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HomeMy WebLinkAbout026-030-060AP 26-03-06--`l JONES, Mary H. 6590 Upper Palermo, Oroville ` }Permit ## 2437-74P,E (util, MH) ELEC . DO a.. GAS L_ C- j SUPPORT STRUCTURE REQ. AP ' COMPACTION TEST REQ. F,P##26-03- 9 /D-� ?ermit #4525-75MHI Cssued �F lot `C 26-03-- • Contr : LaGrone Heating Permit.#2998-77E,M(evap r)SF -_.26-03-6 Contr: Lincoln Village ermit #4903-7 . MHa Issued 026-030=006 05-1841 JONES, KENNETH 6590 UPPER PAL , RL E Cont: OWNER UPGRADE ELEC P.\V 26-006 OS -1843'' JONES, KENNETH / 6590 UPPEER PALERMO %\ OROVILLE 1 Cont: OWNER _\ REROOF '( 026-030-006 ' OS -1844 JONES, KENNETH 6590 UPPER PALERMO RD, OROVILLE Cont: OWNER NEW ROOF STRUCTURE) oDM,�J 026-030-006 929 JONES; KENNETH _ 6590 UPPER PALERMO RD, OROVILLE Cont: SIERRA VIEW CONT r WINDOWS(' I)r,, , L JONES, Harold 58-71B _ _ f 52-71P I 1= IE— 6590 Upper Palermo Rd., Oroville fir= CONTR: H.D. Winigar, 4140 Tami Way,Carmicha , (convert storage to living area & constru+:- newi single family)) N 1 i i AP 26-03-06--`l JONES, Mary H. 6590 Upper Palermo, Oroville ` }Permit ## 2437-74P,E (util, MH) ELEC . DO a.. GAS L_ C- j SUPPORT STRUCTURE REQ. AP ' COMPACTION TEST REQ. F,P##26-03- 9 /D-� ?ermit #4525-75MHI Cssued �F lot `C 26-03-- • Contr : LaGrone Heating Permit.#2998-77E,M(evap r)SF -_.26-03-6 Contr: Lincoln Village ermit #4903-7 . MHa Issued 026-030=006 05-1841 JONES, KENNETH 6590 UPPER PAL , RL E Cont: OWNER UPGRADE ELEC P.\V 26-006 OS -1843'' JONES, KENNETH / 6590 UPPEER PALERMO %\ OROVILLE 1 Cont: OWNER _\ REROOF '( 026-030-006 ' OS -1844 JONES, KENNETH 6590 UPPER PALERMO RD, OROVILLE Cont: OWNER NEW ROOF STRUCTURE) oDM,�J 026-030-006 929 JONES; KENNETH _ 6590 UPPER PALERMO RD, OROVILLE Cont: SIERRA VIEW CONT r WINDOWS(' I)r,, , L JONES, Harold 58-71B _ _ f 52-71P I 1= IE— 6590 Upper Palermo Rd., Oroville fir= CONTR: H.D. Winigar, 4140 Tami Way,Carmicha , (convert storage to living area & constru+:- newi single family)) N ��TICOI ; Al Tv �J- ` 1 — - �i'ERMIT NO._ t � s E M MH UTIL. ' i"—PERMIT NO. 94'17-74P;g I _ PERMIT EXPIRES r + OWNER Mary H, Jones CONTR. ltOCATION (A.P. 26-03-06 ) 6590 UppendPalermo, Oroville L Its • - 4 Temp.. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E 9/JOB FINALED (Dates ,... (Sign t it /C� fi - 7s MOBILEHONME INSTALLATION INSPECTION CHECK LIST 1. Is the mobilehome located with required separation from lot lines and buildings and generally conform to plot plan? Yes %/ --No 2. Does the mobilehome have required clearances above ground? (Sec..5085) Yes No 3. Are footings and supports properly. sized, spaced, and braced as per approved plans? .(Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes No 4. Is the mobilehome level? (Sec. 5088) Yes No 5. If more than a single unit, are crossover connections properly installed? (Sec: 5088) Yes No P 6. Water A. Is flexible connector of adequate size and properly installed (.1/2" ID min.)? (Sec. 5566) Yes No B. Test -.Does water piping withstand working pressure or 50 lbs. air test? Yes�1 No C. Backflow - If coach is not State of California ap roved, does station have backflow. device and pressure -relief valve? Yes Nod(// 7. .Wastes'and.Drains A. Is connection made with Schedule 40 DWV andhave flex connectors at each end? Yes No B. Does it have minimum � per foot slope and is it properly supported? Yes No C. Are any leaks detected in drainage system after running 3 -gallons of water through each fixture including washing machine standpipe?. Yes No� D. If coach is not State of alifornia approved, does station have required trap and vent? Yes No 8. Gas Piping and Gas Vents A. Connector -'Is mobilehome connected to the gas supply -with an approved 3/4" minimum mobilehome connector not more than 6 ft. long? -Note: All piping is to be at least as large as the mobilehome gas line unlet without reductions other than the mobilehome connector. Yes No B: Test OK as per' following procedure?' Yes No 1. Open all appliance connector valves, r 62__ Shut off appliance burner and.pilot valves. Air test with manometer to 10"-14" water column, or,test with slope gauge (minimum 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without drop. 4. Connect gas meter to mabilehome with connector, turn on gas, test connections: with soapy water. C. Are all appliance vents properly installed? Yes No 9. Electrical - - A. Is service large enough to provide adequate amperage -to mobilehome (must equal rating of mobilehome with a minimum of 100 amp) ar-d other facilities on lot, i.e., water pumps, garage, cabana, Yeses No B. Is there proper clearances around panels? Yes No C. Is power supply cord or feeder assembly properly fused? Yes,No D. Icontinuity test satisfactory as per the following procedure? Yes No Pj1 De -energize electrical wiring system of the mobilehome at the pedestal. 1-2. Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected. (./3.- Switch all breakers and switches in the mobilehome to the "on" position. C.onr_ect one lead of a test instrument to the mobilehome grounding conductor and apply the other lead to each mobilehome supply conductor, including.neutral. ,,,3. All non-current, carrying metal parts of the mobilehome (aluminum siding., gas line, water line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. Upon completion of the above procedure, the power supply cord or feeder assembly conductors shall be connected to the site service equipment.. A further continuity test shall then be made between the grounding electrode and the chassis of the mobilehome. Upon satisfactory completion of theelectrical tests, the lot or site service equipment may be approved for energizing. 10 Is job card signed by Health Department for water and sanitation? .11. If everything okay, sign off card and tag services. MOBILEHOME DATA � Manufacturer and/or Namestyle —)1:21 e L` e,!T C Q01 r, Length 57 Width /2 -- Vehicle ZVehicle Serial No. State Identification No. 3 3 L � 4 Additional Information or Comments: I a' a COUNTY OF BUTTE — DEPART MENt OF PUBLIC WORKS BUILDING INSPECTION RECORD � f BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Pi in `— Piers "' Roofing Sewer 7 Garage Fdn. Vents Fixtures Footings Gara a Vents Water Htr. Stemwall Prov. for physically Heaters Slab handicapped Appliances Carport Conformance of ex. Gas Piping & Test / Z' 7 Footings structure Temp. -Gas Slab Final Sanitation Patio FIREPLACE Final ' Footings Footing ELECTRICAL Masonry Walls Throat Rou h Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation I Permanent v Door Closer Final Final DATE REMARKS OR CORRECTIONS LAP Cr I r .��c �s �• �5 ��s �i� vhG•�oc2. COUNTY OF BUTTE — DEPARTMENT OF PUBLIC 0 S f 7 County Center Drive — 5 le, California 95965 _ Telephone: 534-434-4541 APPLICATION AND PERMIT B ILDI Owner SQ. FT. OCC. BUIL ING VALUATION Mailing Address GL+�r �ov! LL6Ih Teo af `t� t! Fireplace Contractor 6) w NJ F_ z Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ $ Building Address PLUMBING No.1 @ FEE PERMIT FILING FEE $2.00 Z.epo (10,5-20 ,5zZLxz 0-2 Each Trap 1.50 c) v �/ CJ Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. '� ^ / 3 •� —Z,. Zani Gas piping system 1 - 5 outlets 1.50 tJ Each additional outlet .30 F s *.e-_' *05tKon I Fire Dept. Fire Zone Use Permit Building sewer 5.00 �. r� EQA Parking arcel Ma Plans rata P 60' R/W Improvements P Lawn sprinkler system 2.00 Bldg. ans Recd Parc royal Pla�ovol Permit Fee $ NEW ❑ ADDITION ❑ UTILITIESg OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service incl. 1 meter) Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Single Family ❑ Duplex ❑ Mobil Home Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures bai dlo Receps., switches & fix outlets CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring -I am exempt from the Contractors License Laws of the State of California. Permit Fee $ 16 WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. Elhave placed on file with the County of Butte a certificate of 'Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. Date 6 `,Re` 7c% Sig ure of P rmitee or Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF P LIC WORKS Byate-7 i 74 ilding permit expires Date ................ <� `� %, ....................... • COUNTY OF BUTTE - DMPARTMENT OF ,PUBLIC WORKS ` ; ^62—,S-- � .7 . / 7 County Center Drive — Oroville, California 95965 GV's - Tel 534-4541 APPLICATION AND PERMIT, authorize representatives of the County of Butte to enter upon the (� above-mentioned property for inspection purposes. C► C X Date Signo '6t of Pe m tee or Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR O PUBLIC WORKS By Date[ C - 7 .0 ifi uilding permit expires Date 1 - i ' 7f.- . BUILDING Owner QA/!�K SQ."FT. OCC. BUILDING VALUATION Mai I i ng Address /65'20 C4 e Cyt (3p2 (_(., — Telephone No. 3 " 07-k-7- Fireplace Contractor (9(U&V_ • Total Valuation Mai I i ng Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee Building Address PLUMBING No.1 @ FEE FILING FEE $3.00 CoRMIT (. S 9 0 G s j2 LP_., -n d Each Trap . 1.50 2 f`` Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. �— Q3 ^Q Zoning 8 Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F441Vpe Senna on FireDept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma p 60' R/W Improvements p Lawn sprinkler system 2.00 61 Ions Recd P a r c e 4kopproval Plan proval Permit Fee $ NEW ❑ "ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service incl. 1 meter a — 7z/ Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) — Single Family ❑ Duplex ❑ Mobil Home Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures b0 2 Receps., switches & fix outlets J. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring -0 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ MECHANICAL _ No. @ I FEE WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit .is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. PERMIT FILING FEE J$3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relatinq to buildinq construction, and hereby GL /D*'1' 9 .3 0 TOTAL PERMIT FEE .$3o7— authorize representatives of the County of Butte to enter upon the (� above-mentioned property for inspection purposes. C► C X Date Signo '6t of Pe m tee or Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR O PUBLIC WORKS By Date[ C - 7 .0 ifi uilding permit expires Date 1 - i ' 7f.- COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — UroviIIe, California 95965 Tel epftDne: 534i4541 APPLICATION AND PERMIT autnonze representatives of the county OT Butte to enter upon the above-mentioned property for inspection purposes. X Signature of Permitee or Agent Date This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Building permit expires Date Date BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ Building Address PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No.Gas Zoning &Planning piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fees W. C. Sanitation Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans I Parcel Declaration Parcel Ma P 60' R/W Improvements P Lawn sprinkler system 2.00 Bldg. Plans Recd I Parcel Approval I Plans Approval Permit Fee $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 OR L Main service 1000 AMP ORSLESS 5.00 Main service EA. ADD'L 100 AMP 2.50 OVER 600V Main service 100 AMP OR LESS 25.00 Single Family ❑ Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD'L 100 AMP 1.00 NEW OR ADDNST ( DACCLLING OCCUP. & BLDG ) .20 sq tt NEW CONSTSL MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS) 12.50ea NEW CONSTR. (POWER APPARATUS & NON -RESID. SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: I " Ex. Occup(OUTLETS OR FIXTURES)@Lzsm BAL@1 FIXED APPLNS. OR Ex. Occup. (OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. ❑I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 = ~ Heating Cooling � Ventilation Hood 1 2.00 Permit Fee $ $ I certify that I have.read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT FEE $ autnonze representatives of the county OT Butte to enter upon the above-mentioned property for inspection purposes. X Signature of Permitee or Agent Date This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Building permit expires Date Date Owner "—a — Mailing Address COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — 34'-45 le, California 95965 Telephone: 534-5541 APPLICATION AND PERMIT BUILDING _ SQ. FT. I OCC. BUILDING VALUATION ne No. Contractor Q Drone_ t°h e, Mailing Address ��.s �5 ISEYr a !�i/e. Building Address P _ 0_/1 /1 -C l Telephone No. M A. P. N . /. (Q 03 — 46 1 Zoning & Planning Fe i6iW. FireDept. Fire Zone Use Permit EQA Parking Parcel Parcel Ma 60' R/W Im rovements Plans Declaration P P BI Parcel Approval Plans Approval NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Single Family � Duplex ❑ Mobil Home ❑ Others ❑ Fireplace Total Valuation Permit Fee Plan Checking Fee &/or Penalty Permit Fee PLUMBING PERMIT FILING FEE Each Trap Repair drainage or vent piping Water piping Each gas water heater or vent Gas piping system 1 - 5 outlets Each additional outlet Building sewer Lawn sprinkler system Permit Fee ELECTRICAL PERMIT FILING FEE Main service 6011 OR LESS 100 AMP OR LESS Main service EA. ADD'L 100 AMP Main service OVER 600V 100 AMP OR LESS Main service EA. ADD'L 100 AMP NEW CONST.( OR ADDNS. DWELLING OCCUP. B ACC. BLDGS. NEWCONSTR. NON •RESID. MULTI.OUTLET ( BRANCH CIRCUITS NEW C ONST R. NON•RESID. ( POWER APPARATUS.8 SINGLE OUTLET CIR. $3.00 1.50 1.50 1.50 1.50 1.50 .30 5.00 2.00 $3.00 5.00 2.50 25.00 •1.00 CONTRACTORS LICENSE LAW 1 I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name Ex. Occup(OUTLETS OR FIXTURES)BgL@U FIXED APPLNS. OR style of: Ex. Occup. ( OUTLETS (RESID.) EA) 2.00 Q e'oVI a GQ 1 1%Q 14 lar e_0 Al Temporary service 10.00 Mobile Home Facilities 15.00 C -",20 se �' Misc. Wiring 6.25 License No.Qc9g 3 ITA Classification ❑ I am exempt from the Contractors License Laws of the State of Cal ifomia. Permit Fee $ MECHANICAL No. @ WORKMEN'S COMPENSATION INSURANCE PERMIT FILING FEE $3.00 1 am aware of the provisions of Section3700 of the California Labor Heating Code which requires every employer to be insured against liability for Workmen's Compensation. I have placed on file with the County of Butte a certificate of J•r' Workmen's Compensation Insurance. ❑I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, .and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X ? �E% ate — l —7Z Signature oof� Permitee or Agent Receipt No. /.�,-:73 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Cooling Ventilation Hood 2.00 Permit Fee $ FEE FEE FEE E TOTAL PERMIT FEE $ /Q 151 This permit is hereby issued under the applicable provisions of the Butte County.Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF, -PUBLIC WORKS �it expires Date LYd wv (IT LL6L T NAA s !-� � U�� ►� �► � to SH'Nom onand dO '1d30 31LnO 10 AlNnoo • r COUNTY OF BUTTE - Department of Public Works .7 County Center Drive, Oroville, California PHONE: -534-4541 a MOBILEHOME INSTALLATION INFORMATION Lot Facilities 1. Plot plan dimensioned, location of mobile and utility connections? Yes No 0 2. Electrical -service equipment ampacity Circuit breaker ampacityg-,fid Permanent Wiring Connection - Ampacity ' Receptacle Ampacity 3. Gas: Natural LPG_ Gas riser size 4. Drain inlet size 5. later riser. size 6. Are utility connecti6fis located outside the rear 1/3 of the mobilehome. within 4 feet of the left wr ll? Yes11 No If not, slow di:mens:ions.above. 7. Is the mobilehome clear of soptic tank, leach fields and locatedutside public utility easements? Yes >� No 8. Do you propose to do other work on the property other than the mobilehome installation which will require a permit Yes No „x If so, specify Mobilehome Data. M K m 0 rt 0 K e K W C W 1. Length_C�� Width ��/� z Manufacturer C x Serial No. y _Vehicle Insignia Control No. 2. Feeder assembly ampacity� %%�- _ Conduit size Power.supply cord,(amps) O 3. Gas inlet' size Mobilehome connector size Capacity __ 4. Drain connector: describe on re'vecse side 5. Water connector: describe on'reverse side 6. Designed loads: Roof live oad psf. . Wind to psf. (only for mobilehomes manufactured after October 7, 1973)' ];—�{�lu��g inch ll�tLn�ng�LLiCt20I1S?. ..Y 8. Will the mobile home .be installed on a separate support structure? Yes NoL *For plans and specifications of support system, see other side. Is, ADDITIONAL COrD! ,NITS Drain Connector, Describe___el.4.ezy It/ e., 'elate Connector, Describe�2 es.Sw&C h a-5-. L - LOAD BEARING SUPPORT AND 20OTING INFORUNITATION Pier Spacing Used Maximum Pier Load Maximum Column Load (multi -units only) ! Sei�; Bearing Capacity L7l� i Foouing Dimension Usod 1 3 4 TYPE OF PIER. USED Steel Concrete Concrete Block f/ Other . TYPE OF FOOTING MATIERIAL USED Pressure Treated Wood Concrete Redwood (Grade) _ Other Approved Type LOAD BEARIN( . SIT TSTS BUTTE COUNTY BUILDING DEPARTMENT APPROVEb G NOTES 1 k RESIDENTIAL :PERMIT NO.026-030-006 - OS -1844 JONES, KENNETH 6590 UPPER PALERMO RD, OROVILLE Cont: OWNER NEW ROOF STRLICTI IPP f S �Cc.o l2� l 5-1?V1 (�d) 0,5, • -L9 L'jI,- jG.�All SPECIAL CONDITIONS SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER JOB FINALED (Date) 12,210- 05 -- Signature X'C' 8 CHECKED BY J=OK 0 =Not OK = NotAppliReady . =Not Heady MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer, Location -Test -Fall -C/O -Concrete 4. Water; Location -Test -Easement Needed (Sketch) S. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat or/ /" L W P LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water, MH Test -Regulator -Connector' 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy Date Cana B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water, MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Cana B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing S. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GF1 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Sec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. • Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 = OK = Not OK = Not Applicable = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except Its 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Gmd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting: Rtng. 49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdnn. Windows or Exiting Doors -Sill Ht & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 52. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Cana B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door, Swing -Landing -Closure 76. A.C. Dud in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (FF1.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 83. Following InstldJDrive 0 Yes O No/Walks O Yes 0 NoRlanters O Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler, Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or M -AC. Wire Size/ /ga Cu or Al 31. Range Circle/ /ga Cu or Al -Oven Circ. / /ga Cu or AI Insulated Neutral O Yes O No 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels-Motors-Mech. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Fumace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting: Rtng. 49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdnn. Windows or Exiting Doors -Sill Ht & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 52. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Cana B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door, Swing -Landing -Closure 76. A.C. Dud in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (FF1.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 83. Following InstldJDrive 0 Yes O No/Walks O Yes 0 NoRlanters O Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: F BUTTE COUNTY DEPARTMENT'OF DEVELOPMENT SERVICES::,.:._ r 'BUILDING PERMIT 24. HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 ' WEBSITE: www.buttecounty.netldds PERMIT NO. BPO51844 LICENSED CONTRACTORS DECLARATION �fi' „ I hereby affirm under penalty of perl'ury',that I am licensed"under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of + Issued Date: 07/25/2005 APN: 026-030-006-000 the Business and Professions Code, and my license is in full force and ..:"License Number Class: ..'�• , •y' , . effect. • ';, �,',; ,: '. Site Address: 6590 UPPER PALERMO RD ORO Date-. -Contractor. a Map Index: Description: replace goof sfr'ucture('1300)' 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 OPE -« •�-. ._ �_ Owner: JONES HAROLD W &MARY HOPE- permit to construct, alter, improve, demolish, or repair any structure, prior] to to its issuance -also requires the applicant for,,such permit to file a ;•-,•• .` ,, ,,»f; -.l, REVOCBALE LIVING TRUS signed statement tK6he or she is licensed pursuant to'the provisionsof; WAYNE the Contractor's State License Law (Chapter`d' ommencing,with'Secti(o f 7000) of DFvisioryof.ttie'Business and Professions Code) or that fie or', •„ :' , _ '�-} ` ,'.` h' 2904 HONEYSUCKLE WAY 4 she is';exempt iherefrooi4nd the basis for, the:alleged,exemption_.Any,, , .:;; ;• r ,rte. ;, ;s� '-.SACRAMENTQ CA 95826=3122 violabonto{ Sectio6'7031.5 by any applican(-for a permit the , _subjects applicant to a civi 'penalty,•'of not more than five hundred , the -.. „. ..I 56 1,'as•ow6er•of property, or my employees with wages as their sole compensation, will do the work, end the structure is not .•,-�,..„int¢nded,or,offered,for sale (Sec;,7044„Business and Professions,, ..,,a-u.,-.,,..,..„,,,.�.,_,,:<,..,:,,..,..«..,.�.,..,...<�,•.,.,,,,-,..,..H.•,:..,..w:.,>.,....,.,...-..-,,...•.,•..n<,•<,.�.�..,.,,,..4,,,- Code: The. Contractors -State -License La..w,does not apply to an Applicant: JONES HAROLD W &MARY HOPE pp 1,'9wnq.r_of,pr9perty who builds or..improves thereon, and who does ._,,(;such:work himself or;herseif;,or•'1.through_his'or ries own employees, REVOCBALE LIVING TRUS provided.that,such improvements are not intended or.offered for sale. If however;'the'budding or improvements are sold one C/O JONES KENNETH WAYNE within yegr of completion, the owner -builder 'will' have, the -burden of 2904 HONEYSUCKLE WAY proving that he or she did not biiild'or improve for the purpose of SACRAMENTO, CA 95826-3122 sale.). F: « ❑...;J,, as,,owner, of�the:.property,,:amzexclusively,.contracting .-with., licensed contractors'to'•con'structrthe'.project. (Sec. 7044, Business r.:and,Professions Code::,The Contractors' State License Law does .not, apply to an.owner of property,who builds or improves thereon, •• ,and who'contracts,for such projects -with a contractor(s) licensed pursuant to the Contractors' State License Law. )._-, . __ Contractor: O :1 am Exerylpbunder Article 3•of,the Business and. Professions Code ^`�y` 'd;: . �> .'af't , -.,. .... .. y .. .., \ _�- .. .. ..i..r .at- k'•.•r. • ,.. i Date. Owner' r ` ' f WORKERS', COMPENSATION"DECLARATION I herebyffirm aunder pehaltyof perjury ohe'of the following Larations: ; i have and swill maintain a certificate of consent to self -insure for <, ,,, ,,, ,• ; ,t- License #. y -�- •• ••• �- ••� �- _, workersw,compensation, as provided for by Section 3700, of •the Labor Code,, for, the performance of. the work for which this permit is issued ❑ I have and•"willimaintain,.workers', compensation insurance, as Architect: required by,Section.3700 the Labor Code,'for,the performance:of ,,the work for which this permit is issued. -My workers! compensation Engineer: c insurance carrier and policynumber are: ,e Carrier: , Policy Total ....... o al Square Ft: 0 S.F. certify that in•the performance of.the work -for which this permit is Valuation: issuediAf•shall , not •'employ any ' person; in'any 'Manner -so as to, Census Code: becomeisubject'to the -workers', compensation. laws of•California, and. agree., than, if I should,: become: subject.* to -the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith.comply with those provisions. Date.' f �lon-'to WARNING Failure to secure Z.workers compensation coverage `is employer to criminal penalties and one unlawful and shall'sublars ' ( hundred��thousand'tlollars'$100;ln 000),'••'adddthe cost of 111 ��4 compensation damages as provided for in Section 3706 of the Labor code interest and attomey s fees ^.1 • ."11 , .0 '[ Iti' .,(� t YY Sr . t w F• - �� � / ��/ �� /�J�j/(�/�j (I /V/��/�' �r/n ;'•>';a'CONSTRUCTION•LENDING'AGENCY= ::• This permit isreby issued under tea licable provisions of the Bufte County Code ?nrvor r I hereby affirm that the a construction lending agency for the Resolutions t do work indicated ove !or which fees have been paid. performance of the work for which this permit is issued.(Sec 3097 Civ.) Q �- �O Name: By: / .L Date: PERMIT EXPIRES 7nL Address: ON: Date ❑ s, I 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 ofhazardous mater(a1s.,: ,.. .,,:..,;;: • ,. ; r», ' 13 Notification'in "a'ccoebance- wiih-Section-19827.5 of California Health 8 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 have read this application, that the above information is correct -arid that I em 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 after 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 purpo es. '+ •. Print Name I,2 %� ltJ\ � f 'Signaturee�� (jU iJ � r a' _+0' �- ... .. .. .. . , . . Date 14 i Owner n ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor .. _ -- y - vrt •rte . ,.., ., •_ _ --."-- �--- - _. .._. _ ...-� -- - -- _. '-..- - -` - . -- .__ ._.__- .. �..._.,._......�.... 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 Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER Last Name O Nes- First, N Address City t�(�3LiL(.6 Stat pp Phone ctl (a ��� i ��o Fax E-mail 1.20� e Ck , CA, GO L) APPLICANT NAME CONTRACTOR Name kov uools Address I` City Lt State _77-1p �t Phone Map Book Fax E-mail 11 Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT NAME Name Owu ig� Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X For office use only: Zoning Property Address 0 O A . fT Flood Zone . SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. BIN N LOCATION / Property Address 0 O A . fT Cross Street WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description noor�Scope of Work: C9 --i 51 GvJ�'� Sq. Footage Ncyv %U S7/LUG7v ❑ Structure Built without Permits i ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check .fees for work plan checked and other department costs are not refundable. a6 Receiivveed/b Amount: — Bldg SRA Receipt#: Sheriff V\ SMIP Other Date:r 2 �b / Total K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 REV 2-24-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal bldgs: (A) Metal -Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. -(D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). 0 ' 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530)538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSMILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 4 ,.,. COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISfON "V+ 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: ASSESSOR CEL NLWBER Proposed Building Use: Permil Technician: Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. N 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. I iN 2. Complete plans,.3 or 4 sets, signed by the preparer of the plans. 0 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. f AJ 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. ❑ 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. must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Letter of intent for non-residential buildings ❑ 12. Hazardous Material Form ❑ 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other Remaining item`s needed to issue the permit.(May require additional plan inview upon receipt of the following items. ) Cl 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable A ❑ 16. Fire Sprinklers...;...,.....:-.;;:5........................................................................... .�. 17. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 18. Soils Report and/or Engineered Foundation required ........................................... 19. Erosion Control Plan,Required. ... :............................................................ 20. Fees as shown. on the attached Schedule of Fees Due Sheet .............................. ❑ ' 21. City of Chico Plumbing permit........................................................................ ❑ 22. Site:plan,and business lice se approval from the City of Biggs .............................. ❑ 23. California Department of Forestry plan approval ❑ paid. Sent by: ............. ❑ 24. Planning approval for (A) Use: (B)Parking: (C) Parcel Check: ............ ❑ 25. Contact Land bout,__Improvements, _Drainage ........................ ❑ 26. NPDES Form ........................ ........ ..::............................................................ ❑ 27. Encroachment Permit focdriveway from the Public Works Dept ........................... ❑ 28. 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) ..................... ❑ 31. Letter of Signature authorization.................................................................... ❑ 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. Existing violations and/or expired permits......................................................... ❑ 34. Deed Restriction.......................................................................................... ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... ❑ 36. Other: ❑ 37. Other: t When issued Telephone s J �Il b 6H 67 V6 and hold for pickup. i I have been formed of the //above items and requirements for obtaining a building permit. Applicant: W .n Date: 1. Index permit application for the above items numbered: Plan CW ck Lett r 2. Additional items required \\ Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Dale: r� Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, 0`60 't b Date: Plans reviewed by: Date: Plans approved by; " Date: ._ Structural reviewed bo!�� Date: Structural approvetl�by: Date: Note transfer by: Date: Yellow,• Biiildng`bivision All of these yam~ COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 PHONE "(530)538-7541, FAX (530)538-2140 SCHEDULE OF RECEIPT OF FEES Website: www.buttecounty.net/dds OWNER 7,101VC__75 A. P. # (9 PROPROSED BUILDING USE /c-&_-_PGFe_off_ )21!�FO F _577 - e-NR�DATE 7—� �'70 REC IPT # DATE REC. 1. BUILDING PERMIT FEES �� --- Balance Due .......:............. $ --- FEMA Flood elevation review ... $ --- Additional plan checking Fee.... $ 2. SCHOOL DISTRICT FEES (paid at School District Office) (form available after Plan Check) 3. SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$_ Units Commercial (sq. ftg.)..... X $0.03 = $ 3q.rcg. 4. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) 5. RESIDENTIAL DEVELOPMENT IMPACT FEES COUNTY WIDE (per dwelling) $ CHICO URBAN AREA (per dwelling) $ EL MEDIO FIRE DISTRICT (per dwelling) $ NORTH CHICO SPECIFIC PLAN (per dwelling) Zoning $ 6. SRA FIRE INSPECTION AND PLAN CHECK FEE $204.98 (paid at Building Division) 7. WATER TENDER FEES BATTALION # $200.00 (paid at Building Division) 8. SMIP 9. OTHER 10. OTHER 11. OTHER At 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 duri the plan checking process. APPLICANT '/ APPLICANT SCJ DATE 7 Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 3/05) r, f' B e County Department of Development Services. r N O T E S 7 unty center Drive, Oroville, CA 95965 (530) 538-7601 www.¢uttecounty neUdds a C�UNtys �OurrE� axEn RESIDENTIAL APN:Permit No. _ el eC ra, t,,* _ � S�a.�i t.¢� 026-030-006 l i Owner. JONES,'KENNETH is �/eJ L bG�� 6590 UPPER'PALERMO'RD, OROVILLE site Address: Cont: SIERRA" VIEW CONT 'i Contractor. WINDOWS(I1) Type of Permit: • 1f t1 h SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE EQUIRED _ FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE 4 DATE JOB'FINALED: iW t� SIGNATURE: A. +=OK 0 = Not OK MANUFACTURED HOMES MISCELLANEOUS DATE PERMANENT FOUNDATION SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; Fall/C/O-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Clrncs-Grnd Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap, Nat L or LPL Inch Sz Ft Lngth 7 Blckng; Sz-Spacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-Clrncs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -C/O to Grade 12 Gas and Electricity Tagged 13 Tie Downs L Foundation L 14 Exits 15 Cert of Occupancy 16 HUD Label/Insignia Numbers Serial Numbers DATE ID E C K S -C O V E R S -C A R P O R T S'G A R A G E S 1 Zoning -Setbacks -Easements 2 Ftgs; Soils-Sz-Dpth-Spacing-Cnnctrs-Steel 3 Decks, Girders/Joists-Dcking-Brcing Stairs-Guard/Handrails 4 Wood Awn; Posts -Beams-Rftrs-Cnnctrs-Shthg Frmg-Brcng 5 Alum Awn; Columns-Cnnctns-Splice-Decal-Enclsrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills-Anchrs-Studs-Rftrs-Trusses 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls s °9 0 DATE IPOOLS 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GF1 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/5' Crcltng Eqp-Pool Ightg Soices-Enclsrs-pnlboards-Insultn to Main Conduit 9 Health Dept Apprvl 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Enclsr, Fencing -Alarms 13 Bonding, Diving board or Slide °� 0�c i Pool Drawing .=OK 0 = Not OK RESIDENTIAL (Single & Duplex)'' DATE JUNDERFLOOR DATE PLUMBING 1 ZoningSetbacks-Easements-FloodSlope 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 2 Ftg Main; Soils-Elec Grnd Ftg Dpth 54 Wtr Pipe; Test & Anchr-Nail Prtctn 3 Ftg Garage; Soils-Steel-Elec Grnd Ftg Dpth. 55 DWV; Test Fittings & Anchr Nail Prtctn 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth 56 Shwr Pan; Test, First fir -Tub Acc 5 Stemwalls Main; Steel-Blockouts-Wrapped 57 Test Tub & Shwr, 2nd fir - Tub Acc 6 Stemwalls Garage; Steel-Blockouts-Wrapped 58 Gas Pipe; Sz & Anchrs 6a Hold Downs and Special Anchrs 59 Fire Sprinkler; Test 7 Slab, Steel Wrapped 60 Yard Gas Piping 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way C/0 -Sewer Test ° 10 UF, Gas Pipe; Sz Anchrs-Sz Test Va O`�C C1 0`y, It Wtr Pipe; Test-Anchrs-RgltrService Test DATE IMECHANICAL 12 Elec Undrgrnd 61 AC Ducts lnsultn & Support 13 Plenums & Ducts; Clrnc-MaterialSupport-Insultn 14 Girders -Sills-Anchr BoltsJoists-Vnts-Cripples 62 Vent Fan, Exhaust abv lnsultn 15 Acc & Vntltn 63 Condensate Drain & Ovrflw, Sz & Grade 16. Insulation 64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic o' 4V ° DATE IFRAMING 17 Sills Proper Materials & Anchrs DATE IFINAL 66 Ext Steps -Door & SideLt Prtctn-Landings 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 19 Bearing Walls over Girders & fir Nailing 67 Smoke Detector 20 Draft Stop in Walls (rat proof) 68 Furnace Vnts-Clrnc-Comb, Air-Cnnctr 21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs In Garage; abv-flr-Ducts-Mech Prtctn 22 Headers & Beams-Sz & Bearing 69 Bedroom Exiting 23 Hangers -Post Caps-Anchrs-Cnnctns 70 GFI & Bath Fxtrs & Tub Acc-Spa 24 Ceiling Joist-Rftr Ties -Purl in -Roof Brac-TrussShthg 71 GFI Arc Fault 25 Frplc Ties or Type A Flue-Frplc Throat Clrnc 72 Elec Trim & Subpnl, Breaker Szs & Labels 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles 73 Stairs, Guard/Handrails 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 74 Frplc or Stove, Clrnc-Hearth 28 Garage Fire Prtctn Framing -RC Channel 75 Elec Outlets at Wood Pnl, Int & Ext 29 Prprty Line Firewall & Opngs 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clrnc 30 Ext Doors -One 3' -Check Garage 3rd Story, 2 Exits 77 Elec Outlets & Rcptcls at Ktchn Counter 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 78 Garage Fire Door; Swing -Landing -Closure 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 79 AC Duct in Garage -Damper 33 Siding -Nailing Veneer 80 Wtr Htr; Vnts-Clrnc-Com Air Cnnctr-PRV; abv fir 34 Stucco Lath -Weep Screed-Fndtri Vnts-Undrflr Acc Mech Prtctn; LPG Appince Undr House 3" drain 35 Glazing Area -Glass Prtctn-SkyLts-Plastic 81 Plmb; Elec & Mech Eqp Listed for Loctn 36 Shear Walls; Nailing -Bolts 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 37 Brace Int/Ext Wall pnls 83 lnsultn-Foam-Looked in Attic 38 lnsultn-Walls-Ceilings 84 Guard Rails & Deck Cnstrctn-Post Caps 39 Infiltration-Walls-Wndws 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Drnge Planters ❑ Yes [:]No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Plmb-Appinc-Frplc-Clrnc to Opngs 90 Wtr Well, Dscnnct, Elec, Plmb 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd DATE JELECTRICAL 40 Fxtr & Trnsfrmr Clrnc-Ins Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 92 Vntltn thru House 42 Sz Boxes & No Of Cndctrs Stapled 93 Glass Prtctn 43 Romex Installed Close to Edge of Studs & CJ 94 Corrections from previous Inspctns 44 Eqp Grnd made up w/Mech Fstnrs 95 Gas Test -Meters Tagged, Gas-Elec 45 Grndng Electrode Bond Gas & Wtr 96 Wtr & Sewer Cnnctd-C10 to grade -HD Apprvl 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 97 Energy Cmpinc Cert -Other Certs 47 Subfeed Wire Sz ga ❑ CU or AL ❑ 98 Address Posted AC Wire Sz ga ❑ CU or ❑ AL 99 Fire Sprinkler 48 Range Circ ga ❑ CU or ❑ AL Oven Circ ga ❑ CU or ❑ AL Insulated Neutral ❑ Yes No oa' 0•``' oma`° 0s 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 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. BPO52929 B. C. Building Permit 01-16-04 pg 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 Issued Date: 10/24/2005 APN: 026-030-006-000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Site Address: 6590 UPPER PALERMO RD ORO Map Index: Date: Contractor: Description: REPLACE 11 WINDOWS 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 Owner: JONES HAROLD W &MARY HOPE permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a REVOCBALE LIVING TRUS signed statement that he or she is licensed pursuant to the provisions of C/O JONES KENNETH WAYNE the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 2904 HONEYSUCKLE WAY she is exempt therefrom and the basis for the alleged exemption. Any SACRAMENTO, CA 95826-3122 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 does Applicant: JONES HAROLD W &MARY HOPE owner of property who builds or improves thereon, and who such work himself or herself or through his or her own employees, REVOCBALE LIVING TRUS provided that such improvements are not intended or offered for C/O JONES KENNETH WAYNE sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 2904 HONEYSUCKLE WAY proving that he or she did not build or improve for the purpose of SACRAMENTO, CA 95826-3122 sale.). I, as owner of the property, am exclusively contracting with F licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed r pursuant to the Contractors' State License Law.). Contractor: SIERRA VIEW CONTRACTORS ❑ I am Exempt under Article 3 of th Business and Professions Code PO BOX 2733 Date:6z owner: RANCHO CORDOVA, CA 95741 WORKERS'COMPENSATIOO DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: 916-628-6614 ❑ 1 have'and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the License #: 853277 Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Architect: insurance carrier and policy number are: Engineer: Carrier: Policy #: I certify that in the performance of the work for which this permit is rotal Square Ft: 0 S. F. issued, I shall not employ any person in any manner so as to Valuation: $0:00 become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' Census Code: compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: \ . o< - Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. �01:2 - CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Resolution do ork indicated above for which fees have been paid. Name: By: Date: d _� PERMIT EXPIRES 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 R 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 9f any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purp s . . Print Name:/p��b7 Signature: Date: �`( ri��%� Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 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 "PLEASE PRINT CLEARLY" OWNER Last Name .�o irst Name Address &V10 , 1 ,1� V City OU I l� State Jp Zip � �1U� C.�V� Phone �� p � _ ,1 ( � `t Fax E-mail -_>1\_13 -,CA, �d U Pf5 C -_>&0_13 -,CA, ARCHITECT GIN ER - CONTRACTOR Address City State Zip Phone Fax E-mail State License Number Subdivision Name IMP Page ARCHITECT GIN ER Name Address City State Zip Phone Fax E-mail State License Number APPLICANT NAME Name Address / _ �/,, 0 V 11 u TP1..,�Ic YC* M D It DA8 City t - State C* Zip Phone ' + Fax E-mail CA ' dU APPLICANT, SIGNATURE X For office use only: Zoning Flood Zone SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Tot # Planner Date Approved: PERMIT NO. BPaq as BIN # LOCATION / AP# oa� . O 56 Pro rty �Uddres City Cross Street WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name -Address IDescription or Scope of Work: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 Nbtu W iobbl a Ot% Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be 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. fjesgilred by: IAmount: Bldg Receipt #: q+6 Date: Sheriff SMIP Other Total REV 6-16-04 SUBMITTAL REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply fora permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE A ND 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! OR 3 'Sets Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed 'calculations. ❑ 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. (Note: Not required for additions to mobile or modular homes.) ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Detached Accessory Building Form, filled out by the property owner (if required). ❑ 8. Sanitation and site plan approval from the Environmental Health Department. ❑ 9. 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 PAPER! ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ 4. 2 Floor plans. ❑ 5. 21 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 GRAPH PAPER! o 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 -signed by 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 KAFORMSMILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 6-16-04 NOTES RESIDENTIAL PERMIT NO. —'-026-030,006 --~ �-''�- - 05=1843 JONES, KENNETH • 6590 UPPEER PALERMO RD, OROVILLE Cont: OWNER REROOF o S> V1 &Zee r SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER JOB FINALED (Date) ` 2 � - 05 Signature 4=OK 0 = Not OK Applic . = NotNot Ready able MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer, Location -Test -Fall -C/O -Concrete 4. Water, Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L'ft. / /Nat or/ /" L "ftJ /LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water, MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert of Occupancy MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men-Uning 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Bec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 :Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water, MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Cana B-1 Date Card B-1 Coate Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men-Uning 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Bec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK - = Not Approable . = Not Ready RESIDENTIAL, (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Gmd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth S. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler, Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card -B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. 28. Equio. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI -AC. Wire Size/ /ga Cu or Al 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or AI Insulated Neutral 0 Yes 0 No 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels -Motors -Meth. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Fumace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform H Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting: Rtng. 49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec_ Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door, Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.FI.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 83. Following InstldJOrive 0 Yes 0 No/Walks 0 Yes 0 WRanters 0 Yes 0 No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle_ Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fre Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.netldds PERMIT NO. BP051843 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: 07/13/2005 APN: 026-030-006-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 6590 UPPER PALERMO RD ORO Date: Contractor. Map Index: Description: re roof 26 squares OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: JONES HAROLD W &MARY HOPE permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a REVOCBALE LIVING TRUS signed statement that he or she is licensed pursuant to the provisions of C/O JONES KENNETH WAYNE the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 2904 HONEYSUCKLE WAY she is exempt therefrom and the basis for the alleged exemption. Any SACRAMENTO, CA 95826-3122 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).): 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: JONES HAROLD W &MARY HOPE such work himself or herself or through his or her own employees, REVOCBALE LIVING TRUS provided that such improvements are not intended or offered for C/O JONES KENNETH WAYNE sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 2904 HONEYSUCKLE WAY proving that he or she did not build or improve. for the purpose of SACRAMENTO CA 95826-3122 ` sale.). ❑ 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, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: ❑ 1 am Exempt under Article of the Business and Professions Code /3 ` Date: ( �5' Owner: 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 License #: workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as Architect: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Engineer: insurance carrier and policy number are: Carrier: Policy #: 0 S. F. �� Total Square Ft: I certify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to Valuation: $0.00 become subject to the workers' compensation laws of California, Census Code: and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: 1 J p8,6 Applicant: UL/ . �j-y/ V WARNING: Failure to secure workers' compensation coverage is \� unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor ' code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is her issued under a pylic a provisions of the Butte County Code anrt/or Resolutions 1 hereby affirm that there is a construction lending agency for the to o work indi ve for hichf es have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Name: BY Date: PERMIT EXPIRES ON: Address: Date ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Cade, 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 inspectionurp s s. Print Named waaM � c Signature: W ` 0 Owner 0 Contractor ❑ Agent for Owner 0 Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTIONC OROVILLE: (530) 538-7636 • CHICO: (530) 591-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REO UIRED AT TIME OF APPLICA TION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** APPLICANT NAME OWNER Last Name 3e� firs Miami Address ,t_ �q �, City StateZip% Phone q16a / Fax E-mail Uzo c FwU APPLICANT NAME CONTRACTOR Name )�, t �N Address it City vt State q_ Zip n Phone LA Fax E-mail t( Lic. # N A _ Class APPLICANT NAME ARCHITECT/ENGINEER Name n M n ,n .,� " Address &M COW "�1� Address Sta e& City Phone �1�- State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT NAME Name _�3vpzs n M n ,n .,� " Address &M COW "�1� City Vtil�(C� Sta e& Zip Phone �1�- Fax Email -A APPLICANT SIGNATURE X For office use only: Zoning Flood Zone SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. I BIN 9 LOCATION Pro "n 6)/� City Cross Street - �� WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: r!� US-s©�i'X3- iZocx� Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be 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-77" Amount: Vl Receipt Date: "_t� O SRA Sheriff OMIP.1 Total SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED: ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 6. Manufactured. homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). - 0 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. :1 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530)538-7541. EXPIRATION OF APPLICATION applications for which a permit has not been issued will expire one year after date of application. In order to renew action m an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Zefunds can only be made upon written request by the person who paid the fee. The request must be made within two ears from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits sued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan .heck fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION 'AFORMSSUILDING F0RMS\BIdgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 NOTES RESIDENTIAL PERMIT NO. '026-030-006 05:1841 _ JONES,' KENNETH "- 6590 UPPER PALERMO RD, OROVILLE E Cont: OWNER j UPGRADE ELEC SRV J �or q3 M f t SPECIAL CONDITIONS CHECKED BY. 1 SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY - f USE PERMIT CONDITIONS SUB-STANDARD HOUSING LETTERq OFFICE COPY ,�rr Address [Q Y9-- (l PPP P/Y/P�►'� j Sers oma.. GAS Meter By Date - x — ELECTRIC .10, 7-Ax— Meter By Date Meter JOB FINALED (Date) l o - '1 S - D i� Signature° J=OK 0 = Not OK . = Not ReNotAppady MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements-Setbacks-Easements 2. Soils; Special MH Support Sketch 3. Sewer, Location-Test-Fall-C/O-Concrete 4. Water, Location-Test-Easement Needed (Sketch) 5. Electricity; Location-Clearances-Gmd-/ /Amp-Concrete 6. Gas; Location-Test-Wrap;-/ /" L'ft. / P Nat. or/ /" L W P LPG 7. Well Clearance & Disconnect 8. Utility Clearance 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Date 1. Zoning Requirements-Setbacks-Easements Date 2. Footings, Size-Spacing-Marriage Line 3. Gas; MH Test-Demand-Valve-Connector 4. Electricity; MH Test-Crossovers-Breakers-Clearances 5. Drain; MH Test-Fall-Flex Connector 6. Water, MH Test-Regulator-Connectot 7. Water and Sewer Connected-C/O to Grade-HD Approval 8. Gas and Electricity Tagged 9. Tie Downs-Type-Installation Cert. 10. Exits; Insp.-Sketch 11. Cert of Occupancy 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) Date 1. Zoning Requirements-Setbacks-Easements 2. Footings; Size-Spacing-Marriage Line 3. Blocking 4. Gas; MH Test-Demand-Valve 5. Electricity; MH Test 6. Water, MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -landings 12. Braced Wall Panels Date Card B-1 Date Cana B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Vofts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK = Not Applicable = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Gmd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Gmd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler, Test 72. Elec. Outlets at Wood Panel, Int. & Ext. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) .OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. 28. Equip. Ground made up w/Meth Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GA 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral 0 Yes 0 No 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels -Motors -Meth. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector 87. Water Well, Disconnect, Electrical, Plumbing Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s Date 41. Sills Proper Materials & Anchors Comments at Final: 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Ging. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdnn. Windows or Exiting Doors -Sill HL & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Botts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door, Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor -Meth. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (FF.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 83. Following InstldJDrive 0 Yes O No/Walks 0 Yes 0 No/Planters O Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BPO51841 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: 07/13/2005 APN: 026-030-006-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 6590 UPPER PALERMO RD ORO Date: Contractor. Map Index: Description: upgrade elec service 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 Owner: JONES HAROLD W &MARY HOPE permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a REVOCBALE LIVING TRUS signed statement that he or she is licensed pursuant to the provisions of C/O JONES KENNETH WAYNE the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 2904 HONEYSUCKLE WAY she is exempt therefrom and the basis for the alleged exemption. Any SACRAMENTO, CA 95826-3122 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: JONES HAROLD W &MARY HOPE owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, REVOCBALE LIVING TRUS provided that such improvements are not intended or offered for C/O JONES KENNETH WAYNE sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 2904 HONEYSUCKLE WAY proving that he or she did not build or improve for the purpose of SACRAMENTO, CA 95826-3122 sale.). 1, 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, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: ❑ I am Exemptunder Article 3Jof t Business and Professions Code -he_ Date: SGSL Owner: 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 License #: 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 have and will maintain workers' compensation insurance, as Architect: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued._ My workers' compensation Engineer: insurance carrier and policy number are: Carrier: Total Square Ft: 0 S.F. Policy #: I certify that in the performance of the work for which this permit is Valuation: $0.00 issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' Census Code: compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date:I Applicant: ,Llr± 92i WARNING: Failure to secure workers' compensation coverage is h unlawful, and shall subject an employer to criminal penalties and one /b hundred thousand dollars ($100,000), in addition to the cost of 2 compensation, damages as provided for in Section 3706 of the Labor 7 code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY — _ - This permit ' hereby issrfe under e s plicable provisions of the Butte County Cody -77, I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Resolutio to do w Ac i icated a ove 6r which fees have been paid. 7 Name: By Date: /� PERMIT EXPIRES ON: -7—�� 0 C� 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 8 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 County to enter upon the above mentioned property for inspection purpo �offcButte Print Name: k,tj�,4/ 6 ` GT �.:, 3� 1U Signature: Date: u( it, ,?/Owner 0 Contractor 0 Agent for Owner ❑ Agent for Contractor r 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 Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY"' OWNER Last NameFirst�N�r�e , Address &9-- 9 w UPA4 A&BPC�7N(kl--) City Nov [L j - Stat Zip Phone % G2 Fax E-mail Ieg-av 's C_e ,CA,6B(J APPLICANT NAME CONTRACTOR Name 9!40�� jrt:�� Address Zip City Fax State Zip t t Phone Ir Fax 1( E-mail t r Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Page Fax E-mail Date Approved: State License Number APPLICANT NAME Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X W For office use only: Zoning Property Address p�V2f�!� p Flood Zone . Cross Street SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. X145 BIN # LOCATION AP# r7 / Q —Ce�6 Property Address p�V2f�!� p CityU� Cross Street WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be 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. Page 1 of 2 REV 2-24-05 Received by-� Amount: Receipt #: ,41�_I ` Bldg SRA Sheriff SMIP Date: � `Z�v / �Other Total Page 1 of 2 REV 2-24-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in. order to apply for a permit. 'INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. r ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) El1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530)538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 T r 1� PLiRMIT NO. 4903-77MH-I PERMIT EXPIRES o. OWNER HAROLD WAYNE CONTR. Lincoln Village Mobile Homes r LOCATION (A.P. 26-03-6 ',6590 Upper -Palermo Rd, Palermo 7, ,i 4 d t Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Cal led JOB FINALED (Dat) (Signature) MOBILEHOME INSTALLATION INSPECTION CHECK LIST 1. Is the mobilehome located w4,4required separation from lot lines and buildings and generally conform to plot plan? YesNo 2. Does the mobilehome have required clearances above ground? (Sec.5085) Yes No 3. Are footings and supports properly sized, spaced, and braced a er approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes No 4. Is the mobilehome level? (Sec. 5088) Ye No 5. If moresingle unit, are crossover connections properly installed? (Sec. 5088) Yes_ o 6. Water A. Is f xible connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes -A-1 B. .Testa Does water piping withstand working pressure or 50 lbs. air test? Yes X No C. - coach is not State of a i o —approved, does station have baa``c""k��flow device and pressure -relief valve? Yes_ No 7. Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes No B. Does it have minimum k" per foot slope and is it properly supported? YesX' No C. Are any leaks detected in drainage system after running 3 -gallons of water through each fixture including washing machine standpipe? Yes No D.ate of Ca1 ooved dation have required trap and vent? Yes No 8. Gas Piping and Gas Vents A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum mobilehome connector not more than 6 ft. long? Note: All piping,is to be at least as large as the mob' ehome gas line inlet without reductions other than the mobilehome connector. Yes No B. Test OK as per following procedure? Yes No_ 1. Open all appliance connector valves 2. Shut off appliance burner and pilot valves. 3. Air test with manometer to 10"-14" water column, or test with slope gauge (minimum 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without drop. 4. Connect gas meter to mobilehome with connector, turn on gas, test connections with soapy water. C. Are all appliance vents properly installed? Yes X, No I 9. Electrical A. Is service large enough to provide adequate amperage -to mobilehome (must equal rating of mobilehome with a minimum of 100 amp) and other facilities on lot, i.e., water pumps, garage, cabana, etc.? Yes No suyes0,4 B. Is there proper clearances around panels? Yes C. Is power supply cord,or feeder assembly properly D. Is continuity test satisfactory as per the following procedure?VNo 1. De -energize electrical wiring system of the mobilehome at the pe estal 2. Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected. 3. Switch all breakers and switches in the mobilehome to the "on" position. 4. Connect one lead of a test instrument to the mobilehome grounding conductor and apply the other lead to each mobilehome supply conductor, including neutral. 5. all non-current, carrying metal parts of the mobilehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. 6. Upon completion of the above procedure, the power supply cord or feeder assembly conductors shall be connected to the site service equipment. A further continuity test shall then be made between the grounding electrode and the chassis of the mobilehome. Upon satisfactory completion of the electrical tests, the lot or site service equipment may be approved for energizing. 10. Is job card signed by Health Department for water and sanitation? --.r- 11. If everything okay, sign off card and tag services. MOBILEHOME DATA Manufacturer and/or Namestyle a� Length Width_ 11 Vehicle Serial No.�.3� State Identification No. Additional Information or Comments: Reinf. Steel I Final I Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES ------------------ Elec- Service Elec. Pedestal Water Piping Sewer Gas Piping OBILEHOME INSTA�LL&TTION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS ---,.v A-1*' (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING. BUILDING (Cont'd) PLUMBING Setback Firewall Soil PipingE Forms Parapets 1st Floor f Main Bldg. Restroom Finish '2nd Floor �` 4 Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. Stemwal I Insulation Heaters Slab Prov. for phsically Appliances Carport Po handicaped Conformance of ex. Gas PipingTest Footings structure Tem . Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Reinf. Steel I Final I Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES ------------------ Elec- Service Elec. Pedestal Water Piping Sewer Gas Piping OBILEHOME INSTA�LL&TTION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS ---,.v A-1*' (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of the California Administrative Code, Title 25, Chapter 51 under permit number for the following location: Owner Owner's Address Mobilehome Mfg..j1� :/?; Model Year��7 Insignia No.�IWO�Serial No. It is hereby certified for occupancy at the above described location and may be occupied. Director of%Public Works` / Date /1 %I $y��i��`v' THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED r 'COUNTY OF -BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — 1 roviIle, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above -m tioned property for inspection purposes. 1 X :Z:LDate /'^B Signa/I e of Permitee or Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant M U4011 I Lam' /Yd -4045 I–AtD?-6 i o W I TOTAL PERMIT FEE IsR3® This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR 0 P BLIC WORKS By tem ding permit expires Date BUILDING '�� ✓ Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address Qu(_�Telephone /& No. Fireplace % I� ,�� �/op �s9 / Contractor 11 !V. &6\3 01 Lb9.I.,: At&.,61 L, Total Valuation Mailing Address ., 8 � � �� i U Il , o� (a..�t_ l., l Permit Fee Plan Checking Fee &/or Penalty � C, T 4 `B Permit Fee $ Building Address PLUMBING No. @ FEE PERMIT FILING FEE $3.00 _ &_Le -78-r D ® tL 11fiea Each Trap 1.50 RiD (d„p,� A I Repair drainage or vent piping 1.50 Water piping 1.50 ��� Each gas water heater or vent 1.50 A. P. No. �j^� GjZ oning &Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F FireDept. FireZone Use Permit Building sewer 5.00 EQA I Parking I Parcel Plans Declaration Parcel Ma P 60' R/W Improvements P Lawn sprinkler system 2.00 Bldg A�ons Rec'd Parcel 4fprovol PloAroApproval Permit Fee $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 l_AN bbl 64 x11 f1d 6b .Si 1 er Main service 100V OR L 00 AMP ORSLESS 5.00 .� j ] �� _ r /cd Main service EA. ADD'L too AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others❑ OVER 600V Main service 100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW CONS.OR ADDNST ( DWEACCLBLOGS.-LING &\ / 20sgft NEW CONSTR. (MULTI.OUTLET NON-RESID. BRANCH CIRCUITS) 2.50ea NEW CONST. (POWER APPARATUS &) NON- R RESID, (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name le of: style Ex. Occup(OUTLETS OR FIXTURES)@25¢ BALImi Ex. Occu FIXED APPLNS, OR P•(OUTLETS (RESID,) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. .3 llo91_ Classification Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. ❑I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above -m tioned property for inspection purposes. 1 X :Z:LDate /'^B Signa/I e of Permitee or Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant M U4011 I Lam' /Yd -4045 I–AtD?-6 i o W I TOTAL PERMIT FEE IsR3® This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR 0 P BLIC WORKS By tem ding permit expires Date DECLARATION REGARDIP+G LOM OR PARCELS I certify that as owner of. tiie property acquired by deed in Volume Page �, Official Kecords of Butte County, (AP. am requesting permission to build or install an additional living unit on .this property. I will not divide the afore- mentioned.property for sale, lease, rent, or financing unless all -applicable land -division -�.aws -arid 'map -requirements are' complied -with. ' I am conversant with the present zoning regulations affecting the .aforementioned property,:, and declare that I shall not violate .same. I -•-.represent-th`c.the'proposed use of the additional living unit is ae L .and -that- further I-shall .-not--change -this -proposed- use -of -the--additional - .:.living.unit unless and until.•I receive written approval therefor from the County of Butte. . I fully understand.that pursuant to Chapter 20 of the Butte County . .Code and §11535 et 'seq of the Business and Professions Code that if I, in .the future, sell, lease, or finance .the area on or adjacent to said -::_improvement without fully complying with the applicable laws and- . '. ordinances, that I shall be -guilty of a misdemeanor and therefore, subj eco to the aforesaid penalties and imprisonment pursuant to law. Further, -­this statement- shall •be-•properly'-acknowledged and-recorded at the request ----of--the.-County -of•-.Butte.. ' a _. _. I Al RE`Ct)FDS Owner $Q-73'F C1)UNTY-`�1�F:. 96) + G t1 C r e s s 6�� FEE . Date _ _ _ - STAT� COUNTY OF Butte ) ss. On this 13th day of June. 19* before me, the undersigned SE—ate, a Notary Public in and for the Gounz-, c Butte commissionecT—and swoin,il personallyf appearednia, r MarylH Jones in, duly • - --- known to me to bet e . person waose na.,&e is su s5scribe t.o the within instrument and acknowledged to me that CAM s executed the same. IN. WITi1%13S W11ZREOF I have hereunto set my hand and offixed my official seal in the-County or- Butte the-day and year in this ertificate first above written. =-CALIFORNIA SEAL - W TELLE ' ® u o CALIFORNIA_NTY O e 'i l l l rMS NOV. 29,-ivn ,_, -END OF DOCUMENT } ' -.._.-...�v.- _ ....... _. _. .. _ _ .. .-....... _.. Recording Requested By KENNETH WAYNE JONES 2904 Honeysuckle Way Sacramento, CA 95826 When Recorded Mail To: KENNETH WAYNE JONES 2904 Honeysiickle-Way. Sacramento, CA 95826' State of California Couny of Sacramento 210QJ2-1010EI5819 Recorded I hIL FEE 16.00 Official Records 1 COPIES 4.00 Count yy Of BUfT � CANDP.LE J. BUBBS I Recorder I ROSEMIRY DICK.:UN I !assistant 1 Myles 12:?5PN 03 -Dec -2002 I Rage 1 of 4 AFFIDAVIT– APPOINTMENT OF SUCCESSOR TRUSTEE lK ) )ss: HAROLD WAYNE JONES and MARY HOPE10NES, being of legal age, being first duly sworn, depose and say: We, HAROLD WAYNE JONES and MARY HOPE JONES, are of sound mind, retain full control of our faculties and -are -the shine persons as HAROLD • WAYNE JONES and MARY HOPE JONES named in the ,HAROLD WAYNRIONES and. MARY HOPE. JONES, Revocable. Living: Trust Dated May 21, 2002; as Grantors. -and Trustees. HAROLD WAYNE JONES and MARY HOPE JONES hereby declare, jointly and individually; as signified by- their ytheir 'signature hereon, that' they appoint KENNETH WAYNE JONES, as Successor Trustee to the HAROLD WAYNE JONES and MARY HOPE JONES.Revocable Living -Trust Dated May 21; 2002; until such tiriie as either or both HAROLD WAYNE JONES and MARY HOPE JONES may wish reinstatement as Trustee(s), which einstatement shall be�� m� b�y��eq, acknowledged request for reinstatement as Trustee(s). 4C HARD WAYNE JONES and MARY HOPE? ' S hereby declare under penalty of perjury under the laws of tie St06.bf•CaEifornia that the facts set forth above are true and correct and that the appointment of KENNETH WAYNE JONES as'Successor Trusteeis made with full intern and without duress under the powers'of appointineiat set forth in the HAROLD WAYNE JONES and MARY HOPE JONES Revocable Living Trust dated May 21, 2002. Dated this a day of 2002, at Sacramento County, California. OLD WAYNE JO Dated this �� day of 2002, at Sacramento County, California. 4 , � - JWA; Page 1 of 2 Pages ACKNOWLEDGEMENT State of California ) ) ss. County of Sacramento ) On' �� � oa, before me, L- /i¢in/L /_ V J-4 /_ o �J (/,L eY Date Name, Title of Officer — e.g. "JaneDoe, Notary Public" personally appeared HAROLD WAYNE JONES and MARY HOPE JONES, personally known to me (or proved to me on the basis of satisfactory evidence) to be the persons whose names are subscribed to the within instrument and acknowledged to. me that they executed the.same itf their' --authorized capacities; and. that by their signatures on the. instrument the persons, or the entity on behalf of which the persons acted, executed the instrument. WITNESS my hand and official seal. Notary Signature V. ALLISON (Searj'W*'��ELAINE MM. # 1268765 YPUBUC• CAUFORM SACRAMENTO COUNTY Comm. Exp. JULY 22, 2004 Page 2 of 2 Pages L*H-t L>, IV ft all that real property situate in the County of Butte, State of California, descfibed as APN: 026-03-0-006-0 Lot 7, in Block 88 of Subdivision No. 1 of the Palefto Citrus Tract, as the same is designated and delineated on &arceatainMap entitled "Map ofPslemso and Subdivision 1 and 2 with Addition to No. l of the Palermo Citrus Tract, Butte County, CaL" which said map was recorded in the office of the Recorder of the County of Butte, State of Califomia, September 17, 1389. t . - ®.,v all that certain real property situate, lying and being in the -'County of Butte, Stale of California, described as follows: Parcel l: Lots 7,.8, 9,10,.11 and 12 of Bloch 63, as shown on that certain map entitled "Map of Themtalito, Butte County; Califamia9; which nmp wasrecorded in the.0ilice ofthe-Recorder of the County ofButte, State of California, on Junw8;1887. Together with the Northerly half Qf abandoned Yolo Avu lying.Southerly of and contiguous to the South line of said lots - as set forth in Resolution-ofAbaadonn=t recorded March- 9, 1-944, in Road Book I; Page F66, Official Records.' Also together withalithe portion ofthe West halfofabandoned 81` Avenue lying Easterly of the past iine of Lot 12 as set forth in Resolution of Abandonment rem—ded in -Road Book 1, Page 49, Official Records. Pareel It: Lots 1,.2,31* 4 and 5 of B16ok 62, as shown on that certain neap entitled„ "lvlap of Themealito, Butte County,-Califomia , which map was recordedin the Office of the Recorder of'the County of Butte, State of t.alifank on June S. 18P. 'together with the Southerly half of abandoned Yolo Ave. lying Northerly of the North line of said lots asset forth in Resolution of Abandomnent recorded M rch 9;1`944, in Road Book -1, Page I66,• Official Records. Also together with all that portion of the West half'of abandoned a Aveuue•lyi ng Easterly of tfie East line ofLot I asset forth in ResaIuiiorrofAbandonment rewarded iaRcad Book 1, Page -49, Official Record-, 0 6590 Upper Palermo Rd. JOB: Jones Ken MID LOCATION: Butte Co. MiTek® TRUSS ENGINEERING MiTek Industries, Inc. 7777 Greenback Lane Suite 109 Citrus Heights, Ca.95610 Phone:(916)676-1900 Fax:(916)676-1909 ► LUMBER ► HARDWARE ► STOCK PLANS ► CUSTOM DRAFTING ► TRUSS ENGINEERING ► TRUSSES ► PRE FRAMED WALLS 655 Cal Oak Rd. P.O. Box 1947 Oroville, Ca.95965 Phone: (530)534-0300 Fax: (530)534-5269 WARNING: DO NOT CUT OR ALTER TRUSSES IN ANYWAY. WARNING: DO NOT STORE TRUSSES ON UNEVEN GROUND. TRUSSES REQUIRE EXTREME CARE IN HANDLING r IIIII� i i c3UTTE CONN I t AUILDING DEPARTMfr_-A1 4 0 P R 0 V r TIMBER PRODUCTS INSPECTION 105 S.E. 124th AVE. Vancouver, Wa. 98684 Phone:(360)449-3840 Fax:(360)449-3953 M—L TRUSS SCHEDULE MiTek Tails Project: JONES KEN County: BUTTE Contractor: Endeavor Homes Date: June 23, 2005 Roof: COMP Plan: Snow: 0 Drawn By: Mw Tail Cut: Plumb Ken Jones Endeavor Homes P.Q. E)ox 1947 Qroville, Ca. 95965 (530) 534-0300 W �1 0 0-"U MiTekO Re: Jones Ken MiTek Industries, Inc. 7777 Greenback Lane Suite 109 Citrus Heights, CA, 95610 Telephone 9161676-1900 Fax 9161676-1909 The truss drawing(s) referenced below have been prepared by MiTek Industries, Inc. under my direct supervision based on the parameters provided by Endeavor Homes. Pages or sheets covered by this seal: R16978661 thru R16978662 My license renewal date for the state of California is September 30, 2006. June 21,2005 Yu, Ray The seal on these drawings indicate acceptance of professional engineering responsibility solely for the truss components shown. The suitability and use of this component for any particular building is the responsibility of the building designer, per ANSI/TPI-2002 Chapter 2. Job Truss Truss Type Qty Ply TCLL 20.0 erector. Additional permanent bracing of the overall structure is the responsibility of the building designer. For general guidance regarding Plates Increase 1.25 TC 0.46 TCDL 10.0 R16978661 JONES_KEN A COMMON 19 1 Rep Stress Incr YES WB 0.69 BCDL 10.0 Code UBC97/ANSI95 Job Reference (optional) Endeavor Homes, Oroville, CA 95965 6.100 s Sep 17 2004 MTek Industries, Inc. Mon Jun 20 12:32:42 2005 Page 1 -2.0.0 6-10-11 12-0-5 18-" 24.3-11 30-1-5 37-0-0 39-0-0 2-0-0 6.10-11 5.9-11 5.9-11 5-9.11 5-9.11 6.10-11 2.0.0 Scale = 1:68.5 3.00 F12 5x5 = 5 3x7 = .14 13 12 11 10 • 1.5x4 II 3x4 = 5x8 = 3x4 = 1.5x4 II i d 3x7 = 6.10.11 I 12-8.5 18.6-0 24-3.11 30.1.5 I 37-0-0 i 6.10-11 5-9.11 5-9-11 5.9-11 5.9.11 6.10-11 LOADING (psf) (locj I/deft Ud SPACING 2-0-0 CSI TCLL 20.0 erector. Additional permanent bracing of the overall structure is the responsibility of the building designer. For general guidance regarding Plates Increase 1.25 TC 0.46 TCDL 10.0 � Lumber Increase 1.25 BC 0.68 BCLL 0.0 Rep Stress Incr YES WB 0.69 BCDL 10.0 Code UBC97/ANSI95 TOP CHORD (Matrix) LUMBER BOT CHORD Rigid ceiling directly applied or 10-0-0 oc bracing. TOP CHORD 2 X 4 DF No.1&Btr BOT CHORD 2 X 4 DF No.1&Btr WEBS 2 X 4 DF Std DEFL in (locj I/deft Ud Suite 109 Citrus Heights, CA, 95610 7777 Greenback Lane Milo PLATES Vert(LL) -0.30 12 >999 360 erector. Additional permanent bracing of the overall structure is the responsibility of the building designer. For general guidance regarding MT20 Vert(TL) -0.69 12-13 >631 180 � Horz(TL) 0.18 8 n/a n/a B Bed) " Weight: 158 Ib BRACING TOP CHORD Sheathed or 2-11-6 oc purlins. N BOT CHORD Rigid ceiling directly applied or 10-0-0 oc bracing. REACTIONS (Ib/size) 2=1431/0-5-8.8=143110-5-8 Max Horz2=-19(load case 4) Max Uplift2=40(load case 3), 8=40(load case 4) FORCES (lb) - Maximum Compression/Maximum Tension TOP CHORD 1-2=0/24, 2-3=-4269/0, 3-4=3528/0, 4-5=-2718/0, 5-6=-2718/0, 6-7=-3528/0, 7-8=-4269/0, 8-9=0/24 BOT CHORD 2-14=0/4086, 13-14=0/4078, 12-13=0/3388, 11-12=0/3388, 10-11=0/4078, 8-10=0/4086 WEBS 3-14=0/252, 4-13=0/415, 5-12=0/987, 6-11=0/415, 7-10=0/252, 3-13=740/0, 4-12=-920/15, 6-12=920/15, 7-11=-740/0 NOTES 1) Unbalanced roof live loads have been considered for this design. 2) This truss has been designed for the wind loads generated by 80 mph winds at 25 ft above ground level, using 6.0 psf top chord dead load and 6.0 psf bottom chord dead load, 100 mi from hurricane oceanline, on an occupancy category I, condition I enclosed building, of dimensions 45 ft by 24 ft with exposure B ASCE 7-93 per UBC97/ANSI95 If end verticals or cantilevers exist, they are exposed to wind. If porches exist, they are not exposed to wind. The lumber DOL increase is 1.33, and the plate grip increase is 1.33 3) This truss has been designed for a 10.0 psf bottom chord live load nonconcurrent with any other live loads. LOAD CASE(S) Standard _ GRIP 220/195 oQROF ESS/pN� y� 00 yG ELc c3 rn m Uj 9919 yt /30/06 s FC ' June 21,2005 ® WARNING - VerM design Parameters and READ NOTES ON TID8 AND INCLUDED MITES REFERENCE PAGE MD -7473 BEFORE USE. Design valid for use only with MTek connectors. This design 6 based only upon parameters shown, and is for on individual building component. Applicability of design poromenters and proper incorporation of component is responsibility of building designer- not truss designer. Bracing Suite 109 Citrus Heights, CA, 95610 7777 Greenback Lane Milo shown is for lateral support of individual web members only. Additional temporary bracing to insure stability during construction is the responsibillity of the erector. Additional permanent bracing of the overall structure is the responsibility of the building designer. For general guidance regarding fabrication, quality control, storage, delivery, erection and bracing, consult ANSI/TPI1 Quality Criteria, DSB-89 and BCSII Building Component � Safety Information available from Two Plate Institute, 563 D'Onofrio Drive, Madison. WI 53719. B Bed) " Symbols Numbering System General Safety Notes PLATE LOCATION AND ORIENTATION Failure to Follow Could Cause Property Damage or Personal Injury •centerpiaie ofijuiiil uIlless dimensions indicate otherwise. Dimensions are in inches. Apply l . Provide copies of this truss design to the plates to both sides of truss and building designer, erection supervisor, property securely seat. owner and all other interested parties. J2 J3 J4 2. Cut members to bear tightly against each t . TOP CHORDS other. cz ca3. o O �� O ZXhJ Place plates on each face of truss at each joint and embed fully. Avoid knots and wane at joint locations. U = 4. Unless otherwise noted, locate chord splices a aat O 1A panel length (± 6" from adjacent joint.) For 4 x 2 orientation, locate O � BOTTOM CHORDS ~ 5. Unless otherwise noted, moisture content of lumber shall not exceed 19% at time of fabrication. plates 1 /8" from outside edge J 1 J8 J7. J6 of truss and vertical web. 6. Unless expressly noted, this design is not applicable for use with fire retardant or preservative treated lumber. *This symbol indicates the required direction of slots in JOINTS AND CHORDS ARE NUMBERED CLOCKWISE 7. Camber is a non-structural consideration and connector plates. AROUND THE TRUSS STARTING AT THE LOWEST JOINT is the responsibility of truss fabricator. General FARTHEST TO THE LEFT. practice is to camber for dead load deflection. WEBS ARE NUMBERED FROM LEFT TO RIGHT 8. Plate type, size and location dimensions PLATE SIZE shown indicate minimum plating requirements. The first dimension is the width 4 4 9. Lumber shall be of the species and size, and x perpendicular to slots. Second in all respects, equal to or better than the dimension is the length parallel CONNECTOR PLATE CODE APPROVALS grade specified. to slots. BOCA 96-31, 96-67 10. Top.chords must be sheathed or purlins ICBG 3907, 4922 provided at spacing shown on design. LATERAL BRACING sacci 9667,9432A 11. Bottom chords require lateral bracing at 10 ft. spacing, or less, if no ceiling is installed, Indicates location of required WISC/DILHR 960022-W, 970036-N unless otherwise noted. .continuous lateral bracing. NER 561 12. Anchorage and / or load transferring connections to trusses are the responsibility of others unless shown. 13. Do not overload roof or floor trusses with stacks of construction materials. BEARING Indicates location of joints at ® 14. Do not cut or alter truss member or plate without prior approval of a professional which bearings (supports) occur. engineer. MiTek®R ® 15. Care should be exercised in handling, erection and installation of trusses. MiTek Engineering Reference Sheet: MII-7473 © 1993 MiTek® Holdings, Inc. Job Truss Truss Type Oty Ply (loc) I/deft Ud PLATES GRIP TCLL 20.0 Plates Increase 1.25 TC 0.16 R1697866 JONES_KEN AGE COMMON 2 1 BC 0.08 Vert(TL) -0.02 31 n/r 90 BCLL 0.0 Rep Stress Incr Job Reference (optional) Endeavor Homes, Oroville, GA 95965 0 6 2-0-0 18-0.0 3.00 F12 3x8 = 15 16 14 6.100 s Sep 17 2004 MiTek Industries, Inc. Mon Jun 2012:32:43 2005 Page 1 18-0-0 2-0.0 Scale = 1:69.5 3x5 = 56 55 54 53 52 51 50 49 48 47 46 45 44 43 4241 40 39 38 37 36 35 34 33 32 3x5 = 3x8 = 37.0-0 LOADING (psf) SPACING 2-0-0 CSI DEFL in (loc) I/deft Ud PLATES GRIP TCLL 20.0 Plates Increase 1.25 TC 0.16 Vert(LL) -0.02 31 n/r 120 MT20 220/195 TCDL 10.0 Lumber Increase 1.25 BC 0.08 Vert(TL) -0.02 31 n/r 90 BCLL 0.0 Rep Stress Incr YES WB 0.02 Horz(TL) 0.00 30 n/a n/a 6CDL 10.0 Code UBC97/ANSI95 (Matrix) Weight: 190111 LUMBER. BRACING TOP CHORD 2 X 4 DF No.18Btr TOP CHORD Sheathed or 6-0-0 oc purlins. BOT CHORD 2 X 4 DF No.18Btr BOT CHORD Rigid ceiling directly applied or 10-0.0 oc bracing. OTHERS 2 X 4 DF Std G REACTIONS (Ib/size) 2=257/37-0-0, 30=250/37-0-0, 45=73/37-0-0, 43=81/37-0-0, 56=241/37-0-0, 55=26/37-0-0, 54=112/37-0-0, 53=93/37-0-0, 52=97/37-0-0, 51=96/37-0-0, 50=96/37-0-0, 49=96/37-0-0, 48=96/37-0-0, 47=97/37-0-0, 46=59/37-0-0 , 42=71/37-0-0, 41=98/37-0-0, 40=96/37-0-0, 39=96/37-0-0, 38=96/37-0-0, 37=96/37-0-0, 36=96/37-0-0, 35=94/37-0-0, 34=107/37-0-0, 33=47/37-0-0, 32=207/37-0-0 Max Horz2=19(load case 3) Max Uplift2=-67(load case 3), 30=-71 (load case 4), 55=-27(load case 3), 53=4(load case 3), 52=-1 (load case 3), 51=-2(load case 3), 50=-2(load case 3), 49=-2(load case 3), 48=-2(load case 3), 47=-4(load case 3), 46=-3(load case 3), 42=-5(load case 4), 41=-3(load case 4), 40=2(load case 4), 39=-2(load case 4), 38=-2(load case 4), 37=-2(load case 4), 36=-1 (load case 4), 35=-4(load case 4), 33=-26(load case 4) ' Max Grav2=257(load case 1), 30=250(load case 1), 45=73(load case 1), 43=81 (load case 1), 56=24i (load case 6), 55=26(load case 6), 54=112(load case 1), 53=93(load case 1), 52=97(load case 6), 51=96(load case 1), 50=96(load case 6), 49=96(load case 6), 48=96(load case 1), 47=98(load case 6), 46=59(load case 6), 42=72(load case 7), 41=99(load case 7), 40=96(load case 1), 39=96(load case 7), 38=96(load case 7), 37=96(load case 1), 36=96(load case 7), 35=94(load case 1), 34=107(load case 1), 33=47(load case 7), 32=207(load case 2) FORCES (lb) - Maximum Compression/Maximum Tension TOP CHORD 1-2=0/24, 2-3=-30/22, 34=21/19,4-5=-8/26, 5-6=-12/30, 6-7=0/33, 7-8=11/40, 8-9=-11/47, 9-10=-11/54, 10-11=-11/61, 11-12=11/68,12-13=1 V75, 13-14=11/82, 14-15=5/85,15-16=12/84,16-17=1 2/84, 17-18=7/84, 18-19=12/78, 19-20=11/69, 20-21=11/61, 21-22=-11/53, 22-23=-11/45, 23-24=-11/37, 24-25=-11/29, 25-26=0/22, 26-27=-12/20, 27-28=8/15, 28-29=-18/8, 29-30=-29/19, 30-31=0/24 fpQFESS/p BOT CHORD 2-56=0/43, 55-56=0/43, 5455=0/43, 53-54=0/43, 52-53=0/43, 51-52=0/43, 50-51=0/43, 49-50=0/43, 4849=0/43, 4748=0/43 ,46-47=0/43. 45-46=0/43, 4445=0/43, 43-44=0/43, 4243=0/43,4142=0/43,40-41=0/43,3940=0143,38-39=0/43, ONG F 37-38=0/43, 36-37=0/43, 35-36=0/43, 34-35=0/43, 33-34=0/43, 32-33=0/43, 30-32=0/43 WEBS 15-45=-50/0, 17-43=-57/0, 3-56=-173/25, 4-55=-21/17, 5-54=-79/18, 7-53=-68/18, 8-52=-70/18, 9-51=-69/18, 10-50=-69/1 Co 2 1149=69/18,12-48=-70/18,1347=70/21. 1446=46/11,1842=-54116,1941=-71/20,2D40=-70/18,21-39=-69/18. 22-38=69/18, 23.37=69/18, 24-36=70/18, 25-35=68/18, 27-34=-77/18, 28-33=-34/19, 29-32=-150/20 9919 NOTES * /30/06 1) Unbalanced roof live loads have been considered for this design. s Continued on page 2 OF CAL�F�� June 21,2005 ® WARNING - Va5 j/y design parameters and READ NOTES ON THIS AND INCLUDED MTEE REFERENCE PAGE MU -7473 BEFORE USE. 7777 Greenback Lane Design valid for use only with MTek connectors. This design's based only upon parameters shown, and is for an individual building component. Suite 109 Applicability of design paromenters and proper incorporation of component is responsibility of building designer - not truss designer. Bracing shown Citrus Heights, CA, 95610 is for lateral support of individual web members only. Additional temporary bracing to insure stability during construction is the responsibillity, of the erector. Additional permanent bracing of the overall structure is the responsibility of the building designer. For general guidance regarding fabrication, quality control, storage, delivery, erection and bracing, consult ANSI/TPII Quality Criteria, DSB-89 and BCSII Building Component M Tek' Safety Information available from Truss Plate Institute, 583 D'Onof io Drive, Madison, WI 53719. Symbols Numbering System A General Safety Notes PLATE LOCATION AND ORIENTATION Failure to Follow Could Cause Property Damage or Personal Injury 3/4*Center plate on joint Unless dimensions indicate otherwise. Dimensions are in inches. Apply l . Provide copies of this truss design to the plates to both sides of truss and building designer, erection supervisor, property owner and all other interested parties. securely seat. J2 J3 J4 2. Cut members to bear tightly against each TOP CHORDS other. cz c3 J5 3. Place plates on each face of truss at each cq joint and embed fully. Avoid knots and wane " ; at joint locations. X: �' O = 4. Unless otherwise noted, locate chord splices a- O 0 /+ panel length (±.6" from adjacent joint.) •For 4 x 2 orientation, locate C8 BOTTOM CHORDS cs O 5. Unless otherwise noted, moisture content of lumber shall not exceed 19% at time of fabrication. plates 1/8" from outside edge J 1 J8 J7. J6 of truss and vertical web. 6. Unless expressly noted, this design is not applicable for use with fire retardant or preservative treated lumber. *This symbol indicates the required direction of slots in JOINTS AND CHORDS ARE NUMBERED CLOCKWISE 7. Camber is a non-structural consideration and connector plates. AROUND THE TRUSS STARTING AT THE LOWEST JOINT is the responsibility of truss fabricator. General FARTHEST TO THE LEFT. practice is to camber for dead load deflection. WEBS ARE NUMBERED FROM LEFT TO RIGHT 8. Plate type, size and location dimensions PLATE SIZE shown indicate minimum plating requirements. The first dimension is the width 4 4 9. Lumber shall be of the species and size, and x perpendicular to slots. Second in all respects, equal to or better than the dimension is the length parallel CONNECTOR PLATE CODE APPROVALS grade_ specified. to slots. BOCA 96-31, 96-67 10. Top.chords must be sheathed or purlins provided at spacing shown on design. ICBO 3907, 4922 LATERAL BRACING SBCCI 9667,9432A 11. Bottom chords require lateral bracing at 10 ft. spacing, or less, if no ceiling is installed, Indicates location of required WISC/DILHR 960022-W, 970036-N unless otherwise noted. continuous lateral bracing. NER 561 12. Anchorage and / or load transferring connections to trusses are the responsibility of others unless shown. 13. Do not overload roof or floor trusses with stacks of construction materials. BEARING Indicates location of joints at which bearings (supports) occur. �® 1 d 4 45 IN 14. Do not cut or alter truss member or plate without prior approval of a professional engineer. M iTekV\/%J® 1.5. Care should be exercised in handling, erection and installation of trusses. MiTek Engineering Reference Sheet: MII-7473 © 1993 MiTek® Holdings, Inc. Job • Truss Truss Type City Ply R1697866 JONES—KEN AGE COMMON 2 1 Job Reference (optional) Endeavor Homes, Oroville, CA 95965 6.100 s Sep 17 2004 MiTek Industries, Inc. Mon Jun 2012:32:44 2005 Page 2 NOTES 2) This truss has been designed for the wind loads generated by 80 mph winds at 25 ft above ground level, using 6.0 psf top chord dead load and 6.0 psf bottom chord dead load, 100 mi from hurricane oceanline, on an occupancy category I, condition I enclosed building, of dimensions 45 ft by 24 ft with exposure B ASCE 7-93 per UBC97/ANSI95 If end verticals or cantilevers exist, they are exposed to wind. If porches exist, they are not exposed to wind. The lumber DOL increase is 1.33, and the plate grip increase is 1.33 3) Truss designed for wind loads in the plane of the truss only. For studs exposed to wind (normal to the face), see MiTek "Standard Gable End Detail' 4) All plates are 1.5x4 MT20 unless otherwise indicated. 5) Gable requires continuous bottom chord bearing. 6) Gable studs spaced at 1-4-0 oc. 7) This truss has been designed for a 10.0 psf bottom chord live load noncdncurrent with any other live loads. 8) A plate rating reduction of 20% has been applied for the green lumber members. LOAD CASE(S) Standard ® WARMNO - Vert/y design yammerers and READ NOTES ON THIS AND INCLUDED WTER REFERENCE PAGE MU -7473 BEFORE USE. 7777 Greenback Lane Design valid for use only with MTek connectors. This design is based only upon parameters shown, and is for an individual building component. suite 108 Applicability of design paromenters and proper incorporation of component is responsibility of building deagner - not truss designer. Bracing shown Citrus Heights, CA, 95610 Is for lateral support of individual web members any. Additional temporary bracing to insure stability during construction is the responsibilrity, of the erector. Additional permanent bracing of the overall structure is the responsibility of the building designer. For general guidance regarding fabrication, quality control, storage, delivery, erection and bracing, consult ANSI/TPII Quality Criteria, DSB-89 and BCSII Building Component MiTek Safety Inform Information available from Truss Plate Institute, 583 D'Onofrio Drive, Madison, WI 53719. I Symbols Numbering System A General Safety Notes PLATE LOCATION AND ORIENTATION Failure to Follow Could Cause Property Damage or Personal Injury 4-13/ •center plate un juiul urdess dimensions indicate otherwise. Dimensions are in inches. Apply l . Provide copies of this truss design to ine plates to both sides of truss and building designer, erection supervisor, property owner and all other interested parties. securely seat. J2 J3 J4 2. Cut members to bear tightly against each t „ TOP CHORDS other. c2 ca o c, J5 0 �' 3 O 3. Place plates on each face of truss at each joint and embed fully. Avoid knots and wane at joint locations. u �, U = 4. Unless otherwise noted, locate chord.splices ,,5 CL u U OCLO at. V. panel length (± 6" from adjacent joint.) •For 4 x 2 orientation, locate Ce BOTTOM CHORDS C6 5. Unless otherwise noted, moisture content of lumber shall not exceed 19% at time of fabrication. plates 1 /8" from outside edge J 1 J8 J7. J6 of truss and vertical web. 6. Unless expressly noted, this design is not applicable for use with fire retardant or preservative treated lumber. *This symbol indicates the required direction of slots in JOINTS AND CHORDS ARE NUMBERED CLOCKWISE 7. Camber is a non-structural consideration and connector plates. AROUND THE TRUSS STARTING AT THE LOWEST JOINT is the responsibility of truss fabricator. General FARTHEST TO THE LEFT. practice is to camber for dead load deflection. WEBS ARE NUMBERED FROM LEFT TO RIGHT 8. Plate type, size and location dimensions PLATE SIZE shown indicate minimum plating requirements. The first dimension is the width 4 4 9. Lumber shall be of the species and size, and X perpendicular to slots. Second in all respects, equal to or better than the dimension is the length parallel CONNECTOR PLATE CODE APPROVALS grade specified. to slots. BOCA 96-31, 96-67 10. Top.chords must be sheathed or purlins provided at spacing shown on design. ICBO 3907, 4922 LATERAL BRACING ssccl 9667,9432A 11. Bottom chords require lateral bracing at 10 ft. spacing, or less, if no ceiling is installed, Indicates location of required WISC/DILHR 960022-W, 970036-N unless otherwise noted. continuous lateral bracing. NER 561 12. Anchorage and / or load transferring connections to trusses are the responsibility of others unless shown. 13. Do not overload roof or floor trusses with stacks of construction materials. BEARING Indicates location of joints at p 14. Do not cut or alter truss member or plate without prior approval of a professional which bearings (supports) occur. engineer. MiTek° ® 15. Care should be exercised in handling, erection and installation of trusses. MiTek Engineering Reference Sheet: MII-7473 © 1993 MiTek® Holdings, Inc. STANDARD GABLE END DETAIL PAGES1 OFX2 *DIAGONAL OR L -BRACING 3/20/00 VARIES TO COM. 1 2 4x4 = TRUSS _ CONT. LOADINC(psf) TCLL 30.0 TCDL 10.0 BCLL 0.0 BCDL 10.0 n rcm iv 1r%0Lc 0MLAvvv 2X4 NO.2 OR BTR. DF -L 1X4 OR 2X3 (TYP) VERTICAL STUD TYPICAL 2x4 L -BRACE NAILED TO 2x4 VERTICALS W/8d NAILS SPACED AT 8" O.C. SPACING 2-0-0 Plates Increase 1.15 Lumber Increase 1.15 Rep Stress Incr YES Code UBC97/ANS195 TOP CHORD 2 X 4 DFUSPF/HF - No.2 BOT CHORD 2 X 4 DFL/SPF/HF - STUD/STD OTHERS 2 X 4 DFL/SPF/HF - STUD/STD JI -ICA 11-III14l7 �1 1/2" (BY OTHERS 3 1/27 NOTCH AT `24" O.C. (MIN.; TOP CHORD NOTCH DETAIL 3x5 K-AIITJ 2X4 LATERAL BRACING AS REQUIRED PER TABLE BELOW Kli[•xq ENO �M\ WALL 0 /1 RIGID CEILING MATERIAL DETAIL -A -- -LATERAL BRACING NAILING SCHEDULE VERT. HEIGHT # OF NAILS AT END UP TO 71-00112 - -�JT —V ' — OVER 8'-6" 4 - 16d MAXIMUM VERTICAL STUD HEIGHT SPACING OF VERTICALS WITHOUT BRACE WITH LATERAL BRACE WITH 2 -LATERAL BRACES WITH L - BRACE 12 INCH O.C. 6-0-0 12-0-0 8-0-0 9-2-0 s c O.C. _ _ -4-is-A-6 - - —__ 24 INCH O.C. �4-0_ 8-8-0 13-0-0 R-6-0 NOTES 1) VERT. STUDS HAVE BEEN CHECKED FOR 80 MPH WIND, EXP. B, HEIGHT 25 FT 2) CONNECTION BETWEEN BOTTOM CHORD OF GABLE END TRUSS AND WALL TO BE PROVIDED BY PROJECT ENGINEER OR ARCHITECT. 3) FURNISH COPY OF THIS DRAWING TO CONTRACTOR FOR BRACING INSTALLATION. 4) BRACING SHOWN IS FOR INDIVIDUAL TRUSS ONLY. CONSULT BLDG. ARCHITECT OR ENGINEER FOR TEMPORARY AND PERMANENT BRACING OF ROOF SYSTEM. 5) DETAIL A (SHOWN ABOVE) APPLIES TO STRUCTURAL GABLE ENDS AND TO GABLE ENDS WITH A MAX. VERT. STUD HEIGHT OF 8'-8". TOP CHORD NOTCHING NOTES 1)THE GABLE MUST BE FULLY SHEATHED W/RIGID MATERIAL ON ONE FACE BEFORE NOTCHING IF STUDS ARE TO BE SPACED AT 24" O.C. ATTACH SCAB (EQUAL OR GREATER TO THE TRUSS T.C.) TO ONE FACE OF THE TOP CHORD WITH 10D NAILS SPACED AT 8" O.C. IF STUDS ARE SPACED AT 24" O.C. AND FACE OF TRUSS IS NOT FULLY SHEATHED. 2) NO LUMBER DEFECTS ALLOWED AT OR ABOUT NOTCHES.APR �� 3) LUMBER MUST MEET OR EXCEED VISUAL GRADE #2 LUMBER AFTER NOTCHING. 4) NO NOTCHING IS PERMITTED WITHIN 2X THE OVERHANG LENGTH. Continued on page 2 OQROFESSIO�I cc) �O STANDARD GABLE END DETAIL PAGES2�0FX2 4/26/00 4- 10d NAILS MIN. ,PLYWOOD SHEATHING TO 2X4 STD. DF -L BLOCK 2-1Od— (TYP) \ 2X4 BLOCK SIMPSON A34 ice" OR EQUIVALENT _ ,,)+45- `2X4 STJD OR BTR SPACED @ 6-0" O.C. SHALL BE PROVIDED AT EACH END OF LEDGER--------"\, BRAC CONNECT AT END WITH STRO BACK W/ 4- 1 Od NAILS. MAX. LENGTH = T-0" GABLE END I I I I I I STANDARD TRUSSES SPACED @ 24" O.C. NOTES , 1)2X4 N0.2 OR BTR. FOR LEDGER AND STRONGBACK NAILED TOGETHER WITH 1 O NAILS @ 6" O.C. 22X4 LEDGER NAILED TO EACH STUD WITH 4- 10d NAILS. 3;2X4 STRONGBACK TO BE CONNECTED TO EACH VERT. STUD WITH 2-10d TOE NAILS 4)THE 10d NAILS SPECIFIED FOR LEDGER AND STRONGBACK ARE 1 O BOX NAILS (0.131" DIA. X 3.0" LGT) THIS DETAIL 1S APPLICABLE TO STRUCTURAL GABLE END IF THE FOLLOWING CONDITIONS ARE MET: 1. MAXIMUM HEIGHT OF TRUSS = 8'-0" 2. MAXIMUM PANEL LENGTH ON TOP AND BOT. CHORDS = T-0"aPR 300 3. THE HORIZONTAL TIE MEMBER AT THE VENT OPENING SHALL BE BRACED @ 4'-0" O.C. MAX. 4. PLEASE CONTACT TRUSS ENGINEER IF THERE ARE ANY QUESTIONS. COUNTY OF BUTTE 202 MIRA LOMA DRIVE OROVILLE, CALIFORNIA 95965 CERTIFICATE OF DEATH 3 200 5 0 4 0 0 0 6 0 0 6fe,E OF WDDNeA STATE CYE NAmFn Dari eU 'XMA'YlwEf �0n"Tawas pE AAT1ON',UuAER I % 000105251 6 c��"� j_ F~%I This is to certifythat the attached is a true and correct copy of the vital = iO &4N record which is on the in this office of which I am legal custodian. ��GM. �„� ��y- DATE ISSUED �4/.06 -2005 MARKA LUND M.P.H. ,• _O O HEALTH OFFICER O - �... -s O Orws This copy is not valid unless prepared on engraved boider, displaying the date, seal and signature of the County Health Officer. Cps I uRy I. UWE of DECEDENT - F66f (G'xsa)z t®0.E S IABr(F-,A a Harold Wayne Jones C AMA. ALSO M1oWNA5-MW4�AIG ,AINOLE USn e. SITE OF SIRM-1M " iAGE Ym FlYOEAO YEAR FDOFRT10U6 0.5E>< s 10/31/191985 I HNN I ' M m 9.6mMSTATENOFE1d1CO1AlfT• fa socA SEUINIY AADEER I1.MRNUBAmSED fORCE97 12 YANTAL STATUS DIrOao." T.OITE OF DEATI mowlxw 6. "OUR IN AR 431-14-5029 E— ❑ND El- Widowed 03/31/2005 1830 t ri� TIRI-lfypl,adDgs hili WAS DECEDENT HWANC&NIMMSPNLSM eI„RmoS Ms ' Ia DECEDENT'S RACE-UPW3a NCelmO(leFYatY wb.M W Some College ❑5� ®"0 Caucasian 17.UWU OOCMATCH-7TPuaa Wb dC,WMTUSEfFTDED to MNDOF DUSNESSOR WDUSTRYfaq, po®,PN¢nCd avMabA maCb,mre APY,%ry 1P. YEARS wOCCUPATOII Warrant Officer US Government 50 R DECEDENI9 REsm4SE a 6590 Upper Palermo Rd. „e 2I.CTY. 22 counrPro TNCE - - amcmE 2A. YEARS -COUNTY 25.STATEFOREON&;.TTRY Otoville Butte 95966 31 CA V. WORYANTS NAME REtATOITeP �- - Z7. NFORIAANT'S IACLDO ADDRESS(so.r ero uc,D.rEaM RAAYH�N. dr rYrM1 WID. SIry d 'Ken Jones, Son f1 2904 Honeysuckle Wy.,,Sacramento, CA 95826 2A HANE OF SUffim WOU5E-FUST a. aaoDtE _- I e0.1AST( 'I, Na -I - i e1.N11EOFFATNER-FDLST j` numGLE l 1 'i!� _ n AST W. &NTN STATE Jessie �.�_ NAME OF NDTER- - _- Jones - AR GS aS FOIST I 8•UDDLE 5 , ; V. LAST (4tip10„ aDN W.E Ivy f A!;, A'\ Unk .. AR a 9. DLSPOmnON DATE YmAwaY, a P101 OF FoM 06POSDCN 04/07/2005. Memorial Park;,Cemetery;.`,%Oioville, CA ¢ 0 41. TYPE OF CSPOSRIONM '_:;� Q.SglU F -R - r f.. 1S UCFlI�NII®ER C� BU , _ _ ,WAC ( t i n'1.8a_c.R•/t_> - 7303 t 1 Z O J 44. MAW OF FUERAL ESTABLMK19FM - - QL1LE/SEAIIImER to �%F - 9I%%`4�G q -SATE ;5/2, Scheer Memorial Chapel FD 975 ► 04/05/2005 0, 10I.PoCEOFDEA7N , • Own 1DL6NOSNTAL SPECFY ONE 1D1 F0 DE"°PD D"'"N TAN HOSMAL WECFY CE DI'TC OI'D«'- W .residenceDW �. -co"" a IDa FACRTYADMEF On LOGTIW"NEIE FOUo (SUAC rC,v,Errlacaad lPa Butte '"�' 6590 IIpper Palermo Rd. Oroville IDT.CMBEOFDEATt t E--C.Md Nrb-dsem4ir*.Iw. ralFm-- eN dFAm/a+Fd CFCs. Do NOT RwM Tel Yra6 W, TwM a— ,� MCmnmffCDT0W1OlEm - nwWevn4rp�i>11 YYIRaarorWeMrfY/Yellv,YmaltlwbV MWW.DOHOTADxL-EMYE Dstl YC pYI OYES ❑lo OYEDIaSTE uta W�.,4 = t ,Nn _ �°�mrn-► Res �irato failure'• - i mins H,Dn..Fo. D05-0421 A -17 `. 1 om 100.510PSYPERFOnUEDT € _ . W, S uainous, cell carcinoma of -the lung' I mos ❑ D O U A. Em, Q ` I rn NOERYNG ,•• ` iJ b1� 1 CADSEDWCFat 1 � a. A � I i IIa AUTOPSYPEWDR EDT ❑1'E9 END o yjY,,e1 CII 114 UBEDNDEIUYae1OFAVSEI Q „pANIpYICWpUST •��� ! r, � 4.. � ., a • I / D� Dtp 11207/�N 610l�CANI COeoITOIS WNf1iBUTPO TO DESTN BUr NOr RESLLTNG NIIE IIOEiCYWDGUSE GIVFNNtDI ' ^ -�-,.,}�•. Multi infarct dementia, Peripheral Vascular Severe chronic obstructive .pulDwnary disease,Cardiomyopathy,Occuluded right carotid artery, disease. - lta WAD OPERAtgH PEf6WOEDFORANYCRIDrtoNx REL 1W OR 112rry,Ya. to rypYa �r+on roaAW - IUAFFLr.aic PlOWNR 01 TFMI Needle -biopsy ulmonary`mass on 09/27/2004 FI— ❑ 1O ❑ "a1 z F to.�CAtFPTINTIO1FFs.3Ta1RIRONIIDGE DFITHaWNED Iti sl(iNATV1E AT7Ni1RTld.IEASDFIACE 6TAfIDTi1oY TNi WISES STAIID. AMD OF CE Ta uLE16E NAn1ER In. DATE roreAtAV.T, DKWWA-KWSee DeaaMYl.I sn. ArY ► G 50682 04/04/2005 nAeToAnaR.G NAME, NAD➢u AWRESiP COEw03/09/1989 11 03/29/2005 wMD, 2721 Olive Hwy 012A, Oroville, CA 95966 MIOSDiY71NTNW000O1oFAM0�Ai♦�ATTEICFLOnERDP1ALESTAT®FRCITE WI¢SSNI®. 1R eWREDATwORM•/ 121.1UUW DATE-1**I- 142 HOUR 11 "OUR • MANNEROFDEATH❑— E:]—[:]— E:1— D ❑o'ACU ❑Yp ❑{Rp( [j No > z 0 IM PUCE OF VNANY IY Ion. mmu .ft-Wdra ry N I VY. DE=W-- Now NANY,oC]xRED (Ew+oYOen nrOtl eat4rT r , O 0 V 145 LOCATION of oUt=(Suer W,empr.rYouaS r C31•. rid 40a) . 1Z46GNATUTE OF COROIER/OEARY CNBIIER IV. DATE mo/ew.w un TYPE NAME TILE OF CCICER/DEPUNODROER { STATE A a C D E FAX AUT/1.• 727 6FNSU571iACT REG6TR11H / I % 000105251 6 c��"� j_ F~%I This is to certifythat the attached is a true and correct copy of the vital = iO &4N record which is on the in this office of which I am legal custodian. ��GM. �„� ��y- DATE ISSUED �4/.06 -2005 MARKA LUND M.P.H. ,• _O O HEALTH OFFICER O - �... -s O Orws This copy is not valid unless prepared on engraved boider, displaying the date, seal and signature of the County Health Officer. Cps I uRy BUTTE COUNTY -DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. OwnerN 2. Installer's name: Z,.NCbLj,4'VJ .L_ 3. Is the site currently under permit? Yes. / / No./ ` (If yes, furnish permit number ) OR Is the site an existing site? Yes / / No/ (If yes, furnish two (2) plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes No ( If no, clarify ) 5. What is the mobilehome electrical rating? ----------------------- , ( Amps 6. What is the mobilehome site service rating? --------------------- Qj Amps 7. What is the mobilehome site circuit breaker rating? -ALC j u-6 Amps 8. Is there any other electric load to be served by the mobilehome site service? --------------------------------------------------- Yes / / No / (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? ---------------------- (in.) 10. What is the type of gas service? ----------------------------- Natural / / LPG 11. What is the gas pipe length from meter or tank to the mobilehome? C* /' ,_;0 (ft.) 12. What is the mobilehome gas demand? ------------------------------ (BTU) a (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) MOBILEH&-- •SUXPORT DATA Mobil ehome Mfr. /i 4-U f=M" N4,8Z jQ I) Setup Model No. / L31,C)9' Year Width lol, /(ft.) Length'. . (ft.) Expand6 Size _ ft.x ft. (Draw support details below) On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets (if not on .file with the County of Butte). le - e Fpotings- (check. one) r.%.� { 1 / 1. Wood either . pressure treated or fdn. grade. f 2. Concrete pad. 3. Other,: specify Supports (check one) %[ 1. Concrete block 2. Concrete piers 3. Steel piers 4. Other, specify Typical Support Footing Size Max. Pier Spacing —Overhang *If center piers are other than drawn above, lr: 'X) j1�Z- 00- 1 -xjS draw in locations, spacing, and dimensions. JAI J)JAIl UJB TTE COUNTY BUILDING DEPARTMENT- _ APPROVED-,, � This set of plans and specifications MUST be ketaf on fire joh at all times and it is unlawful to mole � onv changes or altera+inns on same without wriften,permission from the Department of Public �.TWorks, County of Butte. W djj Z 3 The Setback shall be 5 It. from the side property line and 50 ft. from the cer►ferline of the road, permitting a maxi- mum of a 2 ft. eave overhang but entirely out of all easements. BUTTE COUNTY BUILDING DEPARTMENT APPROVED �r- c co. yhRT • «o. 4k15!! �R1L Fi,raN. r AASTCA Sokoto% � ��wNGaOoM NATN • 060"OK t6l 1 �. V V 8 \ L U ® DAD.gyr70%" KITCHEN MA ST l)k W ROOKh IWO O B[aft" Noel O LWAIQ VA" I r O r oval o-Fil v kG e ® I A. r. DeNi.TR 4K%A A.' 12x6 5 FK 2 RR i yhRT • «o. 4k15!! �R1L Fi,raN. r AASTCA Sokoto% � ��wNGaOoM NATN • 060"OK t6l 1 �. V V q v \ L U ® DAD.gyr70%" r•.i�� 1: 4=0" 1 1 ie=o" 12x65 -FK -2 BR D E S E PT HOME LINCOLN VILLAGE MOBILE HOMES 6366 Lincoln Blvd. Oroville, Calif. 95965 Ph: (916) 534-7774 MOUNTAIN VAIIEY • 6565 Dantoni Road Marysville, California 95901 Phone (916) 742-7303