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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- ` � , � " � � � ' - " ^ - i ' / ` , ' � � ' - " - ` ' / ` , Z-27 ckq CW2 _-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 T 01" s - Ilk TY 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" s - Ilk TY 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: