HomeMy WebLinkAbout025-340-022t
So
!-340-022 OG-04S0
.LEAN, CESENA
'7L') MARIAH
LANE, OROVILLE
-NT: D AND A CONST��
-. p
H PERM IIID
RECORDING REQUESTED BY:
AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE CA 95965
2006-00&58410
Recorded I
Official Records I
County of I
Butte I
CANDACE J. GRUBBS I
County Clerk-Recorderl
I
I
01:SIPN 15 -Dec -2006 I
SPACE ABOVE THIS LINE FOR RECORDER USE ONLY
REC FEE 10.00
COWORh1£D COPY 1.00
Cil
Page 1 of 2
NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH,
INSTALLATION ON A FOUNDATION SYSTEM
Recording 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 occupancy for installation 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 deemed to give
constructive notice as to its contents to all persons thereafter dealing with the real property.
LILLIAN CESENA
BUTTE COUNTY BUILDING DIVISION
REAL PROPERTY OWNER/LESSOR
LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY
5390 PALM GROVE COURT
7 COUNTY CENTER DRIVE
MAILING ADDRESS
MAILING ADDRESS
SAN JOSE BUTTE CA 95123-1754
OROVILLE BUTTE CA 95965
CITY COUNTY STATE ZIP
CITY COUNTY STATE ZIP
580 MARIAH LN.
06-0480 (530) 538-7541
INSTALLATION MAILING ADDRESS, IF DIFFERENT
B ILDING PERMIT NO. TELEPHONE NUMBER
OROVILLEBUT]"E CA12/12/2006
CITY COUNTY STATE ZIP
SIGNATURE OF LO pGENCY OFFICIAL DATE
SAME
NONE
UNIT OWNER (if also property owner, write "SAME"
DEALER NAME (if not a dealer, write "NONE")
SAME
NONE
MAILING ADDRESS
DEALER LICENSE NO.
SAME
CITY COUNTY STATE ZIP
UNIT DESCRIPTION
MARLETTE 2005 RIVERCREST-9599
MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER
HER0239130RA/B 44'X 268" ORE468454/5
SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S)
REAL PROPERTY LEGAL DESCRIPTION: SEE ATTACHED
ASSESSOR'S PARCEL NUMBER: 025-340-022
HCD FORM 433(A) REV 8/91
WHITE —County Recorder CANARY — HCD PINK — Applicant GOLDENROD— Building Dept.
Co
,rr
THE LAND REFERED TO IN THIS REPORT IS SITUATED IN THE STATE OF CALIFORNIA, COUNTY
OF BUTTE, ANS IS DESCRIBED AS FOLLOWS:
PARCEL I:
PARCEL.1, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE
RECORDER OF THE COUNTS- OF BUTTE, STATE OF CALIFORNIA, ON SEPTEMBER -23, 1998, IN
BOOK 144 OF MAPS, AT PAGE(S) 67 AND 68.
RESERVING THEREFROM A 60 FOOT RIGHT OF WAY AND PUBLIC UTILITY EASEMENT AND A 20
FOOT PUBLIC UTILITY EASEMENT AS SHOWN ON SAID MAP.
ALSO RESERVING THERFROM A NON-EXCLUSIVE EASEMENT FOR PUBLIC UTILITY PURPOSES OVER
THE SOUHTERLY 30 FEET; AS SHOWN ON SAID MAP.
PARCELII:
A 60 FEET RIGHT OF WAY AND PUBLIC UTILITY EASEMENT OVER PARCELS 1 THRU 3, AS SHOWN
ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY
OF BUTTE, STATE OF CTJ IFORNIA, ON SEPTEMBER 23, 1998, IN BOOK 144 OF MAPS, AT
PAGE(S) 67 AND 68.
EXCEPTING THEREFROM ALL THAT PORTION LYING WITHIN THE BOUNDS OF PARCEL I, DESCRIBED
HEREIN.
PACERL III:
A NON-EXCLUSIVE EASE' -LENT 30 FEET WIDE FOR PUBLIC UTILITIES PURPOSES LYING
NORTHERLY OF, RUNNIN3 PARALLEL WITH AND ADJACENT TO THE SOUTH LINE OF PARCELS 1,2,
3 AND 4, AS SHOWN ON T_3AT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER
OF THE COUNTY OF BUTTE, STATE OF CALIOFNRIA, ON SEPTEMBER 23, 1998, IN -BOOK 144, AT
PAGE(S) 67 AND 68, FROM THE EAST LINE OF SAID PARCEL 4 TO THE WEST LINE OF SAID
PARCEL 1.
THIS EASEMENT IS APPURTENANT TO AND SHALL INURE TO THE BENEFIT OF SAID PARCELS 1,
2, 3 AND 4, AND APPLIES TO ALL SUCCESSORS OR ASSIGNS OF SAID PARCELS.
EXCEPTING THEREFROM ALL THAT PORTION LYING WITHIN THE BOUNDS OF PARCEL I, DESCRIBED
HEREIN.
PARCEL IV:
A NON-EXCLUSIVE EASEMENT FOR ROAD AND PUBLIC UTILITIES OVER A PORTION OF SECTION 1,
TOWNSHIP 18 NORTH, RANGE 3 EAST, M.D.B. & M. DESCRIBED AS FOLLOWS:
BEGINNING AT THE EAST ONE-QUARTER CORNER OF SECTION 1, TOWNSHIP 18 NORTH, RANGE 3
EAST, M.D.B. & m.; THENCE NORTH 83 DEGREES 46' 06" WEST, 783.19 FEET TO THE TRUE
POINT OF BEGINNING FOR THE HEREIN DESCRIBED EASEMENT, SAID POINT DEING ON THE
NORTHERLY LINE OF PARCEL 4, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE
OFFIE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON SEPTEMBER 23,
1998, IN BOOK 144 OF MAPS, AT PAGE(S)67; THENCE NORTH 86 DEGREES 24' 53" EAST,
663.51 FEET; THENCE NORTH 86 DEGREES 02142" EAST, 80.67 FEET; THENCE NORTH 70
DEGREES 31' 41" EAST, 4..66 FEET TO'A POINT ON THE WESTERLY LINE OF LONE TREE ROAD;
THENCE SOUTH 00 DEGREES 37' 50". EAST ALONG SAID WESTERLY LINE, 8.37 FEET TO THE
NORTHEAST CORNER CF SAID PARCEL.4; THENCE SOUTH 86 DEGREES 55' 01" WEST ALONG SAID
NORTHERLY LINE OF SAID PARCEL 4, 758.26 FEET.
}
Q2 -YT,-U22' f U6-0480
LTLLIAN, CESENA
'w 1_MARIAH LANE, OROVILLE
sJ CONT: DAND A CONST re.
N O T E S 11 7 iCM/H_P.ERM FND ( WI :
— f
RESIDENTIAL
1
APN: Permit No.
T Owner.
Site Address:
Contractor-
Type
ontractorType of Permit_
i'
OFFICE
� COPY
/j
` Address' '90 /Y [� i'G141
1 GAS
,j Meter.By ( —D�t v• V
ELECT n ��
Mete,r ByDatel //�
irz ow
B
Fire Suppression System permit and
FINAL INSPECTION from H.C.D. Stat
of California REQUIRED before Butte
County Building Division will final MH
permit. Provide verification of H.C.D.
final of fire sprinkler system.
SPECIAL CONDITIONS
CHECKED BY
SRA
�LOOD CERTIFICATE EQUIRED
FIRE SPRINKLERS REQUIRED
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
ENCROACHMENT PERMIT
REINSPECTION FEE PAID
ENV HLTH CLEARANCE
Manufacturer�o,;r i -t , � �--�
Date of Manufacture Z- Z c�, S
Serial Number(s)c5(,,r- i -A (C
HUD Number(s)C4QC ii gam��," i_
DATE JOB FINALED:
_ ' • SIGNATURE:
a .
OFC
- MANU'FACTU.RED HOMES
M.ISCELLAN.EO'US
DATE PERMANENT FOUNDATION Lj SOFT -SET
DATE D E C KS -C O V E R S`C A R P O R T S `GARAGE S
1 Zoning -Setbacks -Easements
f 2 Ftgs; Soils-Sz-DpthSpacing-CnnctrsSteel
oning-Setbacks-Easements
2 of s; Special MH Support Sketch
3 Se we • octn-Test; Fall/C/O-Concrete
3 Decks, Girders/Joists-Dcking-Brcing
r; Loctn-Test-Easement Needed -Regulator
Stairs-Guard/Handrails
y_ 5 Elec fn-Clrncs-Grnd Amp -Concrete
- & 6d Gas; Loctn-Test-Wrap . Hat[] or: LPQ
Inch Sz Ft Lngth '
4 Wood Awn; Posts-Beams-Rftrs-Cnnctrs-Shthg
Frmg-Brcng
If 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs
YBfkng; Sz-Spacing-Marriage Line
! 6 Carports; Wndws-Doors
8-1fa—s; MH Test-Demand-Valve-Cnnctr
S 7 Electric
MH Cntnty Test-Crossovers-Breakers-Clrncs
8 Frmg; Sills-Anchrs-Studs-Rftrs-Trusses
10 Drain; MH Test -Fall -Flex Cnnctr
i 9 Siding; Nailing -Veneer -Stucco -Lath
11 Wtr ewer Connected -to Grade
r0�=12 and Electri ' agged
13 a Downs Q Foundation �
.I 10 Roof; Shthg-Roofing
+'� 11 Ext; Steps -Doors -Landings
12 Braced Wall pnls
Exits
IS CeCerrt of Occupancy
16 HUD Label/Insignia Numbers Serial Numbers
o
I
} DATE IPOOLS
4 1 Setbacks -Easements
i 2 Soils- CompactionStructure Stability
'
} 3 Pool Structure; Steel-Cnnctns-Thickness
{ Dead Men -Lining
! 4 Elec Rcptcls/Lting; Distance-GFI
5 Elec Pool Lting; 15 volts-GFI
6 Elec Enclsrs; Conduit Entries -Terminals -Listed
7 Elec Bonding; Metal w/5'-Crcltng Eqp-Htr
8 Elec Grndng; Eqp w/S' Crcltng Eqp-Pool Ightg
B6xes-Enclsrs-pn1boards4nsultn to Main Conduit
9 Health Dept Apprvl
10 Plmb; Cir Test-Wtr Supply Test
( 11 Lt Niche
12 Enclsr, Fencing -Alarms
�rn) ,/ /
CN `'► L) "�
•: U t b b
I 13 Bonding, Diving board or Slide
o�2 `mac
1
Pool Drawing
r
i
4
f1
,� t
OK
= Nw OK
RESIDENTIAL (SIngle- & Duplex)
DATE JUNDERFLOOR
1 Zoning -Setbacks -Easements -Flood -Slope
2 Ftg Main; Soils-Elec Grnd Ftg Dpth
3 Ftg Garage; Soils-Steel-Elec Grnd Ftg Opth.
4 Ftg Porches/Decks; Soils -Steel Ftg Opth
5 Stemwalls Main; Steel -Blackouts -Wrapped
6 Stemwalls Garage; Steel-Blockouts-Wrapped
69 Hold Downs and Special Anchrs
7 Slab, Steel Wrapped
8 Piers-Frplc Ftg-Steel
9 DWV; Fall -Fitting -Test -2 -way C/0 -Sewer Test
10 UF, Gas Pipe; Sz Anchrs-Sz Test
11 Wtr Pipe; Test-Anchrs-Rgltr-Service Test
12 Elec Undrgrnd
13 Plenums & Ducts; Clrnc-MaterialSupport-Insultn
14 Girders -Si lls-Anchr BoltsJoists-Vnts-Cripples
15 Acc & Vntltn
16 Insulation
DATE IFRAMING
17 Sills Proper Materials & Anchrs
I Walls Studs -Nailing Spacing & Braces-PlatesSound
19 Bearing Walls over Girders & fir Nailing
20 Draft Stop in Walls (rat proof)
21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
22 Headers & Beams-Sz & Bearing
23 Hangers -Post Caps-Anchrs-Cnnctns
24 Ceiling Joist-Rftr Ties -Purl in -Roof Brac-TrussShthg
25 Frplc Ties or Type A Flue-Frpic Throat Clmc
26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles
27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions
28 Garage Fire Prtctn Framing -RC Channel
29 Prprty Line Firewall & Opngs
30 Ext Doors -One 3' -Check Garage 3rd Story, 2 Exits
31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn
32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs
33 Siding -Nailing Veneer
34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc
35 Glazing Area -Glass Prtctn-SkyUs-Plastic
36 Shear Walls-, Nailing -Bolts
37 Brace Int/Ext Wall pnls
3B Insultn-Walls-Ceilings
39 Infi 1 tration-Walls-W ndws
o'er m o'er m
DATE JELECTRICAL
40 Fxtr & Trnsfrmr Clmc4ns Prtctn
41 Elec Rcptcls Spacing-Lts & Switches at Doors
42 Sz Boxes & No Of Cndctrs Stapled
43 Romex Installed Close to Edge of Studs & CJ
44 Eqp Grnd made up w/Mech Fstnrs
45 Grndng Electrode Bond Gas & Wtr
46 2 Appinc Cires in Ktchn & Cndctr Sz GFI
47 Subfeed Wire Sz Ba ❑ CU or [:JAL
AC Wire Sz sa ❑ CU or ❑AL
48 Range Circ ga ❑CU or❑AL
Oven Circ ga ❑ CU or ❑ AL
Insulated Neutral ❑ Yes ❑ No
49 Service -Riser Cndctrs & Grnd Main Dscnnct
50 Eqp Clrncs pnls-Motors-Mech Eqp
51 Clothes Closet Lt-Shwr Lt -Spa Lt
52 Smoke Detector
DATE IPLUMBING
53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle
54 Wtr Pipe; Test & Anchr-Nail Prtctn
55 DWV; Test Fittings & Anchr Nail Prtctn
56 Shwr Pan; Test, First flr-Tub Acc
57 Test Tub & Shwr, 2nd flr - Tub-Acc
58 Gas Pipe; Sz & Anchrs
59 Fire Sprinkler; Test
60 Yard Gas Piping
DATE IMECHANICAL
61 AC Ducts Insultn & Support
62 Vent Fan, Exhaust abv Insultn
63 Condensate Drain & Ovrflw, Sz & Grade
64 Furnace -Vent Acc-Comb Air Rtrn[Vent 115 Outlet
65 Attic Acc & Pltfrm if Furnace in attic
DATE IFINAL
66 Ext Steps -Door & Side Lt Prtctn-Landings
67 Smoke Detector
68 Furnace Vnts-Cirnc-Comb, Air-Cnnctr
In Garage; abv-flr-Ducts-Mech Prtctn
69 Bedroom Exiting
70 GFI & Bath Fxtrs & Tub Acc-Spa
71 GFI Arc Fault
72 Elec Trim & Subpnl, Breaker Sts & Labels
73 Stairs, Guard/Handrails
74 Frplc or Stove, Clrnc-Hearth
75 Elec Outlets at Wood Pnl, Int & Ext
76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Cirnc
77 Elec Outlets & Rcptcls at Ktchn Counter
78 Garage Fire Door, Swing -Landing -Closure
79 AC Duct in Garage -Damper
80 Wtr Htr; Vnts-Cirnc-Com Air Cnnctr-PRV; abv fir
Mech Prtctn; LPG Appince Undr House 3•' drain
81 Plmb; Elec & Mech Eqp Listed for Lottn
82 Elec Rcptcls in Garage (GFI) Romex Prtctn
83 Insultn-Foam-Looked in Attic
84 Guard Rails & Deck Cnstrctn-Post Caps
85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth
86 Cirnc Drnge Planters ❑Yes ❑No
87 Stucco Brown -Finish
88 AC Unit Dscnnct, Elec-Plmb
89 Vnts abv Roof, Plmb-Appinc-Frpic-Cirnc to Opngs
90 Wtr Well, Dscnnct, Elec, Plmb
91 Ext Elec Trim, GFI Rcptcl-Undrgrnd
92 Vntltn thru House
93 Glass Prtctn
94 Corrections from previous lnspctns
95 Gas Test -Meters Tagged, Gas-Elec
96 Wtr & Sewer Cnnctd-D/O to grade -HD Apprvl
97 Energy Cmpinc Cert -Other Certs
98 Address Posted
99. Fire Sprinkler
m
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
7 County Center Drive • Oroville, CA • (530) 538-7541
CORRECTION NOTICE °R
OWNER PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please call for re -inspection when correction of
Date O InspectorAl A�� C�/,7 imV
v
REV 4/05 Phone #
FOR RE -INSPECTION CALL: 538-7636 OR 891-2834
COUNTY OF BUTTE
BUILDING DIVISION
` DEPARTMENT OF DEVELOPMENT SERVICES
rx .
t' .. 7 (.ni inty ('ontcr nrivc • I) rrmi I In (`4 • Ir,Qn1 GQQ_79ZA 1
r' CORRECTION NOTICE
OG-
" OWNER PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please call for re -inspection when correction of
work is completed. If you have any questions pertaining to this matter, or need additional
explanation, please contact the Building Inspector as indicated below.
Date +S—A -E' Inspector! "�r
REV 4/05 Phone # 9 D �� Z
FOR RE -INSPECTION CALL: 538-7636 OR 891-2834
lk
1COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
w
7 County Center Drive • Oroville, CA • (530) 538-7541
CORRECTION NOTICE
n/„-Ogyo
OWNER PERMIT NO
A routine inspection indicates that the following violations of Butte County Ordinances exist at
r ' ` the above address and should be corrected. Please call for re -inspection when correction of
N.
work is completed. If you have any questions pertaining to this matter, or need additional
explanation, please contact the Building Inspector as indicated below.
� i✓� � o�,�o,�r,N�d Gl�cw„o `”
Date 3 D. -L, Inspector 41 �A �� l
J
REV 4/05 Phone #
FOR RE -INSPECTION CALL: 538-7636 OR 891-2834
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.
BP060480
PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
Issued Date: 08/24/2006 APN: 025-340-022-000
the Business and Professions Code, and my license is in full force and
effect.
License Class :LJG�aVtl License Number:
Site Address: 580 MARIAH LANE ORO
ZO yJ4tiAX
Date: �(e Contractor: 1.D
Map Index:
Description: NEW MH NEW SITE PERM FNDN (1173)
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
Owner: CESENA, LILLIAN
to its issuance, also requires the applicant for such permit to file a
5390 PALM GROVE CT.
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commencing with Section
SAN JOSE, CA.
7000) of Division 3 of the Business and Professions Code) or that he or
95123-1754
she is exempt therefrom and the basis for the alleged exemption. Any
408-205-8040
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
Applicant: DU PAR & ANGEL INC
owner of property who builds or improves thereon, and who does
MICHELLE FREEL
such work himself or herself or through his or her own employees,
2532 SANTA ROSA AVE
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
SANTA ROSA, CA 95404
year of completion, the owner -builder will have the burden of
530-821-5850 530-821-5854 fax
(fax)
proving that he or she did not build or improve for the purpose of
Sale.).
michellef88@sbcglobal.net
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
Contractor: DU PAR & ANGEL INC
and who contracts for such projects with a contractor(s) licensed
MICHELLE FREEL
pursuant to the Contractors' State License Law.).
2532 SANTA ROSA AVE
❑ 1 am Exempt under Article 3 of the Business and Professions Code
SANTA ROSA, CA 95404
530-821-5850 530-821-5854 (fax)
Date: Owner:
michellef88@sbcglobal.net
License #: 457364
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.
have and will maintain workers' compensation insurance, as
Engineer:
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier: 2k.le f i—L d
Total Square Ft: 1173 S.F.
a' a�0�
Policy #:
Valuation: $76,245.00
❑ 1 certify that in the performance of the work for which this permit is
Census Code:
issued, I, shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith co�mpply, with those provisions.
Date 1 _DJ I — ipJ�J/L1�l t �
__Q
Applicant:T
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
in to the cost of
hundred thousand dollars ($100,000), addition
�T
compensation, damages as provided for in Section 3706 of the Labor
1
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the
This permit is>her"eb issu d under the applicable provisions of the Butte County Code and/or
Resolutions to do • r 1'cated �a�ve for which fees have been paid.
G
performance of the work for which this permit is issued (Sec 3097 Civ.)
/p�
BY % - Date: v
Name:
PERMIT EXPIRES ON:
Address:
(Date) "
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all 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 purposes.,
�Qi"I
Print Name: rn(C r IP.I�p I f Signature:
1 4/(0
Date: r4
❑ owner ❑ Contractor ❑ Agent for Owner gent for Contractor
B. C. t3wldmg Permit of -lb -1.14 pg i
t.
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County, Center Drive, Oroville, CA .95965 Phone (530)538-7541 Fax (530)538-2140
PERMIT APPLICATION DATA SHEET
OWNER:If �_A
ASSESSOR PARCEL NUMBER
,� e -W 7•,.%I , NtW 7; /T �.E� "emsI>, //��jj��. a� U
Proposed Building Use: /" / Permit Technician: 6&5. " Date:
Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply.
1 N 1. Site plans, 3 or 4 sets, signed by the preparer of the plans.
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans.
❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 4. Engineered truss details and layouts in duplicate. No faxesl
❑ 5. Letter from Engineer or Architect for truss design review.
❑ 6. Energy compliance design and supporting documentation in duplicate.
❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
/ N 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in
duplicate.
❑ 9. 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.
❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate.
❑ 11. Hazardous Material Form
'o N 12. Acknowledgement of building permit application without required clearances.
❑ 13. Other
Rema' in ms needed to issue the permit. (May require additional plan review upon receipt of the following items.)
1 anitation and site plan approv I from the Environmental Health Department in ❑ Chico �Q OOr%�villlle,, as applicable ill o t
ire Sprinklers.:-n�.�1?l..V.�...�#� c'�.. �........................................ -�' �-t-��
D .Agricultural Buffer clr and site plan apr from the Ag ommissioner Sent by
\❑ 17. Soils Report and/or Engineered Foundation required ...........................................
❑ 1 Erosion Control Plan Required........................................................................
,Sees as shown on the attached Schedule of Fees Due Sheet ..............................
❑ 20. City of Chico Plumbing permit ............................................. ..
............
❑ 21. Site plan and business license approval from th--A0_7
e City . - i gs................. ...
22. California Department of Forestry plan approval, paid Sent by: _�...�.....
23. Planning approval for (A) Use: (B) Parking: (C) Parcel Check :............
"==
❑ 24. Contact Land Development about _ Improvements, _ Drainage ........................
N 25. Fire Marshall Review (commercial projects only). Sent by: ......................
/ 26 NPDES Form ..............................................................................•...........
27..)1' achment Permit for driveway from the Public Works Dept ........................... aw
❑ Contractor's license information. (Number, Name Style, Classification) ...................
❑ 29. Worker's Compensation Carrier and Policy Number ................................ ...•......
❑ 30. Owner -Builder Verification ( _ Given to owner, _Mailed to owner) .....................
`CCj etter of Signature authorization....................................................................
3 recorded copy of Agricultural Acknowledgment Statement .................................
❑3. Existing violations and/or expired permits.........................................................
❑ 34. Deeoestriction............................................................. ..........................
�j /(J 35. legal description, ❑ M.H. Title, title search, registration or CO ... / ...................
❑ 36. Other:
❑ 37. Other: ( /
When issued Telephone/ X f/i and hold for pickup.
I have been informed of the above items and requirements for obtaining a building permit.
Applicant: Date:
1. Index permit application for the above items numbered: Plan Chec Lett
2. Add" items required41
ontractor signer, owner, was advised of the above data by pphone, ❑mail, ❑counter, by Date:
on i ac or esigner, owner, was advised of the above data by 1phone, ❑ mail, ❑ counter, by Date:
on ractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date:
Plans reviewed by: Date: Plans approved by: Date
Structural reviewed by Dat Structural approved by Date
Note transfer by: Date:
Yellow: Building Division
K/Building/Plan ChecklData Sheets/data sheet page 2 9.27.05
' E.H. USE ONLY
Plot Plan Attached
�i Floor Plan Attached
Sent to BD/DS
TO: Building Division = Development Services
FROM: Environmental Health
SUBJECT: Sanitation Clearance
/Z A,,) Oazj n a --- 1�)A,
Owner Location AP#
Plan Approved for: Sewage Disposal. ----2
Clearance for dwelling. Other
old final
O.K. for:
NOTE:
Supply: Public Private Well
rJ f -r --N ')n A L
Environmental Health Specialist
Building Clearance 9/2005
G -- 23 -z -)L
Date
WIF
' BUTTE COUNTY SCHOOLS IMPACT -FEE CERTIFICATION FORM
(One form per Building)
School District 0i y� L b BuildingDepartment Noel �J' " '
�Part6
J
A.P. Number OZ S— 3` O—Q2 ZJurisdiction: City County
Property Owner
Property Location/Address
Subdivision Lot No.
Residential Development 0 Q Q Sq. Footage 1
No of Living Mobile Home Addition/ "Supplemental to (Group. R
Units Installation Conversion Permit #
•(No foundation inspection)
........................................................................................
Deed Restricted Sq. Footage
(Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document)
Commercial/Industrial 0 0 Sq. Footage
New Addition (Including Exterior
Roofed Areas)
Building Department Representative Date
sy
District Identification No.
"VAX School District certifies that
V
( _'0 V1e-�
(Applicant)
x/v3
(Street Address) ^"`=r (Phone Number)
l� r w ; Cdr 9S-7 bS - -- --
(City) `
has complied with tfhe''rrequirements of Resolution No.
representing ` / square feet.
School District
(State)(Zip Code) q
yby payment of $
B 2926 ~ S
ULL MITIGATION .4 $ '
?' �L/
Date I /
Paid by Check # Remarks: w�
Notice: You may protest the Imposition of the fees Identified above by submitting a written protest to the District, In compliance with
Govemment Code Section 66020(x), within 90 days from tha date fees are paid. Failure to submit a timely written protest wflVprohlbit
you from challenging the Imposition of the fees In any court action.
N, subsequent to the School District Representative signing this Butte County Schools Impact Fee Cwdflcadon 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),
V this project maybe subject to additional school fames to fully mitigate Its Impact on the school disMet's sdrools.
, � White (school district), Yellow (building department), Pink (applicant) feeformift (305WM
0
BUTTE. COUNTY DEVELOPMENT FEE CERTIFICATION FORME
FEATHR RIVER RECREATION AND PARK DISTRICT (FRRPD)
❑ CHICO AREA RECREATION AND PARK DISTRICT (CARD)
❑ PARADISE RECREATION AND PARK DISTRICT (PRPD)
❑ DURHAM RECREATION AND PARK DISTRICT (DRPD)
(j2 �' l a d 22 Building Permit Number /l Py 6 0V 60 O
Assessor Parcel Number (s) g b
Property Owner (s) G CCC^T�%
Project Location /Address l
Subdivision Name Assessable Sq. Ftge 1 2T_
Type of Residential Development (check one)
New Development Single Family -Detached
Alteration/Addition(s) Non -Residential to Residential
Mobile home Mobile home replacement
Demo Permit (date issued )
Comments:
Single Family -Attached
Multi -Family Dwelling
verifi ssessor Department
verified by Building Department
Building Department Representative
X FRRPD ❑ CARD ❑ PRPD ❑ DRPD certifies that:
Applicant Name Phone Number
Mailing Address City State Zip
Has complied with requirements of the Butte County Board of Supervisors Resolution No.
by Payment of:
Dwelling Units @ $
Square Feet @ $
Remarks:
Paid by -Check No: v �" �, Paid by Cash:
per unit for a total of $ (P
per sq foot for a toial of $
Receipt No:
v v
on and Park District Representa v L
Butte County Department ofDevelopinent Sel-vices
0e%3Tr�o
"'
7 County Center Drive
° °
Oroville, CA 95965
00
0 .-' o
(530) 538-7601 Telephone
o .; s ;o 0
(530) 538-7785 Facsimile
cOUNty
BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES
I request and authorize the Building Division to process this building permit application through the plans
examination process WITHOUT first obtaining all necessary, related permits and clearances from other
regulatory entities, including but not limited to, Planning, Environmental Health, Land Development,
County Fire, and Agriculture.
I hereby acknowledge:
I need to submit applications for septic and/or well to Butte County Environmental Health
immediately.
I an: required to bring the approved Environmental Health site plan and approved sanitation
clearance to the Building Division as soon as clearance is obtained
I am responsible for notifying Development Services, in writing, to stop processing of the
application and to arrange for disposition of plans.
The Building Division will process the application through the plans examination process, as submitted,
without input from other regulatory entities that could prohibit issuance of the buildingj2ermit or require
submission of amended building plans to the Building Division. Once the plans examination process
begins, there will be no refund of plans examination fees. Any changes requiring submission of amended
plans to the Building Division will incur additional fees.
Within one year from the date of application for a building permit, all other required permits and clearances
from other entities must be obtained for the permit to be issued. Failure to obtain these permits/clearances
will void the application.
Typically other required permits/clearances include, but are not limited to, verification the parcel was
legally created, adherence to. all mitigations and conditions imposed on the parcel at time of creation, as well
as zoning requirements, legal access, and applicable set -backs and environmental issues (fire, agriculture
buffer zones, and habitat/species).
Please print:
Applicant Name: 910bel,l-?_liki-ePa -(6- lalll(M CLAna.,
Building site address: • 'N ttl wLh U' U , Paurmn
v.—k-P.
APN: OQ4; —t -i O --#o
Permit No.:
I have read, understood and accept the terms and conditions as expressed herein as indicated by my
submission of the above -referenced building permit application and my signature below:
SIGNATURE OF APPLICANT DATE
Copy to Applicant/EH/File K:Forms/BldgPeTmitwithoutClearances 020705
Department of Public Works
C o u n t y o f B .0 t.- t o
J. Michael Crump, Director LA.NDDEVELOPMENT DMSION
Storm Water Management Program
7 County Center Drive
0"ne, CA 95965
(530) 538-7-266
(FAX) 538-7171
National Pollutant Discharge Elimination System (NPDES) Phase 11
Construction Storm Water Permit and Storm Wafer Pollution Prevention
Plan (SWPPP) Acknowledgement (LESS THAN � ACRE)
Project Description -
Cyr, r�ko
Project Location and/or Parcel Number:
00_s-- 3 u4 o— a a
By signing below, L the project owner/owner's agent, certify that this project WILL NOT DISTURB
1 acre or more of land and that L therefore, do not need to apply for a Construction Storm Water Permit
from the State of California Regional Water Quality Control Board. Phased projects that contain
multiple site build -outs of less than one acre but when combined with subsequent phases total more
than one acre of disturbed soil will require a Construction Storm Water Permit from the State of
California Regional Water Quality Control Board.
I am aware that submitting false and/or inaccurate information or failure to apply for a Construction
Storm Water Permit from the State of California Regional Water Quality Control Board for a project.
that disturbs one acre or more of land may result in revocation of grading and/or other permits or other
sanctions provided by law.
Signed:�(i
Title:
Dater a -A P Y/ ! f
OTTF Department ®f Public Works
0 0
0 C o u n t y o f B u t t e
0
' 0 7 County Center Drive
Oroville, CA 95965
�(y0 J. Michael Crump, Director (530)538-7681
(FAX) 538-7171
,o" 5
vetrc WOF�
Shawn H. O'Brien, Assistant Director
Assessors Parcel Number:4�,�,3�� ��2- Building permit # /(26�57
Owners Name:��-
Owners Mailing Address:
Property Address:
ENCROACHMENT PERMIT ACCEP l
PERMIT NUMBER:
ENCROACHMENT PERMIT EXEMPTION:
Reason for exemption:
Not a County maintained road
[] Existing driveway conforms to County S-31 standard
Other
Approved by
Printed Name
Title
Date 7',O`�
CONDITIONS FOR EXEMPTING AD WAY PERMIT
1. An existing home with a driveway 10 years or older and doesn't cause any problems with
the county road or drainage.
2. An existing home with only minor remodeling or repairs.
10/28/05 09:63 FAX BTEC OROVILLE INTEGR�Ty CHICO ID003
.._ ...., v--.--.— - - ..
to n a/ o s 07:17 FAX 530 894 7647 BTEC CUSTOMER SERVICE U 0 0 4
.- - . HIIrrIuu�Itll��lut���rlllr111
Wxo=ING REQUS4= BV
MM VALLEY TME & ESCROW CO.
1 S, AND VAM4 PECOPMED NAM 70'
LM11AN CFSENA
3349 MACHADO AV3
SANTA CLARA. CA 95051
ORO -C
AP.N.: 029-24D-116400 Order NO.: 175978
I g9�_=p-menti. z �9c�
Rvrwrded
1 REC FEE 13.00
Moue! Re ord s
BUTTE
CAiWXE S. GRUBS
1 TAX 3&W
I
RecoRWGWYDIO(50N
I
As istant
69.^e2m 26-8EP-1999
1 Vickie
1 Page 1 of 3
Above Thk l.lno for Amndcea Use Only
Escrow No,: 17597SPE-3 3
GRANT DEED
THB UNDER GNED GRAWMR(s) t)ECLAitEW "THAT DOCUMENTARY TRANSFER TAXIS: COMM 0 5,450
X CoAWted on (till value of propeetzy Conveyed, or
1 coiaputed on full value less taallryuue OR o��_ ��s remaining at time of sale.
X ] =UU- Cotporatod arca; ( a Of
FOR A VALUABLE CONSlDERAT1014, Receipt of which is hereby acknowledged.
EDWARD L. OVEMOLU. JR., as U> nwxlod Main
hereby GRANIV) TO
LIXAJAN CFSENA, ab Vuw=n ed Woman
the following de:wAbed pnq=tY as Uiilncorpotated Area. County of Bunte State of Califorala:
See )n xbg* eA" atmehed hereto and made a part hereof.
EDWARD L OVEMOUSE. M
Decomeai Deux 5 er 71.19
STATE OF CALIFORNIA BUTTE As
COUNTY OA )
on g_27_gg W"e PENNY C. ENGLAND NOTARY PUBLIC
pe auna r apps ono
pcmawk known to we (or proved to we on rhe bads of ®lafaeory etrWc=t) w be the persons) whose name(s) Ware subacrR" to the w Ma
hmwnont W aeltn whdpd 0 n+s iW holeholduy Mand dw soca In hia/hcdaheir outhorind Capaoley(iW =4 Awn by bWht:uthdr elanacWUW an
the Iasa%n=e Ihe pomen(s) or Ihp soft upon behntf of Wb" the persons) acted. execvlod the hrsuument.
Vt►iCN= lav and ofacbI tool.
7ai2 Mea lbe official notai d Beal.
P GLAN
PENNY C. ENGLAND
Commmbn 01On= Hk CPS]
. Nolary Pubic o �/OCL IVDP
butte CDU*. Candmia
My CmnrWnlon E Dom. 3.1999
Mail Tax Sta"=ts to: SAME AS ABOVE or Address Noted HeIOW
£t010Q . asdoaq �+(- samog SITd2alul Z££££t£0£s xyj y tT IM 5o0Z/8Z/oT
10/28/05
09:53
FAX
BTEC Q ILZE
-► INTEGRITY C8XC0 0004
to/28/05
07;18
FAX 530 894'7'47
BTEC C*ljgAER SERVICE
16005
EXHIBIT AWN
DESCRIPTION
ORDER NO. BU -•175978-3
THE LAND REFERRED TO. IN THIS REFORT IS SITUATED iN THE STATE OF
CALIFORNIA, COUNTY OF BUTTE, AND IS VESCRIBED AS FOLLOWS:
PARCEL Is.
PARCEL 1, AS SHOWN ON TFUNT CERTAIN PARCEL MAP; RECORDED IN THE .
OFFICE OF THE RECORDER OF THE COUN' y or BUTTE, STATE OF CALIFORNIA,
ON SEPTEMBER 23, 1998, IN BOOK 144 OF MAPS, AT PAGE (S)' 67 AND 68.
RESERVING. THEREFROM A 60 FOOT RIGiT OF WAY AND PUBLIC UTILITY
EASEMENT AND A 20 FOOT PUBLIC UTI%XTY EASEMENT AS 9lloWN ON SAID
MAP.
ALSO RESERVING THEREFROM A NON-EXCLUSIVE. EASEMENT FOR PUBLIC
UTILITY PURPOSES OVER TEE SOUTHERLY 30. FEET, AS SHOWN ON SAID MAP.
PARCEL xz:
A 60 FOOT RIG= OF WAY AND PUBLIC UTILITY EASEMENT OVER PARCELS 1
THRU 3, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN TRZ OFFICE
OF THE RECORDER OF THE COUNTY OF BUTTS, STATE OP CALIFORNIA, ON
SEPTEMBER 23, 1998, IN BOOK 149 OF MAPS, AT FAC#](S) 67 AND 68.
EXCEPTING TI#EREFROM ALL THAT PORTION LYING WXTRM THE BOUNDS OF
PARCEL I, DESCRIBED HEREIN.
PARCEIL 2II
A NON-EXCLUSIVE EASEMENT 30 FEET WIDE FOR PUBLIC 2)TILITIES PURPOSES
LYING NORTI-WRLY OF, RUNN=G PARALLEL WITH AND ADJACENT TO THE SOUTH
LINE OF PARCELS 1, 2, 3 AND 4, AS SHOWN ON THAT CERTAIN PARCEL MAP,
RECORDED 1N THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE,
STATE OF CALIFORNIA, ON SEPTEMBER 23, 1998, IN BOOK 144 OF MAPS, AT
PAGE (S) 67 AND 69, FROM WHE EAST L±NE OF SAID PARCEL 4 TO THE WEST
LINE OF SAID PARCEL 1.
THIS EASEMENT IS APPURTENANT TO AND SHALL, INURE TO TV8 BENEFIT OF
SAID PARCELS 1, 2, 3 AND 4, AND APPLIES TO ALL SUCCESSORS OR
ASSIGNS OF SAID PARCELS
EXCEP=NG 'THEREFROM ALL THAT PORTION LYING WITHIN THE BOUNDS OF
PARCEL I, DESCRIBED HEREIN.
CONTINUED
t
VO/6002 . • 02JODD �+�- Samog SlTd201uI Z£££U£0£5 XYJ Lt:F IM 5009/89/0/
10/28/05 09:53 FAX BTEC OROVILLE -► INTEGRITY CHICO rA005
^ 10/28/05 07:18 FAX - B30 894 764T BTEC CIIs"KER SERVICE _ 19006
A NON_3XCLV9IV8 EASEMENT FOR ROAD AND PUBLIC UTILITIES OVER A
PORTION OF SECTION 1, TOWNSHIP 18 NORTH, RANGE 3 EAST, M.D.B. & M.,
DESCRIBED AS FOLLOWSe
BEGINNING AT THE EAST ONE—QUARTER CORNER OF SECTION 1, TOWNSHIP IS
NORTH, RANGE 3 EAST, M.D.S. & M.; T'1'iENCE NORTH 83 DEG. 46' 06"
WEST, 783.19 FEET TO THE TRUE POINT OF BEGXMXNC3 FOR THE 11EREIN
DESCRIBED EASEMENT, SAID POINT BEING ON THE NORTHERLY LINE OF
PARCEL 4, AS SEIOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE
OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE -OF CALIFORNIA,
ON SEPTEMBER 23, 1998, IN BOOK 144 OF MAPS, AT PAGE M 67; THMCE
NORTH 86 DEG. 24' 530 EAST, 663.51 FEET; THENCE NORTH 86 DEG. 02'
42" EAST, 80.67 FEET; THENCE NORTH 70 DEG. -31' 41" EAST, 4.66 FEET
TO A POINT ON THE WESTERLY LINE OF -LONE TREE ROAD; THENCE SOUTH 00
DEG. 37' SON EAST ALONG 'SAIb WESTERLY LINE, 8.37 FEET TO THE
NORTHEAST CORNER OF SAID PARCEL 4; THENCE SOUTH 196 DEG. SS' 01"
WEST ALONG SAID NORTHERLY LIM OF SAID. PARCEL 41 758.26 FEET.
_ - � w ..: r +per,,.. : ,,•.,r ' � ' ..'•�' _'_ •:' ' r � '.• 1 , � • '• '.
y
02JO09 SOmog SITJ201uI Z£££M0£S IVA 0:tT IH 900MUOT
AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE, CA 95965
.2006_0043732
Recorded I REC FEE 10.00
Official yRecords I
�Butteof I CONFORMED CONY 1.00
Cffim J. GR1110 I
County Clerk-Recorderl
I
I l�
011:16AN 24 -Aug -M I page 1 of 2
I I I 1111111 l 1111 l 1111111111 I l i 111 I I
AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT
FOR RESIDENTIAL DEVELOPMENT
Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building
permit. 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 farm
operations.
All that real property situate in the County of Butte, State of California, described as follows:
Date ROPERTY OWNERS:
L
U ktiu x 02-ese anG.
State of California.
County of '5t+W 4 CL4&'V-
On t. a -(e . a -'Z t?o before me,
personally appeared _/_ 1 LL/ r4AJ OP 571—�E &6,9- .per }ly
kll.awjLto me—(or proved to me on the basis of satisfactory evidence) to be the person("hose nameW@aAee subscribed
to the within instrument and acknowledged to me that VIDe t1* executed the same in " Der* authorized
capacity(iK, and that by hal/h*r signature(4,on the instrument, the person(oor the entity upon behalf of which
the person(o acted, executed the instrument.
WITNESS my ha and official seal. 4,gEP; WILMA SMITH
Commission #1559640
Signature Seal: S 1 Notary Public - California 8
Santa Clara County a
'�PoR My Comm. Expires Apr. 02, 2009
A. P. # OQ'S at -1- C9Q
I
I
THE LAND REFERED TO IN THIS REPORT IS SITUATED IN THE STATE OF CALIFORNIA, COUNTY
OF BUTTE, ANS IS DESCRIBED AS FOLLOWS: {
PARCEL I:
PARCEL 1, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE i
RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON SEPTEMBER 23, 1998, IN '
BOOK 144 OF MAPS, AT PAGES) 67 AND 68. i
RESERVING THEREFROM A 60 FOOT RIGHT OF WAY AND PUBLIC UTILITY EASEMENT AND A 20
FOOT PUBLIC UTILITY EASEMENT AS SHOWN ON SAID MAP.
ALSO RESERVING THERFROM A NON-EXCLUSIVE EASEMENT FOR PUBLIC UTILITY PURPOSES OVER
THE SOUHTERLY 30 FEET, AS SHOWN ON SAID MAP.
PARCELII:
A 60 FEET RIGHT OF WAY AND PUBLIC UTILITY EASEMENT OVER PARCELS 1 THRU 3, AS SHOWN
ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY'
OF BUTTE, STATE OF CALIFORNIA, ON SEPTEMBER 23, 1998, IN BOOK 144 OF MAPS, AT
PAGE(S) 67 AND 68. I
EXCEPTING THEREFROM ALL THAT PORTION LYING WITHIN THE BOUNDS OF PARCEL I, DESCRIBED
HEREIN. i
PACERL III:
A NON-EXCLUSIVE EASEMENT 30 FEET WIDE FOR PUBLIC UTILITIES PURPOSES LYING
NORTHERLY OF, RUNNING PARALLEL WITH AND ADJACENT TO THE SOUTH LINE OF PARCELS 1,2,
3 AND 4, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER
OF THE COUNTY OF BUTTE, STATE OF CALIOFNRIA, ON SEPTEMBER 23, 1998, IN BOOK 144,;AT
PAGE(S) 67 AND 68, FROM THE EAST LINE OF SAID PARCEL 4 TO THE WEST LINE OF SAID ,
PARCEL 1.
THIS EASEMENT IS APPURTENANT TO AND SHALL INURE TO THE BENEFIT OF SAID PARCELS 1
2, 3 AND 4, AND APPLIES TO ALL SUCCESSORS OR ASSIGNS OF SAID PARCELS.
EXCEPTING THEREFROM ALL THAT PORTION LYING WITHIN THE BOUNDS OF PARCEL I, DESCRIBED
HEREIN. i
PARCEL IV:
A NON-EXCLUSIVE EASEMENT FOR ROAD AND PUBLIC UTILITIES OVER A PORTION OF SECTION 1,
TOWNSHIP 18 NORTH, RANGE 3 EAST, M.D.B. & M. DESCRIBED AS FOLLOWS:
BEGINNING AT THE EAST ONE-QUARTER CORNER OF SECTION 1, TOWNSHIP 18 NORTH, RANGE 3
EAST, M.D.B. & m.; THENCE NORTH 83 DEGREES 46' 06" WEST, 783.19 FEET TO THE TRUE.
POINT OF BEGINNING FOR THE HEREIN DESCRIBED EASEMENT, SAID POINT DEING ON THE
NORTHERLY LINE OF PARCEL 4, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE'
OFFIE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON SEPTEMBER 23,
1998, IN BOOK 144 OF MAPS, AT PAGE(S) 67; THENCE NORTH 86 DEGREES 24' 53" EAST,
663.51 FEET; THENCE NORTH 86 DEGREES 02'42" EAST, 80.67 FEET; THENCE NORTH 70 i
DEGREES 31' 41" EAST, 4.66 FEET TO A POINT ON THE WESTERLY LINE OF LONE TREE ROAD;
THENCE SOUTH 00 DEGREES 37' 50" EAST ALONG SAID WESTERLY LINE, 8.37 FEET TO THE
NORTHEAST CORNER OF SAID PARCEL 4; THENCE SOUTH 86 DEGREES 55' 01" WEST ALONG SAID
NORTHERLY LINE OF SAID PARCEL 4, 758.26 FEET. I
•
RT ANGEL, INC.
D B A
D & A CONSTRUCTION
868 W. ONSTOTT #J
YUBA CITY, CA 95991
(530)821-5850 FAX (530).821-5854
LICENSE #457364
FACSIMILE TRANSMITTAL SHEET
TO: FROM: -�
DAT
COMP U � l� U I^ T l (�L1 DjE
FAX NUMBER: TOTAL NO. OF PAGES INCLUDING COVER:
— 530-2► `I,c� ;,?—
PHONE NUMBER: SENDER'S REFERENCE NUMBER:
RE: YOUR REFERENCE NUMBER:
URGENT_.,XFOR REVIEW ❑ PLEASE COMMENT ❑ PLEASE REPLY ❑ PLEASE RECYCLE
NOTES/COMMENTS:
- sys�
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13:40 FROM:WM F SQUYRES 530-345-1630 TO:8215854 P.1
5 45-1630-`:difpmlo. ...
VEC006
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D.. .a "5 :., . HCD °4'15 APPLICATIOM�F_OR
.Altefnate<AppToyal: : q• TeChrilcaktorvices. O. In>ipecNon.To.6 teln•Inalgnla:
' CONTitA:CTOR/OWNER.BUILDER'DECLARATIONS
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SEqtION t .•UNR:dNFORMATtON
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. o{het;'Ilfrove,.demollSh,o/�epalr'on shu2Me. pNof fo•ItS.ks[3drfc'e'' r ••^, •'r:;
yy
•reout.esihe,opppllcdnf forsuch 'In
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pe"file a rJ�n ed•sfoternenhlhol he. or
-sileASflGertsQd;purs",t:t.oth rovWonsottheGon}roGlaSUceatseLow
pp
aAonufocturer
Mode4Norse L G1F1LI .='N �5
i
(Cfiapfer9 (comrnen wltti'Secllon7000)of DMslan'3'df 1he,Buslness Dnp
-•:Profen+ltonicgde):or:m�%he'ar'st,els:exemFft.there:rlf.rq,and;the�OsufarThe .r. ;
: dlegedre,rempBortn Adt violaflon
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'ifttlgnlo/NUD kabel'Nuffiber(s) " .� �8-��y'�5 •
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t
of,.Sectlon7037,5 byaryy appllcant.for'a .,.
�rmif•sublecTS"TthiA'oGb�Coriffbbtiv0'penollyoPaotmae•}hamiNe�hundred --
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Year:cI.Manufocture l�i4rUh .a3x'Q0os
•'( ). I. os: ownor<of ifie. prd�8ify, w my emp4yee� wlM woges w ihetr sole: -
Cort)pefissatton. ,wf0'do the'work, �t1G'.fhQ st a is ndt IRtertded,.ot'opered> ., :,
f0(SOIe'(SeC:;7Q44, Ek151nB61.OfId Pra}ej310rs5.Code:.,ThOOflifaCfaf$,I tC9nSe:
" 'law'does:riot::oppry.to'ariownecofpropeM:,wnobulld3orlinprovestfaereon, -.: r '.i
,
SETON!;--VWNER/ APPUCANi INFORMAnON_
':' `' i -
t
'. �nBr ,
,ohd.whc hoes+wCla.work,ht"Wit-or herself W firouQh hls,ortterown
_ employ.�ei:,pr&AdorI that.iuchtinprov6ments are not4itended:or offered for
sde, li, ttdwevea the bLdIding Or Improvement•9s:sold.v/flhIn-one yeot r -t "
b0lidao OW(ter-builder wtE.have-the'lwrd etirol.Wwin61ha1.he or'she '`
, Address•'S3-
F
Ci Y[tf '.f✓ t CC fLL : ^ 5'�:d7i t
.
�`a rro�t
o, Wn]prove:lo►'the,purpose.ot scle. .:.. .^ -
County ^ ap
-.�• - .( fit h (:. �' r -
:lnrotlon^Atldtess.1 7s�_�_ V%Q_ l�.l�.
I
(,9Ensrorwner'of the r y
PP opgrty, am:exchAlve :contrci with IICerusd
centrpcfois to:constiucttrya project (Sec.'7044, Business on"Nro}esstons Code; •.
!�
'A
, _ .
?he..C'ofttr(360rs_Ucen3e�L&doevidt,oplof anownernt'f I�NYWttO
am �' A Cb " py%*:
bLCds'or I .. pr��es f wocn, aAdl who controets for sties proeeh wltt)`p •• '' '�
c8rlirocfaKs).)Icensed purworihto fhe CrontraclorsUcense..l aw.). 'tr • ".
• .v i . -
r. Address �D ( � n s i k. ' +l i
r -T
(-) J'0rT1'exefnpf :.0 SeC,. IL.&:P.0*x ttils
..reason:..:!
O
ap A. rnbXU`
,
' - •'' ..
'T:*;CTION;I•-.CONiRACTOR.ARC
rl 1
RELZORENGIN Mi0 TION
'
D-. •J-?�?�`•3'�'•i<, N , .� l
•.5-;..::7,�a'i:�,t.^ "
�' Vdn - !' i. .fir_
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g 9 iW El�9'CONIPEhISAiIONOECLARATIOh1 r '
�1T'erebyamrgtvnderperidty°oi'oerhay'medf:'meiol(6%Z4n
':0. t ''k ' 1`� i#- �•.S 5 �4
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w, deelcrb116ruc
1:JI`hove'.orfdy+N'mbtntaln.oFernlfeote:ofEonsenYloself-IruureYawoArerq;
" n If as prbyrded for Secllon'370D.&IM Labor: Code: for tl
Re%or(rlaflce of'*-work,foruwhlch.thh IS.Issuetl,
Alcnitect/EnpineerNo[r+e 4&1—
, -t
pe .. ti
STATE OF CAFORNIA �'
. -.
: Regutranojt'No: " '' ""'
yi �'
'
Department of Housing & Community Development
Division of Codes and Standards
°
1
FINAL INSPEC Ti0N CERTIFICATION
SECTION 4; DESCRIPTIOWOFWORK/ACTIVRY,AND V ATIO
r.
_
I
Ld7� DATE: ?-q--
Oeacrlbe. the- proposed work/o"vlty 1n doiali. Attach oddltlonal popeSdhnecess[?ry:'.Where.
BY: \�-1 `] \i » 1� 5
pr po rriplefe plops a{�eclnoolloru:derolls:orsd,
alferoTlOriS Or OddnlonS are d _sed co
phacheaio.this form,,. `;; i}' a '° ;a ' ?r `-- • <1 ::.
I
'
District Represent IID No.) t
' ? `
„' ;: celc;LAdKons oio.requlred jo.I�e . :
'Fiovicwthojmake:and rjlade'l'of ony appear)C6'io.be-iiSiglled'and o ovide-completwel8Ch1cd(.--:'.
EA NoAA South County I
LABOR DATA: AR No: d
Iculatloru•fol;onytalectrical-atterricnonsoi-eapltlonx'
PCAIAC T CODE L/.1� TRMILES
,.::.. .
TIME INSP/ACT TRAVEL TIME
': ':.
,.+-. <-:
INSPECTION DATA: �Prlveb Property ❑ MN PARK I...
,.'.:-. y �...' .,s:•
l ,.,,,fir,:;;,..:•.:: -.
,. ~tea_ fe the Totco:C. Or'Ihe: Wak,rO De Rertorrilech 1 lLJ- • , - - . '.airy .
. ti
,
XHOME/UNIT \ FLOORS
SECTION 5 +31GNA1URE.AND'alrflRdATION
VIOLATION DATA: TOTAL CORRECTIONS:
•;..tjyyB:fiefebytr�ake'ap�llcatlon^for the cervices deslpnetbcl dbcve. t
E NP
S_F_ tut_p _G/0_
`j
sooature`'�1L) �1tlt pale' ` -1
—77FEE
COLLECTION AND OTHER INFORMATION:
_ i(.\ �Q� La•+«.:aH
FEES: S.�_ CK# DATE --,1 =--- ��"' ._ :,
[....r. 5-kr�F•�3•.r� ora. ,r ,..r::: .:,., .,y:<s...::. .... .-.;ri
.. - "DEPARTMENTW-ONLY" ' '"
�1
ITEMS ISSUED: MCD 59 ❑ Gas ❑ Electric ❑ M.I A
'
s " r
ATTACHMENTS: ❑ Tledown Cert. ❑ Othoi
• ' '. ' .. ,: .' :. '.. '' , : C :::�-'.' ',^.• a F :'
PRROVET)'' ;. p' :GONDRIONS,( rwerw'tide) O .DISAPPROVED.As" ry s"idd
:.
III PERMIT NO: �5 3 S 0 FILE CLOSED
: 1
". � "^-��� _T•� '�
.
Y�
�
9pnoha , a ot'Dlitnel RepreteritatNe Data
.:...
DLSIT2IBU.TION: yEL'I.OW - DEPARTMENT` WHITE - AREA')FFICE fiNK= OWNER%APpUt AN
4.
Sf notirre.of,Apppcont or A est Date
1. 13 .. O. '
7
.
HCDd i 5 SIDE 1.(Rev i) /2004), '
-.,
SITE PIAN REVIEW APPLICATION r'
Date: V AP#. o� S— 34'0— 0 DL ;Z,
Permit Number (if applicable) (.p n Bin Number
APPLICANT INFORMATION Parcel Sizer
Owners Name: I �'► �S
Owners Address: Po,� lil^ G -y g l ` c51 a=3
Telephone No.: CT ()g,) S , go `c
Site Address: 1 Y o v -,,n L n roti, t
Proposed Use:
Residential
❑ New Single Family Residential
❑ Single Family Addition
❑ Single Family Remodel
Mobile Home
Residential Accessory
❑ Permanent Second Dwelling
❑ Temporary Mobile Home (Aunt Minnie)
❑ Temporary Travel Trailer
❑ Multi -family
Non-residential
❑ New Commercial
❑ Commercial Addition
❑ New Industrial
❑ Industrial Addition
Other
❑ Septic
❑ Agricultural Exempt Building
❑ Other:
Brief Explanation/Issue:
Zone:
GP:
❑ Commercial Remodel
❑ Industrial Remodel
❑ Well
❑ Agricultural Buffer Form
DEVELOPMENT SERVICES INFORMATION (For Staff Use
J] Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval
❑ Resolved
By 191A/ Date YV4
1 .
ALL ITEMS .CHECKED APPLY TO THE PROPERTY
Parcel Is In:
� 4
❑ Williamson Act Minimum Acreage: ❑ Residence can be built per contract
❑ Watershed Protection Overlay Zone
❑ SRA - (CDF to determine specific requirements)
❑ 100 -Year Flood Plain:
• Flood Zone:
• Flood Panel No.: Index Date:
❑ Sacramento River Reclamation District'(Approval must be obtained from the California Reclamation Board)
❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board)
❑ North Chico Specific Plan
❑ Chapman/Mulberry
❑ Cohasset Area
Use Requires:
❑
Use Permit
❑
Variance
❑
Agricultural Worker Affidavit
❑
Administrative Permit
❑
Minor Use Permit
❑
Minor Variance
Zoning: I� General Plan:
Applicable Building Setbacks:
❑ Setbacks identified on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
❑ Use Permit/Minor Use Permit
Permit Number:
Date of Approval:
2
Zoning Code
Streets & Highways
Fire Prevention
Subdivision Map
Front
Side
I o(
v /
Side Street
Rear
J0
'So/
Height
Waterway
N/A
N/A
N/A
❑ Setbacks identified on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
❑ Use Permit/Minor Use Permit
Permit Number:
Date of Approval:
2
M
Parcel Created By:
❑ Deeds:
Date of Creation: Legal Access Provided: ❑ No ❑ Yes
Deed of Reference: Legal Access Required ❑ No ❑ Yes
Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name:
Complies with County Standards for Deed Creation:❑ No ❑ Yes
Comments:
❑ Parcel Deemed to be`legal
❑ Verify.Legal Parcel ❑ Verify Legal Access ❑ Provide Deed of Creation
❑ Obtain a Certificate of Compliance
❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment
❑ Construct road to: ❑ Meet Parcel size required. by zone
❑ Meet current Environmental Health Department requirements
Subdivision Map/Parcel Map:
Map Date of Recording:
Lot: Iqq Page: (- (p (�
s -
I
\\ N. SITE PLAN REVIEW AAPPLICATION\
Date: 10 AP#
Permit Number (if applicable) Bin Number s
APPLICANT INFORMATION Parcel Size:
Owners Name:
Owners Address:
Telephone No.:
Site Address:
Proposed Use:. .
Residential
New Single Family Residential
❑ Single Family Addition
❑ Single Family Remodel
❑ Mobile Home
❑ Residential Accessory
❑ Permanent Second Dwelling
❑ Temporary Mobile Home (Aunt Minnie)
❑ Temporary Travel Trailer
❑ Multi -family
Non-residential
❑ New Commercial
❑ Commercial Addition
❑ New Industrial
❑ Industrial Addition
Other
Aa Septic
❑ Agricultural Exempt Building
❑ Other:
Brief Explanation/Issue:
❑ Commercial Remodel
❑ Industrial Remodel
��'Well
❑ Agricultural Buffer Form
DEVELOPMENT SERVICES INFORMATION (Fop Staff Use)
Zone: �1 1-)
�a�
GP:
ppro Conditionally Approved ❑ Resolve Problems Prior to Approval
❑ Resolved
BDate
1 2006
ALL ITEMS CHECKED APPLY TO THE PROPERTY
Parcel Is In:
❑ Williamson Act Minimum Acreage: ❑ Residence can be built per contract
❑ Watershed Protection Overlay Zone
❑ SRA - (CDF to determine specific requirements)
❑ 100 -Year Flood Plain:
• Flood Zone:
• Flood Panel No.: Index Date:
❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board)
❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board)
❑ North Chico Specific Plan
❑ Chapman/Mulberry
❑ Cohasset Area
Use Requires:
❑
Use Permit
❑
Variance
❑
Agricultural Worker Affidavit
❑
Administrative Permit
❑ '
Minor Use Permit
❑
Minor Variance
Applicable Building Setbacks:
XSetbacks identified on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
❑ Use Permit/Minor Use Permit
Permit Number:
Date of Approval:
2 2006
Zoning Code
Streets & Highways
Fire Prevention
Subdivision Map
Front
Side
w r
Side Street
Rear
Height
Waterway
N/A
N/A
N/A
XSetbacks identified on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
❑ Use Permit/Minor Use Permit
Permit Number:
Date of Approval:
2 2006
Parcel Created By:
❑ Deeds:
Date of Creation: Legal Access Provided: ❑ No ❑ Yes
Deed of Reference: Legal Access Required ❑ No ❑ Yes
Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name:
Complies with County Standards for Deed Creation:[] No ❑ Yes
Comments:
❑ Parcel Deemed to be legal
❑ Verify Legal Parcel ❑ Verify Legal Access ❑ Provide Deed of Creation
❑ Obtain a Certificate of Compliance
❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment
❑ Construct road to: ❑ Meet Parcel size required by zone
❑ Meet current Environmental Health Department requirements
Subdivision Map/Parcel Map:
Map Date of Recording: 2
Lot: / Book: N''� Page: 61?7c6
3 2006
Integrity HOmes
a DuPar and Angel Company
STATEMENT OF FACTS
This unit is a : X Mobilehome Commerical Coach 'Floating Home Truck Camper
Decal (License) No.(s)
Trade Name
Marlette
Serial No.(s)
HER0239130RAB
I / we, the unaersignea, nereny state tnat the unit aescrinea anove:
be placed on a permanent foundation at : Mariah Lane, Palermo
California, 95968 by authorization of Integrity Homes
a Dupar and Angel Company. 025-340-022
Affiant further agress 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, of from issuance of a California certificate of
title covering the same.
I / We certify under penalty of perjury that the foregoing is true and correct.
Executed on 1/6/06 at: Yuba City California
(Date) , , -(City) _
Signature of each affiant Print name of each affiant
Michelle Freel, On Site Director
Address: 868 W. Onstott #J City: Yuba City State: California
HCD 476.6 (Rev. 11/86)
s ( Stoic of Colifornks'
+ " Business, Transportation and Housing Agency
_—BEPART ENT OF HOUSING AND COMMUNITY DEVELOPMENT
I .III `9 kCTlOhI CALL (�� C� �� e { Division of Codes and Standards
_
ll]111O`•IEj/:� �j��� `- a• `f fi. `may DE a`
l < H�® 41 a APPLICATION FOR
CT f1Rr?rali0----O�i UltrOFrvrConversio — Alternate Approval ❑ Technical Services ® Inspection To Obtain Insignia
CONTRACTOR/OWNER BUILDER DECLARATIONS
Not required for Special Purpose Commercial Modular
1. LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions
of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professions Code and my license Is In full force and effect.
License Class (,. Uc. No. �._ `� C;
�c+ Exp. Dote
Coniroctor `; T • 3 4:1 1,+ ✓• s Date
t }
2. OWNER -BUILDER DECLARATION
I hereby affirm under penolt of perjury that I am exempt from the
Ccntractors License Law rot the following reason (Sec. 7031.5), Business and
Professions Code: Any city or county which requires a permit to construct,
olter. Improve, demolish, or repair any structure. prior to Its Issuance, also
requires the applicant for such permit to file a signed statement that he or
she Is licensed pursuant to the provisions of the Contractors License Law
(Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professions Code) or that he or she Is exempt there from and the basis for the
alleged exemption. Any violation of Section 7031.5 by any applicant for a
permit subjects the applicant to o civil penalty of not more than five hundred
dollars(S500).):
( ) I. as owner of the property, or my employees with wages as their sole
compensation, will do the wort(. and the structure is not Intended of offered
for sole (Sec. 7044, Business and Professions Code: The Contractors License
Law does not apply to on owner of property, who builds or Improves thereon,
and who does such work himself or herself or through his or her own
employees, provided that such Impfovemenis ore not Intended or offered for
sale. If, however. the building or Improvement Is sold within one year of
completion. the owner-bulider will have the burden of proving that he or she
did not build or Improve for the purpose of sole.).
( ) 1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business and Professions Code:
Die Contractors License Low does not apply to on owner of property who
bu'Ids or Improves thereon, and who contracts for such projects with a
conlroctor(s) licensed pursuant to the Contractors License Low.).
( ) I cm exempt under Sec. . B. & P.C. for this reason:
3. WDRKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declaration:
( )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.
( ) I hove and will maintain workers' compensotion Insurance, as required
by Section 3700 of 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 .•, i �~ •r ,'+ 4;,
Policy Number 1 I�) {t 16 ` To ~'
(This section need not be completed II the permit Is for one hundred dollars
($100) or less).
( ) I certify that in the performance of the wail(, for which this permit is Issued,
I sl ,all 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 workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
t (t ll 1
Applicant�.- ; S lr Dole 11 rrl !-'
r a
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS
UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (S 100,000), IN
ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
4. CONSTRUCTION LENDING AGENCY
I hereby affirm under penolty of perjury that there Is a construction lending
agency for the performance of the work for which this permit is Issued
(Sec.3097, Civ. C.).
Lender's Name
Lender's Addre
5. CERTIFICATION
I certify that I have read this application and state that the above
Informolion Is correct. I agree to comply with all city and county ordinances
and state lows relating to building construction, and hereby authorize
representatives of this county to enter upon the above-mentioned property
for Inspection purposes.
'S
Signature of Applicant or Agent Dote
SECTION T - UNIT INFORMATION
I/We Are requesting services for the following unit(s):
(Check Appropriate Box) DTN 'Y f7 /'/ •? ,/
❑ Manufactured Home/Mobllehome
❑ Multi -unit Manufactured Home Fe.%
❑ Commercial Modular (Occupancy Group
❑ Special Purpose Commercial Modular
Date 17 r: C
Decal or License No. AA No.
Serial Number(s) i' --�-I \a�• L- .� 1 � � t�• � . t j r, • / ( .,
RT TO r'
Manufacturer NaTe/ RT BY
Nor
Model Name ' .. L l S 1' {trlLti;.% : 1" 1 1 ,�
Insignia/HUD Lobel Numbe
r(s) 7 ( /�Li > v+ % +
Year of Manufacture (t: 1 i ; r i c J _. , • �<• ,',
SECTION 2 - OWNER/ +NER/ APPLICANT INFORMATION
Owner L. 1 t 1 l ( o,, I`(,J.•, i'_ {'1(..•.-
Address --1 ''''�'.I,!, - "( ill : (11 G`,I : ` . ` I .�.
City {_.:.:' : _.t `l. County _ I N- 1. ; . t ! 1' Zip
t . t!,
{"tib + _..tt ^_.:,E:[ illi+ it til.
Location Address I �• ` i C"�•
Applicant
Address 1r' 1: %• �,'i :°tic '1
Cil l- = •(,
Y Zlp Tetephon4
SECTION 3 - CONTRACTOR, ARCHITECT OR ENGINEER, INFORMATION
v•
Contractor's Name \4111t :v u <a i� •,� (i S
Address i 15 Q) X
Architect/EnglneerName �z'-
Reglstrotion No.
Address
SECTION 4 - DESCRIPTION OF WORi(/ACTIVITY AND VALUATION
Describe the proposed work/activity in detail. Attach additional pages If necessary. Where
structural alterations or additions ore proposed, complete plans, specifications, details. and
calculations are required to be attached to this form.
Provide the make and model of any appliance to be Installed and provide complete electrical
calculations for any electrical alternations or additions.
t r
r „(r
Indicate the Total Cost of the Work to be Performed
SECTION 5 - SIGNATURE AND CERTIFICATION
/We hereby make application for the services designated above.
Signature Dote t I 1 ! r
—DEPARTMENT USE ONLY"
O APPROVED ❑ CONDITIONS (see reverse side) ❑ DISAPPROVED (see reverse side)
L'•
i
Signature of District Representative Dole
DISTRIBUTION: YELLOW - DEPARTMENT WHITE - AREA OFFICE PINK - OWNER/APPLICANT
HCD 415 SIDE 1 (Rev 11 /20(14)
HYDRONICS: RESIDENTIAL FIRE SPRINKLER HYDRAULICS 4.4 -SUBMITTAL. Page 1
ENGINEERS : William F. SgUyres, Jr. (530) 345-1012.
ADDRESS P.O. Box 3176,
Chico, CA
95927.
=`"256
TOTAL DESIGN AREA-
Date:
06-04-2006 File: C:\RESDEN44\RVRCREST.RES
14
REQUIRED DENSITY
.055
JOB :
residential 2 heads
flowing
29.1
TOTAL DOMESTIC FLOW
5
SOURCE
I STATIC 45.0.
Psi RESIDUAL 40.0 Psi
FLOW
30 Gpm
DESIGN
I SPRINKLER MANUF
Reliable
MODEL
fl
res 49 ccp
27.5
SPRINKLER Q
14.0 Gpm
VALVE
.0 Psi
SPRINKLER P
8.2 Psi
METER
.0 Psi
NODE
ELEVATION
K-
PRESSURE
DISCHARGE
NO.
-----------------------------------------------------------
Feet
FACTOR
Psi
Gpm
1
10.0
4.9
8.2
14.0
2
10.0
4.9
9.5
15.1
lA
10.0
11.0
3
10.0
9.5
4
10.0
12.6
5
10.0
13.4
6
10.0
14.5
7
10.0
16.5
8
3.0
21.8
5.0 DOME
9
1.0
SOURCE
27.5
34.1
SPRINKLERS FLOWING
.2
AREA PER SPRINKLER
=`"256
TOTAL DESIGN AREA-
512
MIN SPRINKLER FLOW
14
REQUIRED DENSITY
.055
COMPUTED DENSITY
.055
TOTAL SPRINKLER FLOW
29.1
TOTAL DOMESTIC FLOW
5
TOTAL WATER REQUIRED
34.1
TOTAL SPRINKLER PRESS
27.5
WATER METER LOSS
.0
VALVE FIXED LOSS
.0
SUPPLY PRESS AVAILABLE
38.7
DEMAND PRESS REQUIRED
27.5
PRESSURE CUSHION
11.2
MAXIMUM VELOCITY 9.7
Sq Ft
Sq Ft
Gpm
Gpm/Sq Ft
Gpm/Sq Ft
Gpm
Gpm
Gpm
Psi
Psi
Psi
Copyright(2004)
Psi by
Psi Hydronics Engineering
Psi 34,119 Fremont B1, Suite 609
Fremont, Ca., 9.4555
F/S (800) 845-9819
ENGTN.EERS : William
F.
Squyres,
Jr.
(530)
345-1012.
ADDRESS : P.O.
Box 31.76, Chico,
CA 95927.
Date:
05-04-2006
File: C:\RESDEN44\RVRCREST.RES
JOB :
residential
2 heads flowing
PIPE
BEG
FLOW
K -FACTOR
LENGTH
C -FACTOR
PRESSURE
NO.
Gpm
FITTING TYPE
FTG
FR- LOSS
Psi
END
DIAMETER
------------------------------------------------
TOTAL
(Psi/Ft)
1
q=
14.0
K=
4.9
L=
3.5
Pt
8.2
Pt
8.2
1
Q=
14.0
F=
LB
F=
10.0
C= 150
Pe
.0
Pv
-.4
Vel=
7.3
D=
.884
TL=
13.5
.1023
Pf
1.4
Pn
7.8
3
-------------------------------------------
Pt
9.5
2
q=
15.1
K=
4.9
L=
3.5
Pt
9.5
Pt
9.5
2
Q=
2.9
F=
RR
F=
2.0
C= 150
Pe
.0
-Pv
.0
Vel=
1.5
D=
.884
TL=
5.5
.0054
Pf
.0
Pn
9:5
3
---------------------7
Pt
9.5
lA
q=
.0
K=
.0
L=
-----------------------------
7.0
Pt
11.0
Pt
11.0
3
Q=
16.8
F=
B
F=
3..0
C= 150
Pe
.0
Pv
-.5
Vel=
8.8
D=
.884
TL=
10.0
.1442-
Pf
1.4
Pn
10.5
3
--------------------------------------------------------
Pt
9.5
lA
q=
.0
K=
.0
L=
20.5
Pt
11.0
Pt
11.0
4
Q=
16.8
F=
RB
F=
4.0
C= 150
Pe
.0
Pv
-.5
Vel=
8.8
. D=
.884
TL=
24.5
.1442
Pf
3.5
Pn
10.5
6
-------------------------------------------------------
Pt
14.5
2
q=
15.1
K=
4.9
L=
29.0
Pt
9.5
Pt
9.5
5
Q=
12.3
F=
RRL
F=
9.0
C= 150
Pe
.0
Pv
-.3
Vel=
6.4
D=
.884
TL=
38.0
.0801
Pf
.3.0
Pn
9.2
4
---------------------------------------------------------------
Pt
12.6
-
4
q=
.0
K=
.0
L=
7.0
Pt
12.6
Pt
12.6
6
Q=
12.3
F=
B
F=
3.0
C= 150
Pe
.0
Pv
-.3
Vel=
6.4
D=
.884
TL=
10.0
.0801
Pf
.8
Pn
12.3
5
------------------------------------------------------------------
Pt
13.4
5
q=
.0
K=
.0
L=
12.5
Pt
13.4
Pt
13.4
7
Q=
12.3
F=
RR
F=
2.0
C= 150
Pe
.0
Pv
-.3
Vel=
6.4
D=
.884
TL=
14..5
.0801
Pf
1.2
Pn
13.1
--------------------------------------------------------------------------
6
Pt
14.5
6
q=
.0
K=
.0
L=
8.0
Pt
14.5
Pt
14.5
8
Q=
2 9 . l,. .
F,=
L
F=
7.0
C= 150
Pe
.0
Pv
-.6
Vel=
.9.7
D=
1.109
TL=.
15:0
.1315
Pf
2.0
Pn
13.9
--------------------------------------------------------------------------
7
Pt
16.5
7
q=
.0
K=
.0
L=
7.0
Pt
16.5
Pt
16.5
9
Q=
29.1
F=
3RS
F=
10.0
C= 150
Pe
3.0
Pv
-.6
Vel=
9.7
D=
1.109
TL=
17.0
.1315
Pf
2.2
Pn
15.9
--------------------------------------------------------------------------
8
Pt
21.8
ENGINEERS : William F. Squyres, Jr. (530) 345-1012.
ADDRESS* : P.O. $ox 3176, Chico, CA 95927.
Date: 05-04-2006 File: C:\RESDEN44\RVRCREST.RES
JOB : residential 2 heads flowing
PIPE
NO.
BEG
FLOW
K -FACTOR
LENGTH
C -FACTOR
PRESSURE
Gpm
FITTING
TYPE
FTG
FR- LOSS
Psi
---------ND----------------------------------------------------------
.. �
-DIAMETER
---
TOTAL
(Psi/Ft)
10
8
q= 5.0
DOME
----75.0
L=75-
0Pt
-----------
---------------
21.8 Pt 21.8
Q= 34.1
F= RL
F=
9.0
C= 150
Pe
.9 Pv -.3
9
Vel= 7.1
D= 1.4
TL=
84.0
.0567
Pf
4.8 Pn 21.5
------------------------------------
Pt
27.5
-------------------
Meter
= .0
1
--------------------------------------------------------------------------
Q= 34.1
<<<
-------------------------
SOURCE
>>>
Pt
27.5
E=>45-Elb L=>90-Elb B=>TeeBch R=>TeeRun C=>CouPlg S=>SwgChk G=>GatVly
:JUnil] 11 TA -L
ENGINEERS : William F. Squyres, Jr. (530) 345-1012.
ADDRESS : P.O.-Box 3176, Chico, CA 95927.
DATE : 05-04-2006 FILE C:\RESDEN44\RVRCREST.RES
JOB : residential 2 heads flowing
PSI FIRE SPRINKLER HYDRAULIC GRAPH
100 -- --
9 0 -- - — - - -- 80 - --
70 —
60
50 - -- _- ----- --- —
40 --
30 ----
20
10
0
10 15 20 25 30 35 40 45 50
Supply Curve
Static 45.0
Resid 40.0
Flora 30.0
FLOW - Gpm
Demand Curve
Avl Pr : 38.7 @ 34
Req Pr : 27.5 @ 34
Pr Cush: 11.2
Copyright: Hydronics Engineering, 2004.
34119 Fremont Bl, Suite 609,
Fremont, CA. 94555.
(800) 8.45-9819.
a
Ca-=_
Read Carefully!
Installation Instructions
& Technical Data
(Details in bulletins 035 & 135)
• Model F1 Res 49 Pendent
• Model F1 Res 49 Recessed Pendent % F1
(F1 escutcheon, adjustment)
(
I- I rtes 4J I-leiclenl
I- I Hes '19 1(ecessed
Pel deal / F I
• Model F1 Res 49 Recessed Pendent / FP
(FP push-on/thread-off escutcheon)
• Model F1 Res 49 CCP Pendent
F1 nes 49 Recessed
Pendens/FP
F I nes 49 CCP
Perlrienl
Model F1 Res Sprinklers
(UL 1626 Standard)
Technical Data
Max Sprinkler
3pactrcg Flow Pressure Sprinkler
11 (m) (IPccc (I_pm) psi (bar) Idenilllcallon
Number (SIN)
12 x 12 (3.Gx3.(ij 1:3 09) 7.0 (x).411)
14 x 14 (4.3x1.3) 13 (49) 7.0 (0.4(1)
I (; x 16 (4.0x4.9) 13 (/1!)) 7.0(0.40) 13516
III x Ia (s.5x ,.l;) r1 (64.:.1) 12.0 (0.113)
;-102 20(6.1x(;.1) a)(7!i.7) 16.7(1.15)
Technical Data
Tluread
Sprinkler
CCP
Assembly
Max.
Max.
Thread
Ramp •
g
Max.
Ambient K
Sprinkler
Size
Ambient
Temp.
Pressure
Temp. Factor
Length
^F
^F ^C
1
^F
^F ^C
Inch
(mm)
%.." NIT
155 6f3
1751 79
175 psi
12 bac
( )
Im 38
I!'i0 66 4'9
2.25
'
13.5(0.93)
67
(57)
Max Sprinkler
3pactrcg Flow Pressure Sprinkler
11 (m) (IPccc (I_pm) psi (bar) Idenilllcallon
Number (SIN)
12 x 12 (3.Gx3.(ij 1:3 09) 7.0 (x).411)
14 x 14 (4.3x1.3) 13 (49) 7.0 (0.4(1)
I (; x 16 (4.0x4.9) 13 (/1!)) 7.0(0.40) 13516
III x Ia (s.5x ,.l;) r1 (64.:.1) 12.0 (0.113)
;-102 20(6.1x(;.1) a)(7!i.7) 16.7(1.15)
Technical Data
Tluread
Sprinkler
Temp.
CCP
Assembly
Sprinkler
Max.
gpm (LPm)
Sprinkler
Size
Raling
Temp.
Haling
Max.
Pressure
Ambient
Temp.
K
Factor
lenglh
Inch
7.0 (0.4(1)
^F
^C
^F
^C
^F
^C
0.2 (0.56)
(mm)
18 x 111(5.5x5.5)
'
13.5(0.93)
67
I Pi Psi
(12 Isar)
IW
150
38
fib
4.9
2.25
.(57)
Max Sprinkler
Spacing
Flow
Pressure
Sprinkler
it (m)
gpm (LPm)
psi (bar)
Identification
Number (SIN)
12 x 12 (3.6x:1.(1)
I:S (4))
7.0 (0.4(1)
14 x 14 (4 3x4.3)
13 (49)
7.0
IG x 16 (4.9x4.9)
14 (53)
0.2 (0.56)
n3.516
18 x 111(5.5x5.5)
ID (6(3.1)
13.5(0.93)
20x20(61.1x6.1)
20(75.7)
16.7(1.15)
The Reliable Automatic Sprinkler Co., Inc., 525 North MacQuesten Parkway, Mount Vemon, New York 10552
CA -131 nev.0
Basic Principles of
Solvent Cementing .
The solvent cemented connection in thermoplasti
pipe'and fittings is the last vital link in a plastic pip
installation, It can mean the success or failure of
the system as a whole. Accordingly, it requires the
same professional care and attention that are give
•.to other components of the system.
There are many.solvent,cementing techniques
published covering step by step procedures on jus
how to make solvent cemented joints. However,
we, feel that if the basic principles involved are '
explained, known and understood, -a better
understanding would be gained, as to what
techniques are necessary to suit particular
applications, temperature conditions, and variation
:F in size and fits of pipe and fittings.
Be aware at all times of good safety practices.
Solvent cements for pipe and fittings are flammable,
so there should be no smoking nor.other sources
of heat or flame in working or storage areas. Be
`sure to work only.in a well ventilated space and
`avoid unnecessary skin contact with.all solvents.
'More detailed safety information is available from
''Harvel or.IPS (Weld -On) Corporation.
r�;fib ,t',. a j,i� • e J . � �, t
`•To;;.consistentiy make goods a
j
oints" ,the followin. g should .;
be 'carefullyndeirstood,
The jolnlnq`surfaces'must be softened
`and made semifllaid s>f
t
2, Sufficient,cementmust be applied to fill
y , v the;gap,between pipe and fitting j 1
3 Assembly ,of pipe and' fittings' muse be
,.., .
'. made'While the, are,stilI wet '
and fluid
� 4 J61nt'stYeng'th deyelops'as;the dement'
dries. In!the;tlght`part of the Joint the .
surfaces will tend to'.fuse'together in '!
the loose, part the .cement will bond to' j "
These areas must Surfaces must be
be softened and , assembled while they
penetrated pare wet.and•soft
n . I1.. • ., II �
When using the ONE STEP `."' If the,cement coatings:on the plpe��
t cementing process, penetration and; r and fittings,'are wet and fluid When
softening can be achieved by the atsembly takes place; they -will tend'., .{
cement itself (read ONE STEP-., to flow together.and beco(ne ort""
cementing procedures carefully, " layer. Also, if the, cement is wet the
refer to installation Instructions). For.% '• surfaces bene th therri'wlll.still be', `
certaln sizes,,under certain'. " soft, and these softened suifaces in
conditions, It may be desirable to the tight part'of the Joint will tend'
use the TWO STEP process which to fuse together.
utilizes a primer to ensure adequate r rf
S softening. For example, when
working ln'cold weather with large
diameter pipe;: more time and':. Surfaces +
additional applications may be
Bonded Sur act;
required.'.
• t 4,
Cement. coatings. of,
sufficient thickness
„
' Fused Surfaces
li. ,
As the solvent• dlsslpates.the
!•,`' cement.layer arld the softened'.`,.
More than sufficlent cement to fell surfaces'will harden with a
the loose part of the joint must'be . corresporShcng Increase In Joint -` `
applied. Besides filling the gap,' " -strength. A good Joint Will take the
adequate cemenflayers will required working pressure Iohg
penetrate the surfaces and also before tf eJolrlt Is fully dry. and final' ,
remain wet until the joint is , '.T ' strerigth.is obtained. In the tight ! • i
assembled, Prove this yourself.,' (fused). part of,theJolnt, strength.':', ,••i
Apply on the top surface of a: piece will °develop more quickly than in
of pipe -two separate layers of " the looser. (bonded) part of the
r cement,First flow on a heavy'layer tJoint; Information about the•
• of cemerjt' then alongside It a thin 4 `, development of bond strength, of, r -
brushed out layer. Test the,layers i, solvent cemented Jointsas avallable;,
ebery 15 seconds or so by a gentle,
tap with your finger,. You will note
r,
that the'thin layer becomes tacky r
and then'dries quickly'(probably
wlthin 15 seconds) The heavy layer
:wlll:remain wet much longer, Now
1'1i:�
check for• penetration a few minutes
• after applying thes�1ayers: Scrape
them wlth•a knlfe. The thin layer " L
will have achieved little or nq
penetration. The heavy one, much The QIIALITY,Li;ne
more, penetration, ' y 4
FOR SMALL rlrE
tion VSIZ—S G
(9.)POTTER
VANE TVPE WATERFLOW ALARM SWITCH
The Symbol of WITH RETARD AND GLUE -IN UNION
CUL, U1, and CSFM Listed, CE Marked, NYMEA ACCEPTED
Service Pressure: Up to 175 PSI (12,07 IIAR)
hiinimnm.Flow (late furAlann: 8-10 GPM (30-38 I,PM)
Maximum Surge: 18 FPS (5,5 m/s)
Enclosure: Die-cast, tell powdercoat finish
No. 1113555: Cover held in place with tamper resistant screws
No. 1113600 - 'tamper: Cover incorporates micro -switch.
Cover Tamper: Activated by cover removal.
Cover Tamper Switch Contacts: One set SPDT, Rated
at 250VAC.
Cover Tamper Switch Terminations: 8" 22AWO wire
leads.
Contact Ratings: TWO sets of SPDT (Form C)
15.0 Amps at 125/250 VAC
2.0 Amps at 30 VDC
Conduit Entrances: Two knockou[s provided for 1/2" conduit.
Usage: Listed CPVC plastic Piping systems manufactured by Central
Sprinkler Corp., Grinnell Sprinkler Corp., Spears Manufactur-
ing CO., and IPEX (Scepter).
US Patent No. 6,471,255 Fits pipe sires - I", 1-1/4", 1-1/2" and 2"
Environmental Specilicalions:
Stock No. 1113555 Suitable for indoor or outdoor use will, factory installed gasket
1113600 W/TSK and die-cast housing.
•
Service Use: For NEMA 4/11'55 rated enclosure - use will, appropriate conduit
filling and/or plugs.
Automatic Sprinkler NEPA-13 perantre range: 40 F to 120 F °
One or two family dwelling NFPA-
° (1,5° C l0 49 C)
NFI A -13D
Residential occupancy up to filar stories Can""":'Phis device is not intended fiat applications in explosive envi-
NFPA-1311
National Fire Alann Code ronments.
NFPA-72
Tile Model VSR-SFGisa vane type walcrfluwswilchforusconwetsprinkler operation of the VSR-SPG. See Fig. I.) Wait 2 to 4 hours to allow the
Systems using CPVC plastic fittings manufactured by Central Sprinkler glue to dry before attaching the VSR-SFG to the I" male fitting. Select the
Corp., Grinnell Sprinkler Corp., Spears Manufacturing Co., and IPEX proper paddle for [lie pipe size and type of TEE used. See Fig. 3 and Fig. 5
(Scepter) that use I ", 1-1/4", 1-1/2" or 2" pipe sizes. R is equipped with a for instructions on how to change paddle. Verify that the o -ring is properly
union to accommodate installation in confined spaces. positioned in its groove. I land lighten the nut on the union after orienting the
The unit contains twO single pole double throw snap action switches and an device in file appropriate direction to detect walerflow as shown in Fig. 2.
adjustable, instantly recycling pneumatic retard. The switches are achlaled CAUTION: Do not over -lighten the union nut, hand lighten onlyl
when a flow of 8-10 gallons per minute (30-38 liters per minute) or more
occurs downstream of the device. The flow condition must exist ftlr_a period I'he vane nuts[ not 1116 the inside'of the TFI3 or bind in any way. 'the stem
of time necessary tr1 overcome the selected retard period. should move freely when operated by hand.
INSTALLATION: 'I'hcse devices naay be mounted on horizontal or vertical I NSPECTION A N D TESTING: Check the operation orlhe unit by opening
pipe. On horizontal pipe they should be installed on the top side of the pipe the inspector's lest valve at the end of [lie sprinkler line or the drain and test
where they will be accessible. The units should not be installed within 6" (15 conneclion, if.an inspector's lest valve is not provided.
em) of valve, drain or fitting which changes the direction of the walerflow. If there are no provisions for testing the operation of the flow detection
The unil has,' I" male filling for gluing into a CPVC plastic TEE. device on the system, application of the VSR-SF(; is nut recommended or
Loosen the union nut and separate the I" male filling from the VSR-SF(i. advisable,
(il'ue the I" male lilting into the TEE following the_1f1 1 manufacnlrer's The frequency of [lie inspection and'testing and its associated protective
instnlclions fiat preparation and ghling of CPVC,R)ping sys(cros. (NOTE: monitoring system Should be in accordance with [he applicable NFPA
The I" male filling must bollom out on Il,; slop of the TH., for proper Codes and Standards and/or authority having _jurisdiction (manufacturer
recommends quarterly or more f-equently).
Potler Electric Signal Company • 2081 Craig Road, St. Louis, MO, 63146-4161 • Phone: 800-325-3936/Canada 888-882-1833 www.pollersignal.com
PRINTED IN USA MKT. 1t880n(1(19 - ItI:V I'
Mrti, t/5401062 - t 1ins PACU? 1 0F2
INSTALLATION AND MAINTENANCE INSTRUCTIONS
SSKI and SSV SELL Series
Specifications
SSM Series:
Voltage:
Operating Voltage Limit:
Maximum Current:
Operating Temperature:
SSV Series:
Voltage:
Operating Voltage Limit:
Maximum Current:
Operating Temperature:
24 VDC SSM
SSM24-6
SSM24-8
SSM24-10
120 VAC SSV
SSV120-6
SSV 120-8
SSV120-10
P = Polarized
S = Suppressed
(6", 24 VDC, P, S)
(8", 24 VDC, P, S)
(10", 24 VDC, P, S)
(6", 120 VAC)
(8", 120. VAC)
(10", 120 VAC)
Regulated 24 VDC
16 - 33 VDC
DC - 31.1mA/FWR - 53.5mA
-310 to 150°F (-350 to +66°C)
Regulated 120 VAC
96 - 132 VAC
53mA
-310 to 150°F (-35° to +66°C)
UL Reverberant Room
Sound Output per UL 464 (dBA)
82
80
81
85
82
82
Important
Please Read Carefully and Save
This instruction manual contains important' information
about the installation and operation of bells. Purchasers
who install bells for use by others must leave this manual
or a copy of it with the user.
System Sensor supplies bells for nearly all sprinkler/fire
alarm/burglar applications.
These, instructions apply to all System Sensor bells in the
series. Read all instructions carefully before beginning.
Follow only those instructions that apply to the model you
are installing.
ACAUTION
Do not use in potentially explosive atmospheres.
Do not leave any unused wires exposed.
0� SYSTEM
�� SENSOR®
3825 Ohio Avenue, St. Charles, Illinois 60174
1-800-SENSOR2, FAX: 630-377-6495
www.systemsensor.com
NOTE: All SSM Series DC bells were only tested at the
16-33 Volt-DC/FWR limits. All SSV Series AC bells were
only tested at the 96-132 Volt AC limits. This does not
include the 80% low-end or 110% high-end voltage limits.
General Description
The National Fire Protection Association has published
codes, standards, and recommended practices for the
installation and use of the above appliances. It is recom-
mended that the installer be familiar with these require-
ments, with local codes, and any special requirements of
the authority having jurisdiction.
These bells are intended to be connected to alarm indicat-
ing circuits of UL listed fire alarm control panels. The SSM
series is polarized to enable supervision of the installation
wiring. The SSM bells require 24 VDC and the SSV bells
require 1.20 VAC.
36
INCORPORATED
CORONA CA -
a4r?11
•.r. .l.�� �.•tw r.* 'S "��Z:i".'{r...:'��u.t� i. 1.. t� 5T .� � _
FIG. 23
HANGER FOR C. P. V. C. PLASTIC PIPE
DOUBLE FASTENER STRAP TYPE
Size Range - 3/4" thru 2" C.P.V.C. pipe.
Material - Carbon Steel with galvanized finish G-90 govt spec.
Function- The Fig. 23 and Fig. 24 are intended to perform as a
hanger/restrainer to support only C.P.V.C. piping used in
automatic fire sprinkler systems.
Fig. 23 and Fig. 24 can be installed on the top or on the bottom
of a beam. The Fig. 23 can also be installed on the side of a
beam.
The Fig. 23 and Fig. 24 can also function as a restrainer to prevent
the upward movement of the sprinkler head during activation.
Approvals - Underwriters' Laboratories listed to support fire
sprinkler piping. Meets and exceeds the requirements of
N.F.P.A. 13, 1313, and 13D.
Features - The Fig. 23 and Fig. 24 incorporate features which
protect the pipe and ease installation. The flared edge design
FIG. 24
HANGER FOR C.P.V.C. PLASTIC PIPE
DOUBLE FASTENER STRAP TYPE — SIDE MOUNT
rJ.
protects the C.P.V.C. pipe from any rough surface.
The Fig. 23 design mcorpora-es snap retainers allowing easier
and faster installation.
The Fig. 23 and Fig. 24 are easily attached to the building struc-
ture using the two hex head self threading screws` furnished
with the product It is recomrrended that rechargeable electric
drills fitted with a hex socket etachment be used as installation
tools. No impact tools (such zs a hammer) or impact fasteners
(such as drive screws or nails, are allowed. Damage has been
known to result from Installanons using impact type tools. No
pre drilling of a pilot hole in wood is required.
Order By - Figure number and C.P.V.C. pipe size.
Patents Pending
"-Hardened hex head self threading screw is furnished with the
product and is the minimui) fastener size acceptable.
C.P.V.C.
A
B
C
MAX. HANGEE: FASTENER APPROX.
PIPE SIZE
FIG. 23 FIG. 24
FIG. 23 FIG. 24
FIG. 23 FIG. 24
SPACING HEX HEAD WEIGHT(FT.) SIZE PER 100
344
�•;;�-1:�5/16
, 4X� ��ti �
3-1/8 2-5/16
a}, 3:3%$ �s `'5/8JaIt
1-9/16 1 5/32
`?11 16 Y 541�Ts� x'41=311r�.
/'.41-37lf
1-3/16 1 3/16
t i� �
5-1/2 9
E `+¢ w( 1 ai tri :r.;t}l�ae�..r
.+�i& �,��J�/IX��
a r
1-1/4
4-3/16 3
2-3/32 1 1/2
3:111'-3%1M'i13/16
1 3 16 1 3 161/2
�/
t6 s�F � ��?�T��d
`�
6 11
�r«�
rL{4;`F 3'rr(�4-a �r r
2
4-7/8 3-11 16
2-7/1 1-27./32
1-3/16 1-3[16_
8 5/16 7
1♦1.. v1�t_✓ Jr74
NOTES:
1. System to be installed per N.F.P.A. 13D, Manufacturers specifications,
and local A.H.J.
2. System provides protection in selected areas only as per N.F.P.A. criteria
3. All piping to be "listed" CPVC or equiv.
4. Pipe hangers to be "Tolco" or equiv.
5. Freeze protection, carpentry and electrical by others.
6. Riser to be installed in "stud bay" within indicated wall.
7. Exact pipe run lengths and head location subject to field verification.
8. Heads to be Reliable Fl Res 49 CCP
Flows based on a 16'X16' grid pattern. (see attached calcs. And spec. sheets)
9. All pipes to be 1" diameter unless otherwise noted.
10. All ceilings are flat and 9'0" in height, unless otherwise noted
11. "Tolco" pipe hanger spacing per attached manufacturers spec. sheet.
A) The maximum from hanger to the end of line on 3/4" CPVC pipe is 9"
b) The maximum from hanger to the end of line on 1" CPVC pipe is 12"
c) The maximum distance between hangers on 1" CPVC pipe is -G1.-5_' �3/0 if
d) The maximum distance between hangers on '/4" CPVC pipe is—s�& 310o/
12. Total heads required = 11 ,
13. Future Additions of heat sources, like gas or wood burning stoves, should be,
installed according to N.F.P.A. 13D residential sprinkler installation guide.
pANO11LLL DR� NO. IaGA-IB%2401111
0
/7\
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ATTACHMENTS
Inspector Checklist
Tags/Labels
Sprinkler Install Instructions
Approval Notes
Calculations
APPROVED
Approval oftheseplans does not authorize or
approve any omission or deviation from requirements
of State Laws or local ordinances.
One sat of approved plans shall be available on the
project site at all times.
State ofCelifornia
Department of Housing and Community Development
Diysion o Cnxles and Staudar
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Mobilehome Manufacturer: Manufacture Year: 2CO�
If other than single wide, furnish Setup Model -Number:_ clsqGj' '
Width:( €t (ft.) Length:�(ft.) Tagalong or Expando Size ' (ft.) x - (f}.)
On all mobilehomes manufactured after October 7, 1973, . furnish manufacturer's
installation manual and structural setup sheets.
FOOTINGS: Wood pressure treated or foundation grade[K] Other:
SUPPORTS: Concrete block" Other: -
Provide Tie'Down Specifications for all Mobilehomes: utj) 6u 1d
Pier-Fobtings Sizes and Location
SINGLE WIDE blULT14ME
Line 1 e 1
Linc 2 t• - Linc 2
................................................................................................
Main Beams
Line2 ................................................... ............... ....... e 2
Line 1 Line 3
Liao 2
Main Beams .....
...........................................................•----......•---..... .......... Lie 2 _
Line 1
.. C5
Tag or Triple ine4*
.................................................BUTTE COUNTY
e1 BUILDING DIVISION
APPROVED
Line 1 Piers:'
Size minimum: S`f x 3D
Spacing maximum: `d ` O `
From ends -maximum ` `
Line*l Openings
Size minimum: [ ] x [ ].
Each side of openings
with width oven. C`
Lane 2 Piers: Qq .3a Line 4 Piers: -
Size minimum: [ q I x [ 0, 1 Size minimum: [ ] x [ ].
Spacing maximum: -1 ` o Spacing maximum: `
From,ends-maximum From ends -maximum `
Line 3 Roof Loads:
Size minimum Qar
Location (from): .
L 06-6
Line 5 Roof Loads:
Size minimum:
Location (from front):
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GAS INLET
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DRAIN OUTLET
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3
WATER INLET
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35'-4'
@
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4
ELECTRICAL INLET •
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38'-1 �/2"
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11'-10"
_ 5
ELECTRICAL. X -OVER•.
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. � UTILITY LOCATIONS
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DESCRIPTION
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GAS INLET
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DRAIN OUTLET
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@
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3
WATER INLET
@
35'-4'
@
0'-10"
4
ELECTRICAL INLET •
@
38'-1 �/2"
@
11'-10"
_ 5
ELECTRICAL. X -OVER•.
@
34'-0" .
@
13'-4"
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@
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2"x 2"x 3/16"
STEEL ANGLE
DETAIL "A"
f
CHASSIS FRAME
r
1/4" GRIPPER PLATE
. (2). REQUIRED
1/4- GRIPPER BASE
1/2-13UNC—A307 x 4"
BOLT WITH NUTS
(4) REQUIRED
01 1/2- SCH 40 PIPE RISER WITH
01/2" ADJUSTER HOLES AND 3/8"
THICK TOP PLATE
02" SCH 40 PIPE STAND WITH TWO
01/2" ADJUSTER HOLES Q
ABESCO ABS PAD #503 —�
STEEL FRAME
SEE DETAIL "A
3/8" CAD PLATED BOLT, NUT & WASHER COACH "C" FRAME
COUNTER BORED FLUSH WITH BOTTOM 2" CHANNEL
AT 8" O.C.: (8) REQUIRED
1/4"x 1-1 /4
1/4" STAND BASE 7EK STS
r— ABESCO ABS PAD #503 (2) REQUIRED
1/4- GRIPPER
51 BASE
1/2" A307 BOLT -
(2) REQUIRED
3/8"x 6"x 6" -
STEEL PLATE
1/2" A307 BOLT -
(2) REQUIRED
36" MAX - 10.00
TO BOTTOM
• OF PAD � ° o
8
10.00 O
01/2"x 3" C.R.
LOCK PIN WITH
01/8- BRIDGE °
PIN 09/16 HOLE (TYP)
/ STAND BASE
f TOP VIEW
37"
18 1/2"
17918
it p� F � c,
TUF-1 PERMANENT
FOUNDATION SYSTEM
COACH "J" FRAME
1/4 "
/4" GRIPPER 1 TEK 1STS/4"
PLATE (4) REQUIRED
Ph n m .
1/4- GRIPPER
BASE
1/2" A307 BOLT
(4) REQUIRED
C—BEAM J—BEAM
ATTACHMENT ATTACHMENT
4
8' 1/2 DIA. HOLE (8) PLACES
gma
ill�_ :
.._ >![BAL'!R AMID SAFB7'Y ODDS. !t{�
Tocormaclowmam
WAYNE T. POLVADO, PE—LISTING NO. F94249 SHEET 1 of 3
do
GENERAL NOTES GUS GUARD TUF-1
1. DESIGN LOADS: LIVE LOAD - 30 LB.
FLOOR LIVE LOAD - 40 PSF
WIND LOAD - 80 MPH EXPOSURE "C"
SEISMIC ZONE "4"
*SNOW LOAD 100 PSF (SEE NOTE #15)
2. THIS FOUNDATION SYSTEM IS DESIGNED TO BE CONSTRUCTED ON
A FAIRLY LEVEL SITE WITH NO EXISTING SOIL PROBLEMS.
3, CHASSIS BEAM SUPPORTS SHALL BE LOCATED AND SIZED FOR THE LOADS
AS SHOWN IN THE "MOBILE HOME INSTALLATION INSTRUCTIONS
4, IN AREAS WHERE DIFFERENTIAL SETTLEMENT (D.S.) CAN OCCUR,
MANUFACTURED HOME .SHALL BE READJUSTED WHEN DS EXCEEDS 1/4",
OR. WHEN IT WILL ADVERSELY AFFECT MOBILE HOME UNIT.
5. CARRY ALL FOOTINGS DOWN TO FIRM, UNDISTURBED SOIL. FOOTINGS
ARE DESIGNED FOR 1,000 PSF TOTAL LOAD SOIL PRESSURE, AND
SHALL BE COMPATIBLE WITH LOCAL SOIL CONDITIONS. COMPACTED SAND
MAY BE USED TO FILL LOCAL VOIDS UNDER PADS.
6. STRUCTURAL STEEL: FABRICATED ACCORDING TO AISC SPECIFICATION.
WELD ACCORDING TO AWS SPECIFICATIONS. ELECTRODES -370 PLATES -ASTM'
A36 BOLTS -SAE GR 5=ASTM A449=ASTM A3725.
7, THE GUS GUARD ASSEMBLIES SHOWN ON THIS PAGE SHALL BE LISTED AND
LABELED BY BSK AND ASSOCIATES FOR THE FOLLOWING LOADS:
ALLOWABLE LOADS: HORIZONTAL VERTICAL
GUS GUARD TUF-1 2200# 6000#
GUS GUARD MGP PAD 2200# 6000#
GUS GUARD E -Z TIE PAD 2200# 6000#
8. DURING PRELIMINARY INSPECTION, THE ESTIMATOR SHALL ENSURE THAT
MOBILE HOME CHASSIS BEAMS ARE OF STANDARD SECTION.
9.. EXISTING COACHES MAY BE RETROFITTED TO RESIST SEISMIC FORCES BY
INSTALLING GUS GUARD TUF-1 UNITS AS SHOWN ON THIS PAGE OF TYPICAL
FOUNDATION PLANS.
10. THE GUS GUARD TUF-1 SYSTEMS ARE SAFE -FOR INSTALLATION IN FLOOD
PLAIN AREAS WHERE DEPTH OF FLOODING DOES NOT EXCEED THE HEIGHT
OF THREE FEET.
11. MULTIPLE UNIT INSTALLATION IS ACCEPTABLE PROVIDED
THE NUMBER OF TUF-1 UNITS UNDER EACH UNIT IS
THE SAME AS SHOWN REQUIRED PER EACH UNIT.
12. SINGLE -WIDE UNITS REQUIRE ADDITIONAL RESTRAINT. ' (SEE SHEET #3)..*
13. ALL METAL COMPONENTS AND ATTACHMENTS ITEMS SHALL BE PROTECTIVE COATED.
14 WHEN CONCRETE SLAB IS IN EXISTANCE, PAD IS NOT
16. FOUNDATION BLOCKS 16"x 16"x12" POURED IN PLACE AT GROUND LEVEL MAY
BE USED AT INSTALLERS DISCRETION ALTERNATIVE TO PADS.
SINGLE WIDE COACHES DOUBLE/MULTIPLE COACHES
E= 2' MIN. / 8' MAX. E= 2' MIN. / 11' MAX.
S= 6' MN. /161' MAX. S= 6' MIN. / 22' MAX.
VARIES 10'-70' (SEE TABLE ON SHEET #3) -'
E— S 'i - S S E
U u
u ❑ ❑
u
RIDGE BEAM SUPPORT AS
REQUIRED BY MANUFACTURER
a 0 (TYPICAL)
0 1:1 1:1
a
❑ 0-T
❑ ❑ ❑
❑
8' NOM.
❑ ❑
2' NOM.
PADS IN ANY PAIR MAY BE STANDARD
M.H. FOUNDATION
{
ROTATED 90 DEGREES OR PIERS AS RECOMMENDED BY
PVC SERIES,
OFFSET TO OTHER SIDE TO THE MANUFACTURER OR THE
AVOID CLEARANCE PROBLEMS. ENGINEER. TYPICAL THROUGHOUT
SUPPORT
PAD (TYP)
1
f7916
Exp.=�
F 4F
REQUIRED. ANCHOR STAND TO CONCRETE SLAB WITH TUF-1 PERMANENT
FOUR (4) 1/2"x 3 1/2" EXPANSION ANCHORS. FOUNDATION SYSTEM
15. GUS GUARD TUF-1 FOUNDATION SYSTEM PROVIDES
ALLOWABLE SNOW LOAD TO 100 PSF WHEN INSTALLED ABESCO-GUS GUARD COMPANY
WITH EXISTING STANDARDS REQUIRED BY COACH 5851 FLORIN - PERKINS ROAD
MANUFACTURER OR REPLACE THEM ON A ONE TO SACRAMENTO, CA 95823
ONE BASIS. I ou. IsmAN kS 7_ulz-Ai
STATE APPROVAL
-�iVt1iA
MANUFACTURED HOME/MOBILE ROILS
FOUNDATION SYSTEM
HEALTH AND SAFETY CODE. SECTION 18551
APPROVED,
SUBJECT TO CORRECTIONS NOTED .
APPROVAL DOES NOT AUTHORIZE OR APPROVE ANT
OMISSIONS OR DEVIATION FROM REQUIREMENTS OF
APPLICABLE STATE LAWS AND R60ULAIM4
State of Californis
Dep a t of Housing. and Conner De"6g=W
O CODES AND37'
BY �/'� / TB
SPA NO. - / YJ F i
a,
3/4" DIA. x 18" LG.
1/2"x 3 1/2" 1/2"x 8" LONG (4) REQUIRED
EXPANSION ANCHOR ANCHOR BOLT 3/8" CAD PLATED BOLT, NUT & WASHER
(4) REQUIRED (4) REQUIRED COUNTER BORED FLUSH WITH BOTTOM
AT 8" O.C. \ (8) REQUIRED
'� iAl 1 .1
IMAM
CONCRETE PAD INSTALLATION
CHASSIS FRAME
1/4" GRIPPER PLATE
(2) REQUIRED
1/4" GRIPPER BASE
1/2-13UNC-A307 x 4"
BOLT WITH NUTS
(4) REQUIRED
01 1/2- SCH 40 PIPE RISER WITH
01/2" ADJUSTER HOLES AND 3/8"
THICK TOP PLATE
02" SCH 40 PIPE STAND WITH TWO
01/2" ADJUSTER HOLES
ABESCO ABS PAD #503
STEEL FRAME
POURED IN PLACE 16x16x12 CONCRETE
FOUNDATION INSTALLATION
36" MAX MMT1—W1DE UNnS
TO BOTTOM
OF PAD
01/2"x 3" C.R.
LOCK PIN WITH
01/8" BRIDGE
PIN
l�
18 1/2-
E - Z TIE PAD
1WIRS
10
LIGHT HEAVY—WEIGHT
PLASTIC PAD INSTALLATION
LENGTH OF
I HOME1
24
WIDTH OF HOME
1 26 1 28 44d
UP TO 44' 1
8
1 8 1 8 1 12
44--1- to 66-1
12
1 12 1 12 18
66'-1- to 801
20
1 20 120 24
+Y I:���: ,111: LIY►.
LENGTH OF
HOME
10
WIDTH OF HOME
12 14 16
UP TO 44' 1
6
1 6
6 6
44'-1- to 66-1
8
1 8
8 8
66--1- to 801
10
1 10
10 10
NUMULK Ur IUt-1. REQUIRED NUMBER OF TUF-1 REQUIRED
.c
NOTE; SINGLE WIDE UNITS REQUIRE (4) E -Z TIE PADS. GUS GUARD TUF-1 PIERSCARE
TO BE PLACED AT APPROXIMATELY EQUAL INTERVALS ALONG EACH FRAME RAIL
P__' �Elll
1791
EXP.`S:
OF C
37 TUF-1 PERMANENT
FOUNDATION SYSTEM
STATE APPROVAL
FOUNDATION SYSTEM
AND SAFETY CODE, SECTION ISS31
APPROVED
SUBJECT TO CORRECTIONS NOTED a
APPROVAL DOES NOT AUTHORI2t OR APPROVE ANY
r OMISSIONS OR DEVIATION FROM REQUIREMENTS OF
APPLICABLE STATE LAWS AND REGULATIONS
State of California
D en of Housi and Community Development
DES AND STANDARD$
BY ATB '>•i� o
F (signature)
SPA N0. /
This Plan Approval Expires (o
OC.l L, fA i
WAYNE T. POLVADO, PE—LISTING NO. F94249 SHEET 3 of 3
0
g 1i OF BUSINESS, TRANSPORTATION AND 1401 561r +
N AND COMMUNITY
DEPARTMENT IVISION OF CODES AND STANDARDS DEVELOPMENT I U
o ® 11 NUFA,�CTURED HOUSING PROGRAM I
c�'�tnTc>Ev^� MANUFACTURER CERTIFICATE ®F ORIGIN
❑ CHECK IF THIS IS A DUPLICATE MCO -ENTER ORIGINAL MCO NO.
MAN FA TURED HOME OR MULTI ' INIT MANUFACTURED HOU IN NUMBER OF
TRANSPORTABLE SECTIONS
C1SFD (SINGLE FAMILY DWELLING) ❑ MUMH (MULTI -UNIT MANUFACTURED HOUSING
COMMERCIAL C A H:
OCCUPANCY GROUP MANUFACTURER LICENSE NUMBER:
CmH mAnuf act
80); 910/400 w -
Marlette
Nest, Inc.
m Integrity games, Inc.
IFALER OR TRANSFEREE ADDRESS:
Feather River Blvd
iDoa£ba>Ldier CaPita7
1 hjt)untain View Dr.
SECTION I MANUFACTURER SERIAL NUMBER.
TRANSPORTER NAME:
1360 Industrial trWay
AIL
. NATION:
-
TRANSFEREE DESIG
�I
Wbodbug ri
71
(Street
DESTINATION FOR UNIT DESCRIBED ABOVE:
1'740 �eat1'>er River Blvd- C. I
t�x'oyi�.�g�ata CAL95965(Zi
Lx?;te;�rity kioiTaes, Inco S eel
(NAME
I certify under Penalty of Perjury under the laws of the State of Cat'domfa that the above £acts are true and torted
C)h at (County .e s
Executed on lC'h
(Date)
rrun.17M AGENT:
DISTRIBUTION: ORIGINAL (PINK) FORWARD TO THE INVENTORY CREDITOR, UNLESS THERE IS NONE, THEN FORWARD TO
THF -
COPY 1 (WHITE) FORIWVERD TTO T TRANSPORTER AT AP.O. BOX '1828. SACRAMENTO. CA 958`12
CCOMPANY THE UNIT TO ITS DESTINATION.
WITHIN FNE (5) DAYS OF RELEASE.
COPY 2 (YELLOW)'
COPY 3 (GOLDENROD) TO BE RETAINED BY THE MANUFACTURE
HCD 483.0 - Side 1 - (7f9T)
tonuc[FRI
V17A. a
Zi)
o5446
Ca�cileE;�y°r
HCD INSIGNIA OR HUD LABEL NUMBER
LENGTH
(INCHES)
WIDTH
INCHES
WEIGH'
(POUND
Wbodbug ri
71
(Street
DESTINATION FOR UNIT DESCRIBED ABOVE:
1'740 �eat1'>er River Blvd- C. I
t�x'oyi�.�g�ata CAL95965(Zi
Lx?;te;�rity kioiTaes, Inco S eel
(NAME
I certify under Penalty of Perjury under the laws of the State of Cat'domfa that the above £acts are true and torted
C)h at (County .e s
Executed on lC'h
(Date)
rrun.17M AGENT:
DISTRIBUTION: ORIGINAL (PINK) FORWARD TO THE INVENTORY CREDITOR, UNLESS THERE IS NONE, THEN FORWARD TO
THF -
COPY 1 (WHITE) FORIWVERD TTO T TRANSPORTER AT AP.O. BOX '1828. SACRAMENTO. CA 958`12
CCOMPANY THE UNIT TO ITS DESTINATION.
WITHIN FNE (5) DAYS OF RELEASE.
COPY 2 (YELLOW)'
COPY 3 (GOLDENROD) TO BE RETAINED BY THE MANUFACTURE
HCD 483.0 - Side 1 - (7f9T)
tonuc[FRI
RECORDING REQUESTED BY:
.AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE CA 95965
COPY of Docusent Recorded
15-Dec-20*6 2006-0065840
.Has not been compared with
original.
BUTTE COUNTY RECORDER
SPACE ABOVE THIS LINE FOR RECORDER USE ONLY
NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH,
INSTALLATION ON A FOUNDATION SYSTEM
Recording 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 occupancy for installation 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 deemed to give
constructive notice as to its contents to all persons thereafter dealing with the real property.
LILLIAN CESENA
BUTTE COUNTY BUILDING DIVISION .
REAL PROPERTY OWNER/LESSOR
LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY
5390 PALM GROVE COURT
7 COUNTY CENTER DRIVE
MAILING ADDRESS
MAILING ADDRESS
SAN JOSE BUTTE CA 95123-1754
OROVILLE BUTTE CA 95965
CITY COUNTY STATE ZIP
CITY COUNTY STATE ZIP
580 MARIAH LN.
06-0480 (530) 538-7541
INSTALLATION MAILING ADDRESS, IF DIFFERENT
BIJILDING PERMIT NO TELEPHONE NUMBER
OROVILLEBUTTE CA
12/12/2006
CITY COUNTY STATE. ZIP
SIGNATURE OF LO AGENCY OFFICIAL DATE
SAME
NONE
UNIT OWNER (if also property owner, write "SAME"
DEALER NAME (if not a dealer, write "NONE")
SAME
NONE
MAILING ADDRESS
DEALER LICENSE NO.
SAME
ul l Y I:UUN I Y S I A Cly LIF
UNIT DESCRIPTION
MARLETTE 2005 RIVERCREST-9599
MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER
HER0239130RA/B .44'X 26'8"
SERIAL NUMBERS) LENGTH X WIDTH
REAL PROPERTY LEGAL DESCRIPTION: SEE ATTACHED
ASSESSOR'S PARCEL NUMBER: 025-340-022
I ml"ki of
HCD FORM 433(A) REV 8/91
ORE468454/5
INSIGNIA/LABEL NUMBER(S)
THE LAND REFERED TO IN THIS REPORT IS SITUATED IN THE STATE OF CALIFORNIA, COUNTY
OF BUTTE, ANS IS DESCRIBED AS FOLLOWS:
PARCEL I:
PARCEL 1, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE
RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON SEPTEMBER 23, 1998, IN
BOOK 144 OF MAPS, AT PAGE(S) 67 AND 68.
RESERVING THEREFROM A 60 FOOT RIGHT OF WAY AND PUBLIC UTILITY EASEMENT AND A 20
FOOT PUBLIC UTILITY EASEMENT AS SHOWN ON SAID MAP.
ALSO RESERVING THERFROM A NON-EXCLUSIVE EASEMENT FOR PUBLIC UTILITY PURPOSES OVER
THE SOUHTERLY 30 FEET, AS SHOWN ON SAID MAP.
PARCELII:
A 60 FEET RIGHT OF WAY AND PUBLIC UTILITY EASEMENT OVER PARCELS 1 THRU 3, AS SHOWN
ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY
OF BUTTE, STATE OF CALIFORNIA, ON SEPTEMBER 23, 1998, IN BOOK 144 OF MAPS, AT
PAGE(S) 67 AND 68.
EXCEPTING THEREFROM ALL THAT PORTION LYING WITHIN THE BOUNDS OF PARCEL I, DESCRIBED
HEREIN.
PACERL III:
A NON-EXCLUSIVE EASEMENT 30 FEET WIDE FOR PUBLIC UTILITIES PURPOSES LYING
NORTHERLY OF, RUNNING PARALLEL WITH AND ADJACENT TO THE SOUTH LINE OF.PARCELS 1,2,
3 AND 4, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER
OF THE COUNTY OF BUTTE, STATE OF CALIOFNRIA, ON SEPTEMBER 23, 1998, IN BOOK 144, AT
PAGE(S) 67 AND 68, FROM THE EAST LINE OF SAID PARCEL 4 TO THE WEST LINE OF SAID
PARCEL 1.
THIS EASEMENT IS APPURTENANT TO AND SHALL INURE TO THE BENEFIT OF SAID PARCELS 1,
2, 3 AND 4, AND APPLIES TO ALL SUCCESSORS OR ASSIGNS OF SAID PARCELS.
EXCEPTING THEREFROM ALL THAT PORTION LYING WITHIN THE BOUNDS OF PARCEL I, DESCRIBED
HEREIN.
PARCEL IV:
A NON-EXCLUSIVE EASEMENT FOR ROAD AND PUBLIC UTILITIES OVER A PORTION OF SECTION 1,
TOWNSHIP 18 NORTH, RANGE 3 EAST, M.D.B. & M. DESCRIBED AS FOLLOWS:
BEGINNING AT THE EAST ONE-QUARTER CORNER OF SECTION 1, TOWNSHIP.18 NORTH, RANGE 3
EAST, M.D.B. & m.;, THENCE NORTH 83 DEGREES 46' 06" WEST, 783.19 FEET TO THE TRUE
POINT OF BEGINNING FOR THE HEREIN DESCRIBED EASEMENT, SAID POINT DEING ON THE
NORTHERLY LINE OF PARCEL 4, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED.IN THE
OFFIE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON SEPTEMBER 23,
1998, IN BOOK 144 OF MAPS, AT PAGE(S) 67; THENCE NORTH 86 DEGREES 24' 53" EAST,
663.51 FEET; THENCE NORTH 86 DEGREES 02'42" EAST, 80.67 FEET; THENCE NORTH 70
DEGREES 31' 41" EAST, 4.66 FEET TO A POINT ON THE WESTERLY LINE OF LONE TREE ROAD;
THENCE SOUTH 00 DEGREES 37' 50" EAST ALONG SAID WESTERLY LINE, 8.37 FEET TO THE
NORTHEAST CORNER OF SAID PARCEL 4; THENCE SOUTH 86 DEGREES 55' 01" WEST ALONG SAID
NORTHERLY LINE OF SAID PARCEL 4, 758.26 FEET.
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BUILDING PERMIT NUMBER: 06-0480
Address or location of unit: 580 MARIAH LN. OROVILLE CA
Legal Description of Real Property: 025-340-022
SEE ATTACHED
(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: LILLIAN CESENA
Owner's address:5390 PALM GROVE COURT SAN JOSE CA 95123-1754
INSIGNIA OR HUD NUMBER:ORE468454/5
SERIAL NUMBER OR V.I.N.: HER0239130RA/B
MANUFACTURER'S NAME: MARLETTE YEAR: 2005
OFFICIAL APPROVING INSTALLATION:
4;,.0_z fiwu
DATE: I off/ 6
PHONE: (530) 538-7541
H.C.D. 513
BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 COUNTY CENTER DRIVE, OROVILLE, CA 95965
www.buttecounty.net/dds ' PHONE (530) 538-7541 FAX 538-2140
RECEIPT OF FEES SCHEDULE - RESIDENTIAL
Owner cesena, lillian APN No:
025-340-022
Application
Date 3/1/2006 Permit No: BP
06 -0485 -
RECEIPT DATE Tech/Asst
1
BUILDING PERMIT FEES ESTIMATED AT APPLICATION
$549.90
329.94 yNN�92 3
Plan Check portion of Permit Fee
$219.96
2
FEMA Flood Elevation Review $109.98
0
3
RYes
SRA* Yes Fire Plan Check - Non -Refundable $95.00
0
(State Responsibility Area) Building Inspection $109.98
0
NON-REFUNDABLE portion of fees due at application
$219.96
RECEIPT DATE Tech/Asst
FEES DUE AND PAYABLE AT TIME OF PERMIT APPLICATION
$21 6 U L(y '�9Z 3—J
J
4
SMTP* - Strong Motion Instrumentation Program (Enter amount from permit system)
$7_62f py
5
Additional Plan Check Fees (NON-REFUNDABLE)
6
Other*:
sa
Other*:
FEES (BELOW) DUE PRIOR TO ISSUANCE OF PERMIT
7
IMPACT FEES - RESIDENTIAL*
Per Dwelling
Per Dwelling
Per Dwelling
/
--r�5fL.
MH
Applications After 2/14/05 sc
SFD x
MFD
� tP v
County 4096.87 3071.14 1
3117.43
Chico Urban Area 5372.09 3995.45
4889.56
EI Medio Fire District 3128.31 2297.77
2326.36
North Chico Specific Plan
A SR -1, SR -3, SR-1/PD 7938.531 6757.081
S tR-1 8031.53 6850.08
�
° R-2 7541.531 6360.081
7633.49
7726.49
7236.49
R-3 6780.531 5599.081
6475.49
RECEIPT Tech/Asst
(`$3,2- 17. 3� I G/ c� 4
Processing Fee is automatically added to impact fee total 1 $100.00
WATER TENDER FEE (Not collected when Impact Fees Applicable) Enter Bat.#
$200,00
8
�L_J
DRAINAGE FEES*
9
CHICO STORM DRAINAGE
770 Butte Creek
$7,736
MASTER PLAN
771 Comanche Creek $8,069
772 Little Chico Creek
$8,792
New construction, vacant
land, on 1 acre or less -
Enter 1 or less acre value
RECEIPT DATE Tech/Asst
773 Big Chico Creek $6,596
774 Lindo Channel $8,139
775 SUDAD Ditch $6,975
776 Mud -Sycamore Creek $6,070
777 PV Ditch
$8,603
9a More than 1 acre, existing buildings - fees to be assessed by Public Works
Fee Determination Sheet Needed - Enter amount determined by PW
10 THERMALITO DRAINAGE AREA 1 $652 Maximum
Per each new living unit on existing lots where full drainage fees have not been paid
10a Temporary Dwelling 1 $130 At time of building permit
It $130 annual renewal fee for first 4 renewals. Not to exceed $652.
PROOF OF PAYMENT OF FEES (BELOW) MUST BE RECEIVED PRIOR TO ISSUANCE OF PERMIT. Forms will be prepared after plan
check is completed for applicant to take to respective district office.
11 SCHOOL DISTRICT FEES* Orowlle Union_High-School-092 ?
11a RECREATION DISTRICT FEES* Oroville �ven
At the time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan
checking process.
Applicant: (-,m ojQjj/l C Date: _ o/
Pursuant to Government code Section 66020, you are hereby notified those Items followed by an "*" may have been impose n your project. have 90 days
from the date of approval of the porject or from the impostion of the above referenced items during which you may protest. The requirements for a protest are
specified in Goverment Code Section 66020(x). K:/Building/Forms/Schedule of Receipt Fees Residential 1105
1
• 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 OF APPLICATION
OWNER
Name (A i
Address '�)300 ,M mve,
City c1 .
State
Zip _ -a3
Phone ,4O
Fax
E-mail
V
APPLICANT SIGNATURE
X
For office use only:
CONTRACTOR,
Name DD
C, `
We „ 1
Addres g
�`� d A�J
City �C(A'TA
Type Const.
State
Zip
Phontstd
%.Ak s8zF
2a(5854
E -m '
rvq 04 f -e
Uc. %35w
I Classc
V
APPLICANT SIGNATURE
X
For office use only:
ARCHITECT/ENGINEER
Name
C, `
We „ 1
Address
Occ•
City
Type Const.
State
Zip
Phone
Page
Fax
E-mail
State License Number
V
APPLICANT SIGNATURE
X
For office use only:
APPLICANT NAME
Name -D@ p
C, `
We „ 1
Address
Occ•
City
Type Const.
State
Zip
Phone
Page
Fax
E-mail `
V
APPLICANT SIGNATURE
X
For office use only:
Zoning Z %
Flood Zone SRAI Yes
r No
Occ•
I
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS L
K:\FORMS\BUILDING FORMS\B1dgApp1SubRgmts.doc Page 1 of 2
PERMIT
NO.
W96 () t/9
MM -A
LOCATION
AP# J Zfo — C.g�)-
PropeVes`
Cross Street V
(ya- i � d • g5g1
WORKER'S COMPENSATION
Policy Number
1io l.- oil
Carrier k
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
Description or Scope of Work:
Sq. Fo tage 11
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable. _
Received by�
Receipt
Date: l 106
Other
Total
REV 4-30-04
D
T
SUBMITTAL 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.
Residential, New, Remodels, Additions, and Accessory Structures:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER!
❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPER!
❑ 3. 3 Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed
calculations.
❑ 4. 2 Engineered truss details and layouts (if required) (NO FAXESI).
❑ 5. ,Letter from Engineer or Architect for truss design review.
❑ 6. 2 Energy compliance design and supporting documentation: (Note: Not required for additions to
mobile or modular homes.)
❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑ 8. Detached Accessory Building Form, filled out by the property owner (if required).
❑ 9. Sanitation and site plan approval from the Environmental Health Department.
❑ 10. Metal Buildings: (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.
Mobile, Manufactured, or Modular Homes:
❑ 1. 3 Site Plans, signed\by the preparer. NO GRAPH PAPERI
❑ 2. 2 Data sheets and installation instruction manual.
❑ 3. 2 Marriage line information.
❑ 4. 2 Floor plans.
❑ 5. 2 Engineered Tie Downs or Foundation plans.
❑ 6. Sanitation and site plan approval from the Environmental Health Department.
❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
Commercial, New, Additions and Remodels:
❑
1.
4 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑
2.
4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations,
with code analysis.
❑
3.
2 Engineered truss details and layouts (if required) (NO FAXES!).
❑
4.
Letter from Engineer or Architect for truss design review.
❑
5.
2 Energy compliance design and supporting documentation (if required).
❑
6.
2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑
7.
Statement of Intent for Non -heated and A/C (if required).
❑
8.
Metal Buildings: (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-signedy the engineer.
❑
9.
Letter of intent.
❑ 10. Hazardous Material Form.
❑ 11. Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, contact a Permit
Application Assistant at (530) 538-7541.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 4-30-04
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BUTTE COUNTY
BUILDING DIVISION
ATROVED
YED
Fire Suppression System permit and
FINAL INSPECTION from H.C.D. Stat
of California REQUIRED before Butte
County Building Division will final MH
permit. Provide verification of H.C.D.
final of fire sprinkler system.
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