracing. 10 -.'-'Living area over garage - complete 1 -hour separation required including supporting walls and posts, etc. ]tf Two (2) exits on three-story dwellings (Sec. 3302). PERMIT NO. 2337-74B P E M MH UTIL. 2-337-74B PERMIT NO. PERMIT EXPIRES OWNER Mrs. S. A. Wall&r jCONTR. owner LOCATION (A.P 24-16-03 Temp. Power%ole- Called PG& Temp. Elec. Serv. Called PG&E mv. as erv. Called PG&E JOB FINALE[ COUNTY OF BUTTE — DEPARTMENT'OF'PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Piping Pier Roofing Sewer Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr StemwaII Slab Prov. for physically handicapped Heaters Appliances Carport Footings Conformance of ex. structure Gas Piping & Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixture Bond Beam FIRE SPR ERS Motors Framin Jl" Test Water Htr. Stucco Mesh Scratch Brown Finish Interior Lath Door Closer DA TE I MECHANICAL Heating Cooling Ducts Ventilation Final REMARKS OR CORRECTIONS Subpanels Grd. Fault Prot. Service Temp. Pole Underground Permanent Final • a.- /. • - COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WOR S pv///////�� 7 County Center Drive -- Orovi lie, California 95965 ��,e/%_ Telephone 534-4541 / APPLICATION AND PERMIT Owner Z Mai I i ng Address A 0 Telephone No. Contractor �Lc Mai I i ng Address Telephone No. Building Address[ <Z,/ ZJ),ACWA= A. P. N u `J I Zoning & Planning s SSD io Fire Dept. Fire Zone Use Permit EQA Parking Parcel Parcel M 60' R/W Im rovements Plans Declaration P B I d ans Recd I Parcel Approval PIppro vaI NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Single Family ❑ Duplex ❑ Mobil Home Others ❑ 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: License No. Classification ® I am exempt from the Contractors License Laws of the State of California. WORKMEN'S COMPENSATION INSURANCE I 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. ❑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. 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 C unty of Butte to enter upon the above -men a property f r i ction purposes. X / Date S' ature of`Permitee or Agent / Receipt No. 2 d White-D.P.W. – Yello—Assessor – Pink -Inspector – Goldenrod -Applicant BUILDIN13 FT. I OCC. I BUILDING VALUATION Fireplace Total Valuation Permit Fee Plan Checking Fee &/or Penalty Permit Fee PLUMBING PERMIT FILING FEE Each Trap Repair drainage or vent piping Water piping Each gas water heater or vent Gas piping system 1 - 5 outlets Each additional outlet Building sewer Lawn sprinkler system Permit Fee ELECTRICAL PERMIT FILING FEE Main service incl. 1 meter Additional meters, each Sub -panel (12 or less) (more than 12) Range, Cook -top or Oven Water Heater or Space Heater Light fixtures Receps., switches & fix outlets Hood, Ex. FanorF.A. Furn. Motor Evap. cooler, gar. disp. or D.W. Air conditioner or heat pump Water pump Mobil Home Facilities Temp. Power Pole Misc. wiring Permit Fee MECHANICAL PERMIT FILING FEE Heatinq Coo I i Ventilation Hood Permit Fee r0 s— v�� FEE $2.00 1.50 1.50 1.50 1.50 1.50 .30 5.00 2.00 $3.00 2.00 FEE TOTAL PERMIT FEE $ 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 OF PUBLIC WORKS By Date I 2-S 2 wilding permit expires Date................4. 7::.z7 S .?.S- t UTILIIES'-FOR MOBILE HOME 342-74P,E j PERMIT NUMBER - B P ti y' E PERMIT EXPIREScR -I4�S Max Schohr .{OWNER I CONTR: Owner LOCATION (A.P. 24-16-03 i N/W corner of cowee & Turner y 900' N. of"Turner, Gridley 1 Y � 1 ' J of • t •1 r - t COUNTY -OF BUTTE Department of Public Works BUILDING INSPECTION RECORD ��v Zoning Setback ✓ Forms Foundation Piers & Girders Fireplace Rgh. Plumbing Bond Beam 00Lath & Plaster Rein. Steel Gas Piping & Test _ Found. Vents Framing Pimg. Topout Rough Elec. Wtr. Htr. Furnace Kitchen Vent Firewall Garage Vents Sanitation & Water ELECTRI GAS BUILDING Temporar � Temporary 3 Cert. of Occup. Final �J cJ Final __ Final/ S DATE f — / REMARKS OR CORRECTIONS COUNTY OF BUTTE — DEPARTMENT OF PUBLIC 7 County Center Drive — Orovi lie, California 95965 Tel ephon€.- JT4541 APPLICATION AND PERMIT WORKS authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. . , ?,/ z I / - /� 4 xr Date 5 gnature of Permitee or Yget Receipt No. :7 White-D.P.W. — Yellow -Assessor — 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 OF BLIC WORKS By Date —� Y— 7 Building permit expires Dafe BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address - l T e e hone � Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee Building AddressPLUMBING No.1 @ FEE PERMIT FILING FEE $2.00 L114 00 k- dip Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. Ng,/ Q—:3 Zo ng Gas piping system 1 - 5 outlets 1.50 41 Each additional outlet .30 F sSa ire Dept. I Fire Zone Use Permit Building sewer 5.00 Q EQA I ParkinPlans l Parcel Map 60' R/W Improvements Lawn sprinkler system 2.00 Permit Fee Bldg. Plans Rec'd Parcel Approval Plans Approval NEW ❑ ADDITION ❑ UTILITIES OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Single Family ❑ Duplex ❑ Mobil Home D2/ Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures 1 P 25 011113 Receps., switches & fix outlets 2002 b. 10 1 OF 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: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring 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. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 14 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 $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT FEE authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. . , ?,/ z I / - /� 4 xr Date 5 gnature of Permitee or Yget Receipt No. :7 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF BLIC WORKS By Date —� Y— 7 Building permit expires Dafe FvI"4.,AtAA-4' r 4, Septic system a pe Butte County Health Dept. Rer quirements. A ll utility connections shall be I0eated Within,4 ft. outside the rear third section of the mobile home on the left (road) side of the mobile home. 1 -his set of plans and specifications MUST be 'sept on the ,job at all times and it is unlawful to make any changes or alterations „on same without written permisson from the ,Dep Works, County of :$ fie artment of Public BUTTE COUNTY 8UILDING DEPARTMENT APPROVeD BUTTE COUNTY DEPARTMENT OF PUBLIC HEALTH Division of Sanitation •° 695 Oleander Avenue P. O. Box 1100, Chico 343-4211, Ext. 51 Applicant's Name: Applicant's Home I License Number of mobile nome Registered owner: Description: Length Make Date first placed on site: Number of Bedrooms:- - APPLICATION FOR PERMIT TO CAMP OR LIVE IN MOBILE HOME 2430 Bird Street Oroville 533-123O,.Ext. 297 Date: in Color Number of people to reside in camp area or mobile home:_ 2 Location of proposed site:T47�H'p (Address or detailed description in addition to route and box Name of Property Owner: ��04 �2�r� - Address of Property Owner:(� r71.,y-e `- Le Size of Property: acres; or'- ft. wide x ft. deep Proposed Length of Stay: . . Proposed Water Supply: Proposed Sewage Disposal: Proposed Garbage Disposal Method: — Does Trailer have: Sink , Shower Toilet This application is made pursuant to provisions of County Ordinance No. 632 and the above information is complete and true to. the best of my knowledge. No rent will be charged or paid for occupancy of this mobile home. (Sx ature of ApplicAt). For Planning Department Approval Where Necessary .Approved By: - -- --- -- --- Signature Date: 517-11678 0�f ® "1 ,E1* .S L0 P , o�• Date To 14 ......Approval ......Necessary action ......Prepare reply ......Comment ......Note and return ......Note and file ......Investigate ......Signature ......Confer ......As requested ......For information ......Per telephone conversation BUTTE COUNTY s" BUTTE COUNTY DEPARTMENT OF PUBLIC HEALTH Division of Sanitation 695 Oleander Avenue P. 0. Box 1100, Chico 343-42112 Ext. 51 i MOBILE HOME SITE PROPERTY USE AUTHORIZATION To: Butte County Health Department 2430 Bird Street Oroville 533-1230, Ext. 297 Date: I am the legal owner or person in charge of the following property: (Property description, location, or -address) and have the authority �o give and hereby do give my permission to: to camp ( ); live in ( Name) �--� a mobile home on the above mentioned property, and to construct, main - twin and use such sanitary facilities as -the Butte County.Health Department deems necessary. This permission extends from to • (Date) (Date) I understand that under the provisions of the California Health and Safety Code, it is illegal to charge rent for a mobile home on the above mentioned property unless I hold a valid permit from the State Division -of' Housing to operate a mobile home park. I will not charge rent for the Placement or occupancy 'of a mobile home on this property. NOV- c w/ `.• -Signature S26 -1167R X81