HomeMy WebLinkAbout024-170-043NOTES
RESIDENTIAL
PERMIT NO.
C124
05-1723
VRABLICK,MICHAEL
422 TURNER AVE, GRIDLEY
Cont: OWNER
ELEC SERV UPGRADE
DETACH FOR SERVING UTILITY
Address
GAS
Meter By Date
ELECTRIC
Meter By Date
SPECIAL CONDITIONS
— SRA
— FLOOD CERTIFICATE REQ.
— FIRE SPRINKLERS REQ.
— SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
JOB FINALED (Date) r) bain r—
Signature
CHECKED
BY
4 = OK
D = Not OK
- Not 4plicable
= Not Ready
MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
I . Zoning Requirements -Setbacks -Easements
2. Soils; Specidl MH Support Sketch
3. Sewer, Location -Test -Fall -C/0 -Concrete
4. Water Location -Test -Easement Needed (Sketch)
5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap;-/ /" L 'ft.
/ P Nat. or/ /" L 'ftJ P LPG
7. Well Clearance & Disconnect
8. Utility Clearance
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
MOBILE HOME INSTALLATION (Plans) OK except #'s
Date
1 . Zoning Requirements-Setbacks-Easernents
Date
2. Footings; Size -Spacing -Marriage Une
3. Gas; MH Test-Dernand-Valve-Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
5. Drain; MH Test -Fall -Flex Connector
6. Water MH Test-Regulator-Connectoe
7. Water and Sewer.Connected-C/0 to Grade -HD Approval
8. Gas and Electricity Tagged
9. Tie Downs -Type -Installation Cert.
10. Exits; Insp.-Sketch
11. Cert. of Occupancy
10. Plumb.; Cir. Test -Water Supply Test
11. Light Niche
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date PERMANENT END SYSTEM (ONLY)
1 . Zoning Requirements -Setbacks -Easements
2. Footings; Size -Spacing -Marriage Une
3. Blocking
4. Gas; MH Tesl-Demand-Valve
5. Electricity; MH Test
6. Water, MH Test
7. Water and Sewer Connected
8. Gas and Electricity Tagged
9. Exits
10. Ucense Decals
11. Verify #'s with Office
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
MISCELLANEOUS
Date
DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1 . Zoning Requirements -Setbacks- Easements
2. Footings; Soi[s-Size-Depth-Spacing-Connectors-SteeI
3. Decks, Girders and/or Joists -Decking -Bracing -Stairs- Rails
4. Wood Awn.; Posts-Beams-Rftrs-Connectors
Shthg-Frg-Bracing
5. Mum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof-, Shthg-Roofing
11. Ext.; Steps -Doors -Landings
12. Braced Wall Panels
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-Uning
4. Bec.; Receptacles and Lighting, Distance -GA
5. EJec.; Pool Ughting: 15 Vofts-GF1
6. EJec.-. Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
B.- Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Main Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
11. Light Niche
12. Enclosure; Fencing-AJarms
Date Card B-1 Date Card B-1
Date Card 13- 1 Date Card B-1
OK
Not OK
Not Applicable
Not Ready
RESIDENTIAL (Single & Duplex)
)ate UNDERFLOOR (Plans) OK except #'s
1. Zoning -Setbacks -Easements -Rood -Slope
2. Ftg., Main; Soils-Elec. Gmd.-/ r Ftg. Depth
3 . Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ r Ftg. Depth
5. Sternwalls, Main; Steel-Blockouts-Wrapped
6. Sternwalls, Garage; Steel- Blockouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab, Steel -Wrapped
8. Piers -Fireplace Ftg.-Steel
9. D.W.V.-, Fall -Fitting -Test -2 Way C/0 -Sewer Test
10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test
11. Water Pipe; Test -Anchors -Regulator -Service Test
12. Electric Unde!Rround
13. Plenums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
15. Access &Ventilation
16. Insulation
Date FRAMING (Continued)
47. Hangers -Post Caps -Anchors -Connectors
48. Cling. Joist-Rftr. Ties-Purlin-Roff Brac.-Truss-Shting.-Ptng.
49. Fireplace Ties or Type A Rue -Fireplace Throat Clearance
50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
52. Garage Fire Protection Framing -RC Channel
53. Property Line Firewall & Openings
54. Ext. Doors -One X -Check Garage 3rd Story, 2 Exits
55. Stairs; Width -Headroom -Rise- Run- Landing -Fire Protection
56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
57. Siding -Nailing Veneer
58. Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access
59. Glazing Area -Glass Protection -Skylights -Plastic;
60. Shear Walls. Nailing -Bolts
61. Brace Interior/Exterior Wall Panels
62. Insulation -Walls -Ceilings
Date
Card B-1 Date Card B-1
-1
Date
Card B-1 Date Card IT
Date
PLUMBING Wermit) OK except #'s
Date
17. Water Htr.; Vent -Access -Combustion Air Baffle
18. Water Pipe; Test & Anchor -Nail Protection
19. D.W.V.; Test Fittings & Anchor -Nail Protection
2 0. Shower Pan; Test, First Floor -Tub Access
21. Test Tub & Shower, Second Floor -Tub Access
22. Gas Pipe; Sixe & Anchors
23. Fire Sprinkler, Test
70. Stairs & Rails
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) OK except #'s
24. Fixture & Transformer Clearance -Ins. Protection
25. Elec. Receptacles Spacing -Lights & Switches at Doors
26. Size Boxes & No. of Conductors Stapled
27. Romex Installed Close to Edge of Studs & C.J.
28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water
29. 2 Appliance Circuits in Kitchen & Conductor Size GFI
30. Sutifeed Wire Size/ /ga. Cu or AJ-A.C. Wire Sizet /ga Cu or A
31. Range Circle/ /ga Cu or AJ -Oven Circ. / /ga Cu or AJ
Insulated Neutral 0 Yes ONo
32. Service -Riser Conductors & Ground Main Disconnect
33. Equip. Clearances Panels-Motors-Mech. Equip.
34. Clothes Closet Light -Shower Light -Spa Light
35. Smoke Detector
85. A.C. Unit Disconnect, Electrical -Plumbing
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MECHANICAL (Permit) OK except #s
36. A.C. Ducts Insulation & Support
37. Vent Fan, Exhaust above insulabon
38. Condensate Drain & Overflow, Size & Grade
39. Fumace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet
40. Attic Access & Platform if Furnace in Attic
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FRAMING (Permit) OK except #'s
Date
41. Sills Proper Materials & Anchors
Date
42. Walls Studs -Nailing Spacing & Braces -Plates -Sound
43. Bearing Walls over Girders & Floor Nailing
44. Draft Stop in Walls (rat proof)l
45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
46. Headers & Beams -Size & Bearing
Date FRAMING (Continued)
47. Hangers -Post Caps -Anchors -Connectors
48. Cling. Joist-Rftr. Ties-Purlin-Roff Brac.-Truss-Shting.-Ptng.
49. Fireplace Ties or Type A Rue -Fireplace Throat Clearance
50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
52. Garage Fire Protection Framing -RC Channel
53. Property Line Firewall & Openings
54. Ext. Doors -One X -Check Garage 3rd Story, 2 Exits
55. Stairs; Width -Headroom -Rise- Run- Landing -Fire Protection
56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
57. Siding -Nailing Veneer
58. Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access
59. Glazing Area -Glass Protection -Skylights -Plastic;
60. Shear Walls. Nailing -Bolts
61. Brace Interior/Exterior Wall Panels
Date Card B-1 Date Card B-1
Comments at Final:
62. Insulation -Walls -Ceilings
63. Infiftration-Walls-Windows
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #s
64. Ext. Steps -Door & Sidelight Protection -Landings
65. Smoke Detector
66. Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
67. Bedroom Exiting
68. G.F.I. & Bath Fixtures & Tub Access -Spa
69. Elec. Trim & Subpanel, Breaker Sizes & Labels
70. Stairs & Rails
71. Fireplace or Stove, Clearance -Hearth
72. Elec. Outlets at Wood Panel, Int. & Ext.
73. Kit- Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance
74. Elec. Outlets & Receptacles at Kit. Counter
75. Garage Fire Door Swing -Landing -Closure
76. A.C. Duct in Garage -Damper
77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-RR.V.
in Garage; Above Floor-Mech. Protection
78. Plb.; Bec. & Mech. Equip. Listed for Location
79. Elec. Receptacles in Garage (F.Fl.)-Romex Protection
80. Insulation -Foam -Looked in Attic
81. Guard Ra:ils & Deck Construction -Post Caps
82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor 13 Yes
83. Following InAdJOTive 0 Yes 0 No/Walks 0 Yes 0 No/Planters 0 Yes 0 No
84. Stucco Brown -Finish
85. A.C. Unit Disconnect, Electrical -Plumbing
86. Vents Above Roof, Pibg-Appliance-Fireplace-Clearance to Openings
87. Water Well, Disconnect, Electrical, Plumbing
88. Exterior Elec. Trim. G.F.I. Receptacle-Underg round
89. Ventilation Throughout House
90. Glass Protection
91. Corrections from Previous Inspections
92. Gas Test -Meters Tagged, Gas -Electric
93. Water & Sewer Connected -C/O to Grade -HD Approval
94. Energy Compliance Certificate -Other Certificates
95. Address Posted
96. Fire Sprinkler
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:
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
WEIBSITE: www.buftecounty.netIdds
PERMIT NO.
BPO51723
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: 06/30/2005 APN: 024-170-043-000
the Business and Professions Code, and my license is in full force and
effect.
License Class License Number:
Site Address: 422 TURNER AVE GRI
Date: _ Contractor:
Map Index:
Des cription: ELECTRICAL SERVICE UPGRADE
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, after, improve, demolish, or repair any structure, prior.
Owner: VRABLICK MICHAEL & KRISTIN
to its issuance,- also requires the applicant for such permit to file a'
422 TURNER AVE
signed statement that he or she is licensed: purstiant to the: provisions of.
'cerise
GRIDLEY,- CA,
the Contractor's State'Li Law (Chapter !�`commen'cing vith'Section
7000) of Division 3 of the Business and Professions Code) or that he. or
95948
she is exempt therefrom and the basis.,for the alleged exemption.. Any
I n
violation of Sec io 7031.5. by any applicant for a permit subjects the
applicant to'a ci . vil.penalt.y of not more than five hundred dollars ($500).):
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.,offqrqd.t9r,saIe. (Seq.JQ44_Qv 9 .
pi ass and.Professions
Applicant: VRA13LIC.K.MIQH,�,E�L,!& KRI.S.TIN-..,
Code: The Contractors' State License Law'does not apply to an
owner of property who.builds or improves thereon, and who does
422 TURNER AVE
such work himself or herself or'through his or her own employees,
GRIDLEY, CA
provided that.such improvements are not intended or offered. for
95948
sale. If however. the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
provin� that he or she did not build or'improve for the purpose of
sale.).
as..owner.. of .,.t he. -propert y,, am... exclusively .: contra cling with.,,
licensed contradtb�s%td consVuct'the project (Sec. 7044, Business
and Professions Code,t- The Contractors' State License Law does
Contractor:
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.).
1 am Exempt under Article 3 of the Business and P/ofessions Code
Date: %ner: /y,11 A
'License #:
WORKIERS'-COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
13 1 have and will maintain a certificate of consent to self -insure for
workers' compensation. as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
Architect:
is issued.
Engineer:
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:
Total Square Ft: 0 S. F.
Valuation: $0.00
Census Code:
Policy
13 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 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
$15
Date:
Applicant:
T3 1 2_q
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 attomey's. fees.
7 -
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending'agency for the
This permit is hereby issued undler the applicable provisions of the Butte County CodA ?nrtlor
Resolutions to do work indicate . d bove for which fees have been paid.
performance of the work for %vhich this permit is issued (Sec 3097 Civ.)
Name:
By:___*At1 t74AI', f!17�1-idlkm.4 Date: an
t i - - - ., , " .. , - -
Address:
PERMIT EXPIRES ON:
(Date)
.
. . . . r .—
.. . .. I I w
13 1 hereby certify that -the use of this facility shall comply with Section's 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
0 Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
0 Attached are copie ' s.o * f the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document
of,Butte County. I hereby
authorize representatives of Butte Co ty o enter upbn the above mentioned property for inspectio'n purposes.
Print Name:
Signature:
C)
Date:
Owner
Q Contractor 0 Agent for Owner Q Agent for Contractor
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION M (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAX#: (530)538-2140
WEIBSITE: www.buttecounty.net\dds
PERMIT NO.
BP051723
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: 06/30/2005 APN: 024-170-043-000
the Business and Professions Code, and my license is in full force and
effect.
License Class: License Number:
Site Address: 422 TURNER AVE GRI
Map Index:
Date: Contractor:
Description: ELECTRICAL SERVICE UPGRADE
OWNER43UILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
Owner: VRABLICK MICHAEL & KRISTIN-
.
permit to construct, alter, improve, demolish, or repair any structure, pnor
to its issuantc,also requires the applicant for such permit to file al
422 TURNER AVE
signed statement thai"he or she is licensed�otlisUant td,-toe��Ordvisibhs of,
'G R I D L EY,, CA' -
the Contractor's State Li6ense Law (Chapter 4 c6mmencing �ilfth* §e6tiori�
95948
7000) of Division 3 ofIllib'Business and Professions Code) or that he'.o'r!
she is exempt therefroni and the basis�,for the alleged. exemption.. Any�
J,:
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to'6* civilpen'altyof not more than five hundred dollars ($500).):
1, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
..,inten4d,prqfftFgLd,Lor..P,11§,($ec-�1Q.44,-E!vsJ ess.ancl-Professions.-
. M
Applicant:.VRABLIC.K-M[,QH. P,,j5TJN
Code: The Contractors' State License Law does not apply to an
422 TURNER AVE
owner -of -property who.builds orimproves thereon, and who does
GRIDLEY, CA
such work himself or herself or through his or her own employees,
provided.tha - t.such improvements. are not intended or offered. for
95948
sale. If hiow6er, the'66ilding or? im'p'rov;ementis are sold within one
year of completion, the owner -builder will have the burden of
proving that he or she did not t3bila br,im-6rbve for the purpose of
sale.).
as.�owner�.-ol-the��property�.am,,.exclusively.7contracting...with-
licensed contmdt&e. td conisf�uct'the project (Sec. 7044. Business
and Professions Code%�- The Contractors' State License Law does
Contractor:
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.).
0 1 am Exempt under Article 3 of the Business and P/Ofettions Codd .
Date: .6 3p - o !��,ner:
License*
WORKERS! -COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
13 1 hav& and will maintain a certificate of consent to self -insure for
workers'. compensation, as. provided for by Section 3700 of the
Architect:
Labor Code, for the performance of the work for which this permit
is issued.
Engineer:.
El 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:
Total Square Ft: 0 S. F.
Valuation: $0.00
Policy #:
Census Code:
LI I certify that ilh the performince ofthe work for which this permit is
issued. I shall not. employ any person in any manner so as to
become subject to -the workers' compensation laws of California,
and agree thaV if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwithcomply with those provisions.
Date:
Applicant:
WARNING: Failur ' e to secure workers' compensation coverage is
unlawful, and shall su6ject 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 attomey's. fees.
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the applicable provisions of the 80P County COCIA enrl/or
I hereby affirm that there is a construction lending,agency for the
Resolutions to do work indicated bove for which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
Name:
I
I
By: 4 _Date:
Address:
PERMIT EXPIRES ON: 6)
(Date)
CI I here�y certify that-th6 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 a66.6rdance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
• Attached are copieslol'Ahe required E.P.A. notification forms.
I hereby certify tha ' I 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. -1 agree -to cor�ply with
all county 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 Butte County/to enter upbr� the above mentioned property for inspectio'n purposes.
W
Print Name: Ulra -k
Signature:
30 0
Date:
Owner
Q Contractor Q Agent for Owner 0 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 A T TIME OF APPLICA TION
Website: www.buttecounty.net/dds
"PLEASE PRINT CLEARLY"
APPLICANTNAME
OWNER
Name
Last Name
Address
r irst Name kt
Address
LK
A -v -p—
City
j I
State
Fax
Zip
Phone
OL16
Fax
E-mail
Name
APPLICANTNAME
CONTRACTOR
Name
City
Address
zip
City
LFa
State
Zip
Phone
Policy Number
Fax
E-mail
Lic. #
Class
APPLICANTNAME
ARCHITECTIENGINEER
Name
City
Address
zip
City
LFa
State -Fz-'p
Map Book
Phone
Policy Number
Fax
E-mail
State License Number
APPLICANTNAME
Name V
Address LI(RV AV C,
City
'ale - I
zip
EEax__,tlone 51 b�
LFa
_m
APPLICANT $IGNATURE
X alub j
__ � t/� L
For office use only:
Zoning
Flood Zone
�)7
SRA I Yes
I No
Occ. I
Type Const.
Subdivision Name
Map Book
I Page
Policy Number
IDate Approved:
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING FORMS\BldgAppiSubRqmts.doc
PERMIT
NO.
BIN N
Description or Scope of Work:
eleel—saly, /,o &-zL
Sq. Footage
0 Structure Built without Permits
13 Proposed Change of Occupancy
(Note previous use):
Page 1 of 2
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.
Received by' Amount: Bldg
4�, V.
SRA
Receipt It: 4 3127 2. Sheriff
Date:6 _r)n�
cu 0_�
SMIP
Other
Total
REV 2-24-05
LOCATION
AP# �,jco_
�)7
Prrop3Ad dre7—
Cross Street
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than licens'econtraic--tiors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
Description or Scope of Work:
eleel—saly, /,o &-zL
Sq. Footage
0 Structure Built without Permits
13 Proposed Change of Occupancy
(Note previous use):
Page 1 of 2
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.
Received by' Amount: Bldg
4�, V.
SRA
Receipt It: 4 3127 2. Sheriff
Date:6 _r)n�
cu 0_�
SMIP
Other
Total
REV 2-24-05
0'.
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.
1:1 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
13 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.
0 3. Engineered truss details and layouts in duplicate (if required). No faxes!
0 4. Energy compliance design and supporting documentation in duplicate.
0 5. Statement of Intent -for Non -heated and A/C for Non -Residential Buildings.
0 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in
duplicate.
0 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the enginee .
0. 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if -required).
0 9. Site plan and business license approval from the City of Biggs.
E3 10. Letter of intent for non-residential buildings.
0 11. Detached Accessory Building Form filled out by the owner (if required).
El 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.)
0 1..
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
0 2.
Imp8ct Fees.
0 3.
California Department of Forestry plan approval (if required).
0 4.
NPDES Form.
0 5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
0 6.
Contractor's license information.'(Number., Name Style, Classification).
0 7.
Worker's Compensation Carrier and Policy Number.
El 8.
Owner -Builder Verification (if required).
0 9.
Letter of Signature authorization (if required).
0 10.
Recorded copy of Agricultural Acknowledgment Statement.
0 11.
0 Grant Deed, 0 M.H. Title/Statement of Facts.
0 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
KAFORMSSUILDING F0RMS\B1dgApp1SubRqmts.doc Page 2 of 2 REV 2-24-05
URROUGHS JUDITH C
Addr1F4i2--TLiR—NERRD
Addt21GRIDLEY CA 9594B-9753
Addr3F—.
AdAIA
Asmt # I Fee #PT4-1-70-043-000
Status IZ-T—IVE Status Date
Tax [00.0 F�ORIVIAL OWNCR—SHIP--- TRA 02 -068 --
Situs 422 TURNERAVE GRIDLEY
Base D t 1010/2-004
T
S tiucture 76,400
Fixtures 0
6 rowing 0
Total L&I 127,333
Fix. AF 01
MH PP 0'
PP 0
Exemptl 0
Netol =127033
R/C#F-
T/R DtF . --
R/C Statr-
T SIT
it J' 1�,fwjj - a;. E���
IRe - --y ers, 10/201200;8-.29.-33 AM
F2004 [mdemm
r Timber Preserve
r AgPies
'Comments 1241700430000OERTED F9 08/88
r E tal
Creating D oc#F��Rll 8914-06 DateF—.
Current Doc# 200480027137 D a t e [69-io—o
Bonds
Killing Doc# F- D ate.
WO Multi S itus
f Flagl
Asmt Desc]422 424 TURNER AVE SuplCnt�-
12�
FIag2
ZoningFA40 Dwell�—
910 MH
Actes/Sq Ft 11 N/Cpi�—
Asmt PP Pen
r Tax PP Pen
r Appeal Pending
Split Pending
T
S tiucture 76,400
Fixtures 0
6 rowing 0
Total L&I 127,333
Fix. AF 01
MH PP 0'
PP 0
Exemptl 0
Netol =127033
R/C#F-
T/R DtF . --
R/C Statr-
T SIT
it J' 1�,fwjj - a;. E���
IRe - --y ers, 10/201200;8-.29.-33 AM
F2004 [mdemm
1b
RECORDING REQUESTED BY
North State Title Company
EsuowNo. 05100124 OTdcr No. 219328
AND WHEN RECORDED MAIL TO
Michael E. Vrablick and Kristin Vrablick
422 Turner Avenue
Gridley, CA 95948
A.P.N. 024-170-043
The undersigned grantor(s) declare(s):
*2-005-0031637
Recorded I
Official Records I
County of I
Butte I
CMM J. GRUBBS I
County Clerk-Recorderl
09:%M 03-Jun-2NS I
SPACE ABOVE THIS LINE FOR RECORDERS USE
INDIVIDUAL GRANT DEED
Documentary transfer tax is $396.00. City Transfer Tax is $.
0 computed on full value of property conveyed, or
0 computed on full value less value of liens and encumbrances -remaining at time of sale.
13 Unincorporated area: k City of , and
REC FEE M N
TAX 3%.00
KH
Page I of 2
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
Judith C. Burroughs, An Unmarried Woman
hereby GRANT(S) to Michael E. Vrablick and KristiWVrab lick, Husband and Wife as Joint Tenants
the following described real property in the County of BUTTE, State of California:
'SEE EXHIBIT'A'ATTACHED HERETO AND MADE A PART HEREOF'
Dated: May 26, 2005
STATE Or CALIFORNIA
COUNTY OFSutter SS. e4
Ori 4(0- before me, the �#`dith C. B rrougfis
undersigned Notary Public, personally appeared Judith C. Burroughs
personally known to me (or proved to me on the basis of satisfactory
evidence) to be the person(s) whose narne(s) is/are subscribed to the
within instrument and acknowledged to me that he/she/they executed V. KELLY J. KEITH
the same in hisiber/their authorized capacity(ies), and that by CMM.#13XI86
NOTAAy FUBLIC - rORNIA
his/her/their signa�rew on tjie instrument the person(s), or the entity SUTMR COUNTY
0 - ExOres AUG. 29,20%
upon behalf'of Vch the persop�� acted, executed the instrument .92�� — — — X
WITNESS my h c�ir
Signature _
MAIL TAX
STATF.MENTS TO:
NAME
9" Vision Fo� S0004CA Rev. 05/10/96
CITY, STATE & ZIP
A
Iffi
Order No. : 00219328-004
EXHMIT A
THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS:
ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE
OF CALIFORNIA, DESCRIBED AS FOLLOWS:
PARCEL 1, AS SHOWN ON THAT CERTAIN PARCEL MAP, FILED IN THE OFFICE OF
THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON
FEBRUARY 28,1973, IN BOOK 45 OF MAPS, AT PAGE(S) 44.
AP NO. 024-170-043
. .... ...... ......
BUTTE COUNJ
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION M (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE M (530) 538-7541 FAM (530)538-2140
WEBSITE: wwwbuitecounty.netkdds
PERMIT NO.
BP041234
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: 04/30/2004 APN: 024-170-043-000
the Business and Professions Code, and my license is in full force and
effect.
License Class: License Nunb r:;7,)' 5 -
Site Address: 422 TURNER AVE GRI
Date: Contractor:
Map.Index:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Description: CHARGE FOR 3 ADDITIONAL
Contractors' State License Law for the following reason (Sec. 7031.5
INSPSECTIONS
Business and Professions Code: Any city or county which requires a
pqrmit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
Owner: FOWLER FAMILY TRUST ETAL
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
GOOTMAN EDWARD & JOANNE
she is exempt therefrom and the basis for the alleged exemption. Any
1355
violation of Section 7031.5 by any applicant for a permit subjects the
REGENT ST
applicant to a civil penalty of not more than five hundred dollars ($500).):
ALAMEDA, CA 945014627
Ell 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 (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,
;Applicant: OVERHEAD
provided that such improvements are not intended or offered for
IMPRESSIONS
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
839 RICHLAND ROAD
proving that he or she did not build or improve for the purpose of
sale.).
YUBA CITY, CA 95991
0 1, as owner of the property, am exclusively contracting with
530-6734789
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to.an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
Contractor: OVERHEAD IMPRESSIONS
13 lam Exempt under Article 3 of the Business�nd Professi sCode
839 RICHLAND ROAD
Owner
YUBA CITY, CA 95991
530-6734789
WORKERS' PENSATION DECLARATIO�
I hereby affirm under penalty of perjury one of the following declarations:
Q I have and will maintain a certificate of consent to self -insure for
License #: 707509
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 the Labor Code, for the performance of
Architect:
the work for which this permit is issued. My workers' compensation
Engineer:
insurance carrier and policy number are:
,&- /_ f
Carrier:
Totai Square Ft: 0 S. F.
Policy#: 7 Z o-) /q
I certify that in the performance of the work for which this permit is
Valuation: $0.00
issued. I shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
Census Code:
and agree that if I should become subject to the workers'
compensation provisiohs of Section 3700 of the Labor Code, I shall
f
forthwith comply with those provisions.
Date:
Applicant:
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
14-14D q4 -
code, interest, and attorney's fees.
1
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the applicable provisions of tfe B, 'tte County Ctd[ F!nrvor
i
I hereby affirm that there is a construction lending agency for the
Resolutions to do work indicated above for which I ees have be n p
performance of the work for which this permit is issued (Sec 3097 Civ.)
Name:
By: D le:
PERMIT EXPIRES ON: A
// (Date) y
Address:
1"W
)11( -1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Heall and Safety de which regulate e storage,
handling and use of hazardous materials. �O
Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to.the-vd - qdof ed construction of i ject.
0 Attached are copies of the required E.P.A. notification forms. "' . . _ /.'/ / /
I hereby certify that I have read this application, that the above inforrriation is correct, and that I arr6he owner or"de duly authorize owne agree to comply with
all county and state I!j�yvs relating to "ui g constrAction. ) acknowledge it is unlawful to alte tfie substance ny official f or d c ment of Bu I hereby
ves 9
authorize rep esen o 'nt
u bove mentioned prc rr
e a )pertyfo i spec purp
sp ti.n
.4ttote Mon
A
Print Narr Sionature: A
Si,
-0. V
Date: P
Vf
. .4owner CI Contractor Q Agent for Owner 0 Ageifr Contractor
COUNTY OF BUTTE - DiPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive * Oroville, California 95965 9 Telephone (530) 538-7541 PERMIT NO.
(Rev. 12/96) k '. APPLICATION AND PERMIT 1111-2350
ASSESSOR PARCEL NUMBER
U24-1/0-043
ZONIN�
I
BUILDING PERMIT
OWNER FEDERAL, NX
TELEPHONE
SO. Fr. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS
13.5 NOM LOS ROBLES #3009 PABADENA 9110,4.
owr 500.00
CONTRACTORS NAME
UVk2*ffAD IMPMSIMS
TELEPHONE
1673-4789
CONTRACTORS MAILING ADDRESS
839 RWILAND RD,i, YLMA CM 95W1
CONSTRUCTION LENDER
[Fireplace -
LENDERS MAILING ADDRESS
Total Valuation 5M.00
ARCHITECT OR ENGINEER
E NO.
Filina Fee $ 20.00
Permit Fee $ 15.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
-Plan Checking Fee $
BUILDINGAIDDRESS
422 = RRJM,, GRIDLEY-
Energy Plan Checking Fee $
$
PERMIT FEE $ 35.00
LOT NO.
SUBDNISPONS NAME
PARCEL MAP
PLUMBING PERMIT Filing Fee 20.00
USEOFSTRUCTURE
%
SF 0 Duplex 0 Mobilehome 0 Other
SPECIFY
Each Trap 1 7.00
-
Solar or heat pump water heat,, 23.00
Water piping 15.00
Each gas water heater or.vent 15.0-0
TYPE OF WORK,
New 0 Addition 0 Remodel 0 Ufilities 0 Installation 0 Othee�O
_X
Describe Work: �q*7morXii, PARWAL It)^ I J.^V*
-STUQM� ?*14 WFATERREAD
Gas piping system I - 5 outletit- 15.00
Building sewer 15.00
Mobile Home I S I G W '�!920 .00
PERMIT FEE $
ELECTRICAL PERMIT Filing Fee 20.00
R
Main Service 'a. Lss: 23.00 23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am.lic6ns�ed under provisiont; 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 41 1
Lic. No.
OWNER -BUILDER DECLARATION,
I hereby affirm under penalty of perju.ry*,th�t I aim exempt from the Contractors License
Law for the following reason: A J,
0 1, asownerof theproperty, army eml:)Ioyee� With wages a's their sale compensation,
will do the work, and the structure -is not int6rided or offered for sale.
1, as owner of . the property, am exclusivelvl�ontricting.with licensed contractors
to constr6ct the project.
0 1 am exempt under Sec. Business and Professions Code for this
reason
Main Service TO 46.00
NEW CONST. DWELLING OCCUR ' so
OR ADDNS. & ACC. BLDS. 3.50FT.
Nt:w UUMT- MULTI -OUTLET
NON-RESID. EpAANCH CIRCUITS 1 @7.501
, . .. G WER APPARATUS
NGLE OUTLET CIR. I
.
OUTLET OR FIXTURES 20 0 '-00
Ex. Occup. ( BAL @ .50
IED APP .0'
a. Occup. 6. I= I E.A. 5.00
Temporary Service' 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE $ 43.00
WORKERS" COMPENSATION DECLARATION
1 hereby'affirm under penalty of perjury orie of the following declarations*.
0 1 have an� will maintain a certificate of, consent to self-insure,tor workers
co6Iperiseition, as provided for bi se�tion 3700 of the Labor Code, for the
;performarice.6f the work for which this permit is issued.
El I haVe� and will maintain workers' compensation insurance, as required by Section
13700 of the Labor Code, for the performance of work for which this peirnit is issued.
My woikers''compensation insurance carrier and policy number ar6:
P61 -icy Number 7 X o T1 s-1
'(The'above sections need not be completed if the permit is for work of a valuation
of one hundred dollar ($100) or less.) . ' I
V i
11 '1 c erf
ertify that in the p or�nance of the work for which this permit is iisued, I shall
1. 1 .
not employ any person in any manner so as to become subject to workers'
I �1*
Compensation law' f.'Calif �rnia, and agree that if I should become subject to the
workers -c " &Msaon p 0
0
olnp.. 'T%risions of section 3700 of the Labor,'Code, I shall
f6rth,;�ith �oirn I� wifth those lirovisions.
0
f/ ��i -
V/Jrm
Dat
SignatLire of Applicant : 0 Owner 0 Contractor 0 Agent
I
-An OSHA permit is required for excavations over 60" deep arid demolition a I rconstruction-
of structures ove'r. 3 stories in height.
MECHANICAL PERMIT Filing Fee 20.00
Heating
- Cooling
Hood 6.50
Ventilation
-
PERMIT FEt, $
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST.'n,PE
t
TOTALFEEr 78.00
CDF
PARCEL
IND
I HD
I
I ISSUE
1XX
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.
'f Vf-
3��, //YV 0-11D
*By Date&, 6
PERMIT, EXPIRES(O�N (Date)
ReceiptNo. ...385095/978.00-"
PljNK-INSPECTOR' GOLDEN 800 -APPLICANT
t
Ae
t
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION M (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE M (530) 538-7541 FAM (530)538-2140
WEBSITE: www.buttecounty.net%dids
PERMIT NO.
BP041234
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: 04/30/2004 APN: 024-170-043-000
the Business and Professions Code, and my license is in full force and
effect.
License Class: License Numb r: 7
Site Address: 422 TURNER AVE GRI
Date: Contracto,6..,�&—�L.
Map Index:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Description: CHARGE FOR 3 ADDITIONAL
Contractors' State License Law for the following reason (Sec. 7031.5
INSPSECTIONS
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
Owner: FOWLER FAMILY TRUST ETAL
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
GOOTMAN EDWARD & JOANNE
she is exempt therefrom and the basis for the alleged exemption. Any
1355 REGENT ST
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).):
ALAMEDA, CA 94501-4627
El 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 (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,
Applicant: OVERHEAD IMPRESSIONS
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
839 RICHLAND ROAD
proving that he or she did not build or improve for the purpose of
sale.).
YUBA CITY, CA 95991
E3 1, as owner of the property, am exclusively contracting with
530-673-4789
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
Contractor: OVERHEAD IMPRESS1014S
LI I am Exempt under Article 3 of the Business d Professi s Code
839 RICHLAND ROAD
Date:��--2-0-/ Owner:
YUBA CITY, CA 95991
530-673-4789
WORKERS'COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
13 1 have and will maintain a certificate of consent to self -insure for
Ucense M 707509
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 the Labor Code, for the performance of
Architect:
the work for which this permit is issued. My workers' compensation
Engineer:
insurance carder and policy number are:
Carrier:
Total Square Ft: 0 S. F.
Policy#: / 7 o4,1V
Ell I certify that in the performance of the work for which this permit is
Valuation: $0.00
issued, I shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
Census Code:
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date:
Applicant: Zeei�,�
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
A-*dn!51,,5D
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the applicable provisions f t�e Blitte County
Cl�
d qn(Vor
I hereby affirm that there is a construction lending agency for the
b,
Resolutions to do work indicated above for which fees have e -
0
performance of the work for which this permit is issued (Sec 3097 Civ.)
T
Name:
By: te:
PERMIT EXPIRES ON:
(Date)
Address:
I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California a I and Safety de which regulate a storage,
�handling and use of hazardous materials.
Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the-sc e ed construction of i ject.
0 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 mi the owner a a duly authorize owne a ree to comply with
d bui eetisubpstance
all count state rIssrelatino to ny official or d c ment of Bu I hereby
Ig 0 strUction. J acknowledge it is unlawful Ifo ail�
ry ani �T
authorize represent 0 u e 0 t or _�c
e above mentioned property on urp
)V—
2 �Kteon
Print Name: (Sicinature: A4
Date: o
40—er El Contractor El Agent for Owner 0 AgeL Contractor
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
. . BUILDING PERMIT APPLICATION
24 HOUR INSPECTION M (530) 538-7636 (OROVILLE) (530) 891'-2834 (CHICO)
OFFICE -M (530) 538-7541 -
PERMIT NO.
B P
DATE:
APN:
t 7,n +5
ZONING:
OWNER'S LAST NAME:
OWNER'S FIRST NAME:
PHONE:
STREET ADDRESS:
FAX:
CITY. ZIP:
E-IAAIL:
SITE ADDRESS:
CITY, ZIP:
NEAREST CROSS STREEr:
TRACT/LOT #.
APKICANTNAME:
PHONE.'
STREETTDRESS:
FAX:
CITY. ZIP-
E-MAIL,
CONTRACTOR NAME:
PHONE:
STREET ADDRESS:
FAX:
CITY, ZIR.
E4VIAIL
LICENSE NUMBER.
LICENSE TYPE:
ARCH ITECT/ENG IN EER NAME:
PHONE*
STREETADDRESS:
FAX*
CITY, ZIP:
LICENSE NUMBER.
E4VIAIL:
DESCRIPTION OR SCOPE OF WORK: _t:sp, -n -,On
L] Structure Built without permits
0 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 applic ' ation. In order to renew
action on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR REFUNDS
Refunds can only be- made upon written request by the person who paid the fee., The request must be made prior to
the- expiration of the 'permit and no construction work has been done. Filing fees, plan check fees for work plan
checked and other department costs are not refundable.
For office use only:
Notes:
Application Received by: Date: -*/a 4 -
Receipt number: Amount Received:
024-170-043 'vo 9'2,6
FOWLER, RICHARD,
422 TURNER AVE, GRIDLEY
RE-R66F.
lk
ki
(Rev. 12/96)
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUIL ING DIVISION
7 County Center Drive * Oroville, California 95965 * Telephone (531� 538-7541 o
k /0!
APPLICATION AND PERMIT Na
A
PERMIT &
ASSES
=R-11'1=43
ZONING
A-40
BUILDINGPERMIT
OWNER
Richad Fowler eral 510-522-1140
TELEPHONE
SO. FT. Occ. BUILDING VALUATION
OWNEWS MAILING ADDRESS
1355 IN"gmt Street Alameda CAS 94501 -70NE
44 sq coy 00
est 500;.00
CONTRACTOR'S NAME
owner
CONTRACTOR'S MAILING ADDRESS
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation 1$ _32,4�. Z�/FOTU
ARCHITECT OR ENGINEER
E NO.
Filing Fee $ 20.00
Permit Fee $ 63.00
ARCHITECT OR ENGINEER -r, MAIL31 I
Z. fill/
k Y)wv
Plan Checking Fee $
'u'LUALYKIW Gridley
Energy Plan Checking Fee $
PERMIT FEE 83.00
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT Filing Fee 20.00
USEOFSTRUCTURE
SF 0 Duplex 0 Mobilehome 0 Other
SPECIFY
Each Trap 7.00
Solar or heat pump water heater 23.00
Water piping 15.00
Each gas water heater or vent 15.00
TYPE OF WORK
New 0 Addition 0 Remodel 0 Utilities 0 Installation 0 Other 0
Describe Work: comp roof, tear off dry rott
—Gas piping system I - 5 outlets 15.00
Building sewer 15.00
Mobile Home I S I G I W I
PERMIT FEE $
ELECTRICAL PERMIT Filing Fee 20.00
Main Service DO' . ',s.: 23.00
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:
0 1, as owner of the property, or my employees with wages as their sole compensation,
ill do the work, and the structure is not intended or offered for sale.
N-1� was owner of the property, am exclusively contracting with licensed contractors
io construct the project.
0 1 am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
0 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.
0 1 have and will maintain workers' compensation insurance, as required by Section
3700ofthe Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Main Service 200A TO 1000A 46.00
NEW CONST. DW= .0GCUP_ so.
OR ADDNS. 3.50 FT.
CONS MULT'_O 97.50
=RESIDT 13RANCHNRCUITS
P0.W.E.RAP1RATUS
S CIR.
20 @ 1.00
Ex. Occup. OUTLET OR FD(TURES SAL @ .50
..FIXED A LNS OR"
Ex. Occup. PPRES,6.) E 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wirina 23.
9�
PERMIT FEE
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
one hundred dollars ($100) or less.)
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to 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
Sibnature of'Applicant - 0 Owner 0 Contractor 0 Agent'
An OSHA 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 $ 83. 00
HAZ-
D. FEES IMP
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.
"
By Date
PERMIT EXPIRES ON
(Date)
ReceiptNo. _J '�J , I— - L,
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDEN ROD -APPLICANT
111119
(Rev. 12/96)
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 e Telephone (530) 538-754103
APPLICATION AND PERMIT
If PERMIT NO.
1112
'16
ASSESUIZRCEI�64EIER
_1 _043
ZONING
A-40
BUILDINGPERMIT
OWNER
Richard Fow1pr Prnl 510-522-114)
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNEWS MAILING ADDRESS
1355 . Rpgpnt Street Alameda CAS 94901
44 scl Coy 2640-00
est 500;.00
CONTRACTOR'S NAME—
owner
TELEPHONE
CONTRACTOWS MAILING ADDRESS
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
—Fireplace
Total Valuation $ 314.0
ARCHITECT OR ENGINEER
LICENSE
_Flinq Fee $ 20.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Permit Fee $ 63.00
Plan Checking Fee $
BUILDING ADDRESS
4221utner Gridley
Energy Plan Checking Fee $
$
PERMIT FEE $ 8_1 on
LOT NO.
SUBDIVISIONS NAME
I
PARCEL MAP
_
PLUMBING PERMIT Filing Fee 20.00
LISEOFSTRUCTURE
SF 0 Duplex 13 Mobilehome 0 Other
SPECIFY
Each Trap 1 7.00
-
Solar or heat pump water heater 23.00
Water piping 15.00
Each gas water heater or vent 15.00
TYPE OF WORK
New 0 Addition 0 *Remodel 0 Lifilities 0 Installation 0 Other 0
Describe Work: comp roof, tear off dry rott
Gas piping system 1 - 5 outlets 15.00
Building sewer 15.00
Mobile Home I S I G I W @20.00
PERMIT FEE
ELECTRICAL PERMIT Filing Fee 20.00
Main Service =',v, o.R 'ss: 23.00
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:
0 1, as owner of the property, or my employees with wages as their sole compensation,
ill do the work, and the structure is not intended or '61fered for sale.
was owner of the property, am exclusively contracting with licensed contractors
io construct the project.
0 1 am exempt under Sec. Business and Professions Code for this
reason
Main Service 200A TO 1000A 46.00
NEW CONST. DWELLING OCCUP. so
OR ADDNS. & ACC. BLDS. 3.50FT.
NtW UUNb . MULTI -O 7
U
NON-RESID.1 X BRANCH COIRCUITS @7.50
&POWE.RAP= US
0 CIR.
Ex. Occup. OUTLET OR FMRES 2*
BAL @ .50
LNS Oil
Ex. Occup. O=PPRES,6.1 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
0 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.
0 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, forthe performanceof work for which this permitis issued.
My workers' compensation insurance carrier and policy number are:
Carrier
MECHANICAL PERMIT Filing Fee 20.00
Heating
-
Cooling
- Hood 6.50
Ventilation
PERMIT FOE, $
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
_,W -one hundred dollars ($100) or less.)
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to 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
fo h comply with those provisions.
7,
�//// Date
Si6nature of "Ap�ltba 0 Contractor 0 Agent
An OSHA 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
IT OTALFEE $83.0
HAZ. ���FL�00D
I I
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.
01
By Date 4-LIV
PERMIT EXPIRES ON
I Pate)
ReceiptNo. 3 9
I
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDEN ROD -APPLICANT
a.B.- I
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An "owner-buildee' building permit has been applied for in your name and bearing your signature.
Please complete and ieturn this information at your earliest opportunity to avoid unnecessary delay
in processing and issuing your building permit. No building permit'will be issued until this
verification is received.
I personally plan to provide the . labor and materials for construction of the proposed
property bnproveement: YES0 NO 13
2. 1 HAVE b�-�V"OT E3 signttan application for a building permit for the proposed work.
3. 1 have contracted with the following person (firm) to provide the proposed construction:
NAME:
ADDRESS: CTrY:
PHONE: CONTRACTOR'S LICENSE NO.
4. 1 plan to provide portions of this work, but I have hired the following person to coordinate,
supervise, and provide the major work:
NAME:
ADDRESS: CTrY:
PHONE: -CONTRACTOR'S LICENSE NO.
5. 1 will provide some of the work but I have contracted (hir ed) the following persons to provide
the work indicated:
NAME ADDRESS PHONE TYPE OF WORK
SIGNED:
PROPERTYOVVNE
SOCIAL SECURI7TY ER:_
DATE:
NOTE. This Owner -Builder Veritication is required by Section 19831 and 19832 o the
f
California Health and Safety Code. This verification must be completed and
returned to our office before we arepermitted to issue thepermit.
al�kbl
0. B-
I OWNER BUILDER INFORMATION I
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of property
improvements specified.
For your protection, you should be aware that as "owner-buildee'you are the responsible party ofrecord on such
a permit Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself� you may protect yourself from possible
liability if did person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business
license from the city or county. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should
be aware of the following information for your benefit and protection:
+ Ifyou employ or otherwise engage any persons other than your. immediate family, and the work (including materials
and other costs) is'$300 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
+ If you are an employer, you must register with the State and Federal Governments as an employer and you are
subject to several obligations including state and federal income tax withholdin& federal social security taxes,
workers compensation insurance, disability insurance costs, and imemployment compensation contributions.
+ There may be fi=cial risks for you if you do not carry out these obligations, and these risks are especially serious
with respect to worker's compensation insurance.
+ For more specific information about your obligations imder Federal Law, contract the Internal Revenue Service (and,
if you wish, the U.S. Small Business Administration). For more specific information about your obligations under
State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building
permits are not required to be signed by property owners unless they are performing their own work personally.
Information about licensed contractors may be obtained by contracting the Contractors State License Board in your
community or at 1020 N Street, Sacramento, CA. 95814.
Please complete the'fiOwner Builder Verification" on the reverse side of this form so that we can confirm that you
are aware of these matters. The building permit will not be issued until the verification is returned.
\ I ely,
Wr
Mic el C. ViJiM, C.B.O.
1z I�B
M
Building Iiiipection
M ger, �n
NOTE.- Th is Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
OVER
I
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING 91VISION
7 County Center Drive 9 Oroville, California 95965 * Telephone (530) 5 541 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT r 01-2390
ASSESSOR PARCEL NUMBER
024-170-043
ZONING
BUILDINGPERMIT
OWNER FEDERAL HM
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS
135 NORTH LOS ROBLES #300, PADADFNA 91101
500-00
CONTRACTORS NAME
OVSUffAD IMPHSSIONS
FTELEPHONE
1673-4789
CONTRACTORS MAJUNG ADDRESS
839 RICHLAND RD, YUBA CITY 95991
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $ 500.00
ARCHITECT OR ENGINEER
UCENSFN0
Filing Fee
$ 20.00
Permit Fee
$ 19-00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDINGADDRESS
422 THN TtJRNFR, GRIMEY
Energy Plan Checking Fee
$
PERMIT FEE
$ 35.00
LOT NO.
SUBDIVISIONS NAME
1
PARCEL MAP
1
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF XI Duplex 0 Mobilehome 13 Other
SPECIFY
Each Trap
7.00
Solar or heat pump water heater
23.00
Water pipirbg
15.00
—Each gas water heater or vent
15.00
TYPE OF WORK
New 0 Addition 0 Remodel 0 Utilities 0 Installation 0 Other�p
Describe Work: SRFT7-
.mnr.K, PARITAT FOUDMATION ADM
S'n](YO, MR -7 UEATRFRUP.Ar)
—Gas piping system I - 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I G I W
@D20.00
PERMIT FEE
$
ELECTRICAL PERMIT
Filing Fee 20-00
R LE::
OOOV 0 LE
Main Service ..OR
23.00 23.00
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 force and effect.
License Class X Lic. No.
OWNER -BUILDER UE LARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
0 1, asownerof theproperty, ormy employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
44 1, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
0 1 am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
13 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.
0 1 have and will maintain workers' compensation Insurance, as required by Section
3700ofthe Labor Code, for the performance of work for which this permit is issued.
My workers' compe sattinrWmirice cliarrier and policy number are:
Carrier 411�
Main Service 200A TO 1000A
46.00
NEW CONST. DW�.LUNG OCCUR
OR ADONS. C. S.
so
3.50FT.
NEW CONST. MULTI -OUTLET
NON-RESID. BRANCH C RCVITS
97.50
OWER APPARATU
IPSIN.LE OUT. . SIR.
Ex. Occup. OUTLET OR FIXTURES
20 @ 1.6�_
13AL @ .50
..FIXED A LNS OR,
Ex. Occup. PPRES,6.) E
5.00
Temporary Service
23.00
—Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE
$ 43.00 -
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FElE_
$
Policy Number e 7 X,0 zz Joe — 6
(The above sections need not be corripleted if the permit is for work of a valuation
0 n hun red�4 1 11 ela r so ( 1�) or less.)
n , Eir
._2a ce
0 1 (!eoti; that', ee I . of the work for which this permit is issued, I shall
not Ploy ers in any manner so as to become subject to workers'
cc e ti la nia, and agree that if I should become subject to the
In pro isions of section 3700 of the Labor Code, I shall
rt ith I ose rovisions.
Dat (I/— 1�y
Si natuY; of A P i nt f 0 Owner 0 Contractor 0
AnOSHApermiti equired for excavations over 60" deep and demolition or constructioK-11
of structures over 3 Stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
NST
CONST. TYPdE
TOTALFEE$ 78.00
HAAZ.
FEES IMP
I FLOOD
COF
PARCEL
ISSUE
XX
This permit is hereby issued under
of the Butte County Code and/or
indicated IDove for which fees have
By
PERMI*v;XPIRES
the applicable provisions
Resolutions to do work
been paid.
Date&
Receipt No. 78-00
WHITE-D.O.S.-B.D. CANARY-XSSESSOR PINK -INSPECTOR GOLDEN ROD -APPLICANT
tOUNTY OF BUTTE - DEPARTMffNT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Orovilie, California 95965 * Telephone (530) 538-7541 PERMIT NO
APPLICATION AND PERMIT 6 - a2)�20
Vv. I
ZONING
ASSEMORPAAMNJ
BUILDINGPERMIT
FSOFT.
TEU7"*NE
OWNER
SO. FT. OCC. BUILDING VALUATION
,
CIRESS
cOwTR^=R*2 M&ME,
001A
S MWNO D
comsTnuCTIONLEND
7
Fireplace
LENDERS ADDRECS
Total Valuation
ARCHIrECT OR ENNINEER
UDENSE NO.
Filing Foe
2D.00
Permit Fee
ts
,ACWECT'0R ENGWEE" M4AJF4 ADDRESr
Plan Chackina Fee
,
BuLDwr AMR=
Energy Plan Checking Fee
6
PERMIT FEE
UOT No
SU13DWMIDUS UWE
C, MAP
PAR EL
PLUMBING PERMIT
Filing Fee 20.00
ap
7.'00
USEOFSTRUCTURE
SF,* Duplex 0 Mobilahorne, 0- Other CPMFY
Solar or heat pump water heater
23.01)
Water piping
1 S.DO
Each gas water heater or vent
15.00
TYPE OF WORK
In na, 0 Other,
New C3 Addition 0 Rom t
Describe Work-
S-� LA
Gas piping syrtarn� I - S outlets
15.00
Building sewer
I S.DD
Mobile Horne I S G I W
PERMIT FEE
ELECTRICAL PERMIT
Firing Feel 20.00
( = gRR LES9
Main Service I.Ess
23.00
-
SIR )k
6
S11"kAY-111 4
�DO
AWM4
fib bc..?"+
"+or
Main Service 20" TO IOWA
4S.00
RM PONST: OwEujm occw.
a A=. SUDS.
rdtw POW].
NON-RESIDL = @7.50
.=MAP.P=&
200 1.00
Ex. O=up. OLMET OR FWPJM SAL q? .501
OR, 5.00
Ex. Occup. .==,ij E
Temporary Service 23,DO
Mobile Horne Facilitie's 20.0D
Wsr. Wiring 23,0D
I f :4
PERMIT FEE -'-r ' -
MECHANICAL PERMIT Firing Fee 2D.00
Heating
Cooling
Hood 6.50
Ventlabon
IEEE -
PERMIT FE�-
Mobile Home Installation Foe
Energy Inspecton Fee
TOTALFEE$
LT
H&Z.
IMP
I POOD
I CDF PARCEL
PD
'This permit is hereby imed under the &ppficable provisions
Of the Butte County Code and/or Resolutions to do work
indicated above for which feas have been paid.
a Daie
Y
PERMIT EXPIRES ON
6-�) -- ���
--T-
IST ge,
.This set of Plans and spe and it is unlawful to
kept on the job at all firnes 'ne wlth6ut
3�9 any changes or altera-L.ions On Sol
r"I - Department,of PUbV'c
ion from the
Written permiss
works. COUMtY Of 'Utte-
SWI Be in
WorkmanSWIP
Practices Ond
Good ',ed use in the
*f nd
M.atericlls 8t
, th RecocrIze Codes
SO W1 for The SPec'
r
C-1 'Ordance prescribed. St VA,ch'"'cal
'01 0 cluctrity Plumbing
Unijorm SjWnCJ. . I C,;de.
tih, N60nol,
utility connections sh2I,6- -within
4 ft. of the mobilehoms,,either
1 L, k;nd or within the icear,
dired y - f ., I , , I
side (left) of the
half of the rcpd
mobilehomeL
e.
V4
,\e _Q
%)De O\o
Ito o
-T,
NTY
ou
UTMTE
.A
6 ft. from ih;
f 5 BUILDING EPARTMENT
P% a ancIA'setbach
PrIoperty lines
of 50ft. f rom the ro,d or
centerline shall be C'e of
structures Or equipment except
for a 2 ft. eave overhang,
M
.'FROVED
/VI
N71,
'7�
dired y - f ., I , , I
side (left) of the
half of the rcpd
mobilehomeL
e.
V4
,\e _Q
%)De O\o
Ito o
-T,
NTY
ou
UTMTE
.A
6 ft. from ih;
f 5 BUILDING EPARTMENT
P% a ancIA'setbach
PrIoperty lines
of 50ft. f rom the ro,d or
centerline shall be C'e of
structures Or equipment except
for a 2 ft. eave overhang,
M
.'FROVED
/VI
AP 24-17-43
BORGES
Vs Tunner Ave., app. 300' E. of
�owee Ave., Gridley
Permit # 2760-74B,P,E
(swimming pool)
24-17-43
Ray d Borges
422 Tur Ave., Gridley
Permit #38 80P,E(
ELEC. -9
cJcA
GAS
SUPPORT STRUCTURE RE
COPACTION TEST REQ.
24-17-43
Permit -80mi
Iss
OWNER
COUNTY OF BUTTE
BUILDING DIVISION
ODEPARTMENT OF DEVELOPMENT SERVICES
1469 Humboldt Road, Chico, CA - (916) 891-2751
7 County Center Drive, Oroville, CA - (916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
&es' Ae OZY-170-0
PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the abovi 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.
Date Inspector
REV 10/92
Suite
L A N D 0 F NAT U RA L W E A L T H A N D B E A U T Y
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
7 COUNTY CENTER DRIVE - OROVILLE. CALIFORNIA 95965-3397
TELEPHONE: 1916) 538-7541
FAX: 1916) 538-2140
October 18, 1995
Raymond Borges
422 Turner' -Avenue
Gridley, CA 95948
RE: Code Violations A.P.#024-17-0-043
424 Turner Avenue, Oroville
Dear Mr. Borges:'.
This is a formal warning notice. Pursuant to Butte County Code (BCQ)
Section 41-2, we sent you a courtesy notice dated May 16, 1995 notifying
you that you are in violation of the BCC.at the above -referenced location.
As of this date, the following violations still exist:
Failure to obtain the required permits, inspections and approvals from
this of f ice f or construction . of covered decks f or mobilehome in vio-
lation of the Mobilehome Parks Act of iritle 25, Calif ornia Code of
Regulations, adopted by Section 28A-1 of the Butte County Code as
follows:
(a) 1018 -Permits Required for' 'any Mobilehome Accessory Structure
(b) 1048 -Inspections Required for any.Mobilehome Accessory Structure
The above violation(s) shall be corrected or abated by you by submitting
three (3) complete sets of plot plans, applying for the required permits,
and paying the appropriate fees, including penalties. After permit issuance
and field authorization to proceed, the work must be completed and approved
by this office within the permit specified time.
This is your final warning. Unless you contact this office and make the
proper arrangements to correct or abate the violation(s) voluntarily, within
ten (10) days from the date of this letter, enforcement shall be pursued
through the issuance of a citation (ordering you to appear in court) for
said violation(s) and for failing to comply with this warning letter. -
Upon conviction of said violation(s) or of failing to comply with this
Jetter, the court shall impose penalties (fines) and a Notice of Violation
shall be recorded in accordance with Butte County Code Section 41-7. The
Notice of Violation shall include a description of the premises the violation
concerns, a description of the violation, the date of your conviction and
the action necessary to correct or abate the violation(s).
.Should you have any questions concerning this matter, please contact Scott
Rutherford or "Michael Vieira' in this office at the address or telephone
number listed above.
Sincerely,
MCV: dms Mi - c�ael C.'Vieira, C.B.O.
Manager, Building Inspection
.2
3
4
7
.9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
PRCOF OF SERyICE BY MAIL X %.
U"" 11�-U��,;�__
!7
am over the age of 18
and not a party to -this 'cause. am ,"a
.risident of .. and employ!9d in t#e.
county. where the -mailing occured. My*
business address is
Building Division*
Departmei2t of Development Services
7 County Center Drive
Oroville, CA 95965.
I served the foregoing
SECOND NOTICE VIOLATION LE=
(A.P. #024-17-0-043)
by enclosing -a. true copy in a sealed envelope and depositing said envelope
in the United States mail with postage fully prepaid on 18t -h. of Or-tober
19 '95 and addressed as follows:
Paymond Borges .
422 Turner Avenue -
Gridley, CA 959.48
I declare under penalty of perjury under the laws of the State
of Calififo'rnia tha t the foregoing is true and correct and that this
declaration was executed on 18th. of October
at Oroville California.
bonna Spe rling
Office Assistant III
AV
ffatte Count
N;
Raymond Borges
422 Turner Avenue
Gridley, CA 95948
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965-3397
TELEPHO ' NE: (916) 538-7541
FAX: (916) 538-2140
May 16, 1995
RE: Code Violation I A.P. #024-17-0-043
424 Turner Avenue, Oroville
Dear Mr. Borges:
This is a courtesy notice to notify you that you are in violation of the
Butte County Code, as follows, at the above -referenced location.
Failure to obtain the required permits, inspections and approvals from
this office for construction of covered decks for mobilehome.
Since'permits and inspections are required for the above work, please submit
three (3) complete sets of plans, apply for the required permits, and pay
the appropriate fees. All work must stop until these permits are issued.
and you are authorized by our field inspector to proceed. The f ield
authorization cannot be made until the existing work is inspected and
approved.
It is the County's goal to obtain voluntary compliance with the Butte County
Code. However, you should be advised that Butte County has an active Code
Enforcement Program which provides an effective means of enforcement if
voluntary compliance is not obtained. Enforcement may be pursued through
the issuance of citations, fines and the recording of a Notice of Violation
including a description of the action necessary to abate the violation.
You have thirty (30) days to- voluntarily comply with the above directions
or to present an acceptable plan for abatement or corrective actions to
be taken by you. Should you have any questions concerning this matter,
please contact Scott Rutherford or Michael Vieira in this office at the
address or telephone number listed above.
Sincerely,
MCV: dms
Mich el C.lVieira, C.B.O.
M, 2ger, Building Inspection
cc: Assessor
VIOL ATION CHECK LIST
A.P. Address
Owner Rd4
Owner' s Ad'dress
Owner's Phone No. Supe`�visoral District
Tenant's Name Phone No.
Type of Violation.in Detail with Code Section Priority No.
(0 Y Y .0 a,
Specific' Plot'Plan with C/V Noted __yes no -Periailties Required
1st. Notice S ent —16� — 9o* 2nd. Notice Sent
pate57 (pate)
Comments and/or Determination
Disposition For Citation Citation
(DateT— (Date)
Department Recommendation to Court
Court Action
Notice of Violation Recorded
(Date)
MOST
This set Of Plans and Wful to
a+ 01,1, iimes Ond 1� 'ts tflawifh6uf
kept on t6 i0b ions ()n Coyne
�e any r_�ancjes er 011terr"I .
Ma Depcirtment Of Public
wr-Rien permission froM Jhe
Works, County 0, 'Utte.
sl�cjjj Be
�Orkrnonsh!P
ractices
Materials & .\' d Good P in the
NOTE.—Al" with Recognae 'f ed Use 1 d
A,ccordartce escribed jor �he SDec' Codes on
of 0 Cu0.jjtj pri plurnbing &
BU;Adinci, . I Code.
uniform. .1 ElectricG
the NOtlon
utility connections sha?14 -within
4 ft. of the mobilehoma�ejther
directly behind or withhh, the rear
half of the rctaclside (left) of the
mobilehome'. 'ne
OT
)De v%c
0
A setback of 5 ft. f rOm tn'
1: es. and a setback
properly road
of 50ft. from th' e clear of
terline shall b
cen ot
structures or equipment excel-
verhang.
for a 2 ft. eave 0
3�
SUITE 6OUNTY
BUILDING 6EPARTMENT
D
APPROVE
/VI
ZPERMI-T NO.
PERMIT EXPIRES
Raymond Borges
'OWNER
owner
CONTR.
�,LOCATION (A.P 24-17-43
422 Turner Ave., Gridley
Temp. Power Pofe
Called PG&E
Temp. Elec ASery —;5A
CallediPG&E
Temp. Gas Serv.
Cal.led PG&E
Jow N
FINALED-3-0,1—V 'q
(Date)
(Signatur6)—
Setb)kck
Forms
Main Idg.
Foot)Rgs
StemLIN
Slab
Piers
Garage
Footings
Stemwa I I
Slab
Carport
Footings
Slab
Patio
Footinas
Bond
Intotior Lath
D& Close r-
MOBILEHOME
Water Piping
MQBILELIOME
Water Piping
DATE
COUNTY OF BUTTE DEPARTMENT OF PUBLICVORKS
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont,d)
hrewall / S I Piping
Pa ets T loor
:s om Finish
e
Winedin a
t
Roof She!Nhing
Roofing \
Fdn. Vents \
Garage Vents\
Insulation
Prov. for
handicaD
Conformance of ex.
OREP,LACE
Footing V
Throat
Final
Test 4 4FIRE SPRINKLE1
Final /
MECHANICAL
N I V�ntllatlon
141nal
----------- Elec. Service
Sewer
'ION ----------- Support 3
:-" —A, / Drainage Z?
REMARKS OR CORRECTIONS
PLUMBING
Water Pipihg
Sewer
Fixtures
Watpr 14tr'
Heater2
Appliances
Gas Piping,& Test
Temp. Gas
Sanitation
Final
EL
Fixtures
Grd. Fa P Prot.
ServicQ(
Te 0. Pole
deraround
kermanent
Anal
Elec. Pedestal
Gas Piping
Elec. Continuity
Gas Piping
(NOTE: An entry must be made on this form each time you visit the job *site.)
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 Couniy Center Drive, Orovi Ile — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
V-1
BUILDING OR PROPERTY A6DRESS
L
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. It you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
.1 / --
TV 3A(Fryf,(#11V,(- PD -41! -e -11L 8f 6 k
0 C>,4-/3
Inspector Date—
t
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS'
196 Memorial Way, Chico — Phone: 891-2751
7 Count'y Center Drive, oroville — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
71//L//Vk,-t- Az6E
BUILDING OR PR9PERTY ADDRESS
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work Is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
—XOUlf-�� AA1
-Aa
e-Zc7 -5 li;-
/44��,/Zb 64
T -?K -4V
c- -7,
Co^�Tuc,T6,4- 76 6/49c/,r� lvl-:-u7--
QeSTn-W,6,:-t 7bC7/0e-/ ot'7 .5&X.
��P&(JIQZ -4'^1 �DlVuC4
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE
OROVILLE, CALIF. - 534-4541
CERTIFICATE OF OCCUPANCY
This mobilehome has been installed in accordance with the =ement.s
of the California Administrative Code, Title 25, Chapter 5, permit
number LL'L—for the following location:
Owner
Owner's Address
Mobilebome Mfg. L
Mode I 7� Year�L�
_j
Insignia Serial No. ", � , ; I
It is hereby certified for occupancy at the above described location and
may be occupied. ^
Director of Public Works
Date By
THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED
White - Owner, Yellow - Installer, Pink - D.P.W.
9. Electrical aomd'(must equal rating of
A. Is service large enough to provide adequate.amperage-to mobile'
mobilehome with a minimum of 100 amp) �Li�d other facilities on lot, i..e. , water
garage, cabana, etc.? Yes ;.1- 0
Is there proper. clearances around panels? Yes_.L�O�
,g._,Is power supply cord or feeder.a ssembly properly fused? I Yes
,P�_�Ts continuity test satisfactory as per the following procedure? Yes, -----No
1. De -energize electrical wiring system of the mobilehome at the pedestal.
2.'Make sure that the power supply cord or feeder assembly conductors,, including neutral
conductor, have been disconnected.
3. Switch all breakers and switches in the mobilehome to the "on" position.
4. Connect one lead of a test instrument to the mobilehome grounding conductor and
apply the other lead to each mobilehbme supply conductor, including neutral.
5. Allnon-current, carrying metal parts of -the mobilehome.(alum . inum siding gas line,
water line), including fixtures and appliances, shall be tested'for continuity from
such equipment and the grounding conductor.
6'. Upon completion of the above procedure, the power supply cord or feeder assembly
conductors shall be connected to the. s ' ite service equipment. A further continuity
test shall then be made between the grounding electrode and the chassis of the
mobilehome. Upon satisfactory ' completion of theelectrical tests, the lot or site
service equipment may be approved for energizing.
14.-�s job card signed by Health Department for.water and sanitation?
4�if'everything okay, si gn off card and tag. services.
MOBILEHOME DATA
Manufacturer and/or Namestyle
Length U;O Width
Vehicle Serial No.
State Identif ication No. AOA 3
Additional Information or Comments:
f
MOBILEHOME INSTZLATION. INSPECTION CHECK LIST'
I.- Is the mobilehome located with required separation from lot lines and buildings and generally
conform to plot plan? Yes .—No -
2. Does the mobilehome have required clearances above ground? (Sec.5085) Yes 'r�o
3. Ate footings and supports properly sized, spaced, and braced as per approved plans? (Note
possible variation at spring shackles.) (Sec. 5082 & 5083) Yes P ---No
4. Is the mobilehome level? (Sec. 5088) Yes %__�o
5. If more than a single unit, are crossover connections properly installed? (Sec. 5088)
Y e s L-�N o'
6.. Water
A. Is flexib connector of adequate size and properly installed (1/2" ID min.)? (Sec. .5566)'
Yes No
B. Test - Does water piping withstand working pressure or 50 lbs. air test? Yes No
AAackflow - If coach is not State of California approved, does station have bdckflow device
-'�-, I
and pr.essure-relief valve? Yes No
7. Wastes and Drains
A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes A ---No
B. Does it have minimum k" per -foot slope and is it properly supported? Yes,�N9__
C. Are any leaks detected in drainage system after running 3 -gallons of water through each
fixture including washing machine standpipe? Yes— Nocl--*"-
-Tr--If coach is not State of Californiaapproved, does station have required trap and vent?
Yes— No
8. Gas Piping and Gas Vents
A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum
mobilehome connector not more than 6 ft. long? Note: All piping is to be at least as
large as the mob I ilehome gas line inlet without reductions other than the mobilehome
connector. Yes t -'to
B. Test.OK as per following procedure? Yes 0-
4'."--6pen all appliance connector valves.
off appliance burner and pilot valves.
G, ----Air test with manometer to 10"-14" water column, or test with slope gauge (minimum
6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without
drop.
lt".�CO'n*nect gas meter to mobilehome with connector, turn on gas, test connections with
soapy water.
C. Are all appliance vents properly installed? 'Yes4l�No-
COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS MI N2��',
7#County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 U
APPLICATION AND PERMIT -.A
ASSESSOR FIARCEL NUMBER
24-17-4-5 .
ZONING
lose Z
R-1
BUILDING PERMITIV I
OWNP
TELEPHONE
1_7226
SQ.FT. OCC.1 BUILDING VAL6ATION
VW;7TR'AAILING ADDRESS
0,00
_TRA�
&CTOR'S
CU NAME
ITELEPHONg
CONTRACTOR'S MAILING ADDRESS
CONSTRUCTION LENDER
JUNKNOWN
Fireplace
Total Valuation $
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDING ADDRESS
r— Z Arc,,,—
PLUMBING PERMIT
FilingFee 3.00
Each Trap
2.00
Repair drainage or vent piping
2.00
Water piping
LOT NO.
SUBDIVISION NAME
1
ARCE
1P
Each qas water heater or vent
2.00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
SF 0 DuplexEl Mobilehome;R Other SPECIFY
Building sewer
Lawn sprinkler system
2.00
TYPE OF WORK
NewF� Addition 0 Remode I [–] Utilities [:1 InstallationX Other 0
Describe work: —
Permit Fee
$
Contractor
ELECTRICAL PERMIT
FilingFee 3.00
Main service 600V OR LESS
100 AMP OR LESS
5.00
Main service EA. ADD -L 100 AMP
2.50
NEW CONST. ( DWELLING OCCUP.&)I
OR_ADDNS. ACC.BLDGS.
1 20 sq it
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the B ness
and Professions Code and my license is in full force and effect.
License No. Classification
1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
El I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
F1 I am exempt under Sec.—, Business and Professions Code
for this reason
NEW coN5TR ( MULTI -OUTLET
NO N.RESID, BR ANCH CIRCUITS) 12.50 ea
NEW.CONSTF;L (POWER APPARATUS.&)
NON RESID. SINGLE OUTLET CIR
Ex. OCCUP(OUTLETS OR F1 TURES 50 @ 25C
IBAL@12�
FIXED APPLNSXOR
Ex. Occup.(OUTLETS (RESI*D . I EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 6.25
Permit Fee $
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
R The permit is for $100.00 (valuation) or less.
Ej I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Cemiicate
of Consent to Self -insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this stateme.nt, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shal I be deemed revoked.
MECHANICAL PERMIT
FilingFee 3.00
Heating
Cooling
Hood
2.00
Venti lation
_+
Permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said ?Nnty in conseq e e of the granting of this permit.
X 7XAA.) 0NU.,- (Z4 2 - D ate —_2 k— F!!2
Signature of Applicant — *nr to C.Qr.ctorEJ Agent
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Land Development Fee $
—
TOTAL PERMIT FEE $ C)
OCCUP. GRO.P
I TYPE TF—CONST.
IPARCELI
PD I HD
I
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRE R.? F LIC
P
By- 4.
PERMIT EXPIRES Date —
the applicable provi-
resolutions to do
fees have been paid.
WORKS
-
Date
L
Receipt NO.
WHITE-D.P.W.. YELLOW-ASSE:SSOR, PINK -INSPECTOR. GOLDENROD-APPL I CANT
F56
3,3
q.0 6�
3
�4-1 0 1
BUTTE COUNTY DEPARTMENT OF PUBLIC
WORKS
7 County Center Drive, Oroville,
CA.
PHONE: 534-4541
MOBILEHOME INSTALLATION SHEET
1.
owner's name:
2.
Installer's name: Auig-ad �Lm,-
1V
3.
Is the site currently under permit? Yeh IXI No
(If --yes, furnish permit number,-? rlle�
OR
Is the site an existing site? Yes No
(If yesi furnish two (2) plot plans.)
4.
Will the'mobilehome be located at least 5 ft. away from
septic tank
and leach fields and
clear of all setbacks and easements? Yes No
(If no, clarify
5.
What is the mobilehome electrical rating? --------------------
Amps
.6.
. What is the mobilehome site service rating? ---------------------
Amps
'site
7..
What is'the mobilehome circuit breaker rating? -------------
Amp 8:
8.
Is there any other electric load to be served by the mobilehome
siteser'vice? -----------------------------------------------------
Yes NoZ77
(If yes, identify the load and size:
(Load)
(Amps)
9.
What is the mobilehome-site gas pipe size? -------------------
--
10.
What is the type of gas service? -----------------------------
Natural7T(7
LPG
11.
What is the gas pipe length from meter.or tank to the mobilehome?
JJA .(f t.)
12.
What is the mobilehome gas demand? --------------------------
(BTU)
(This information not required if pipe length less
than 6 ft.
on natural gas
or less than 50 ft. on LPG.)-
MOBILEHOME SUPPORT DATA
If oth�r'fhan single wide,
Mobilehome Mfr. ZO// mr: furnish Setup Model No. Year. 1976
Width (ft.) Box Length (ft.) Tagalong or Expando Size ft. x ft.
(SHOW SUPPORT DETAILS BELOW)
On all mobilehomes manufactured after Oc ' tober 7, 1973,- furn*ish manufactur&rls instillation
manual and structural setup sheets (if not on file with the County of Butte).
All center supports measured from front of
mobilehome'unless otherwise specified.
Single
1. -6 1 -
(ft.) (in;)
Center support
locations*
I&OVI C>6
suppoe-FIS",
15614RIM4
I �J' 9. 1 -
(f t.) (in.)
I v, 9 " I
(f t.) (in.)
(ft.)l (in.)
'If'01'6181Z
086L
I)II10AN 0119nd do Idlo
*If ce ' nter piers are other than dh%1lawtiago
dr�4w. in. -locat ions, . spac ing, and d linens ions.
Footing$ (check one)
1. Wood - 'either,
pressure treated or
foundation grade.
2.,Other (specify)
SupOorts (check one)
M. l.; Concrete' block.'
E] 2 i Other' (specify)
Tagalong or Expandot
show support details.
Typical Support
Footing Size
-- Max. Pier Spacing
-- Max. Overhang
3gqV-(P -
BUTTr- COUNI I -
BUILDING . DGP#,RTMCN`
APPROVED
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 91,3/534-4541
APPLICATION Am PERMIT
0 N
INA
ASSIZ,yo:,�PARC NU BER
—M 1�
G
Z ?_
BU1LD,NGPt,,,4f
r
0
TELEPHONE
SQ. FT. OCC.1 BUILDING VALUATION
OW - R-JrMArLING ADDRESS 0`
�V
I ��?_ :�� ,ae,
TOR'S NAME
TEL EPHONS
CONTRACTOR'S MAILING ADDRESS
CONSTRUCTION LENDER
4C5 4,k a -e_ I-- .
UNKNOWN
I
Fireplace
Total Valuation $
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
kv fl -A n e 01�
ILI CENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDING ADDRESS
PLUMBING PERMIT
FilingFee 3.00
Each Trap
2.00
Repair drainage or vent piping
2.00
4�v
Water piping
/ft 420
LOT NO.
UBDIVISION NAME
is
A(RCEL MAP
1P
Each qas water heater or vent
2.00
Gas piping system 1 - 5 outlets
/0-0 C)
USE OF STRUCTURE
SF [I Duplex[:] Mobilehomeo? Other SPECIFY
Building sewer
CFO
Lawn sprinkler system
2.00
TYPE OF WORK
New R AdditionE] RemodeIEJ Uti lities JR InstallationD OtherE]
Describe work:
Permit Fee
$
contractor
ELECTRICAL PERMIT
FilingFee 3.00
Main service 600V OR LESS
100 AMP OR LESS
5.00 &-,00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. ( DWELLING OCCU P-")
OR ADDNS. ACC.BLDGS.
20 sq ft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the 'Uzi Inu"
and Professions Code and my license is in full force and e f fect.
License No. Classification
1. as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
1, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
I am exempt under Sec.—, Business and Professions Code
for this reason
NEW CONSTR. ( MULTI-.UTLET
NO._RES'D, BRANCH CIRCUITS)
2.50 ea I
NEW.CON,STR. (POWER APPARATUS.&)
NON RES D. SINGLE OUTLET CIR
Ex. OCCUP(OUTLETS OR FIXTURES 50 @ 254t
BAL@1
FIXED APPLNS. OR
Ex. Occup.( OU TLETS (RESIC.) EA.1
I -_
2.00
Temporary service 10.00
Mobile Home Facilities
15.00 S% CPO
Misc. Wiring 6.25
Permit Fee $ Z S%
Contractor
WORKMEN'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
The permit is for $100.00 (valuation) or less.
I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shal I be deemed revoked.
MECHANICAL PERMIT
Filing Fee 3.00
Heating
—Coo
I i ng
Hood
2.00
Venti lation
Permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County ot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said R-unty in conAequenSpof the granting of this permit.
7_
x 21?A,4) QC5'91n� Date .2 y, —,?o
Signature of Applicant — O�nVr-W Contuctor El Agent F1
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Land Development Fee $
TOTAL PERMIt FEE $
OCCUP. GROUP
I TYPE OF CONST.
IPA
71
No I
k-
ISSUE
i,,-
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF BLIC
B y _VA
PERMIT EXPIRES Date-
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Af-4----tf /
Receipt NO. _f I If 11
WHITE-O.P.W.. YELLOW-ASSKSSOR, PINK -INSPECTOR, GOLDENROD-APPL I CANT
,Z,11
2760-74B,P.E
�f,"E R M I T N 0.
P
E
UTIL.J-4,�
PERMITNO.
PERMIT EXPIRES
OWNER gaymc)i�& Ac)rqe.-,
CONTR.
tl�6%TION (A.P. 24-17-43
P� 3'
s/s Turner'Avel, ap
le 00 .-E. of
cowee'Ave,.i Gridley
X;2 7e"'e'X
YL
Temp. Power Pole
Called PG&E
Temp. Elec. Serv.
Called PG&E
Temp. Gas Serv.
Called PG&E
JOB
FINALED (Date)
(Signature)
COUNTY OF BUTTE DEPARTMENT Oi��-PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont'd) PLUMBING
Setback aj v4C4 z7 Firewall Soil Piving .11
Forms Cy Parapets Ist Floor J
Main Bldg. Restroorn Finish 2nd Floor
Footings Windows 3rd Floor
Stemwa I I Sidinq Topout
Slab Roof Sheathing Water Piping
Piers Roofing Sewer
Garage Fdn. Vents Fixtures
Footings Garage Vents Water Htr.
Stemwa I I Prov. for physically Heaters
Slab handicapped Appliances
Carport Conformance of ex. Gas Piping & Test
Footings structure Temp. Gas
Slab Final Sanitation
Patio FIREPLACE Final
Footings Footing ELECTRICAL
Masonry Walls Throat Rough
Reinf. Steel,,I—A-Ir�(�-- Final Fixturc(s
Bond Beam FIRE SPRINKLERS Motors
Framing Tes! Water Htr.
Stucco Final Subpanels
Mesh MECHANICAL Grd. Fault Prot.
Scratch Heating Service
Brown Cooling Temp. Pole
Finish Ducts Undeiground
Interior Lath Ventilation Permanent
Door Closer Final Final
DATE REMARKS OR CORRECTIONS
COUNTY OF BUTTE" 9EPARTMENT OF PUBLIC WOR
7 County Center Drive -_Oroville, California 95965
Telelphorie: 534-4541 960— 2V
JAPPLICATION AND PERMIT kz �
Signature of Fermitee or Agent B Date
Receipt No. _Z Z 12- 151, a _P_1
White-D.P.W. — Yellow -Assessor — Pink -inspector — Goldenrod'�,p ............
Vh— �Iicont ��uilding per it expires Date ... 7 .......................
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mai I ing Addre
Telep�one No
Fireplace
Contractor
Total Valuation
Mai I I ng Address
Permit Fee
PlanChecking Fee&/orPenalty
T lephone No.
—
Permit Fee $
1$
Building Address
No. FEE
PERMIT FILING FEE -$2. 00
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50 -4-"d
Each gas water heater or vent 1.50
A. P. No. I/
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
FAesl
*<
SabaAn
I Fi re Dept.
FireZone
Use Permit
Building sewer 5.00
E Q/
Parking
I Plans
Parce!
I Declaration I
Parcel Map 1
60' R/W
I Improvements
Lawn sprinkler system 2.00
Bldg. Plans Rec'd
P o'er Aopop ro v a
P(lawe`X`�pep ro v a
Permit Fee $
NEW CR ADDITION UTILITIES OTHER
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service incl. 1 meter
Additional meters, each 1.00
Single FoilyE] Duplex Mobil Home Others
Sub -panel (12 or less) (more than 12)
Range, Cook -top or Oven 1.00
Water Heater or Space Heater 1.00
20025
Light fixtures bal (610
Receps., swi tAas & f i x OkIT-lets ba
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. di sp. or D.W. 1.00
Air conditioner or heat pump
Water pump / zf��
Mobil Home Farciliti4s 5.00
Temp. Power Pole 5.00
License No. Classification
Misc. wiring
14 1 am exempt from the Contractors License Laws of the State of California.
Permit Fee $ CY
$
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.
EJI 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
19 plermit 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
42.00
Hood
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
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X D ate
TOTAL PERMIT FEE 1$3,01
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 PYYLIC WORKS
.-n— —
Signature of Fermitee or Agent B Date
Receipt No. _Z Z 12- 151, a _P_1
White-D.P.W. — Yellow -Assessor — Pink -inspector — Goldenrod'�,p ............
Vh— �Iicont ��uilding per it expires Date ... 7 .......................
fc
I I
1.215AC(4
ANDREW
W. CAMPBELL
SUB. M.O. R.
SK.
8
PG.* 32 - 33
GRIDLEY
COLONY NO.
I M.O.R. SK.
4
PG.
3 7
-9144 001.
--ASSESSOR.'S,- M'AP- NO
2 4 -17 -
Y. C
COUNT 0 F'� BUT.TE-
CW-.:
R E V S