HomeMy WebLinkAbout024-230-008f'Ll-Rogei� D. LucasOcen/s Central House Rd. app. mi. least -of Hwy. 70, Gridley24 23-8GACOMPACTION TEST REQ.24-23-8r :Earle;,Town Mobile Home Sales,Permit #17§�-77MHI0 24_2247232b-008. '�95-054-
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_-RESIDENTIAL
"024-23-0-'008 95-0548 B,P,E
KINGMAN, Charles
39 Mockingbird Lane Gridley
(mobile/Perm fdn)
3�n
S tale W 0-�
LOFFICE Cogy
Address
ddress OFFICE-—
Cop -
G S y J'
AS
Meter E83y
CTR C D
ELECTRI Datel
M ter 8 y
Meter E3y Date
JOB FINALED (:,ate,
Signature
V OK
0 Not OK
Not Applicable
Not Ready MOBILE HOMES
Date MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Soils: Special MH Support Sketch
3. Sewer; Location -Test -Fall -C/O Concrete
4. Water; Location -Test- Easement Needed (Sketch)
5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete
6. Gas: Location -Test -Wrap: / /"L"ft.
/ P'Nat. or/ /"L ft./ /-LPG
7. Well Clearance & Disconnect
8. Utility Clearance
Date Card B-1 Date Card B-1
Date Card B-1 Date Card 8-1
Date MOBILF_HOME INSTALLATION (Plans) OK except #'s
&,Ioo2��5equirements-Setbacks Easements
,attn'gs:,,Size-spacing-Marriage Line
_C�,'Ga5:�H Test-Demand-Valve—Connector
lec i ity; MH Test -Crossovers- Brea ke rs- Clea ra nces
Test -Fall -Flex Connector
t4__1rv_r__M H Test -Regulator -Connector
6-SAter-and Sewer Connected -C/O to Grade -HO Approval
and Electricity Tagged
Exi �n
sp.- Sketch
,,+<-Cert. of Occupancy
DateVX065--Card 13-71"Ai Date Card B-1
Datel/ Card B-1 Date Card B-1
el> MISCELLANEOUS
Date
DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s
1. Zoning Requ i rements-Setbacks- Easements
2. Footings; Soils-Size-Depth-Spacing-Connectors-SteeI
3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rftrs.-Connectors
Shthg.-Rfg.-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps- Doors-Landi ngs
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
POOLS (Plans) OK except #'s
1. Setbacks- Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Recepta cles and Lighting, Distances-GF1
5. Elec.; Pool Lighting: 15 volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elec.; Grounding: Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes -Enclosures -Pane I boa rds- Ins. to Main in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
V OK
0 Not OK
Not Applicable
Not Ready RESIDENTIA1 (Wncgle
Date UNDERFLOOR (Plans) OK except #'s I
& Duplex)
Date FRAMING (Continued)
1 Zonin -Setbacks- Easements-Flood-Slo e
W 1 45 Han ers-Post Caos-Anchors-Connectors
46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Rfng.
Date Card B-1 Date Card B-1
Date ELECTRICAL (Permit) OK except #'s
22. Fixture & Transformer Clearance -Ins. Protection
- ------------------- ------ ---------------
E-lec. Recept-a.cles Spacing -Lights & Switches at Doors -------------
24. Size Boxes & No. of Conductors -Stapled
-------------- ------------------------- - ----- - ----------------------------------
25. Romex Installed Close to Edge of Studs & C.J.
-- - -------------------------- -------- - --------------------------
26. Equip. Ground made up w/Mech. Fastners-Bond Gas & Water
------------------------------------------------------------ -------------------
27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI
--------------------- -------------------------------------------------------------
28. Subteed Wire Size ga. Cu or AI-A.C. Wire Size ga.
Cu or Al
---------------------- ---------------- - ----------------------------
29. Range Circ. ! / ga. Cu or Al -Oven Circ. / / ga. Cu or Al.
------------------- Insul-ated Neutral --------- 0 --Yes - ------ 0 No -------------------
30. Service -Riser Conductors & Ground -Main Disconnect
-------------- ------------------------------------- - ------------------------------
-------------- 31.- Equip.-Cleara-rices -Pane Is- Moto-rs- Mech. Equip.
- -32.- Clothes -Closel- Light-Shower.1-i-ght-Spa-Light ----------------------
--33... Smoke -Detector -------------------------------------------------
--------------------------- ------ ---- ------- ------------------------ ------------ ----
Date Card B-1 Date Card B-1
-------------- ------------- ------------------------------------------------
Date Card B-1 Date Card B-1
Date MECHANICAL (Permit) OK except 4's
-------------- 34.- X.C.- Ducts Insu-latio-n & - Sup - port 7 ---------------------------------
-------------- 35.- Vent- Fan:-Ex-haust -a-bove insulation - - ----------------- ----------
------------- 36.-.Cond-enFate Drai-n- & Overflo-w: Size -&-Grade ----------- -----------
37. Furnance-Vent: Access -Comb. Air -Return Air Vent -1 15 outlet
----------------------------------------------------------------------------------
. 38. Attic Access & Platform if Furnance in Attic
-----------------------------------------------------------------------------------
---------------------------------------------------------------------------------
Date Card B:l Date Card B-1
---------------------- --------------------------------------------------------
Date Card B-1 Date Card B-1
Date FRAMING (Plans) OK except ft's
39. Sils. Proper Material & Anchors
------- ----- - -------------------------------------------------------- ---------
------------- 4-0.- W.alls-Stud-s--Nailing. Spacing-&-Bracing-Plates-Sou-nd -------------
41. Bearing Walls over Girders & Floor Nailing
------------- - ------- I --------------------------------------------------
42. Draft Stop in Walls (rat proof)
----------------------- ------------------- I ------------------------------
------------- 43.- F -ire -Stops: Furred Ceilings -Stairs -Chases -Tub
44. Headers & Beam -Size & Bearing
47. Fireplace Ties or Type A Flue -Fireplace Throat clearance
48. Attic Access; Size & Romex Protection- Draft Stop -Ins. Baffles
49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
50. Garage Fire Protection Framing
51. Property Line Firewall & Openings
--------- __52. Ext. Doors -One T -Check Garage -3rd Story, 2 Exits
53.- Stairs: Width -Head room -Rise- Run-Landing-Fi re Protection
54. plywood on Root Overhang -Attic Vents -Rafter Outriggers
-------------- 55. -Siding -Nailing Veneer
-- ---------- 56. Stucco Mesh-Drip.Screed-Fd. Vents-Underfir. Access
57. Glazing Area -Glass Protection-Skyl ights- Plastic
58. Shear Walls: Nailing -Bolts
59. Insulation -Walls -Ceilings
60. Infiltration -Walls -Windows
-----------------
--------------------
Date Card B-1 Date Card B-1
---- ------
Date Card B-1 Date Card B-1
Date FINAL (Plans) OK except 4's
61. Ext. Steps -Door & Sidelight Protection -Landings
------------- 62.. Smoke -Detector
63. Furnace: Vents -Clearance -Comb. Air -Connector -
In Garaae: Above Floor-Ducts-Mech. Protection
64. Bedroom Exiting
65. G.F.1' & Bath Fixtures & Tub Access -Spa
-------------
66. Elec. Trim & Subpanel: Breaker Sizes & Labels
----------------
67. Stairs & Rails
------------
68. Fireplace or Stove: Clearances- Hearth
-------------- ---------
69. Elec. Outlets at Wood Panel: Int. & Ext.
----------------- - - ------ -
70. Kit.Fixt. & Appliance: Grnd.-Air Gap -Cooking Clearance
------------- 71.--Elec. Outlets & Receptacles at Kit. Counter
72. Garage Fire Door: Swing -Landing -Closer
----------------------------------
73. A.C. Duct in Garage -Damper
------- ----------------------
74. Wtr. Htr.: Vents -Clearance -Comb. Air-Connector-P.R.V.
In Garage: Above Floor-Mech. Protection
------------- 75.-Plb.. Elec.-&-Mech. Equip. Listed for Location
76. Elec. Receptacles in Garage: (G.F.I.)-Romex Protection
7;. Insulation -Foam -Looked in Attic Yes
---------------- ----------------
------------- 78. -Guard -Rails & Deck -Const ruct ion -Post Caps
79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth
...... I ---------- Clearance Looked -under Floor- 0 Yes
80. Following instid.: Drive 0 Yes 0 No; Walks 0 Yes 0 No:
Planters 0 Yes 0 No
-------------------------------------- - - -
81. Stucco: Brown -Finish
82' A.C. Unit: Disconnect. Electrical, Plumbing
----- --------------------------
83. Vents Above Roof: Plbg.-Appliance-Fireplace.-Clearance to
Openings
------ ------- ------ - ------
84. Water Well: Disconnect, Electrical, Plumbing
---------------- ------ ------
------------- 85.-.E-xterior-Elec.-Trim; G.F.I. Receptacle- Underground
86 . Ventilation Throughout House
87. Glass Protection
-1 ---------------------- - - --- - - - - -
88. Corrections from Previous Inspections
-- --- --------------- ----------
89. Gas Test -Meters Tagged: Gas -Electric
------------- --------------------
90. Water & Sewer Connected -C/O to Grade -HD Approval
91. Energy Compliance Certificate -Other Certificates
------------------------- - ------
------ ------- I ------------ - -----------
D-a-t e ------- ...... C a rd -6: 1 ------ Date Card B-1
-Da-te--. Card _B- 1 ----------Date Card B-1
Date Card B-1 Date Card B-1
Comments at Final:
2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped
6. Stemwalls, Garage; Steel-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 -Anchor -Regulator -Service Test
12. Electric; Underground
13. Pienums & Ducts; Clearance -Materia I -Su pport- Ins.
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
15. Access & Ventilation
16. Insulation
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PLUMBING (Permit).OK except ft's
Water Htr.: Vent -Access -Combustion Air -Baffle
17. Water Pipe: Test & Anchor -Nail Protection
18. D.W.V.: Test -Fittings & Anchor -Nail Protection
----------------
19. Shower Pan: Test. First Floor -Tub Access
Date
20. Test -Tub & Shower, -Second Floor -Tub Access - ----- - ----------
21. Gas Pipe: Size & Anchors
Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date ELECTRICAL (Permit) OK except #'s
22. Fixture & Transformer Clearance -Ins. Protection
- ------------------- ------ ---------------
E-lec. Recept-a.cles Spacing -Lights & Switches at Doors -------------
24. Size Boxes & No. of Conductors -Stapled
-------------- ------------------------- - ----- - ----------------------------------
25. Romex Installed Close to Edge of Studs & C.J.
-- - -------------------------- -------- - --------------------------
26. Equip. Ground made up w/Mech. Fastners-Bond Gas & Water
------------------------------------------------------------ -------------------
27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI
--------------------- -------------------------------------------------------------
28. Subteed Wire Size ga. Cu or AI-A.C. Wire Size ga.
Cu or Al
---------------------- ---------------- - ----------------------------
29. Range Circ. ! / ga. Cu or Al -Oven Circ. / / ga. Cu or Al.
------------------- Insul-ated Neutral --------- 0 --Yes - ------ 0 No -------------------
30. Service -Riser Conductors & Ground -Main Disconnect
-------------- ------------------------------------- - ------------------------------
-------------- 31.- Equip.-Cleara-rices -Pane Is- Moto-rs- Mech. Equip.
- -32.- Clothes -Closel- Light-Shower.1-i-ght-Spa-Light ----------------------
--33... Smoke -Detector -------------------------------------------------
--------------------------- ------ ---- ------- ------------------------ ------------ ----
Date Card B-1 Date Card B-1
-------------- ------------- ------------------------------------------------
Date Card B-1 Date Card B-1
Date MECHANICAL (Permit) OK except 4's
-------------- 34.- X.C.- Ducts Insu-latio-n & - Sup - port 7 ---------------------------------
-------------- 35.- Vent- Fan:-Ex-haust -a-bove insulation - - ----------------- ----------
------------- 36.-.Cond-enFate Drai-n- & Overflo-w: Size -&-Grade ----------- -----------
37. Furnance-Vent: Access -Comb. Air -Return Air Vent -1 15 outlet
----------------------------------------------------------------------------------
. 38. Attic Access & Platform if Furnance in Attic
-----------------------------------------------------------------------------------
---------------------------------------------------------------------------------
Date Card B:l Date Card B-1
---------------------- --------------------------------------------------------
Date Card B-1 Date Card B-1
Date FRAMING (Plans) OK except ft's
39. Sils. Proper Material & Anchors
------- ----- - -------------------------------------------------------- ---------
------------- 4-0.- W.alls-Stud-s--Nailing. Spacing-&-Bracing-Plates-Sou-nd -------------
41. Bearing Walls over Girders & Floor Nailing
------------- - ------- I --------------------------------------------------
42. Draft Stop in Walls (rat proof)
----------------------- ------------------- I ------------------------------
------------- 43.- F -ire -Stops: Furred Ceilings -Stairs -Chases -Tub
44. Headers & Beam -Size & Bearing
47. Fireplace Ties or Type A Flue -Fireplace Throat clearance
48. Attic Access; Size & Romex Protection- Draft Stop -Ins. Baffles
49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
50. Garage Fire Protection Framing
51. Property Line Firewall & Openings
--------- __52. Ext. Doors -One T -Check Garage -3rd Story, 2 Exits
53.- Stairs: Width -Head room -Rise- Run-Landing-Fi re Protection
54. plywood on Root Overhang -Attic Vents -Rafter Outriggers
-------------- 55. -Siding -Nailing Veneer
-- ---------- 56. Stucco Mesh-Drip.Screed-Fd. Vents-Underfir. Access
57. Glazing Area -Glass Protection-Skyl ights- Plastic
58. Shear Walls: Nailing -Bolts
59. Insulation -Walls -Ceilings
60. Infiltration -Walls -Windows
-----------------
--------------------
Date Card B-1 Date Card B-1
---- ------
Date Card B-1 Date Card B-1
Date FINAL (Plans) OK except 4's
61. Ext. Steps -Door & Sidelight Protection -Landings
------------- 62.. Smoke -Detector
63. Furnace: Vents -Clearance -Comb. Air -Connector -
In Garaae: Above Floor-Ducts-Mech. Protection
64. Bedroom Exiting
65. G.F.1' & Bath Fixtures & Tub Access -Spa
-------------
66. Elec. Trim & Subpanel: Breaker Sizes & Labels
----------------
67. Stairs & Rails
------------
68. Fireplace or Stove: Clearances- Hearth
-------------- ---------
69. Elec. Outlets at Wood Panel: Int. & Ext.
----------------- - - ------ -
70. Kit.Fixt. & Appliance: Grnd.-Air Gap -Cooking Clearance
------------- 71.--Elec. Outlets & Receptacles at Kit. Counter
72. Garage Fire Door: Swing -Landing -Closer
----------------------------------
73. A.C. Duct in Garage -Damper
------- ----------------------
74. Wtr. Htr.: Vents -Clearance -Comb. Air-Connector-P.R.V.
In Garage: Above Floor-Mech. Protection
------------- 75.-Plb.. Elec.-&-Mech. Equip. Listed for Location
76. Elec. Receptacles in Garage: (G.F.I.)-Romex Protection
7;. Insulation -Foam -Looked in Attic Yes
---------------- ----------------
------------- 78. -Guard -Rails & Deck -Const ruct ion -Post Caps
79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth
...... I ---------- Clearance Looked -under Floor- 0 Yes
80. Following instid.: Drive 0 Yes 0 No; Walks 0 Yes 0 No:
Planters 0 Yes 0 No
-------------------------------------- - - -
81. Stucco: Brown -Finish
82' A.C. Unit: Disconnect. Electrical, Plumbing
----- --------------------------
83. Vents Above Roof: Plbg.-Appliance-Fireplace.-Clearance to
Openings
------ ------- ------ - ------
84. Water Well: Disconnect, Electrical, Plumbing
---------------- ------ ------
------------- 85.-.E-xterior-Elec.-Trim; G.F.I. Receptacle- Underground
86 . Ventilation Throughout House
87. Glass Protection
-1 ---------------------- - - --- - - - - -
88. Corrections from Previous Inspections
-- --- --------------- ----------
89. Gas Test -Meters Tagged: Gas -Electric
------------- --------------------
90. Water & Sewer Connected -C/O to Grade -HD Approval
91. Energy Compliance Certificate -Other Certificates
------------------------- - ------
------ ------- I ------------ - -----------
D-a-t e ------- ...... C a rd -6: 1 ------ Date Card B-1
-Da-te--. Card _B- 1 ----------Date Card B-1
Date Card B-1 Date Card B-1
Comments at Final:
COUNTY OF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive - Oroville,'California 95965 - Telephone (916) 538-754�� . PERMIT NO.
APPLICAT16N AND PERMIT 7e
ASSESSOR PARCEL NUMBER 2AXIA 24-230-008 .
ZONING A5
BUILDING PEF7
OWNER
CHARLES KINGMAN
TELEPHONE
846-2171
SO. FT. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS
39 MOCKINGBIRD LN OROVILLE
2340 126,360.00
ELEPHON
CONTRACTORS NAME JIM FIELDS CONSTRUCTION T 872— E 1639
CONTRACTORS MAJUNG ADDRE
!;�35 CIRCLE LN PARAT)T,,;F, 'A
Fireplace
CONSTRUCTION LENDER
UNI<NOWN
Total Valuation is
LENDER'S MAILING ADDRESS
Filing Fee
$ 20.00
Permit Fee 730.50/2
$ 365.25
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ 23.00
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Penalty
$
BUILDING ADDRESS 39 MOCKINGBIRD IN
PERMITFEE
$ 408.25
PLUMBINGPERMIT
Filing Fee 20.00
Each Trap
1 7.00
LOT NO.
SUBDNISIONS NAME
1
IPARCEL MAP
Solar or heat pump water heater
23.00
—
USEOFSTRUCTURE
SF 0 Duplex 0 Mobilehome M Other
SPECIFY
Water piping
15.00 15.00
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00 15.00
Building sewer
15.00 15.00
TYPE OF WORK
New 0 Addition 0 Remodel 0 Utilities 0 Installation 0 Other Cy
Describe Work: MOBILE ON PE?ZMANENT FOUNDATION
Mobile Home TF[d[7W
920.00
PERMITFEE
$ 65.00
Contractor
ELECTRICAL PERMIT
Filinq Fee 2 O.'o 0
a V 0 LESS
Main Service 20000A ORR LESS
23.00
Main Service 200A TO 1000A
46.0
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�n�ll 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, asownerof theproperty, or my employeeswith wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
0 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
NEW CONST. DWELLING OCCUP.
OR ADONS. & ACC. BUDS.
a
ST._
NEW CONST. LTI-OUTLET
NON-RESID. BRMAUNCH CIRCUITS
—3.5,t
97.50
,FUWER APPARATUS
SINGLE OUTLEr CIR.
Ex. Occup. ( OUTLET OR FIXTURES
20 @ 1.00
BAL 0 .50
FIXED APPLNS. OR
Ex. Occup. ( OUTLETS (RESID.) EA
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.OL�=
PERMITFEE
$ 4 -no
Contractor
-3
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
El I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
0 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, forthe performance of work forwhich 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
PERMITFEE
$
Contractor
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provis . s.
7
Date C.;,
X –22!7-- z _e___
Signsw e of Applicant 0 Owner 0 Contractor 0 Agent
An,0SHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee
Energy Inspection Fee s
Occ
CONST. TYPE
ITO AL FEE$ 516.25
This permit is hereby issued under the
of the Butte County Code and/or
indicated 7ab e �forwhh* 4hnfe s have
By
PERMITEXPIRESON
I
applicable provisions
Resolutions to do work
been paid.
Date3
ReceiptNo. 175599
.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDEN ROD -APPLICANT
COUNTY OF -BU, E
TT
-BUILDING DIVISION
DEPARTMENT OF DEVELOPME%TSERy
1469 Humboldt Road, Chico, CA (9 '1 JYA, �J-27511
7 County Center Drive, Oroville, CA - (916) 5,38-7541
747 Elliott Road, Paradise, CA7,j9'1-6) 872-6-307 –
CORRECTION NQTICE
.i.
b�VNER PFRMIT NO.*
A routine inspection indicates that the -following violations of,,Butte County Ordinances exist at
the above address and should be corrected. Please notify this office when correction' of work
is completed. If you have any questions pertaining to this matter, or need additional explanation,
please contact this office immediately.
I
7f
Date 5�/—/2/,/fK-'lnspector
REV 10/92
. 44-
7"
COUNTYOF BUTTE - DEPARTMENTOF1017,M�COPM ENT SERVICES -BUILDING DIVISION
7COUNTYCENTER DRIVE - OROVILLE,CALIFORNIA:95965 -TELEPHONE (916)538-7541
PERMIT APPLICATIMDATA SHEET.
OWNER
Proposed Building Use
Building Inspector
Date
At time of permit application, I was advised the following data must be submitted prior to p�r it pi�ocessing and/or issuance:
DA TE RECEIVED BY
1. All items have been' -submitted . ........................................
2. Plot plans, 3/4 sets, signed by preparer of plans . ..........................
3. Complete plans, 3Wsets, signed by preparer of plans . ......................
4. Engineered plans ar�d calcs, 3/4 sets, with wet signature on plans . .............
5. /Hazardous Material Form . ............................................
6. Energy Design Compliance and suppqrting documentation . ..................
7. Statement of Intent for Non-He9ted and A/C Buildings . ......................
8. Enginebred truss details and layout in.duplicate (required prior to plan check).
9. Mobilehome data and manufactUter-s-installation instructions, 2 sets . ...........
10,- Fees of $ 4P
-9 In 64�
Impact fees as shown on attached sc 4: �* 't
12. California Department of Forestry plan approval/fees ......................... —
/i.13..-Ehx1itI elevation letter (100 year flood by California Engineer .............
&&-"-�anitation and plot plan approva Health Department . ......
15. City of Chico plumbing permit . .........................................
Plot plan and business license approval from City of Biggs/Gridl
W k,.ii, � � tA
:A�1( anning approval for (A) Use: (B) Parking: -J,� i� 1
18. Contact Land,lDevelopmentabout (A) Improvements (B) Drainage ............ —
�"!51J`119- Driveway permit (construction approval required prior to occupancy) . ..........
Inspection equest
20. Pre -inspection for required. t1o"Building Inspector Date)
21. Contractor's license information. (No., Name Style, Classification) . ..............
22. Certificate of Workmans Compensation Insurance . ................... �' * -! I — , ,
Owner -Builder Verification (Given to owner , Mail to owner ) ............
Recorded copy of Agricultural Acknowledgement Statement . ........ s ..........
25. Letter of signature authorization . ........................ - - `t� .......
26. Copy of recorded deed of parcellcreation-and r60,right'6fWWio a public road ......
27. Letter of intent on building use . ..........................................
28. Mobilehome utility clearance . .................... I ...................... A�
29. Documentation of legal access . ..................... ; ...............
30. Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning'- area and frontage requirements . ...............
31. Existing violations/expired permits . ......................................
32 Plan check list.
1/ -3 ;;; -M
When you issue the pe'rmit, process as follows: Madtoowner. Mail to contractor.
Txelephone - and hold for ��ickup at office. Deliver with inspector.
Other
Parcel Creation
Acreage Applicant *_QZ-�2 !!���—�Date
Copy of Haz-Mat fdim sent Health Dept. Fire Dept. _Air Pollution Date
Copy of plans sent Health, Dept. _ Fire Dept. Other Date ,,By
The following data must be submitted prior,to permit issuance: (Circle new item not checked above).
1. Index permit for above items No.
2. Additional items required:
Contractor, designer, owner, was advised of above required data by _ phone mail —Counter by _ Date
Contractor, designer, owner, was advised of above required data by _ phone mail Cou Date
Plans checked by Date Plans approved by Date�9-'S
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Works
V
-TO: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
K, 7 Mej
Owner Location
R.H. USE ow
Plot Phu Ans&d
Floor Plan
Scat to JIM
)-,? - 0 011
AP#
L'I�
Plan Approved for: Sewage Disposal V" Water Supply: Public Private Well.
Clearance for _Jf'�� bedroom mobile home. Other
Hold final for:
Final clearance O.K. for:
NOTE:
Environmental Health Specialist Date
8/92
BUTTE COUNTY SCHOOLS 114PACT FtE CERTIFICATION FORM
.(One Form Per Building)
School District oSD
A.P. Number 3e) -00 Jurisdiction
Property Owner L <z-1
Property Location/Address
Building Department No.
'00000e /:;� . I
a
Subd.ivison 0, z 7-110
Residential Development Sq. Footage te
No.- =ofLiving VH JI Additio n " i /76:3-7
Units
&S�l 7 1 �3
A& -S
.Commercial/Ind'ustrial Sq. 000tage
New Addition (Including Exterior
Roofed Areas)
136iidifilg Departmgtft F�eprese niative Date -
(Floor Plans reviewed by'School District Personnel),
District Identification No.
4!��'� �/—School District certifies that
(Api6licant)
(Street Address) (Phone Number)
(City)
has complied with the requirements of Resolution No..
representirig square feet.
School District
Paid by Check Number
Bank Number
Paid by Cash
(State) (Zip
Remarks:
by payment of $
Date
If, subsequent to'the School District Representative signing this Butte County Schools Impac:VF6e
Certification Form, the School District is notified by the applicable Local Planning Agency that this project
is being reviewed under the California Environmental Quality Act (CEQA), this,project may be subject to
I t
additional school fees to fully mitigate its impact on the school district's schools.
White (applicant), Yellow (building department), Pink (school district) feeformmkl (4/92)
V
LI ON -NJ UVI_ 1 It hN:11 , A I tj It L*..'l
'faille SYIICFn
ungiiiudi.311:14)o i
Folly Insulatcd F:loors. Walls. & Rot)(
r x 6- rxie6rr Walls. 16" O.0
Pull Vaulted Ceilings ihioughOul
Teup 3/12 Roof Pitch
T 0 INTFRioR m%TURUS
lb N -V
k 1p-,- shcetrock Walls, Ceilings and
HE 1b - 'A Ab
-,Iv Y, Ridgebeams - Taped. Textmd.
0
'N'
HOMES Of 1 PU ell" and pointed including all Wei Areas,
Wardrobe.,;. NO Omels
.,Shut-off V31ves; lhioushout
Unokurn in nillunoint, Kitchen.
GDADEN WEff Utility. arul FMTY
White Enameled Dows slid Casings
4- 0, 0* ;?Trr-_R?01R DRCOR FEATURES
Continenlal Valance
. MinihIjilds throughatio-wiih
- Bright Brass Dow lfardw=
r - Finished Baseboard ehrouphout
(except cabinet aTess)
FXTCRIOR FEATURIN,
W Ultl . compositban Roof Shingles
SUT - Irl" I Imilholui Siding
empoom 7 ku
cpf. lxmmu 3 - 2" % a" Rnugh Sawn Fa2cia.
- FD -2 US 36" x go' 6- Panel R -I
WACCOM [IS 30
utte Cc)unty - RD x W, clixure
t"I Window Reat Door
FkAWSWEnvironMen - While Flame DU21 G1311 Window'
rtall SAF - w Fromi and Rear Fave
J-) 1�-" _
7_1� 6* Side Eaves
KITOWN FFATURFS
19 Co. Fl. From Free Refrigerator
Fire Smnding Gas Range
30' Range Illond
Metal Dlaxrer Guide %Yslcm
Nrcelain Sink
Laminale will, 03cksPlAsh
V" Countef(ops
1: 11tillow Core Cabinelty
While Sbelvo Cabinet$
3=1
Gas 1:0M.1ce wl 1�0..%. Vero. System
bi 1!d W)JUte f2f
&Y�'rhlbcrglass TulgSbower 1el Plan
U711% Swu ?-,,, ffinmllr,�
NO ~I - "M Isk az
Model #BD60OW2
pleage
2g8O SQ-F&.Ir
L
X
'tj tow T1 IAJ'
a N't AA A
tw�IV
-\ -
FOWqt
MOILEHOME
bo
oPOVM M)LE
*WELL
our
-IN
DRIVEWAY
Ja
SHOP
0'
Zoo
INN
tub
V4
o o
11A
t2
cak
122r
0)
Jill
Ln
r1a
cc
C3
777.
Jill
�4 . �
d3
02
11
95-0104771' Rec Fee 6.00
And when recorded mail to: I COP 1.00
Building Division Recorded I Check 7.00
#7 Countv Center Drive official Records I
Oroville, Ca. 95965 County of I
Butte I
Candace J. Grubbs I
Recorder
2:06pm 29 -Mar -95 I PUBL XX I
AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT
FOR RESIDENTIAL DEVELOPMENT
Section 26-8 of the Butte Countv Code requires this acknowledgment to be recorded prior to issuance of a building pern-dt. The
property described herein is adjacent to land or included within an area zoned for agricultural purposes. and residents of this
property may be subject to inconveniences or discomfort from the use of agricultural chemicals. including. but not limited to
herbicides. pesticides, and fertilizers: and from the pursuit of agricultural operations including, but not limited to cultivation.
plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise. and odor. Butte County has established
agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or
discomfort from normal. necessary farin operations. I � 11 r . . .
All that real property situate in the Countv of Butte,. State. of California. described as follows:
ow. %.wsxorna&�. acamma. as. tonows:
BEGINNING*.. at.. the. Southwest corner of - the Southeast Sec -
quarter of
tion -1, Township 17' North.,. Range 3, East, M.D.B. ' M. running
thence -East along the South line -of said Southeast quarter a
distance -of 869 feet to a.point, said point being the point of
beginning- of. this description and marking the Southeast corner of
that.certairr piece or parcel.of land heretofore conveyed in Deed
fron-Orrela Dowdin, et al, to Robert C. Dowdin, recorded in Book
95'of Deeds, at,page,399, running thence North along the East line
of:the.,land conveyed to Dowdin as aforesaid, a distance of 1320
feet to a -point in the North line of the Southwest quarter of said
Southeast quarter of Section 1; thence East along said line, a
distance of 434.5 feet to a line dividing the East and West half
of said Southeast quarter; thence South along said dividing line,
1320 fee.t to the,South line'of. said Southeast quarter; thence West
along said South line a- distance of 434.5 feet to the point of beginning.
Date: March- 28, 1995 � PROPERTYOWNERS:
C 44t& g -S C. k� �' e , "�
State of California
County of Butte
On—March 28, 11%"eme, Michelle A. -Miller
personally appeared Charles C. -Kingman and Diane E. Kingman
"Hown to (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the
within instrument and acknowledged to me that he/she/they executed the same in his/her/(heir authorized capacity(ies), and
that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which- the person(s) acted.
executed the instrument.
WITNESS mv hand and official sea].
OFFICIAL SEAL
S i g n a t u r2�&'& Sea]:
A. P. #
WCHELLEA.MUM
NOTARY PUBUC-GAI"KIA
co.
0 'M
.;W'1996
LIP= j*.4 a a
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HCD FORM 433(A) Rev. 8/91
WHITE—County Recorder CANARY—HCD PINK—Appiicant GOLDENROD Building Dept.
RECORDING REO.U1ESTED BY:
1'2Q60,-',ie6 F�e', 00.
j I' Tcital
.'00
lRe-c-r
o 'd�'d
Offtcial�pecordisi I
AND WHEN RECORDED MAIL TIO:
J'
BUILDING DIVISION
it
_/.B,u e.-.
NAME -7 COUNTY CENTER DRIVE
CaxfdacjPN,J. KGru 8 -1
b bi
. . �
OROVILLE CA 95965
jlkecoraer' �)
'J4"'m,.13-�4pr:-95'
STREET
I =Msl XX_ 2
ADDRESS
----------
CITY,
STATE
and ZIP
SPACE ABOVE 'THIS LINE FOR RECO'RDER USE ONLY
NOTICE OF MANUFACTURED
HOME �(MOBILEHOME) OR COMMERCIAL COACH;
INSTALLATION ON A FOUNDATION SYSTEM
.Reco�cling of this document at the request of the local agency indicated is in accordance with California Health and Safety Code
Section 18551. This document. is. evidence that such local agency has issued a certificate of ocliuponcy for installatioli of the unit
described hereon,.Upon the real property described with certainty below, as of the date of recording. When recorded, this document
shall be indexed by the county recorder to the named owner of the real property and shall be deem6d to give constructive notice as to
its contents to all persons thereafter dealing with the real prope�rty.�
CHARLES C.AND DIANE KINGMAN
BUTTE.COUNTY-BUILDING DIVISION
REAL PROPERTY OWNER/LESSOR
.1OCAL AGENCY iSSUING PERMIT and CERTIFICATE OF OCCUPANCY
39 MOCKINGBIRD LANE
7 COUNTY CENTER DRIVE
MAILING ADDRESS
MAILING ADDRESS
OROVILLE, BUTTE, CA,95965
OROVILtE, BUTTE; CA:95965
CITY COUNTY STATE
zip CITY COUNTY STATE ZIP
SAME-
95-6548 (916) 538-7541
INSTALLATION MAILING ADDRESS, IF DIFFERENT
BUILDING PE * RMC -140., TELEPHONE, NUMBER
4147T
-4/13/95
CITY COUNTY STATE
ZIP SIGNATURE OF LOCAL AGENC��.OFFICIAL DATE
SAME
INTEGRITY HOMES, INC.
UNIT OWNER (if also property owner, write "SAME'l
DEALER NAME (If not a dealer sale. write "NONE'l-
92834
MAILING ADDRESS
DEALER LICENSE NO.
C17Y COUNTY STATE
ZIP
UNIT DESCRIPTION
GOLDENWEST
.3/30/95 GOLDENWEST BD600
MANUFACrURER'S NAME
DATE OF MANUFACTURE 'MODEL NAME/NUMBER
GW6—CAL—BDII338A,B & C
60'X38' RAD -815415/815416/8115417
SERIAL NUMBER(S)
LENGTH X WIDTH INSIGNIA/LABEL NUM8ER(S) I
A.P. #024-23—'0-008
REAL PROPERTY LEGAL DESCRIPTION ASSESSOR'S PARCEL NUMBER
SEE ATTACHED LEGAL DESCRIPTION;
T 01"
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HCD FORM 433(A) Rev. 8/91
WHITE—County Recorder CANARY—HCD PINK—Appiicant GOLDENROD Building Dept.
unincorporated -area
the real property in the State of California. described as follows:
County of BUTTE corner of the So�theas.t quarter.. of Sec -
BEGINNING at the Southwest Easti I M.D.B. & m., running
tion 1: Township 17 North, Range 3 arter a
thence EaSt-a-lxong- -t-he sou:th ll,i,ne�-.of said... southeast qu.
point, said POIn't --b'e-i ng the po-Int
distance of s69 feet to a arking the Southeast corner.of
of this description and m
beginning I of land heretofore conveyed in Deed
that certain piece or parce Robert C. Dowdin, recorded in Book
from Orrela Dowdin, et al, to ine
unning thence North along the East 1*
95 of Deeds, at page 399, r . , a distance of 1320
of the land -conveyed to Dowdin as aforesaid st quarter of said
to a oint in the North line of the Soutliwe
p East,along said'line, a
feet f 'Sec'tiOn li thence half
southe4,st quarter o line dividing the East and West.
distance of 434.5 feet to a line,
rter; thence south along said dividing
of said southeast qua Southeast quarter; thence West
1320 feet to the South line"Of said the point of beginning.
along said'South.line a distance of 434.5 feet.to
BUILDING PERMIT NUMMER: 95-0548
. . Address or location of unit: 31j MU&INUDIND LRAL, VAVVILLE
Legal Description of Real Property: '
SEE ATTACHED LEGAL DESCRIPTIOff-.
A.P. #024-23-0-008
[X]Mobilehome/Manufactured Home
]Commercial Coach
Has been affixed to the real property above by installation on a foundation system
pursuant to Health and Safety Code Section 18551.
Owner's name: CHARLES C. AND DIANE KINGMAN
39 MOCKINGBIRD.LANE, OROVILLE CA 95965
Owner s address:
INSIGNIA OF EIUD NUM113ER: RAD 815415/815416/815417
SERIAL NUM13ER OR V.I.N. GW6-CAL-BD11338A,B & C
NIANUFACTURER'S NAMIE. GOLDENWEST YEAR: 1995
OFFICIAL APPROVING INSTALLATION:
DATE: 4/13/95 PHONE: (916) 538-7541
H.C.D. 513C
the real property in the unjncorporated*area Stateof California, described as follows:
-County of BUTTE corner of the Southeast quarter of Sec -
BEGINNING at the Southwest Range 3 East, M.D.B. & M.,, running
tion 1: Township 17 Northe
'South line of said Southeast quarter a
t
tj�`ed,'Tast along he. id point be, ng. the..poin,t -:otf...
en f 869 feet 'to a point, sa
distance 0 f this description and marking the& Southeast co,rner*of'*
beginning 0 1 of land heretofore conveyed in Deed
that certain piece or-,parce to Rober� C. Dowdin, recorded -in Book
t
from Orrela Dowdin, et al, unning thence North along the East line
95 of Deeds, at page 399, t aforesaid, a distance'of 1320.."
of the land conveyed to, Dowdin'as - said
to a point in the North line of the southwest quarter 01
feet on 1; thence East along -said line, a
southeast quarter of Secti
f 434.5 feet to -a line dividing the East and west, half,.
distance o ; thence touth'along said dividing line,
of'said Southeast quarter of said Southeast quarter;' thence West
1320 1 feet to the south line tance of -43*4.5 feet to the poillt-of beg inning,-,
along said south.line a dis
-a Land Tible. Gompuny
Xevada County'.
AM vivak ItlCoRiAlD *AIL'90
Home F Mr. and Mrs. Charles C. Kingman, J
SI("t 39 Mockingbird Lane
Addroso oroville, CA 95965
C1" &
$1.10 L
MAIL TAX STATEMENTS 70
F
No.@
$f,"l
Acklf.tj Same as Above
Cite L
s'— L
APN 024-23-0-008-0
'iu
OCT
rl.uu
CLERK -RECORDER FEE -22
SPACII ASOVII THIS UNI FOR RECORDER'S USE
Documentary Transfor Tax $ 65.45 computed on
f ull -ue
CAtI(ORNIA LAND TITLE COMPANY Of NEVADA COUNTY
GRANT DEED
ROGER DEAN LUCAS and JOANNE Z. LUCAS, husband and wife
)V, PAID
k
L L
pa(., i ,-, ".
(GRANTOR - GRANTORS)
FOR A VALUABLE CON SIDERATION, receipt of which is hereby acknowledged,
Do Hereby Grant To
CHARLES C.KINGMAN, JR. and DIANE ELIZABETH KINGMAN, husband and wife, as JOINT TENANTS
the real property in the unincorporated area I
State of California, described as follows:
County. of BUTTE Sec -
BEGINNING at the Southwest corner of the Southeast quarter . of
tion le Township 17 North, Range 3 East, M.D.B. & M., running
thence East along the South line of said Southeast quarter a
to a point, said point being the point of
distance of 869 feet t corner of
beginning of this description and marking the Southeas
that certain piece or parcel of land heretofore conveyed ill Deed
from Orrela Dowdin, et al, to Robert C. Dowdin, recorded in Book
95 of Deeds, at page 399, running thence North along the East line
-o . f the land conveyed to Dowdin as aforesaid, a distance of 1320 1
feet to a point in the North line of tile Southwest quarter of said
Southeast quarter of Section 1; thence East along said li-Ile, a
distance of 434.5 feet to a line dividing the East and West half
thence South along said dividing line,
of said Southeast quarter; . St
1320 feet to the South line of said southeast quarter; thence We
along said South..line a.distance of 434.5 f . eet to the point of beginning.
Dated .............
1L.19.V .............................
STATE OF CAUFORNLA
COUNTY OF
......................................... ................... : .........................................
0 . . ......... 19.8.7 ...........................................
P ..........
before me, the undersigned. a Notary Public in and for said
County and State, personally appeared
'Roger Dean Lucas and.J.oa.n.n.e Z ................
..... ........ ............................................................. ... ...... .. ... ..
Lucas'.
...................... ..................................................................................
M Per -, sonany known to me
In
1z en-tlte..basis of satisfactory evidence
C1. P .0
to be the person(s) whose name(e) is (are) subscribed to the within
they
instrument and acknowledged that ................. 0 .......................
executed the. same.,
Witn and and official Be
as
.. .. . ... ..... . .... .. . ......... .. .............
..........
(Notary si�nature line)
........................................
........................................ .................................
("His name (notarY'8) shall be typed or legibly printed")
(Sec. 8205 - Government Code 1969)
... ........ ...............................
R Dean Lucas
...............................................
i oann� Z. Lucaq
* ..... :,r,,,,
............... ................. I ................................................... : ..................................................
.................................... ........ I .......................... I ........................................
CFF1(>NL REAL
MAUDIE WALKE13
N01illy PUIPIC-C-01i'0111i�1
FICE IN
PRINMIAL OFFICE IN
N I y
NEVAP COUN I Y
-My Fxpires Julie U.. 1908;9
OF DOCUNTNT
4
Sy^yg OF
DEPARTMENT OF OU IING AND C.OM UNITY DEVELOPMENT
DIVISION 0 F CO 01, S AND 3 TANOARDS
MANUFACTURED HOUSING SECTION
STATEMENT OF FACTS
HCD 476.4
Date iv7
I/We,
the undersigned, hereby state that the unit described below:
a I A L . 0 - (S I <--- t- L 6 0 3 3 �- /4
C'ft
A-,, A I I f -e 3
MO@#LK.OM /COMMERCIAL M^NUF CYVEWN TRADE NAM&
Corm 06C:' NUM94'MISI
5 5S
Y
4,7
Affiant further agrees to indemnify and save harmless the Director of Housing and Community Development,
State of California, and subsequent purchasers of said'unit, for *any loss they may suffer resulting from registration
of the above-described unit in California, from issuance of a California certificate of title covering the same, or
transfer to:
I certify under penalty of perjury that the foregoing is true and correct,
Executed on at 12- o t'l I
OATK cITv $T^Tg
Signature 12
7
Address Z 7 Y 0 cz "F 1-4"Z7, x2c '/ e' -
or" L) r c— State C_Y4
City
' * *� If 17( — - - - - - - - -
L HE " P12
APR 04 '95 ��LEIA HEST HQ'
PEPAA-rM2NT OF HQvf;lr4G AN D CUOMPAUNlyY 6Lt' V WIMCNT
mi-digi(>N OF CODPS AND WtAPJDAFID
MANVic-ACrURCO HOW-IN11- r.rr.TIGN
P.Q Put 1001
w t, NU —MB -E R
SACIIIIAMINT0. OA CE960- 111120
858016
MANUFACTURER CERTIFICATE -OF ORIGIN
MANUFACTURED HOME/MOBILEHOME COMMIRCI�t, COACH
SFD (SINGLE FAMILY DWELLING) OCCUPANCY GROUP.-..,..
MFP (MULTIPLE FAMILY DWELLING) E3 CHECK ir THIS IS A DUPLICATE MCD
14UMBER OF 7RANSPORTADLE SECTIONS 3 ENTER ORIGINAL MCO NUMBER
�%IUPACTURER N4ME MANVACTUMA RENSE NUMBER
au= RM BMW, Shr"WM b=Uv 9248
57-UIA—CTURER ADDRE66 SUr.,0C.%Tf!D ItEiXIL E_
Chi 95827
VLACMW= - ]RD.
IcIrn (STATE)
,NUFACTV ER TRADE NAME MODEL -NAM ond/or NUMBER DATE OF MANUFACTURE
91>.-6"W 03-301-96
am wm 4f , NI )
IER OWNERSHIP TRANSFERR R NUMBER DATE Of - TRANSFER
IMF QT-blx DEALE
M?Iwm= 92934
?4T)4) (DAY)
CA 91") ZIP)
_($TAT&)
VENTORY CAERTM-=1
dAq CREDIIZW �00)055
or su= 640s 151A!
(ZIP,
AANUfACTUAER MCD INSIGNIA or 7WIDTM
SERIAL NUMBER HUD LABEL NUMBER (It4ctics) (INCHES)
d ... , . I&' -%I 46i
tANSPORTER NAME
MINI= Dom SXKY=
ftb= 179
co(tify under penalty of p4priury that the dibove facts ofji�cvv on < k'
. of
Exemed on
(COUNM
SIGNATURC.-OF AUTHORIZED .,AG
9 15, tJONF. Tmt w rORWA
ORIGINAk (PINK) TO THE INVENTORY UNUS'. TH
V
(WHITI) FORYWO TO lh('DIPARTMINT AT IMC ADOVE ADDRESS WITHIN FIVI (5) DA S OF S06:
COPY. 'i (YfLILOM DIEUVIR .10 lid TAAN$tC�IFR, 1O.ACCOMPANY:11if UNII.,TO IIS USTINA70N,
4& A 'z
&
COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS
7 County Center Drive -- Oroville,_ California 95965
Telephone: 5-34-454i
.APPLICATION FOR SPECIAL INSPECTION zone:
V
Applicant 00 P1 e Telephone No.
Mailing Address
Building Location
I hereby reque.st a special inspection of the following building:.
/ / 1. Dwelling (if only a portion, specify)
2. Apartment House (if on ly a portion, specify)
3. Commercial (specify present occupancy)
1X7 4. Other (specify)
I'am requesting a special inspection fo-r the purp-ose of:
1. Moving the building..
/ / 2. Financing (specify agency)
3. Change of occupancy to
4. Other (specify)
Case No.
I hereby certify that I will obtain the necessary permits and make any necessary corrections,
alterations, or repairs required by the County of Butte, as a result of this inspection, to comply
with building and housing code requirements. I also certify that prior to the use or occupancy
of this building, I will complete the above required corrections, alterations, or repairs, or,
if the. building is presently occupied, I will complete the above required corrections, alterations,.
or repairs within thirty (30) days.
I certify that I have read this application and state the above information is correct and hereby
-authorize representatives of the County of Butte to enter upon the above-mentioned property for
inspection purposes.
r_s Date
Sijnature of Owner
Fee paid $
lst-DPW - 2nd -Inspector - 3rd -Applicant
Receipt No. C�,6 2911-)
%_1
COUNTY OF BUTTE DEPARtMOIT
014�-IPUBLIC WORKS BUILDING DIVISION
7 COUNTY CENTER DR1,VE � OW6VILiE,,CArIFORNIA 95965 - TELEPHONE: 916/538-7541.
PERMIT APPLItATIaN- BATN SHEET
Permit No.
V, A;,P. No.
0 WNER
�s
Proposed Building Use z1viBuilding Inspector Date �),41
At time of permit application, I was advised the following data must be submitted prior to permit processing
and:/orissuance: DATE RECEIVED APPROVED
.A. All items.have been submitLed.,,
2. Plot plans in d4p4e.E Oi6a-te, signed by preparer of plans.
3. Complete plans in duplicate/triplicate, signed by preparer of plans.
4. Complete engineered plans and calts, with wet signature on -plans.
5. Plans with Energy Design Compliance Statement . . . . . .
6. School District "Fees Paid" Stamp on Floor Plan.
7 Statement of Intent for Non -Heated and AC Buildings.
8. Fees of $ . . . . . . . . .
9. Letter of signature authorization . . . . . . . . . . .
10. Sanitation approval from Health Dept. . .
11. Planning approval for (A) Use: — (B) Parking:— .
12. Certificate of Workmen's Compensation Insurance . . . . . .
13. Contractor's License Information (no., name style, classif.) I .
—14. Owner -Builder Verification I (Given to ownerEl, Mai I to ownerEl)
15. Improvements may be required.
. . . . . . . . . . .
16. Mobilehome Installation Data. . . . . . . . . . . .
17. Pre -Inspection for Pre-Inspec. request to
-_ Required. Building Inspector
18. Recorded copy of Agricultural Acknowledgment Statement.
19. Driveway Permit.
20. Plot plan approval from city of
4. Engineered trusses*in duplicate (re�uired or to plan check).—
'111� C 0.
3/22. Zoo e� 4 )a 0
Date)
When you issue the permit, process as follows: / Mai I to owner, —Mai I to contractor.
—Telephone and hold for pickup at—off ice, —De*l iver w/inspector.
Other
Applicantae"LL
Mte — /0/
,popy of plans sent — Health Dept., —Fire Dept., — Other— Date
hhe following data must be'submitted prior to pern, it iss'uance: (Circle new item not checked above).
1. Index permit for above items No.
2. Additional items required:
Contractor, designer, owner, was advised of above required data by-- phone ----mal I —counter by— date
Contractor, designer, owner, was advised of above required data by —phone _rna I I —counter by— date
Plans checked by Date Plans approved by Date
Sets of plans on hold in
Copy—DPW
File cabinet _AP folder
At 133 -77P,E
PERMIT NO.
PERMIT EXPIRES
OWNER
Roger Lucas
CONTR.'
ownei
LOCATION
(A.P. 24-23-8
N/S'Central House Rd -,app.' 1 mi.E.of Hwy 70,
Gridley
A
Temp- Power e
Called P &E
Temp. E-Lec. Serv-
C,,Ired PG&E
e p. Gas Serv*
Called PG&E
/T1
J JOB
OB -7
INALED
F LED-
(Date)
(SignaTure)
COUNTY OF BUTTE
DEP"TMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE
OROVILLE, CALIF. 534-4541
CERTIFICATE OF OCCUPANCY
This mobilehome has been installed in accordance with the re5uirement.s
of the -California Administrative Code, Title 25, Chapter 5, un er permit
. i' bei. "for the following location: 41A
um
� - /I — X" I "f
Ow6er—
'Owner's Address
Mobilehome Mfg. Model Y e a r 422-7
I�signia No. /W 0 ;Z-- .'Serial No.
It is hereby certified for occupancy at the above described location and
may be occupied.
Director of Public Works
7
Date 7 By A
THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS -RELOCATED
COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKSp,
BUILDING INSPECTION §ECORD
DAT REMARKS OR CORRECTIONS
(NOTE: An entry must be made on this form each time you visit the job site.)
BUILDING
BUILDING (Cont'd)/
PLUMBING
Setback
Firewall
Soil Pipf - nil
Forms
Parapets
1st FJ;o 4
Main Bldg.
Restroom Finish
2nd.FloA
Footings
Windows
3rd FloorA
Stemwall
Siding
Topout
Slab
Roof Sheathing
Wa te r P i p I n g
Piers
Roofing
Sewer /,C/X�
Garage
Fdn. Vents
Fixtures
Footings
Garage Vents
Water Htr.
Stemwa I I
Insulation
Heaters
Slab
Carport
Footings
Prov. for ph sically
handica pew
Conformance of ex.
structure
Appliances
Gas PiDina & Test
Temp. Gas
Slab
Final
Sanitation
Patio
FIREP.A E
Final
Footings
Footing
ELECT�IC�I-
Masonry Walls
Throat
Rouah
.Reinf. Steel
Final
Fixtures
L Bond Beam
FIRE SPRIkKLEhS
Motors
X
Framing
Test
Water Htr.
Stucco
Final
Subpanels
Mesh
MECHANICAL�
Grd. Fault Prot.
Scratch
Heatin
Service
Brown
Cooling
Temp. Pole
Finish
Ducts
Underaround
Interior Lath
Ventilation
Permanent
Door Closer
Final
Final
MOBILEHOME UTILITIES -------------
Elec. Service
Elec. Pedestal
Water Piping
Sewer
Gas Piping
MOB16EtIOME INSTALLAT12N ----------
Support
Elec. Continuity
77-20,77-7m—"
Water Piping
#1";17Z11RX
Drainage 111--71�1111-0 I"
Gas Piping
-
DAT REMARKS OR CORRECTIONS
(NOTE: An entry must be made on this form each time you visit the job site.)
INSIACATION - INS PECT ION CRECK LIST
1. Is the niobilehomt:� located w- i -requircd separation from lot lines 'and buildings and generally
conform to plot plan? Yes No
2, Does thE! iw�-.)bilehome have require -d clearances above I ground? (Sec.5085) Yek-It No
3. Are footin,:,s and supports properly sized, spaced, and, -b raced as per approved plans? (Note
possible variation at spring shackles.) (Sec. 5082 & 5083) YesN, No
4. Is the mobilehlome level.? (Sec. 5088) ye No
SX
5. If
,�Z, than a single unit, are crossover connections properly installed? (Sec. 5088)
Ye N 0
5. Water
A. Is fke
,�Uble 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 -V No
EMI
C. '139Ct7ftow - it . lao�t LStat�e�ifornia approved, does station have*backflow device
and pressure -relief valve? Yes— No -
7. Wastes and Drains
A. Is connection made with Schedule 40 DWV and have flex connectors at each'end? Ye No
S
B. Does it have minimum lz," per foot slope and is it properly, supported? Ye No
SX
'C'. Are any leaks detected in drainage system after ru
nnin� 3
,�,rgallons of water through each
fixture includin.g*washing machine standpipe? Yes_ N oX
D. coach is n tate of Cal iLo���does station have required trap and vent?
Yes No
8. Gas Piping and Ga Vents
A. Connector - Is mobilehome connected the gas shpply with an approved 3/4" minulnu'm
I
I s
V
m
en
obt
is
I eh n ec t ed
mobilehome conn ctor -not more than f't. long? Note: All piping is to be at least as
ine i e t
ur
large as the mob ehome gas line i' et without reductions other than the mobilehome
0
connector. Yes No
i
B. Test OK as per follo ing proce ure? Yes No
1. Open all dapplianc connec or valves.
2. Shut off aDpliance �urq(er and pilot valves.
3. Air test with manomeAr to 10"-14" water column, or test with slope gauge
(minimum
6oz.-maximum 8 oz.)/�a\ibrated in tenth pound increments. Test for 10 min. without
drop-'
4. Connect gas mete to mob�ehouie with connector, turn, on gas., test connecti6ns with
soapy water.
C. . Are all appliance ve ts proper, 4,�stall6d? Yes No
9. Electrical.
j\. is se -l -vice large eiioitg1t to provide adequate amperage to mobilchome (must equal rating of
mob ilehome with a -.niniwum of 100 amp) and other facilitiEls on lot, i.e. , water pumps,
garalye, CaMna, ctc.? Yes No
ex No
B. Is ther--� proper clearances around panels? Y
C. Is power supply cord or feeder assembly properly fused?- Y 1\1 o
D. is continuity test satisfactory as per the following procedure? YeN/' No
/C-- —
1. De -energize clectrical wiring, syste,,u of the mobilehome at the pedestal. .
2. Make sure that t1he power supply cord or feeder assembly conductors, -�Lncluding neutral
conductor, haVE1 been disconnected.
3. Switch all breakers and switches in the mobilehome to the "on" position.
4. Connect one load of a test ins�rumpnt to the mobilehome grounding conductor and
apply t1le 0!:Iier lea.d t.o, C�al_;LL [JUDL.L�_ILOLILU S-UPPLY Co'n"'Lictor, ilicluding neuLral.
5. All non-current, carrying metal parts of the mobilehome (aluminum siding, gas line,
water. line) , including fixtures and appliances, shall be tested for continuity from
such eqiij.pment and the grounding conductor.
6. Upon com.pletion of the above procedure, the power supply cord or feeder assembly
conductors shall be connected to the site service equipment. A further continuity
tez;u shall then be made between the grounding electrode and the chassis of the
11101)ilehome. Upon satisfactory completion of the(2.ectrical tests, the lot or site
service eqiApment may be approved for energizing.
.; i
T�j -;ob card si-ned by Health Departmeat for water and sanitation?
I.,- if everything olay, sign off card and ta.- services.
MOBILEMRL DATA 77
Manufacturer and/or Namestyle
Length Width
Vehicle Serial No.
State Identification No.
-m-ation or Comments:
.&ILtional Infoi
.4 COUNTY OF 9L)TTEt- - DEPART ' MF,,NT OF PUBLIC WORKS
7 County Center Drive — Oroville, California 95965
Telepho�(� 534-4,5'41
APPLICATION AND PERMIT
-'e*q
rBALL @ M I
BUILDING
2.00
Owner
SQ. FT. OCC. BUILDING VALUATION
Mobile Home Facilities
15.00
Mailing Address"Jet
6.25,
Fireplace
Contractor 04 0 I
Total Valuaiion
PINg
Mailing AddressLY41V I
Permit Fee
PlanChecking Fee&/orPenalty
Telephone No.
Permit Fde $
$
Bu i I d i Ing 'Address NIS
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
AP41� 41W&&V / "I
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No.
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
LF44Vre
FireDept.
I Fi re Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
Declarationi
Parcel Map
60' R/W
I
I Improvements
Lawn sprinkler system 2.00
BldgNaPs"re"d
c
---- ---I—
(P,4
rcel Approval
P I an s J4Jro-v_a_1."
Permit Fee $
NEW ADDITION UTILITIES VL OTHER
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
100 AMP OR L 5.00
main service 6001 OR LESSESS
Main service EA. ADD -L 100 AMP 2.50 ;L
OVER 600V
Main service 100 AMP OR LESS 25.00
Single Family Duplex Mobil Home Others
Main service EA. ADDIL 100 AMP 1.00
A—
NEW CONST. DWELLING OCCU
OR ADDNS. ( ACC.BLDGS. P - 20sq ft
NEW CONSTFL (MULTI -OUTLET
NON . RESID. BRANCH CIRCUITS) 2.50ea
NEW.CONSTF;L (POWER APPARATUS.&)
ON RESID. SINGLE OUTLET CIR
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
Ex. OCCUP(OUTLETS OR FIXTURES �
-'e*q
rBALL @ M I
(FIXED APPLNS..)R
Ex. Occup. OUTLETS 4RESI* 0 F—A)
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
I Misc. Wirinq
6.25,
License No. Classification
�Iam exempt from the Contractors License Laws of the State of Califomia. Permit Fee $ $
WORKMEN'S COMPENSATION INSURANCE MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
1 am aware of the provisions of Section3700 of the California Labor Heating
Code which requires every employer to be insured against liability
for Workmen's Compensation.
EI have placed on file with the County of Butte a certificate of Cooling
Workmen's Compensation Insurance.
OTaI certify that in the performance of the work for which this Ventilation
permit is issued I shall not employ any person in any manner
s to become subject to the Workmen's Compensation Laws of Hood 1 1 2.001
California.
i 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 R — D ate
flin-ture of Permitle or Agent
Receipt No. I t 0 V 7 1 -
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod-Appli cant
TOTAL PERMIT FEE 1$ _154t#sw
This permit is hereby issued under the applicable provisi(7q3b4,"�'
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR �UBLIC WORKS
Ry nate7---&,?- 7 7
e f - C/
uilding permit expires Date 2
�IL( b';A- ....
Mimeo No. BUTTE CO' -.,i
mimeo S�
Title:
NOTE;. -.,i' -AH Materidis & Wotkmanship'Shall Be'in Ik
�P' ood Practictes' and',
-Ac"'ordonce with Recogni.-zed G
of a quality- prescribed for the Specified use in the
Uniform Building, Plurn6ing & MechalliccAl Codes and
cal 'ode.
the National Electri
Septic system apd4acatte
to "be ins'per
Buffe Coun*fy Health Dept. Re..,,
quiretnenfs.
.0-0 -4
0
3 ;1
0
C M 5
3 :2L ID
0 tit
0 0
19 0
Q -0.
0
z T, :3 rv-,
M 3 a
a :1: ;or. 5 2,
a �o "i "A tz. 'lift
3 a ot
< 0 nf
A permit will be required fo f Rg M :t 0.4
o CL.
installation of the mobilehoft, < - =
N a .3 C, CD
:3 L�n -a '5---1 0-
a
10
3
0 :3
V) 3 3
f9 C, r, i:--
0
t ir rP
o "
'M Ej. 0
All/utility connections shall be
located wi+hin 4 ff. outside the rear
third section of +he mobile home
on f he left (road) side of the mobile
home.
V-
WTTE.COUNTY
I B ILDING WtPA
U RTMr
-A"PROVED
COUNTY OF..BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County CeAter Drive - oromi lie, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
_1 '
X —Date
tignature of Permitee or Agent
Receipt No. .16 e 7 ;1- S!�
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR O��UBLIC WORKS
B Date
- i-ilding permit expires Date q— t
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mailing Address /V:r—
Telephone No.
7.7', . .1 er Y
Fireplace
Contractor 7_� JkJ IV a ^10 4 C #V�A IZ
Total Valuation
Mailing Address -S 8,
Permit Fee
PlanChecking Fee&/orPenalty
04,TP,915,;! tA, 5A2i4l
Telephone No.
if 22-1.72 1/
Permit Fee $
---
1$
Building Address /yA C.Z�,, mq,_� 9J,
PLUMBING No.1 @ FEE
PERMIT FILING FEE $3.00
M 0A.0
Each Trap 1.50
Alo-4e_a
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No.
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
Fe "t
W�e—1
Sanitation
Fir Dept.
I Fi re Zone
Use Permit
Building sewer 5.00
EC�A,
Parking
I Plans
Parcel
I Declaration
I Parcel Map 1
60' R/W
Improvements
Lawn sprinkler system 2.00
Bldg. Plans Re4c'd--
Parcel Appko�v�a`l�
Plan s/A-5-ro-val
Permit Fee $
$
NEW ADDITION UTILITIES OTHER M
ELECTRICAL No.1 @ FEE
PERMIT FILING FEE , $3.00
—
A^,,�OJA_k lJJJtr" 4*
Main service 600V OR LESS
100 AMP OR LESS 5.00
U I
Main service EA. ADD -L 100 AMP 2.50
Single Family Duplex Mobil Home Others
Main service OVER 600V
100 AMP OR LESS 25.00
Main service EA. ADDIL 100 AMP 1.00
7_7 ------ Irl
NEW CONST. f DWELLING OCCUP.
OR ADDNS. % ACC. BLDGS. 120sq ft
NEW CONSTR. (MULTI -OUTLET
NON-RESID. BRANCH CIRCUITS) 12.50ea
NEW.CONSTFL (POWER APPARATUS.8,)
NON RESID. SINGLE OUTLET CIR
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of -
25t
Ex. Occup(OUTLETS OR FIXTURES) BAL @ 109
FIXED APPLNS OR
Ex. Occup. (OUTLET S ( R E S I*D.) E A) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No.__2_f5_'7f Classification
Misc. Wiring 6.25
El I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$
MECHANICAL No. @ FEE
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of'the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
N?!�certify that in the performance of the work for which this
p'ernrit is issued. I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.001
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 relatinq to buildinq construction, and hereby
O)nllV IAI I TA Z/- j2 7-/ 0 N
TOTAL PERMIT FEE
31
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
_1 '
X —Date
tignature of Permitee or Agent
Receipt No. .16 e 7 ;1- S!�
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR O��UBLIC WORKS
B Date
- i-ilding permit expires Date q— t
BUTTE COUNTY DEPAktMENT- OF PUBLIC WORKS
7 C6unty Center Drive,'Oroville, CA.-
THONE: 534-4541 1
MOBILEHONE INSTALLATION SHEET
1.
Owner's name: Ci?_ L C A 5
2.
Installer's name: 4 0, L C 0 U), WC
3.
Is the site.currently under permit? Yes No
(If yes, furnish permit number
dR
Is the site -an existing site? Yes No
(If yes, furnish two (2) plot plans.)
4.
Will the mobilehome be located.at least 5 ft. away.'from
septic tank
And leach fields and
clear of all setbacks and easements? Yes No
(If no, clarify
5.
What is the m.obilehome-.electrical rating? ----------------
0
Amps
6.
What is� the mobilehome site.service rating? -------------
---------
S
7.
What is the mobilehome site circuit breaker rating? --------------
zoo
Amps
8.
Is there any,other electric load fo be served by the fhobilehome
site service? ----------------------------------------------------
Yes V/
No IX
(If yes, identify the load and size':
(Load)
(Amps)
1 9.
What is the mobilehome site gas pipe size? ---------------------
(in.)
10.
What i's the type of -gas service? -------- -----------
Natural—/—/— LPG
:11.
What is the,gas pipe length from,meter or tank to the M'obilehome?
(ft.)
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
Mobilehome Mfr. 5�04W C Setup Model No. 96-) 'Year
Width 74 (ft.)- Length I") (ft.) ' Ex"pand& Size ft.x - ft.
(Draw support details below)
On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation
manual and structural setup sheets (if not o.n.file with. the County of Butte).
SiAnle 0*, Footings (check.one)
11 P1 -,v
Z
07 1. Wood*either
-A
1
r
pressure treated or
Cent
- r
Center Support
fdn-. grade.
r
Supp,rt
p
Footing; Sizes
tF
Loca ionsl
(in.)
2. Concrete pad.
IL
0 (in.
j
3. Other, -specify
Supports (check one)
1. Concrete block
f F(
2. Concrete piers
v in�
3. Steel piers
4. Other, specify
Typical Support
10
A
ft.)
Footing Size
k in.) kin.
(in.)
(in.)(in.)
Max. Pier
Spacing
Pin W.1
ft. in.)
E "-X
T73h'-.)rin-.)
9-1 Max.
Overhang
in.)
*If center piers are other than drawn above,
draw in locations, spacing, and dimensions.
BUTTE COUNTY
BUILDING DEPARTMENT
APPROVED
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS
SPECIAL INSRECT20N REPORT
Owner:
Address:
Tenant:
Building Location:
Type of Inspection requested:
A. P. #
Date of Inspec.tion
Inspector
1. Housing 2. Financing 3. Change of Occupancy
to,
4. Other (specify) V -,e
Present -use of building:
A.
Sanitation (Housing)
1. Water closet:
2. Lavatory:
3. Bathtub -or shower:
4. Kitchen sink:
5. Hot and cold water to fixtures:
6. Heating facilities:
.7. Natural light and ventilation:
.8. *Room -and space requirements:
9. Bedroom window or door for second exit:
10. Infestation of insects, vermin, or rodents:
11. Connection to sewage disposal:
12. Connection to water supply:
13. 'Rubbish and garbage facilities:
14. Comments:
R.
Structural
1. Piers and footings:
2. Floor construction -
3. Wall construction:
4. Ceiling and roof construction:
5. Fireplaces:
6. C ents:
C.
Electrical I
1. Servic� and ground:
2. Receptacles:
3. Fusing:
4. Co ents: A -r
4/64Z
D.
Plumbing oe 4101>0
1. Fixtures connected and vented:
2. Gas water heater:
3.� Gas heatingvents:
4. Comments:
(continued on back)
E. Other
1. Maintenance and repair:
2. Fire hazards:
3. Safety hazards:
4. Weather protection:
5. Underfloor and attic ventilation:
6. C ents:
F. Commercial Buildings
1. Roof covering:
2. * Distance to property lines:
3. Physically handicapped:
4. Restroom floors and walls:
5. Exits:
6. Improvements:
7. Zoning:
8. Comments:
G. Field Problems or Violations
1. Problem or violation (give complete description):
2. What action taken (give complete description):
3. What action rec—ended:
T—/ A. Inform;tion only - file.
B. Hold
for ten
C. Wr\ite letter.
77 D. Other.
(10) days, then write letter.
40�
00
1*1)� 01,
0
e,
Complaint -Date
CE�-Gth4r-Date
BUTTE COUNTY DEPARTMNT OF PUBLIC WORKS
SPECIAL -INSPECTION REPORT
ZONING
Own'er
--r, 't,
1. Piers and -footings:
A.P.
Y2. Floor construction:
Address:
-7!j -.41 j
do
Date of Inspection
5. Fireplaces:
-1JJ
'.T,enant:,
Inspector
C. El ectrical
Building
Location:
2. Receptacles:
3. Fusing:
Type of
Inspection requested.
7-7
Ho'�sing,. 2. Financing
77 1. Change of Occupancy to
4. Work WIO Permit 1.5. other (specify'
-Present use of building:
A;
A. Sanitatic�n (Housing)
1.
Water closet:
.2.
Lavatory:
3.
Bathiub or"'shower:
4.
Kitchen sink:
5.
4ot and c'ola,water to fixtures.*
6. _;-Heating
fac ift'ities:
7.
Natural light and ventilation:
8.
Room and space requirements:
9.
Bedroom window or door for second
exit:
10.
Infestation of insects,' vermin, or rodents:
11.
Connection to'sewage disposal:
-12.
Connection to water supply:'
13.
Rubbish and.garbage facilities:
14.
Stairs:(Rise, Run, Headroom, 1HR,
TolerancesHandrails)
'Commen.ts:
B. Structural
1. Piers and -footings:
Y2. Floor construction:
3. Wall cons truction:
�o7
4. Ceiling and roof construction: -
5. Fireplaces:
-1JJ
6.. Comments:-
C. El ectrical
Service and.ground:
2. Receptacles:
3. Fusing:
4. Comments:
a
Plumbing
1. Fixtures connected and vented:
2. Gas water heater:
3. Gas heating vents:
AL r^mmant-Q.
E. Other
1. Maintenance and repair:
2. Fire hazards:
3. Safety hazards:
4. Weather protection:
5. Underfloor and attic ventilation:
6. Energy:.
7. Comments:
F. Commercial Buildings
1. Roof covering:
2. Distance to property lines. -
3. Physically handicapped:
4. Restroom floors -and walls:
5. Exits:
6. Improvements:
7. Zoning:
8. Comments:
G. Field Problems or Violations
1. Problem or violation (give complete description):
2. What action taken (give complete description):
3. What action recommended:
" A. Information only - file.
" B. Hold for ten days, then write letter.
= C. Write letter.
"..D. Other: