Loading...
HomeMy WebLinkAbout025-220-069R 25-22-69 CHARLOTTE WILLSON �If&ORy -Y J. BALCOM 25-22-6Y 680 Stimpso.n�Rd, Oroville Permit#31-85A(Agricultural Bldg Exemp Fermit#3871-aF;E, utll, 1III) Permit/hay & tractor storage) GAS- 5 33 1 — 8--fj i �Vl'`� • SUPPORT STRUCTURE REQ `ice I_TRUJILLO , Robert 5323B COMPACTION TEST REQ Yt o a S -oda - �� .4114P 512'7E 25-22-6.9 CHARLOTTE W,ILLS_Q)�1� n/s Oro -Gridley Rd. just east of Watts Lars Perini t##630-8 MHI for -3871-.84) Robinson Corner$ I_ue-d (� -/ 4— Y6 - CONTR : Yu -Mar Builders. Inc . , 1018 Live O!a, (new single family) Hwy.,Yuba Cit 25-22-69 ,3 i a—G DAVID WILLSON_ _ ' 6 ' `-b� & f, -70980 Stimpson Rd, _ Oroville 31111 g� Permit#198-87B(reroof/porch/SF) 025-220-069 01-294 PORTER, WANDA & REX�j i 680 STIMPSON RD. OROVILLEa?? _ �__-• CONT: TFIRESFIER HEATING & AIR hY REPLACE 3 WALL HTRS/RF MT AIR 025=220=069'' 05-2028 PORTER/HIGH, REX & WAND l 680 STIMPSON RD, PALE AL Cont: DON'S ROOFING RE ROOF � rr 1 � 1j}(� � � , nye. '��F,Q�yy- � i NOTES RESIDENTIAL PERMIT NO. 025 220-069 05-2028 PORTER/HIGH, REX&, WANDA 680 STIMPSON RD, PALERMO Cont: DON'S ROOFING'' RE ROOF , i i s S a SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER S JOB FINALED (Date) r Signature J=OK 0 = Not OK - = Not Applicable . =Not Readyeady MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s Card B-1 Date 1. Zoning Requirements -Setbacks -Easements Date 2. Soils; Special MH Support Sketch 3. Sewer, Location -Test -Fall -C/O -Concrete - 1. Zoning Requirements -Setbacks -Easements 4. Water, Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or/ /" L "ftJ P LPG 3. Blocking 7. Well Clearance & Disconnect 8. Utility Clearance 10. Roof; Shthg-Roofing 5. Electricity; MH Test 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Date 1. Zoning Requirements -Setbacks -Easements Date 2. Footings; Size -Spacing -Marriage Line 9. Exits 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 11. Verify #'s with Office 6. Water, MH Test-Regulator-Connedoe 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged Card B-1 Date 9. Tie Downs -Type -Installation Cert. Date 10. Exits; Insp.-Sketch Card B-1 11. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg- Frg- Bracing 1. Zoning Requirements -Setbacks -Easements 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 2. Footings; Size -Spacing -Marriage Line 7. Electric 3. Blocking 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 4. Gas; MH Test -Demand -Valve 10. Roof; Shthg-Roofing 5. Electricity; MH Test 11. Ext.; Steps -Doors -Landings 6. Water, MH Test 7. Water and Sewer Connected Card B-1 Date Card B-1 Date 8. Gas and Electricity Tagged Date POOLS (Plans) OK except #'s 9. Exits 1. Setbacks -Easements 10. License Decals 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 11. Verify #'s with Office 4. Elec.; Receptacles and Lighting, Distance -GA 5. Elec.; Pool Lighting; 15 Volts-GFI Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg- Frg- Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance -GA 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-Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope Date 2. Ftg., Main; Soils-Elec. Gmd.-/ /" Ftg. Depth Date 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth Date 4.Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth Date 5.Stemwalls, Main; Steel-Blockouts-Wrapped Date 6. Stemwalls, Garage; Steel-Blockouts-Wrapped Date 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall-Frtting-Test-2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test Date 12. Electric Underground j Date 13. Plenums & Ducts; Clearance -Material -Support -Ins. Date 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation 43. Bearing Walls over Girders & Floor Nailing Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler, Test 87. Water Well, Disconnect, Electrical, Plumbing Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI _ 30. Subfeed Wire Size/ /ga. Cu or AI -AC. Wire Size/ /ga Cu or AI Date 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or AI Insulated Neutral .O Yes O No Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac: Truss-Shting.-Rtng. 49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels-Motors-Mech. Equip. Date 34. Clothes Closet Light -Shower Light -Spa Light Date 35. Smoke Detector Date FINAL (Plans) OK except #'s Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 j Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac: Truss-Shting.-Rtng. 49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door, Swing -Landing -Closure 76. A.C. Dud in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (FF.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor D Yes 83. Following InsUdJDrive 0 Yes O No/Walks O Yes O WPlanters O Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fre Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: BUTTE COUNTY DEPARTMENT,OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO: BP052028 Y • LICENSED CONTRACTORS DECLARATION I hereby affirni.`under,penalty of perjury that I am licensed under Issued Date: 08/01/2005 APN: 025-220-069-000 provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and Site Address: 680 STIMPSON RD PAL effect. / ,���5�, I License Number: I License Class: Map Index: Date: �- 1-125 Contractor:201V! t .; Description: new roof, 27 squares OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Seca°7031.5 Owner: PORTER REX D & WANDA JUNE HIGH Business and Professions Code: Anycity or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 680 STIMPSON RD signed statement that he or she is licensed pursuant to the provisions of OROVILLE, CA the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 95965-9651 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the. applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not, intended or offered for sale (Sec. 7044, Business and Professions Applicant: DON'S ROOFING Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does 4482 PENNINGTON RD such work himself or herself or through his or her own employees, LIVE OAK, CA provided that such improvements are not intended or offered for 95953 sale. If however, the building or improvements are sold within'one year of completion, the owner -builder will have the burden of 530-755-4009 proving that he or she did not build or improve for the purpose of sale.). r O I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor: DON'S ROOFING not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed 4482 PENNINGTON RD pursuant to the Contractors' State License Law.). LIVE OAK, CA ❑ I am Exempt under Article 3 of the Business and Professions Code 95953 530-755-4009 Date: Owner: License #: 816858 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as, provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. Engineer: ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: . Carrier: Total Square Ft: 0 S. F. Policy #: Valuation: $0.00 Census Code: 1p 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 n become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant�-MlDj_ I WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one thousand dollars ($100,000), in addition to the cost of Ihundred compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is h y issue- u r the plicabW provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutions do work' is ted abov for wWdh fees have been paid. ,-- performance of the work for which this permit is issued (Sec 3097 Civ.) Name: By: Date: PERMIT EXPIRES ON: ' — 1 --el - Address: (Date) ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safely Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection puLrr cses. n D AJ p i Ci�� �" L Print Name:ID(V Signature: VSO Date: (01—/ OF. 0 Owner /Contractor 0 Agent for Owner ❑ Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION - Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER P� f � AaT Fi5,Name L LL( Addre s . City 6eia tL 0�4State , , Phone Q TI 'f� D Fax E-mail APPLICANT NAME_ CONTRACTOR Name Name 00 rlA , Address 2 City V 0 Zip St 7 ��5 72 Phone 5-S _ � Fax 6 State License Number E mail Lic. 16 Class APPLICANT NAME_ ARCHITECT/ENGINEER Name \ Address SRA .City State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT NAME_ Name Vo / pr6� Address b tiC City',ll� NFax( SRA n E-mail APPLICANT SIGNATURE X 0 &&� For office use only: Zoning Property Add re�� Flood Zone Cross Street SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApp1SubRgmts.doc PERMIT NO. 01520 BIN # LOCATION AP# D 2 q�;- 22D Property Add re�� City Cross Street WORKER'S COMPENSATION Policy Number k C�GyI Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Page 1 of 2 Description or Scope of Work: 49191!tNejj 30 ` "p- D2ed rgk,�"�e Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. ReceiivOed- by: Amount: Receipt #: � �7 l Date: ,o"5 �I vtner > Total REV 2-24-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information: (Number, Name Style, Classification). El 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530)538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KIFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 05-220-069 0 I -2949 PORTER, WANDA & REX 680STIMPSON RD. C;ROVILLE 'CONT: THRESHER HEATING & AIR IlEPLACE3)WALL FITRS,/RF MT AIR COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 -PERMIT NO. (Rev. 12/96) APPLICAT1,0N AND PERMIT "I ASSES SORPARCELNUMBER 025-220-069 ZONING — BUILDING PERMIT OWNER WDA & REX PORTER TELEPHONE 46-796 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 680 STIMPSON RD., OROVILLE, CA- 95966 CONTRACTOR'S NAME THRESHER HEATING & TELEPHONE 5 4— CONTRACTORS MAILING ADDRESS IO BO -Y -LE LN a CONSTRUCTION LENDER Fireplace LENDERS MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ SUILDINGADDRESS as 680 STIMPSON RD. R Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF .p Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Describe Work: REPLACING (3) WALL HEATERS WITH ROOF MOUNTED HEATING & AIR Gas piping system 1 - 5 outlets 15.00 15.0( . Building sewer 15.00 Mobile Hone I s I G I W I@20.00 PERMIT FEE $ 35.00 ELECTRICAL PERMIT Fling Fee 20.00 Main Service .OA OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class /— ! O./ E Lic. No. C A 7 'Y � OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Main Service 200A TO L000A 46.00NEW CONST. DWELLING OCCUP. OR ADDNS. ( & ACC. BLDS. s0 3.5¢FT_ T. INjON.pESID. MULT.' CRR UT 97.50 POWER APPARATUS 8 SINGLE OUTLET CIR. Ex, Occup. OUTLET OR POCTUREs � � ' � SAL o .so Ex. Occup..OUTLETSRESISID•) EES 5.00 Temporary Service 23.00 Mobile Horne Facilities 20.00 . Misc. Wiring 23.00 • OC PERMIT FEE $ 43.00 MECHANICAL PERMIT Fling Fee 20.00 Heating 15-00 Cooling 1 :11, . Hood 6.50 Ventilation PERMIT FEt $ V.00 Policy Number (The above sections need not be completed if the permit is for work of a valuation ` _ of one hundred dollars ($100) or less.) I� I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers'HAZ. compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X __ ,� _ Date // 1 ti / � f _ Signature of Applicant - ❑ Owner JUp Contractor ❑ Agent f An OSHA permit is required for excavations over 5'0',deep and demolition or construction of structures over 3 stories in heid�it. Mobile Home Installation Fee $ Energy Inspection Fee $ OCCCONST. TYPE TOTAL FEE $128. 40 D. PEES IMP FLOOD CDF PARCEL PD HD ISSI�E �/ is hereby issued under oeutte County Code and/or ind' ated above for which fees have By .' PERMIT EXPIRES ON U 1111 I the applicable provisions Resolutions to do work been paid. Date D /to r f Dete ReceiptNo.57F7f WHITE-O.D.S.-B.. CANARY -ASSESSOR P INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVEILOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 195965 - Telephone (530) 538-7541 ERJT NO. (Rev.12/96) APPLICATION AND PERMIT 6, 02 41 . ASSESSOR PARCEL NUMBER 025-220-069 ZONING . BUILDING PERMIT NnDA & REX PORTER _ T8760-7965 SO. FT. OCC. BUILDING VALUATION . OWNER'S MAILING ADDRESS 68 r CONTRACTOR'S NAME THRESHER HEATING & AIR I TELEPHONE 93zi-9nng CONTRACTORS MAILING ADDRESS 10 HO -Y -LE LN CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS 680 STIMPSON RD. 0 Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Describe work: REPLACING (3) WALL HEATERS WITH ROOF MOUNTED HEATING & AIR Gas piping system 1 - 5 outlets 15.00 15 . 0 Buildingsewer 15.00 Mobile Home ISI GI W1 920.00 PERMIT FEE $'35.00 ELECTRICAL PERMIT Fling Fee 20.00 Main Service z�o.oa.ss 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full for a d effect.pp License Class f-ZU % Lic. No. -7 7 p o OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Main Service 200A TO 1000A 46.00NEW CONST. DWELLING OCCUP. SO OR ADONS. ( i ACC. BLDS. 3.5QFT; PpµR.,. MULTI.OUTLET @7,50 POWER APPARATUS 8 SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES SAL @';50 Ex. Occup.. OuT�rs RE�S,D,DEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 23 . Q PERMIT FEE $ L�3 , QQ MECHANICAL PERMIT Fling Fee 20.00 Heating 15 00 Cooling 0 Hood 6.50 Ventilation PERMIT FEt s 50. 00 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 forth It comply with se ovisions. X Date / / D % Signature of Applicant - ❑ Owner P Contractor ❑ Agent An OSHA permit is required for ext ons over V9 deep and demolition or construction of structures over 3 stories in h ht. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $12 8.00 HAZ. D PEES IMP FLOOD cDF PARCEL PO HD ISSPE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work in ated v or w ch fees have been paid. By Date PERMIT EXPIRES ON Ufa ReceiptNo. 1 / WHITE-D.D.S.-B.D. CANARY-ASSgSSOA4NSPECTOR GOLDENROD -APPLICANT t. PERMIT NO. 3871-84P2 E(MH) PERMIT EXPIRES— OWNER XPIRES OWNER DOROTHY J. BALCOM CONTR. owner ASSESSOR PARCEL 25-22-69 LOCATION - 680 Stimpson 'Rd,.ill�.;`�.,�5 t 1 �t I r i ! OFFICE COPY Address ' Temp. Po - GAS — - } Me er y Date i. Called '- t ELECTRIC Meter By Date ` Temp. Ele..:. Called PG&E Temp. Gas Service Called PG&E JOB FINALED (Date) { Signature I F V = OK 0 = Not OIC – = Not Applicable MOBILEHOMES = Not Ready, ' ' MISCELLANEOUS u• . , Date lVl0B1jL<0ME UTILITIES (Plans) OK except H's Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except p's VZ g Requirements–Setbacks–Easements 1. Zoning Requirements–Setbacks–Easements S ; Special MH Support–Sketch 2. Footings; Size–Depth–Spacing–Connectors Se Location–Test–Fall-C/0–Concrete 3. Decks; Girders and/or Joists–Decking–Bracing–Stairs–Rails 4, ter; Location–Te asement N ded S h) 4, Wood Awn.; Posts–Beams–Rftrs.–Connec.–Shthg.–Rfg.–Bracing Q - VEIricity; Lo ion–Clearan s– –/ / Amp–Concrete 5. Alum. Awn.; Columns–Connections–Splice–Decal–Enclosures – p:/ /"L"ft./ /"Nat.or/ /"L"ft./ /"LPG 6. Carports; Windows–Doors tj 7/.2U1ity Clearance 7. Elec. Card -BI DateCard-BI Date Card -BI Date Card -BI Date Card -BI Date s 'Card -BI Date Card -BI Date Card -BI Date Date MO IL OME INSTALLATION (Plans) OK except q's Date POOLS (Plans) OK except k's 1. Zo g Requirements–Setbacks–Easements 1, Setbacks–Easements Footings; Size–Spacing–Marriage Line 2. Soils; Compaction–Structure Stability as;Test–Demand–Valve–Connector 3. Pool Structure; Steel–Connections–Thickness–Dead Men–Lining 4 ectr' y; MH Test–Crossovers–Breakers–Clearances 4, Elec.; Receptacles and Lighting; Distances–GFI 5.d&9<1 n,; Test–Fall–Flex Connector 5. Elec.; Pool Lighting; 15 volts–GFI 6. er; M est–Regulator–Connector 6. Elec.; Enclosures; Conduit Entries–Terminals–Listed 7. er and Sewer Conne –C/0 to Grade–HD Approval 7. Elec.; Bonding; Metal w/5'–Circulating Equipment–Heater B. Gas apd-Electrilil agged 8. Elec.; Grounding; Equip. w/5'–Circulating Equip.–Pool Lghtg. Boxes–Enclosures–Panelboards–Ins. to Main in Conduit 9. Health Department Approval 9, zits; .–Sketch 1 . of Occupancy 10. Plumb; Cir. Test–Water Supply Test Card B -I ate Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date d i = OK = Not OK = NojApplicatie RESIDENTIAL/(Single and Duplex) = Not Ready Date UNDERFLOOR Plans OK except #'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date FINAL (Plans) OK except q's Card -BI Date Card -BI Date Date PLUMBING (Permit) OK except q's 14. Water Ht.; Vent -Access -Combustion Air 15. Water Pipe; Test & Anchors -Nail Protection 56. 57. 58. Ext. Steps -Door & Sidelight Protection -Landings Smoke Detector Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except q's 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 22. Size Boxes ll No. of Conductors -Stapled 70. Plb., Elec. &Mech. Equip. Listed for Location 23. Romex Installed Close to Edge of Studs & C.J. 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas &Water 72. Insulation -Foam -Looked in Attic ❑Yes 25. 2 Appliance Circuits in Kitchen & Conductor Size 73. 74. Guard Rails &Deck Construction -Post Caps Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral []Yes❑No 75. Following instld.:Drive E] Yes E3 No; Walks ❑ Yes ❑ No; Planters ❑Yes El No 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77, A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opn s. 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B -I Date Card -BI Date 81. 82. Ventilation throughout House Glass Protection Card B -I Date Card -BI Date Date MECHANICAL (Permit) OK except N's 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 31. A.C. Ducts; Insulation & Support 85. Water & Sewer Connected -C/O to Grade -HD Approval 32. 33. Vent Fan; Exhaust above Insulation Condensate Drain & Overflow; Size & Grade 86, Energy Compliance Certificate -Other Certificates 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FRAMING Plans OK except N's Comments at Final: 36. Sills; Proper Material & Anchors 37. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound 38. Bearing Walls over Girders & Floor Nailing 39. Draft Stop in Walls (rat proof) 40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. Header & Beam -Size & Bearing 42. 43. 44. Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rflr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfn_g_._ _ Fireplace Ties or Type A Flue -Fireplace Throat 45. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 46. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing (NOTE: Anentry must be made each time you visit job site) COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS ; 196 Memorial Way, Chico —Phone: 891-2751 7 County Center Drive,,Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone:_ 872-2961, Ext. 57 CORRECTION NOTICE A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. Inspector Date 's ht _r Inspector Date COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS , 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. (lei Inspector i Date — MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA — 534-4541 PERMIT NO. 16 Address or location of mobilehome _� K0 Owner's name Owner's address Insignia or hud number Manufacturer's name Serial number of V.I.N. Year of manufacture2 (Official Approving Installation) (Date) IF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE MOBILEMOME IS INSTALLED ON A FOUNDATION SYSTEM. 5138 White - Owner, Yellow - Installer, Pink - D.P.W. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, CalifoFnia 95965 - Telephone 916/534-4541 • APPLICATi'ON AND PERMIT . PERMIT NO. ASSESSOR P RC L UMBER —0 _ ZONI G — BUILDING PERMIT owN 0 WF to 1/150 yt TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILI AD RESS ✓I O ✓ {' TRACTOR'S NAME CON7RAC TELEPHONE CON ACTOR'S MAILING ADDRESS Fireplace CONST UCTION LENDER n 6 UNKNOWN Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCH OCT CT OR ENGINEER "' Ovk_'P LICENSE NO. Plan Checking Fee $ 1t5 .DC7 Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ � BUILDING ADDRESS C� f s0 if PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 ©✓ Water piping 5.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehomepr Other SPECIFY Building sewer 5.00 Mobile Home S G W 10.00e TYPE OF WORK ,{s New ❑ Addition ❑ Remodel [:1Uti lities ❑ InstallationOther ❑ Describe work: _ e "*1 i j ����._ C� L� Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 60v OR LESS 1000 AMP OR LESS 10.00 Main service EA, ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADONS. ( ACC. BLDGS. 21/20sq ft - CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check One): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Secy—, Business and Professions Code for this reason NEW CONSTR ULTI-OUTLET 2,SOea NON•RESID BRANCH CIRC ITS NEW CONSTR POWER APPARATUS & NON.RESID, (SINGLE OUTLET CIR, 200500 Ex. Occup(o TS OR FIXTURES eAL®30 FIXED APPLNS. OR Ex. OCCUp. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue ami stsai �tinonsenc ol the granting of this permit. Date ��a—((`�}jL�� Signature of Applicant — Owner Contractor 0 Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ t¢ 49Q TOTAL PERMIT FEE $ 00 occu P, GROUP I TYPE OF CONST. PARCEL PD HD ISSUE l� This permit is hereby issued under sions f the Butte County Code and/or worR�(r above for which ECTOR OF PUBLIC BY PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date /a JuN � l//(J If 6 Receipt No. WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT BUTTE COUNTY.DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1, owner's name: 1l () K U 1 H Y. !U", '( Cin, 2. Installer's name: 3. Is the site currently under permit? Yet No _� • ( If yes, furnish permit number OR } Is the site an existing site? Yes / / No / 577 (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 ) S. What is the mobilehome electrical rating? ----------------------- 02j�:ZjLnrrC Amps 6. What is the mobilehome site service rating? --------------------- IoC'1 Amps 7.. What is the mobilehome site circuit breaker rating? ------------- �1Amps 8. Is there any other electric load to be'served by the mobilehome siteservice? --------------------------------------------------- Yes /:Z No Za (If yes, identify the load and size: (Load) (Amps) •9. What is the mobilehome site gas pipe size? --------------------- i p (in.) 10. What is the type of gas service? -------- ---------- ---- Natural 7 LPG 11. What is the gas pipe length from meter or tank to the mobilehome? 12. What is the mobilehome gas demand? -------Alt------------------- (BTU) 1 (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) t�T[+i+��J6.{ MOBILEHOME SUPPORT DATA �� IIf' otfier than single wide, ' Mobilehome Mfr. furnish Setup Model No. Year F idth_ (ft.) Box Length _(ft.) Tagalong or Expando Size ft. x ft. (SHOW SUPPORT DETAILS BELOW) On all mobilehomes manufactured after October 7, 1973; furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of Butte). All center supports measured from front of . mobilehome unless otherwise specified. ) •;� t �' r _ Footings (check one) Single 1'. Wood either pressure treated or foundation grade. (ft.)(in:) (in.) (in.) 2. Other' (specify) Center support Center support locations* footing sizes Supports.(check one) (in.) L Concrete block. .2. Other. (specify) (in.) (in.) E ---Tagalong or Expando,' show support details. (ft.)(in.) (in.) (in.) Typical Support (in. (in.) Footing Size x (ft.)(in.) (in.) (in.) Max. Pier Spacing (ft.)(in.) Max. Overhang (ft.) (in.) (in.) (in.) - -i (ft.)(in..) BUTTE COUNTY BUIMNG. DEPARTMENT *If center piers are other than drawn above, APPROVED draw in. -locations. spacinz. and dimensions. JCOUNTY bF BUTTE --DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 Telephone 916/534,4541 .R 4 • APPLICATION AND PERMIT PERMIT NO. ASSES O PARCEL NUM R ZON NG t BUILDING PERMIT/ Ove R At I c TEL PHONE SQ. FT. OCC. BUILDING VALUA%TION OWNR'S AI ING ADD SS 1nn CON AC OR'S NAME •� W LE ONE - CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER r Al UNKNOWN Total Valuation $ Filing Fee $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER - LICENSE NO. Plan Checking Fee $ ^ ' ' Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING DD E - PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 D Water piping 5.00 LOT NO.SUBDIVISION NAME PARCEL 9MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF ❑ Duplex[]Mobilehome[�Other, SPECIFY Building sewer 5.00 Mobile Home G t0.00e TYPE OF WORK/ New ❑ Addition [:1Remode1 [:1 Utilities lUo1_`Installation❑ Other ❑ Describe work: Permit Fee $ 1 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100v OR LESS 100 AMP OR LESS 10.00 (fit Main servlce'EA• ADO'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ( ACC. BLDGS. t 2/20sq tt CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification ZI, as the owner, or my employees with wages as their sole compen- sation, will do the work,and'the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NCIITS 2.50 ea NON -RESIT R BRACH RCT NEW CONSTR. (POWER APPARATUS &\ NON-RESID. (SINGLE OUTLET CIR. / Ex 20®50: TS OR FIXTURES . Occup(o BAL®30 FIXED APP LNS. OR Ex. Occup. OUTLETS (RESID.) EAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 1 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. E]I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee10.00 Heating Cooling Hood 3.00 Ventilation • Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction,, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all Iiabilities,M,judgments, costs, and expenses which may in any way accrue against s id County in consequence of the granting of this permit. 3�_ / _ � X / Cu Datef Signature of Applicant — Owne4�'Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ t OCCUP. GROUP I TYPE OF CONST, 1171PD HD Issu This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIREC R OF PUBLIC By PE T EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date / Receipt No., WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT • r COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA 95965 Dorothy J. Balcom 680 Stimpson Road Oroville, CA 95965 ,With reference to the above subject: 1� Attached is: Application for permit Building Plans Engr. Calcs Owner -Builder Verification Form OTHER PHONE: 916-534-4541 DATE December 27, 1984 RE: Building Permit Application #3871-84 for Mobilehome Utilities A.P. # 25-22-69 Mobilehome Utilities Installation Sheet Mobilehome Installation Information Sheet Typical Plan Sheet List of Codes Enforced We need the following information: Permit application signed and completed where indicated with all copies returned. Fees,of $ payable to Butte County Treasurer. ,Certificate of Workmen's Compensation Insurance or check exemption statement. -Contractor's License Law information or check exemption statement. Complete plans in , including plot plans. Plot plans in rr{p1e-ate� Structural details in . Complete plans and calcs in by registered engineer or architect. Energy design including Street and drainage improvement plan approval.from Land Development Section (DPW). sets of plans in accordance with the changes marked in red. Sanitation approval from Butte County,Health Department at: 196 Memorial Way,'Chico X_ 7 County Center Dr . , Oroville Skyway,& Elliott Rd.,,Paradise Planning approval.. from Butte County Planning Department, 7 County Center Drive, Oroville, for Completed Owner -Builder Verification form. X_ Recorded copy of deed showing pareel wan lestally created x Recorded copy,of agricultural acknowledgement statement. Should.you have any questions concerning the above, please contact this office. JFG/aj Yours very truly, William Cheff Director of Public Works .F. Glander Chief Building Inspector Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT 85— 402 FOR RESIDENTIAL DEVELOPMENT C.FF1CiAL. BUTTE CC)UNTY-CAl.: .l Section 26-8.1 of .the Butte County Code require's' this ac know ledgemd�hANUS KE4Uf.5T1. �,�, 6�Q � be recorded prior to issuance of a building permit. JAH l i 5, W1��pr- T., '85 The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of thiKEaH`1itdl •U �tiK - ftf �„'�,il,Glt property may be subject to inconveniences or discomfort arising from FEE 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 zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience or disconform from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: �/� aJ ey Date PROPERTY OWNERS' State of 0.11 On this the TD- day of ��crc� 19 �� , before ` ) SS. me, the undersigned Notary Public, personally appeared County of-/-)U—,T-k= ) 77FI V e-�J k C_c, al �m m mmmnm OFFICIAL SEAL' GARY D. FIFE p NOTARY PUBLIC•1'A�IFORNIA PHINCIPAI O{CICE IN BUTTE COUNTY My Commission Expires Mar. 20,1985 LA CI -A-1 L/ Personally known to me...& Proved to me on the basis of satisfactory evidence. to be the person(s) whose fiame(s) /S subscribed to the within instrument and acknowledged that S Nt executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and.official seal. Present A. P. No. i2 1 tary Publik � t` �i.. t..iCterl��f:., � +�i�iy L •--� V., aq,' �Y t ����+��e�n `.�z `•r` � t 7`_��r i� .sj� a��+ rrlf,iA � ': RECORDING REGU[ST[O RI OFFICIAL NECORQs 9U'TE COUNTY-CA1.11, AND WNCN MCCOMDCD MAIL TO Co. -S REESTE) 09 Gdo• `;/`CELE6NORH.Bf.r.:NrTT - , C ��� 1 ' KEt OH9E8 0- l FE f • �'r�"�Y CLERKFEE 2 S4-14400 SPACE ABOVE THIS LINE FOR RECORDER'S USE 4 i �Pp of (gift %B�It�PtitlilrPmade the.th;entieth,,,,,,,, day of ... ...»__»..»„»»».. _»_„.„._._. !! ei ht four .! .......AP.T.b.�....»......_....................... one thousand nine hundred end.„.......RI.»..Y..:............... »».............. li IPlll]PPtI .....Dorothy,„Balcom.................... ............ „.......................................... „.. :I I.......... „......... .._.._..».._»»__..».._»_..„..„. »..».._..».._.._„„......„.. „„... the part.y.. of the first part, �I and__.Cb XJQ. F.g.„N. ..,and „David -f::. Willson, „husband and wife 1 „ ....... »OS.„1471AF..Fenantsf.»..__..„__„ _..»..».„......„»_„_„_..».._.. ........„„»..„„„.......»„. ji _ the partiezfthe second part 1t1t1VS0Pt4: That the party... of the first part, for and in consideration of the love and i affection which „slhe „_.hoes., for the partl.f.soj the second part, do 95.by these presents give and grant unto the parWof the second part, and to t he_iAeirs and anigns forever. �� th..al.». i�il6irXt6�X,1SXX��fX1C7SXxxx�panei„.........„�..•of fandsituare in the ...�_......�.„,...�w Ii......................... »....... ................................... County of..SuS tee.»..» .......»»»»......„..„..».._..„.._„.» State of _.C.alifoxIli.tt................... ................. ..„. , and bounded and described as follows, to wit: All tri% —1 property .ttu\t d t. tot 16. Ilett. ari41.r colony eyes 1, ...haw. a. that eretat. ' tap an file t. the :Atte County Neear.•r•. OKte. 1. Book 7 of Map..t M 34. Wf.e . fortion N the soethw•t 1/4 of 6eetim 15 10 1,tp No 15 North, ese \ner 3 •t, M.D.M. te6 being eortitelarly 1 ..weribeA A\ Nllov.t �tLr»: X4 . ,� Y888 . 1 :a ;�, = ._la of riA {cot 16, t16 f.a to . polot. three lonlwly —4 parallel "th the We” It. of r14 got 16, a mttree of 20B feet to . point a ah. North tlr of lot 16. 7o— pet -13 ala” rf. North 11 r, ee1.5 feet u the Northeeat comer of rte lot, thence SMtherly .lo” :he It.. It— or of rico lot 16, ?U feet to the Noralre.t eases of that eert.1. gre.l d..erltod tt hoot 2605, g 3 S' , ,{ 0 3 w I OKttt.l 14m",* of Mt” Qxnty at Pete 158, thence p..terly Vary the Northerly line of rIJ parcel .n0 tonll wi” on the I,ee heertry . mtettnee of 606 feet to • point, thra south f0' IS' 20� Wet, • mletaa * of 619.24 feet, thenen Vest.r17.A6 perellel. rlth the North time of tot 16, . 4,.taaee of R9.5 feet u a point oa the wet its of tat 16. theme Nort6erlr..lo” -td ve.% 1ta., . maute or 244 feet W the point of M.lmlq, mntAlni” 7 1/2 a»•ease ar t.•a. •1' � � t` �i.. t..iCterl��f:., � +�i�iy L •--� V., aq,' �Y t ����+��e�n `.�z `•r` � t 7`_��r i� .sj� a��+ rrlf,iA � ': RECORDING REGU[ST[O RI OFFICIAL NECORQs 9U'TE COUNTY-CA1.11, AND WNCN MCCOMDCD MAIL TO Co. -S REESTE) 09 Gdo• `;/`CELE6NORH.Bf.r.:NrTT - , C ��� 1 ' KEt OH9E8 0- l FE f • �'r�"�Y CLERKFEE 2 S4-14400 SPACE ABOVE THIS LINE FOR RECORDER'S USE 4 i �Pp of (gift %B�It�PtitlilrPmade the.th;entieth,,,,,,,, day of ... ...»__»..»„»»».. _»_„.„._._. !! ei ht four .! .......AP.T.b.�....»......_....................... one thousand nine hundred end.„.......RI.»..Y..:............... »».............. li IPlll]PPtI .....Dorothy,„Balcom.................... ............ „.......................................... „.. :I I.......... „......... .._.._..».._»»__..».._»_..„..„. »..».._..».._.._„„......„.. „„... the part.y.. of the first part, �I and__.Cb XJQ. F.g.„N. ..,and „David -f::. Willson, „husband and wife 1 „ ....... »OS.„1471AF..Fenantsf.»..__..„__„ _..»..».„......„»_„_„_..».._.. ........„„»..„„„.......»„. ji _ the partiezfthe second part 1t1t1VS0Pt4: That the party... of the first part, for and in consideration of the love and i affection which „slhe „_.hoes., for the partl.f.soj the second part, do 95.by these presents give and grant unto the parWof the second part, and to t he_iAeirs and anigns forever. �� th..al.». i�il6irXt6�X,1SXX��fX1C7SXxxx�panei„.........„�..•of fandsituare in the ...�_......�.„,...�w Ii......................... »....... ................................... County of..SuS tee.»..» .......»»»»......„..„..».._..„.._„.» State of _.C.alifoxIli.tt................... ................. ..„. , and bounded and described as follows, to wit: 0013Pt) r with the tenements, hereditaments, and appurtenances thereunto belonging or appertaining, and the reversion and reversions, remainder and remainders, rents, issues and profits thereof. U70 i&= 1111b tD WOO the said premises, together with the appurtenances, unto the part.1cof the second.part, and tothgi.Theirs and assigns forever.................................................. ......................„..........„......„..................„................................„............................................................. Jti N ttgW N4fr?Vf the par1Y... of the first part ha. 5 ..............».... hereunto set ..............bras:.„... hand..... the day and year fust above written. ,S sned and DcGveied in the Presence of (�l .s ... ................................»......»................»..................................„».....„.... f�I t to fee o w• v G y �....................................................„.... „.......... „... „.. t t i All tri% —1 property .ttu\t d t. tot 16. Ilett. ari41.r colony eyes 1, ...haw. a. that eretat. ' tap an file t. the :Atte County Neear.•r•. OKte. 1. Book 7 of Map..t M 34. Wf.e . fortion N the soethw•t 1/4 of 6eetim 15 10 1,tp No 15 North, ese \ner 3 •t, M.D.M. te6 being eortitelarly 1 ..weribeA A\ Nllov.t 4 = OOL.ICIt37t1 .t the No .1 tomer of rte lot 16. thrt. 6aethefly .fang the We.% Itoe of tot 16. 106 feet to toe tree po1.t of haelM I:4. 1Nwn 6.terly rd parallel with the Northerly line . ,� Y888 . 1 :a ;�, = ._la of riA {cot 16, t16 f.a to . polot. three lonlwly —4 parallel "th the We” It. of r14 got 16, a mttree of 20B feet to . point a ah. North tlr of lot 16. 7o— pet -13 ala” rf. North 11 r, ee1.5 feet u the Northeeat comer of rte lot, thence SMtherly .lo” :he It.. It— or of rico lot 16, ?U feet to the Noralre.t eases of that eert.1. gre.l d..erltod tt hoot 2605, g 3 S' , ,{ 0 3 w I OKttt.l 14m",* of Mt” Qxnty at Pete 158, thence p..terly Vary the Northerly line of rIJ parcel .n0 tonll wi” on the I,ee heertry . mtettnee of 606 feet to • point, thra south f0' IS' 20� Wet, • mletaa * of 619.24 feet, thenen Vest.r17.A6 perellel. rlth the North time of tot 16, . 4,.taaee of R9.5 feet u a point oa the wet its of tat 16. theme Nort6erlr..lo” -td ve.% 1ta., . maute or 244 feet W the point of M.lmlq, mntAlni” 7 1/2 a»•ease ar t.•a. 0013Pt) r with the tenements, hereditaments, and appurtenances thereunto belonging or appertaining, and the reversion and reversions, remainder and remainders, rents, issues and profits thereof. U70 i&= 1111b tD WOO the said premises, together with the appurtenances, unto the part.1cof the second.part, and tothgi.Theirs and assigns forever.................................................. ......................„..........„......„..................„................................„............................................................. Jti N ttgW N4fr?Vf the par1Y... of the first part ha. 5 ..............».... hereunto set ..............bras:.„... hand..... the day and year fust above written. ,S sned and DcGveied in the Presence of (�l .s ... ................................»......»................»..................................„».....„.... f�I t to fee o w• v G y �....................................................„.... „.......... „... „.. t t i FROM BEARING DISTANCE NORTHING TRAVERSE 2 2 N 90 00' 00" E 329.500 10208.000 TRAVERSE - 3 N 60 15' 20" E 419.240 10415.999 TRAVERSE 4 N 90 00' 00" E 190.000 10415.999 TRAVERSE 5 S 00 00' 00" E 208.000 10207.999 TRAVERSE 6 S 90 00' 00" W 208.000 10207.999 TRAVERSE 7 S 00 00' 00" E 208.000 9999.999 TRAVERSE 8 S 90 00' 00" W 675.500 9999.999 INVERSE 9 N 68 50' 16" W 0.004 10000.000 AREA 10000.000 1 `N 00 00' 00" E 208.000 10208.000 2 N 90 00' 00" E 329.500 10208.000 3 N 60 15' 20" E 419.240 10415.999 4 N 90 00' 00" E 190.000 10415.999 5 S 00 00' 00" E 208.000 10207.999 6 S 90 00' 00" W 208.000 10207.999 7 , - S -08--00''-00'-E' \ 208.000 9999.999 8 S 90' 00' 00" W 675.500 9999.999 --�r-~ , . N__&8__ ' -68 50' 16" W 0.004 10000.000 AREA 217,881.959- < ' OR 5.002 ACRES AREA 111V- 11/ 2�_- -2 -2~e'� ����c_ /~- � u/ ^ EASTING ELEVATION PT.# 10329.500 10693.504 10883.504 10883.504 10675.504 10675.504 10000.004 10000.000 10000.000 10000.000 10329.500 10693.504 10883.504 10883.504 10675.504 10675.504 10000.004 10000.000 40' 1 Al 204 L or i/ x �I �z Po.Wr OF ,gC: x 5 c•q c 4 / _ /00 J This set of plans and specifications MUST be kept on the job at ��!! times and it is unlav�f. l make eny changes or al,ierafions on same wifho;.. written permission from the Department of Pub lic Works, County of. Butte, IN Utility connectionsZome,. . me wvithip permit will be required for the installationfa �cg mobilehome. 4 ft. of the mol i either L h f-, WAY A Kor wiT in, a twe 0-79, '5 half of the roadside (left) of the 11-190 mobilehome. pt -ora s .ed . � 4ddiWA) 0 MlNIMUNt� df 7!5 . 5' NOTE:—fill Materials & Workmanship Shall Be ire Accordance with Rccoenized Good Practices and of a quai,fy prescribed for the Specified use in the Uniform Building, Plumbing & Mechanical Codes and the National Electrical Code. �1 7 74 11c. r 20 f III �-- loDec, A.e. 25 -22 -69 Zoe 2605 O.R. 158 3 00 7/ -OPY SOU NTY ARTMENT Roo 1 11vfr30t4 :MOTE: 'phis plat co;npiled from record data and not the result of a field survA.P P R O V E D COUNTY OF BUTTE Department of Public Works 7 County Center Drive Orovil.le -- -534-4541 ELECTRICAL INFORMATION FOR'DE-RATING MOBILEHOMES Owner N � L', tI --kZ 721 Cy e2N ,Location 4 Mobilehome Installation Permit. No., FILL IN. INFORMATION FOR ITEMS 1 THRU 10 Watts 1: Width /� x' Box ' L.ength . 4:� x 3 2, 2 Kitchen.Appliance Circuits ................... = 3,000 3. 1 Laundry Circuit........ ......... .......... = 1,5.00 4. Ovens ........... ................... 5. Cook Stove Top ...........:........: ..... ... Al �p0 6. Hot Water Heater ........:..... 7. Dishwasher &Disposal...........:... _ g u 8. Clothes Dryer ............... ........... ....... 91., Other (specify, i.e., motors, exhaust. fans, etc'.) Sub -total Watts First. 10,000 watts @ 100% .......... ........ .... = 10x.000 Remaining ! watts @'40% ........ .. .......... _ �pci�7 10. Air Conditioner watts. @100%.. _ ) Largest Demand" _ _ j 13 Central Heat.System / "% watts @ 65%. _ q14 1 ) TOTAL DEMAND WATTS REQUIRED .............. �7,� "Demand Watts Required" - 230 ...... AMPS De -rate Mobilehome to ................................... AMPS d V /avte� Quitclaim Deed This Indenture made the ........ �•1f tP.............................................. day of ;i , f Ofl"i;• .. • ...... , , .... • .......... one thousand nine hundred and ... HI—KY ?0: P. ........................ Between....;u�toT;tY.......:,;..cu....................................................................... ................................................................................... the part.. Y.. of the first part, T T\ •t f T;, T and.. .: '17 �.�Y:.• t,..':..`�,..:LGT ........ i �:;.n.................................................... ... ................................................................................ the part. ".. of the second part, Witnesseth: That the said part_....... .. of the first part, in consideration of the sum of. Tt,'ra"r i 7: ^t.... i (� "'.'^ . .T`•.^.." l- n ..tri .. 0!i . dollars, i .\1 :iu... 'J r.. I...... .. .. �y .. LJl ✓ WI.i h .� OJ OU - lawful money of the United States of America, 6111..3 s. • been. p -id . • • . • . • . • . , in hand,�Yid by the part..! -...S .... of the second part, the receipt whereof is hereby acknowledged, do.. T ....... hereby release and forever QUITCLAIM unto the part .. iL'.... of the second part, and to . TIiEIR heirs and assigns, all th ......... certain lot .......... piece .......... or parcel .......... of land situate in the...CI1�:F ,��ROVIiL C BUT'LE County of ...... BUTI. ........................................ : State of ... :\L?rCRNZA................................ . and bounded and described as follows, to -wit: See Exhibit "A" Together' with the tenements, hereditaments, and appurtenances thereunto belonging or -appertaining, and the reversion and reversions, remainder and remainders, rents, issues, and profits thereof. : To have and to Mold the said premises, together with the appurtenances, unto the part . of the second part, and to ..`."` I": heirs and assigns forever. In Witness Whereof the part..Y ....... of the first part ha ....v..... executed this conveyance the day and year first above written. Signed and Delivered in the Presence of This Coc lis only a general torte which may be prom for use in srmole transactions and o noway acts. a:s:ntenoed to act. as a subsidute for the advice of an anomey. The printer does not make any warranty. either . esaess or knphed. as to the legal validity of any prows:on or the suitability of these tams :n any specific vansaihon. Cowderr's-.Fprm-No-490_--QUITCLAIM:DEED—.Short,Forrrr—iRev:9$3)- _..._..___._..._..._...._— 0 EXHIBIT "A" All that real property situated Lot 16, Watts Gridley Colony 1o. 1, as shown on that certain map on file in the Butte County Recorders Office in Book 7 of Maps at Page 34, being a portion of the South- east 1/4 of Section 35, T18N,R3E, M.D.M., and being more particularly described as follows: ' __Beginning at the -Southwest corner of said Lot 16, thence East, a distance of 675.3 feet to the Southwest corner of that certain parcel described in Book 2605, Official Records of Butte County at Page 158, thence, North a distance of 208 feet. Thence, East a distance of 208 feet to a point. Thence, North a distance of 208 feet to a point. Thence, West a distance of 190 feet to a point. Thence, South 601 15' 20" West, a distance of 419.24 feet to a point. Thence, West a distance of 329.5 feet to a point in the West line of said Lot 16, thence, South a distance of 208 feet to the point of beginning. Containing 5.00 acres. Cow, LAND OF N1ATURAL WEALTH AND' EAU TY sem` PLANNING COMMISSION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965-3397 .. PHONE: 534-4601 Dorothy J. Balcom, January 2`8; 1985- 680 Stimpson Road Oroville, Ca. 95965 -CERTIFIED MAIL Re: Use Permit, AP 25-22-69 Dear Ms. Balcom; Enclosed is your validated Use Permit.No.. 85=27 to allow a mobile home as a temporary second dwelling on property zoned -A-5 located at the northeast corner of Watt Lane and Stimpson Road in the Robinson`s Cor-- ner area south of Oroville... Should you have any questions, please feel free to contact this office.. Sincerely., 7 ' c1 /B. /Kir her B . �A. c Director of Planning BAK:lr .Enc. cc: Department of Public Works (2) Environmental Health Departmnt of Forestry, BUTTE COUNTY PLANNING COMMISSION USE PERMIT PAGE 1 OF 2 PAGES January 28, 1985 DATE (Registered mail receipt)' 85-27 PERMIT NO. • AP 25-22-69 ASSESSOR'S PARCEL NO. Pursuant to the provisions of the Zoning Ordinance of the County of Butte and the special conditions set forth below: Dorothy J. Balcom is hereby granted a Use Permit NAME in accordance with application filed: 11-13-84 to allow a mobile home as a temporary second dwell 'in€date ora. proparty zoned A-5 located at the northeast corner of Watt Lane and Stimpson Roach in the Robinson's Corn -or area saute. of Orovi.11e, 1 Failure to comply with the conditions specifies herein as the basis for approval of appli- cation and issuance of Permit, constitutes cause for the revocation of said permit in accor- dance with the procedures set forth in the Butte County Zoning Enabling Ordinance. 2. Unless otherwise provided for in. a condition to a use permit, all conditions must be com- pleted by the permittee within 12 months of the delivery of the countersigned permit to the permittee. 3. If any use for which a use permit has been granted is not established within one year of the date of receipt of the countersigned permit by the permittee, the permit shall become null and void and reapplication shall be required to establish the use. SPECIAL CONDITIONS: 1. Occupancy of the mobile home, is limited to a close friend or relative by blood or marriage. 2. No rent is to be charged to the occupant of the mobile hone. 3. The tomporary mobile home is to be connected to the existing septic tank . and water wolf. 4. The nobtle home is to be a temporary use on the property pursuant to the roquirernents of Section 24-y304 of the Butte County Code. 5. The Use Perwi.t shall expire two years from the date of issuance of the Use i errtit, Upon application, the Planning Commission may gaunt an extension of the Use Pennit not exceeding one year. I hereby declare under penalty of perjury that I have read the foregoing conditions, that they are in fact the conditions which were imposed upon the granting of this use permit, and that I agree to abide fully by said conditions. NOTE: Issuance of this Use Permi and Health Department permits i any other requirements.-------' CC: Health Department ,,,..Department of Public Works (2) Fire Department Applicant rive requirement of obtaining Building ing construction, nor does it waive Chairman of Planning Commission ' USE PERMIT PAGE OF 2 PAGES BUTTE COUNTY PLANNING COMMISSION Janua u 28, 1985 DATE (Registered mail receipt)' • 3S-27 • • PERMIT NO. O N AP 25-22-69 ASSESSOR'S PARCEL NO. Pursuant to the provisions of the Zoning Ordinance of the County of Butte and the special conditions set forth below: Dorothy J. Balcom is hereby granted a Use Permit NAME in accordance with application filed: 11-13-84 to allow a mobile home as a temporary second dwellindate on property zoned A-5 located At thn northeast cernor of Watt Lane and Stirnson Road in the Robinson's Corner area south of. Oroville. 1 Failure to comply with the conditions specifies herein as the basis for approval of appli- cation and issuance of Permit, constitutes cause for the revocation of said permit in accor- dance with the procedures set forth in the Butte County Zoning Enabling Ordinance. 2. Unless otherwise provided for in a condition to a use permit, all conditions must be com- pleted by the permittee within 12 months of the delivery of the countersigned permit to the permittee. 3. If any use for which a use permit has been granted is not established within one year of the date of receipt of the countersigned permit by the permittee, the permit shall become null and void and reapplication shall be required to establish the use. �J SPECIAL CONDITIONS: 6. _ In the event that the applicant who is residing within the mobile home or the conventional residence, for any reason, moves to another location or is deceased, then, in that event, the Use Permit granted herein shall automatically expire and the mobile home shall be removed within rine hundred twenty (120) days. In ::. -�i72*event the mobile home is not romoved within one hundred twenty (120) stays pursuant to the terms cif the Use Permit, the County shall remove tho mobile homy: and store it at the owner's expenso. 7. Meet the requirements of tno Building Division of the Butte County Department of Public forks. 8. Applicant must also comply with all other applicable State and local statutes, ordinances and regulations.. I hereby declare under penalty of perjury that I have read the foregoing conditions, that they are in fact the conditions which were imposed upon the granting of this use permit, and that I agree to abide fully by said conditions. Dated: Applicant NOTE: Issuance of this Use Permit does not waive requirement of obtaining Building and Health Department permits before starting construction, nor does it waive / any other requirements. CC: Health Department - I Department of Public Works (2) Fire Department Chairman of Planning Commission 2, WA T 15 o C) 47� F is b 7.50 14.54,'- 40' 624 40 Plllt.Qce:k. L-OCATION FILE No. BUTTE COUNTY PLANNING COMW,SSION I HEARING DATES- 20 5 APPLICANT: -Pc%zan-!o -&/V-clot-q OWiN"r-R:--(- �"'PWI-0,7rTe 0.1". L"'o m IREQUEST*oc--i�:- PE4zkAll-i TO EXISTING ZONE. A5 SCALE A L :s -4-0.-,)D ___ - - - , I It i- ... ::�:.`lr• ` r+..�.w..w�.rw�.r2r-...�-wr..r.r; - r+wenr�w»..•rnwwer x _. _�.....��a.: _ ._ i ww^�,:'.......�.i.,:' •t 753'. E ©ROy ,.LE G R I D L E Y -iIG N.iN': b/ 14 3y. ---- - - - -_ A 1 I l �— 9.7A0. r i IZ74 ! 3 6ACy 19 4AG !} 13 IC�r94a�2 19 sac. i COZ r 40 P�2CE:L- L oc,aTtoN --- i BUTT'E COUNTY PLANNING HEARING DATES- 20 ►JOr. & - FILE No. COMMISSION APPLICANT 0WN'R PEQUEST=vs+, P �" t -t TU A�� ortit EXISTING ZONE. F 5 ' -re4"kfo12X!;:''/ :S (-o?3D SCALE tr`= Boo, '57) o O to G m b/ 14 3y. ---- - - - -_ A 1 I l �— 9.7A0. r i IZ74 ! 3 6ACy 19 4AG !} 13 IC�r94a�2 19 sac. i COZ r 40 P�2CE:L- L oc,aTtoN --- i BUTT'E COUNTY PLANNING HEARING DATES- 20 ►JOr. & - FILE No. COMMISSION APPLICANT 0WN'R PEQUEST=vs+, P �" t -t TU A�� ortit EXISTING ZONE. F 5 ' -re4"kfo12X!;:''/ :S (-o?3D SCALE tr`= Boo, 41, 210 5- (63 z� 2 7 r. 3 IF. -2.6 1553 3 40. O'A 1 .7G R 1, r) L EY LOCATION G Hw A.,; FILE No. BUTTE COUNTY PLANNING COMMISSION' HEARING DATES- :zc -Oe-6, � N APPLICANT:,-pr--,i2jDr-r.,'-1 OWNER: V6;-lom I /i REQUEST: 0 c--+�- ?E? -EXISTING ZONE. A.5 SCALE I Fts a .. ("pl J.; OL ON, Za 615. 9 91 41, 210 5- (63 z� 2 7 r. 3 IF. -2.6 1553 3 40. O'A 1 .7G R 1, r) L EY LOCATION G Hw A.,; FILE No. BUTTE COUNTY PLANNING COMMISSION' HEARING DATES- :zc -Oe-6, � N APPLICANT:,-pr--,i2jDr-r.,'-1 OWNER: V6;-lom I /i REQUEST: 0 c--+�- ?E? -EXISTING ZONE. A.5 SCALE I Fts a .. AP#s-a�-�C OWNER PERMIT MH UTIL.CLEARANCE DATE INSPECTOR ELECTRIC GAS Support Struc. Compaction Test Re . iervice Size Other Load Type Pipe Size Length YES NO YES NO COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 AGRICULTURAL BUILDING EXEMPTION PERMIT PERMIT NO. j 3 Z5 Agricultural building is defined as follows: Agricultural building is a structure designe and constructed to house farm implements, hay, grain, poultry, livestock, or other horticulutral products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place used by the public. ASSESSOR PARCEL NO. ZONING ,a-- /o� OW /f &0 PHONE NO. I N 6 ea. 11 r1l C�6 Q 01 -- OWN R'S ADDR S - 1,90 D P ki ✓' LOC TION OF BUI ING © t el - PI In ro USE OF BUILDING r Stov"ag!e SIZE OF STRUCTURE x_ lcr ® SQ. FT. TYPE OF CONSTRUCTION: WOOD FRAME --k STEEL CONCRETE OTHER (Specify) TYPE OF SIDIN''GI111 ROOF COVE 1O )lr'- 7REPE �ta' W 14 0 In C d" f` ESTIMATED COST OF CONSTRUCTION $ AG Buildings shall comply with the building front, side, and rear yard requirements of the applicable County Ordinances as follows:, "-'^ k— e--1FRONT Sb' SIDES REAR S - AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a mobilehome, and 23 feet from a commercial building. AG Buildings greater than 1.000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a mobilehome, and 40 feet from a commercial building. I declare under penalty of perjury that the building will be used as stated above and the proposed use conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Department of Public Works and will obtain any necessary permits, inspections, and approvals to comply with the requirements in effect at that time and before occupancy. Date � � " s— Signature of OwnerOi�4�N4& 4�&� Permit Fee - $25.00 The above described AG Building is exempt from a building permit. Receipt No. ��%�--� Director of Public Works By Date—�`�''��^ White - DPW, Yellow - Assessor, Pink - B. I., Goldenrod - Appllcant' .. r •kr •.F ��. ' `:1t'3 � r%'`�""�- �� r-�t�•,.^�.�-...r ti,..�.,, �/l..� ,,.w ..�-... f� ...�-a; r; "�"'`��_ �� PermrtIP198-87 bav,Ld' Willson w 680 StIimpson''Rd,' Oro {t f I I COUNTY OF BUTTE - DTMENT OF PUBLIC WORKS �7•County Center Drive - Oroville, orJa 95965 - Telephone 916/534-4'Si't- APPLICAT AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER Z ING .� BUILDING PERMIT OWNER r TELEPHONE S0. FT. OCC. BUILDING VALUATION \ OWNER'S MAILING ADDRESS CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee -_.. $ Er.� ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ /v Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ - BUILDING ADDRESS _ Permit fee - $ �• PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE ❑ Duplex❑ Mobilehome❑ Other 411PSPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00 ea TYPE OF WORK New❑ Addition❑ Remode;Q Utilities❑ Installation❑ Other❑ Describe work: A-42/1 � TJ � "Y_�. Yr"�+L Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 110.00 Main service Quo AMP ORV OR LESS10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under peralty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ontract- ors. ors.(Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.e , ) h¢sgft New CONSTR.(A MULTI -OUTLET ODUTLET NON.RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS a (SINGLE OUTLET CIR. Ex. Occup(OU—LETS OR FIXTURES 8AL@ALe30 EX. Occup. FIXED OUTLETS P(RESID )REAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments; costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X ` • ' "' a / .. r Date f /fin _, Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee TOTAL PERMIT FEE $ __ --,•� `NO 1ISSUE occU P. CONST.TTPE FLOO=D PD This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS J Date Receipt No. / WHITE-D.P.W.. YELLOW-ASSF330R. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT P IT / �m�- N ASSESSOR P RCEL NUMBER ,�- ZOWING BUILDING PERMIT owN y/o - TELEPHONE S0. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee einzow $ ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS S Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2,00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each gas.water heater or vent 5.00 USE OF STRUCTURE S DuplexMobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W O.00ea TYPE OF WORK New ❑ Addition ❑ Remode'l;Q Utilities ❑ Installation[] Other ❑ Describe work: /CLC/�QQ�1� ��--Z, C/ -"z Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification Q i, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ontract- ors. ors.(Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST.(DWELLING OCCUP.tr , OR ADDNS. ACC. SLOGS. �Osq ft NEW CONSTR. MULTI -CUTLET NO N•R ESID BRANCH CIRCUITS/ 2.50 ea POWER APPARATUS tr (SINGLE OUTLET CIR. ) Ex. Occup(ourLETs OR FIXTURES BALD 30 9ALe30 Ex. ()CCUp. OUTLETS ((RESID,)FIXED APPLNS.REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. �yirin 15.00 9 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. 1 shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation pernit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all li lilies, judgment costs, and expenses which may in any way accrue agai st said � ou ty sequence of the granting of this permit. r� Date `—� 3 —7t �r� Signature of Applicant — Owne� Contractor Q Agent F1work An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ occ up. CONST.T7 I I FLOOD PARCEL PD I NO I ISSUE This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS ^ By'Cnf// Date/> PERMIT EXPIRES Date -3� Receipt NO. T7?Z�7 WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - Department of Public Works 7 County Center Driwe,-Ofoville, CA 95965 Phone: 916-534-4541 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) �. 2. I (have/have not) ' signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction:` Name -77 Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name !::-w_ Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons'to provide the work indicated: Name Address Phone Type of Work Signed: Property Owner Socialecurity Numbe — Date p? .1?,p NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code: This verification must be completed and returned to our office before we are per- mitted to issue the permit.